Kaine addresses e-cigarette use during Henrico visit

Members of Virginia’s health care community discussed with U.S. Senator Tim Kaine (D-Va.) how to address youth e-cigarette use during a roundtable conversation June 24 at the Libbie Mill Library, at which they brought up topics such as smoking cessation efforts and chemical processes in e-cigarettes.

The discussion was held so that Kaine could receive information and thoughts on youth e-cigarette use and The Tobacco-Free Youth Act, a bipartisan bill he introduced May 21 with Senate Majority Leader Mitch McConnell (R-Ky.).

The Tobacco-Free Youth Act raises the national minimum age for sale of any tobacco product, including e-cigarettes, from 18 to 21, for all populations with no exemptions, such as one for the military, Kaine explained. The bill does not prevent states from imposing stricter state laws on the matter.

Kaine also said that the bill included a provision that incentivized states to raise state tobacco ages to 21 for increased enforcement.

“We put a provision in our proposal, raise your smoking age to 21 and if you don't, you run the risk of losing [Substance Abuse and Mental Health Services Administration] funding,” Kaine said.

Starting July 1, Virginia state law mandates that the minimum age to buy tobacco products will be 21. Active-duty military aged 18 or older with a valid military ID can still purchase nicotine products, although Kaine and McConnell’s bill would change that.

There has been an increase in e-cigarette use by middle and high school students in recent years, according to the U.S. Food and Drug Administration. More than 3.6 million kids used e-cigarettes in 2018, according to the FDA.

"The progress that we made in wiping out youth smoking has been completely turned around because of vaping and e-cigarettes,” Kaine said. “So decades of working on a public health and actually making headway, making success, very quickly has been sort of erased because of the vaping and e-cigarette epidemic.”

Dr. Bernard Fuemmeler, associate director for cancer prevention and control at the VCU Massey Cancer Center, said that although Virginia’s smoking rates were lower than some other states, certain areas in the state – the Appalachian areas and east coast areas – and certain populations (such as those with mental health issues and the LGBTQ+ community) still had higher smoking rates.

Fuemmeler also raised issues regarding enforcing online sales of tobacco products.

Dr. Thomas Eissenberg, director of the VCU Center for the Study of Tobacco Products, expressed concern about a lack of research into effective e-cigarette use cessation programs. Teenagers who have been using e-cigarettes and intaking nicotine for several years may lose access to these products if the minimum age is raised to 21.

“They're going to need some help quitting, and I'm not sure what to offer them,” Eissenberg said.

Eissenberg also explained how JUUL products contained higher amounts of nicotine because of a chemical process called protonation that made high-concentration nicotine easier to inhale without irritation. There has been no legislation regarding protonated nicotine, Eissenberg said.

Jill Hanken, director of the Center for Healthy Communities at the Virginia Poverty Law Center, suggested that warning labels depicting the gruesome health effects of smoking, such as those on cigarette packs in European countries, be implemented on e-cigarettes as well.

Hanken also said that adults covered under Medicaid expansion in Virginia had smoking cessation services as a required benefit whereas adults covered under traditional Medicaid did not.

There should be more opportunities for students – not adults – speak to other students about the dangers of e-cigarette use, said Zachary Scott, senior manager of federal engagement and outreach at the National Association of Secondary School Principals.

One such student, graduate Brynna Walker from J.R. Tucker High School, participated in the roundtable and spoke about the efforts of the Virginia volunteer organization for high schoolers – Y Street – that seeks to promote tobacco-free lifestyles, including informing students and visitors that tobacco is not allowed on campus.

After the roundtable, Kaine told reporters that he would discuss matters he had learned about, such as the nicotine protonation process and the Medicaid smoking cessation discrepancy, with his health policy adviser, Katie Wright.

On June 26, Kaine’s bill was approved by The Senate Health, Education, Labor and Pensions Committee.

During his time as governor of Virginia, Kaine signed a bill that banned smoking in bars and restaurants in Virginia and an executive order that banned smoking in state buildings and vehicles.