1 Chat with Us! In the chat pod, share with us: One prevention leader whose work has influenced you 2 Multi-Level Prevention Strategies to Address Teen E-Cigarette Use National Prevention Week Webinar February 26, 2019 Disclaimer: The views, opinions, and content expressed in this presentation do not necessarily reflect the views, opinions, or policies of the Center for Substance Abuse Prevention (CSAP), the Substance Abuse and Mental Health Services Administration (SAMHSA), or the U.S. Department of Health and Human Services (HHS). Recording in Progress! This meeting will be recorded for archiving purposes. 4 David Lamont Wilson NPW Coordinator Public Health Analyst, Center for Substance Abuse Prevention Substance Abuse and Mental Health Services Administration Today’s Presenters • Brian A. King, PhD, MPH, Deputy Director for Research Translation, Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, CDC • John O’Donnell, MA, Acting Synar Lead, Division of State Programs, Center for Substance Abuse Prevention, SAMHSA • Donna Vallone, PhD, MPH, Chief Research Officer, Truth Initiative • Emily D’Iorio, MPH, Health Communication Specialist, Center for Tobacco Products, FDA 6 NPW 2019 7 NPW Goals • To involve communities in raising awareness of behavioral health issues and in implementing prevention strategies, and showcasing effectiveness of evidence- based prevention programs. • To foster partnerships and collaboration with federal agencies and national organizations dedicated to behavioral and public health. • To promote and disseminate quality behavioral health resources and publications. 8 NPW 2019 Daily Health Themes Prevention of Prescription & Opioid Drug Monday, May 13 Misuse Prevention of Underage Drinking & Tuesday, May 14 Alcohol Misuse Prevention of Illicit Drug Use & Youth Wednesday, May 15 Marijuana Use Thursday, May 16 Prevention of Youth Tobacco Use Friday, May 17 Prevention of Suicide 9 Prevention Challenge Pre·ven·tion Cham·pi·on Noun: a person, activity, program, or organization that inspires others to take prevention actions every day that change lives. 10 Prevention Challenge Take the Prevention Challenge 1. Take a photo or video. 2. Add one word to best describe your Prevention Champion. 3. Share your #PreventionChampion photo or video on social media. 4. Use the hashtags #PreventionChampion and #NPW2019. 11 Prevention Challenge What one word best describes your #PreventionChampion? 12 Get Involved in NPW Get Involved with NPW Today ❑ Visit samhsa.gov/prevention-week for the latest resources. ❑ Take the #PreventionChampion challenge. ❑ Plan prevention activities and events in your community. ❑ Join the conversation on social media using #NPW2019. 13 Prevention Every Day 14 Brian A. King, PhD, MPH Deputy Director for Research Translation Office on Smoking and Health National Center for Chronic Disease Prevention and Health Promotion Centers for Disease Control and Prevention E-cigarette Use Among Youth and Young Adults BRIAN A. KING, PHD, MPH DEPUTY DIRECTOR FOR RESEARCH TRANSLATION OFFICE ON SMOKING AND HEALTH SAMHSA’s National Prevention Week Webinar Series • February 26, 2019 The Tobacco Landscape Is Evolving Cigars, Cigarillos Cigarettes Little Cigars Smokeless Pipes Tobacco Snus Hookah Bidis Dissolvables Kreteks E-cigarettes Heated Tobacco Products The Rise of JUUL The “4th Generation” E-cigarette Has Arrived: The “Pod Mod” MarkTen Elite myBlu Vuse Alto Phix (Altria) (Imperial Tobacco) (RJR) Myle Suorin Drop Suorin Air KandyPens Feather Daze MFG ZOOR Source: Campaign for Tobacco-Free Kids Current Tobacco Product Use Among U.S. High School Students – NYTS 2011–2018 20.8% Cigarette 15.8 % Cigar 11.6% Smokeless 7.9% 8.1% 7.6% Hookah 4.1% 5.9% Pipe 4.0% 4.1% E-cigarette 1.5% 1.1% 2011 2012 2013 2014 2015 2016 2017 2018 YEAR Source: Gentzke AS, Creamer M, Cullen KA, Ambrose BK, Willis G, Jamal A, King BA. Vital Signs: Tobacco Product Use Among Middle and High School Students — United States, 2011–2018. MMWR Morb Mortal Wkly Rep 2019; 68(6):1-8. Youth E-cigarette Initiation and Use Advertising Flavors Nicotine Net Public Health Benefit or Harm? Youth Initiation Adult Cessation Potential Health Risks of E-cigarettes Leads to initiation of Exposes combustible Leads to Diminishes the Discourages children, Results in tobacco use relapse chances that a smokers from pregnant Glamorizes or poisonings among non- among former smoker will using proven women, and renormalizes among users smokers, smokers quit quit methods non-users to tobacco use or non-users particularly secondhand children aerosol Nicotine Poses Unique Dangers to Young People Chapter 3 Conclusion 1, 2, & 5 Nicotine salts allowJuul Containsparticularly Nicotine high levels Salts of nicotine to be inhaled more easily and with less irritation than free base nicotine. Benzoic Acid Nicotine Free 00 Base Salts Nicotine E-cigarettes and Cannabinoids Conclusion: Nearly 1 in 11 U.S. students, including 1/3 of those who ever used e-cigarettes, had used cannabis in e-cigarettes in 2016. Conclusion: E-cigarette products can be used as a delivery system for cannabinoids and potentially for other illicit drugs. Sources: Singh T, Kennedy S, Marynak K, Persoskie A, Melstrom P, King BA. Characteristics of Electronic Cigarette Use Among Middle and High School Students — United States, 2015. MMWR Morb Mortal Wkly Rep 2016;65:1425– 1429. Trivers KF, Phillips E, Gentzke AS, Tynan MA, Neff LJ. Prevalence of Cannabis Use in Electronic Cigarettes Among US Youth. JAMA Pediatr. Published online September 17, 2018. doi:10.1001/jamapediatrics.2018.1920 https://e-cigarettes.surgeongeneral.gov/ Public Health Actions to Address E-cigarettes Federal Regulation State, Local, Territory Family Smoking Prevention Potential Sub-National Action: and Tobacco Control Act • Signed into law on June 22, 2009 • Including e-cigarettes in smoke free indoor air policies • Granted FDA the authority to regulate • Restricting youth access to e-cigarettes in retail tobacco products settings • Enhanced the ability to intensify policy to • Licensing retailers reduce tobacco industry influence: • Establishing specific package requirements o Manufacturing • Setting price policies o Marketing • Increasing the minimum age of sale of tobacco products to 21 years of age o Sale • Prohibiting the sale of flavored tobacco products E-cigarettes are a tobacco product that produces an aerosol by heating a liquid that typically contains 1 nicotine, flavorings, and other chemicals. Several factors have contributed to the popularity of e-cigarettes, including advertising and the vast array 2 of available flavors. E-cigarette use is higher among young people than adults. As of 2014, e-cigarettes were the most 3 commonly used tobacco product among U.S. youth. Youth use of any tobacco product, including 4 e-cigarettes, is unsafe. As the tobacco product landscape continues to diversify, it’s important to modernize tobacco 5 control strategies to adapt. Brian A. King, PhD, MPH Office on Smoking and Health [email protected] www.cdc.gov/tobacco For more information, contact CDC 1-800-CDC-INFO (232-4636) TTY: 1-888-232-6348 www.cdc.gov The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. John O’Donnell, MA Acting Synar Lead Public Health Advisor, Center for Substance Abuse Prevention Division of State Programs SAMHSA National Prevention Week Multi-Level Prevention Strategies to Address Teen E-Cigarette Use: The Synar Program and Electronic Products February 26, 2019 John O’Donnell Public Health Advisor Center for Substance Abuse Prevention Substance Abuse and Mental Health Services Administration U.S. Department of Health and Human Services Webinar Presentation Substance Abuse and Mental Health Services Administration (SAMHSA) SAMHSA is the agency within the U.S. Department of Health and Human Services that leads public health efforts to advance the behavioral health of the nation. Substance Abuse Prevention and Treatment Block Grant (SABG) The SABG program provides funds to all 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, 6 Pacific jurisdictions, and 1 tribal entity. • States use the funds to plan, implement, and evaluate activities that prevent and treat substance abuseSAMHSA’s and promote Strategic Initiatives public health. • Preventing substance abuse includes youth tobacco access prevention. • States may use SABG funds to support certain youth tobacco access prevention activities. References to states in this presentation include the 50 states, DC, Puerto Rico, the U.S. Virgin Islands, and the Pacific jurisdictions. Tobacco Use “Tobacco addiction is the single most preventable cause of death in our society.” Centers for Disease Control and Prevention 21st-Century Tobacco Use Between 2010 and 2014, smoking caused: • Nearly half a million premature deaths per year; • More than 87 percent of all lung cancer deaths; • 61 percent of all pulmonary deaths; and • 32 percent of all coronary deaths.1 1. U.S. Department of Health and Human Services. (2014). The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. Tobacco and Youth Tobacco Use Is a Pediatric Disease • 88 percent of adults who have ever smoked daily report that they first smoked by the age of 18, and 99 percent report that they first smoked by the age of 26.2 • More than one-third of adults who have ever smoked report trying their first cigarette by the age of 14.2 • 80 percent of adult smokers who are nicotine-dependent report that they started smoking before they were 18 years old.3 2. U.S. Department of Health and Human Services. (2012). Preventing Tobacco Use Among Youth and Young Adults: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health.