OPINION: City Council Should Ban Flavors For E-Cigs

Stop Feeding The Fires Of Youth Addiction

By Ali Zirakzadeh, M.D., M.Sc.

For the GPHN

Every day I come to work ready to battle the scourge of tobacco addiction. In my career, I am most proud in helping to establish the Denver Health Tobacco Cessation Clinic in 2012 and leading its expansion to seven clinics integrated in community health centers throughout Denver. This model of delivering individual cessation services at a patient’s medical home is one of the most successful treatment programs currently available in the United States.

 The program has been one of the pillars of the tobacco cessation efforts at Denver Health that saw its tobacco prevalence rate impressively drop from 27 percent in 2013 to under 17 percent this year.

I am now using my expertise in tobacco cessation to help tackle the vaping crisis in our youth. E-cigarettes addict our kids, endanger their health and has started to reverse decades of hard-fought progress in reducing adolescent tobacco use. The most recent Healthy Kids Colorado Survey shows that a shocking 46 percent of Colorado youth in 2019 had used electronic cigarettes. This should alarm all of us. Scientific studies have shown that adolescents who vape are three and half times more likely to start smoking than adolescents who have never vaped.

 Both access to electronic cigarettes and product flavoring have contributed to the rise of vaping. In Denver, 627 tobacco retailers sell electronic cigarettes. Astonishingly, 49.5 percent of our public schools reside within 1,000 feet of these businesses, according to a study by the Advancing Science and Practice in the Retail Environment (ASPiRE). The role of electronic cigarette flavoring in this epidemic is equally troubling. The same Healthy Kids Colorado survey showed that other than peer/family use, the most common reasons kids vaped was because of the flavor.

 Even more disturbing, monthly e-cigarette sales increased in 2020 and by the end of the year, e-cigarette sales were at their highest volume ever. The CDC Foundation’s Monitoring U.S. E-Cigarette Sales: State Trends Data Brief, released in January, found that from January 2020 to December 2020 monthly total e-cigarette sales increased by nearly 47 percent in Colorado. The brief also found that menthol-flavored e-cigarette sales increased by nearly 200 percent.

 This data on e-cigarette sales and youth e-cigarette use, taken together, clearly show flavoring helps drive youth vaping. The limited federal action to restrict flavored e-cigarettes has not reduced e-cigarette sales or stemmed the use of flavored products. Once certain flavored products are removed from the market, kids quickly migrate to the flavored products that remain available.

Even restrictions that exempt certain flavors (for example, restrictions that leave menthol e-cigarettes on the market) will likely shift sales to the flavors that remain on the market, deterring progress in reducing use.

I strongly urge Denver City Council to tackle the problem of youth nicotine addiction by banning the sale of all flavored tobacco products in the city — including menthol flavored products — once and for all. Eliminating all flavors from the e-cigarette market will remove the fuel that feeds the fire of youth addiction and ultimately reduce youth e-cigarette use.

Ali Zirakzadeh, M.D., M.Sc., is the Medical Director, Denver Health Tobacco Cessation Clinic and Associate Professor of Medicine at the University of Colorado, Denver School of Medicine.