As high rates of e-cigarette use among Massachusetts teens and the prevalence of vaping frighten doctors and advocates, two lawmakers are making it a priority to pass a bill forbidding the sale of flavored tobacco or tobacco products this session.
Dr. Jonathan Winickoff, director of pediatric research at the Tobacco Research and Treatment Center at Massachusetts General Hospital, said one in five Massachusetts high school students already use e-cigarettes and many teens cite the availability of flavors like mango, minty menthol and fruit medley as reasons they become interested in vaping.
Sen. John Keenan of Quincy and Rep. Danielle Gregoire of Marlborough are pushing legislation that would ban the sale of flavored tobacco products, like some of the most popular Juul pods.
"Of all the legislation I have seen in tobacco, this is probably the most targeted, the one about flavoring, is the most targeted to protect kids," Winickoff said at a State House briefing Thursday morning. "This legislation targets exactly the problem that we need to fix."
Keenan also plans to offer the proposal as an amendment to the Senate budget, which already seeks to expand tobacco excise taxes to e-cigarettes and vape products.
"With the e-cigarette tax already in the budget, we have a real opportunity to push back on companies like Juul and protect our kids from addiction, but we need to include flavors, cessation and education programs in that effort too," Keenan said in a statement. "An increase in tax alone won’t disrupt the underlying issue of Big Tobacco attracting new customers, underage customers, with flavors. To really prevent another generation from being lost to Big Tobacco, we need to push back on the flavored products specifically designed to target kids."
Massachusetts teens are nine times more likely than adults to use e-cigarettes, Winickoff said, despite the insistence from vaping-related companies that their products are meant to be used by of-age smokers seeking a less harmful alternative to traditional cigarettes. He said 25% of current high school seniors in Massachusetts have reported actively using e-cigarettes.
A pediatrician, Winickoff said it is "one of the saddest things as a pediatrician" for him to see a baby in his practice grow up to be a teen who is now asking for help with an addiction to vaped nicotine.
"We were down to single-digit use rates of combusted tobacco. Now, not a kid comes in who isn't either addicted to Juul or has a friend who's using it," he said. "So we went from it's not a problem, basically solved, to almost everyone is having a problem and that happened in the last two years."
Winickoff said the flavors attract kids to vaping — 80% of high school tobacco users say they've used a flavored product in the last 30 days — and that once they start, they are more likely to become addicted to the nicotine in the vaping liquid and more likely to carry a nicotine or tobacco addiction into adulthood.
"We need to end this and we need to end this now because kids don't know what they're getting themselves into," Gregoire said. She added, "We're putting on all the pressure we can to get it done."
Juul has said that it never marketed to anyone underage and always tries to block anyone below the age of 21 from purchasing its products. Last year, it stopped selling some flavors of pods in stores and now only sells them online where the age of a customer can be verified.
"We don't want anyone who doesn’t smoke, or already use nicotine, to use JUUL products. We certainly don’t want youth using the product. It is bad for public health, and it is bad for our mission," Juul CEO Kevin Burns wrote in the company's youth prevention action plan. "Our intent was never to have youth use JUUL products. But intent is not enough, the numbers are what matter, and the numbers tell us underage use of e-cigarette products is a problem. We must solve it."
Last year, the Legislature raised the minimum age to purchase tobacco products and e-cigarettes to 21 statewide. Last month, Attorney General Maura Healey joined the growing field of elected officials who support taxing e-cigarettes and banning flavored products.
"I think it's important that we update our law to address and try to curb this epidemic. I'd like to start by treating these products as we treat other tobacco products. Ban flavors and tax them," Healey said in a speech to business leaders at Bank of America in Boston.