Emerging Nicotine Products Tobacco Use Prevention and Control - - PowerPoint PPT Presentation

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Emerging Nicotine Products Tobacco Use Prevention and Control - - PowerPoint PPT Presentation

Sep 29, 2022 312 likes •786 views

Emerging Nicotine Products Tobacco Use Prevention and Control (TUPAC) Program 1190 S. St. Francis Drive Santa Fe, NM 87505 Phone: 505 -827- 2613 Fax: 505 -827- 2530 nmhealth.org Learning Objectives As a result of this

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

Emerging Nicotine Products

Tobacco Use Prevention and Control (TUPAC) Program

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

Learning Objectives

As a result of this presentation, participants will:

▪ Recognize an e-cigarette and where kids like to hide them ▪ Review the latest data regarding e-cigarettes ▪ Understand how kids help market e-cigarettes ▪ Become familiar with the tobacco industry’s marketing tactics ▪ Become familiar with the signs and symptoms of acute nicotine poisoning ▪ Review data and information about how nicotine effects the adolescent brain and social and emotional learning ▪ Review the findings and recommendations of the Surgeon General and Centers for Disease Control and Prevention ▪ Become familiar with campaigns and resources available from TUPAC and other national partners

The TUPAC Program strives to reduce and prevent the harmful and addictive use

  • f tobacco products outside of its use in traditional Native American practices.
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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

Anatomy of an E-cigarette

Electronic Smoking Devices, including e-Cigarettes

▪ Battery-operated products designed to turn liquid nicotine, flavorings, and other chemicals into an aerosol that is ingested by the user into a vapor that is inhaled by the user

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

Evolution of E-Cigarettes

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

Nicotine + Flavor = Pediatric Addiction

All these products have two things in common … the addictive drug nicotine and candy flavor.

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

(dis)tasteful Findings

NM youth collected 2,481 public opinion surveys from 87 communities across the state to assess what New Mexicans thought about flavored tobacco products.

83% think flavored tobacco products are more

appealing to youth than regular tobacco products.

85% were more likely to try a flavored cigarillo

than an unflavored one.

17% think flavored tobacco is probably or

definitely safer than regular tobacco

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

Flavor Danger

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

1 Product

More than 7 in 10 NM high school youth tobacco users used a flavored product in past month

72.1%

SOURCE: 2015 YRRS-NM DS

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

Nicotine Addiction

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

Deceptive Packaging

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

JUUL: Nicotine Delivery in Disguise

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

Hidden in Plain Sight

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

Peer-to-Peer Marketing: Kids Share

Social Media

▪ Snap Chat ▪ Instagram ▪ Twitter ▪ YouTube - Kids provide “instructional” and “aspirational” videos

▪ “How to Hide Your JUUL at Home” ▪ “How to Hide Your JUUL at School”

SOURCE: https://www.youtube.com/watch?v=9n3JdsQlm64 SOURCE: https://www.youtube.com/watch?v=ESmNW1Mp2M4

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

JUUL Use in School Bathrooms and Classrooms

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

Nicotine is Poison

Source: https://www.tobaccofreekids.org/press-releases/2015_01_13_poisoning

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

New Mexico Poison & Drug Information Center (NMPDIC)

The lethal dose of nicotine (1.4 mg/kg) is half that of morphine (2.7 mg/kg) and similar to arsenic.

SOURCE: NMPDIC - Exposures to e-Cigarettes and Liquid Nicotine in NM

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

Acute Nicotine Poisoning

Symptoms

▪ Symptoms typically last an hour or two after a mild overdose and up to 24 hours for severe poisoning ▪ Early symptoms can appear within the first 15 minutes to an hour

▪ Feeling queasy or throwing up ▪ Stomachache ▪ Mouth watering ▪ Quick, heavy breathing ▪ Faster heartbeat ▪ Higher blood pressure ▪ Pale skin ▪ Headache ▪ Dizzy, off-balance, or confused

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

Emerging Data

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

8.2% 9.3% 10.2% 10.6% 24.7%

Spit/Chew Hookah Cigars Cigarettes e-Cigarettes

SOURCE: 2017 YRRS & 2017 YRBS

U.S. (2019): 27.5% use e-cigarettes and 5.8% use cigarettes

Current Tobacco Use by New Mexico HS Youth

2017

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

NM High School Youth Tobacco Use Trends

2009-2017

24.0 18.1 11.8 19.9 15.1 9.5 19.9 14.4 12.3 8.0 21.9 11.4 10.5 8.7 11.9 24.0 10.6 10.2 8.2 9.3 24.7

Cigarettes Cigars Spit/Chew Hookah E-Cigarettes

Percent Use in Past Month

SOURCE: 2009-2017 YRRS

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

More HS youth have tried e-cigarettes than regular cigarettes

35.3%

Youth who have ever tried cigarettes

51.0%

Youth who have ever tried e-cigarettes

SOURCE: 2017 YRRS

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

12.0% 24.7% 10.6% 3.4% 4.0% 10.6% 16.5% 17.8%

Mid School High School 18-29 yrs 30+yrs

Age Group E-Cigarette Cigarette

E-cigarette use highest in HS youth, while cigarette use is higher among adults

SOURCE: 2017 YRRS & 2017 BRFSS

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

Emerging Findings and Recommendations

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

CDC Findings and Recommendations

  • 1. Protect Youth
  • 2. Protect Unborn Children
  • 3. Encourage Cessation
  • 4. Protect Clean Indoor Air
  • 5. Enact Rules to Restrict Use and Exposure
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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

Findings and Recommendations

  • 1. Protect Youth

▪ Nicotine exposure is not safe for youth ▪ Nicotine is highly addictive and can harm brain development, which continues until about age 25 ▪ Nicotine use during adolescence can disrupt the formation of brain circuits that control attention, learning, and susceptibility to addiction ▪ Nicotine can train the brain to be more easily addicted to other drugs ▪ Children are at risk for poisoning by accidental exposure to e-cigarettes and liquid nicotine

SOURCE: E-Cigarette Use Among Youth and Young Adults. A Report of the Surgeon General

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

  • 2. Protect Unborn Children

▪ Nicotine exposure is not safe for unborn children ▪ Nicotine can cross the placenta and affect fetal and postnatal development ▪ The Surgeon General has concluded that nicotine adversely affects maternal and fetal health during pregnancy, contributing to multiple outcomes such as preterm delivery and stillbirth ▪ Nicotine is known as a cause of Sudden Infant Death Syndrome

Findings and Recommendations

SOURCE: E-Cigarette Use Among Youth and Young Adults. A Report of the Surgeon General

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

  • 3. Encourage Cessation

▪ Although e-cigarettes have been marketed as smoking cessation aids, there is currently no conclusive scientific evidence that e-cigarettes promote successful long-term quitting. ▪ There are proven adult cessation strategies and treatments, including counseling and FDA-approved cessation medications. ▪ Electronic nicotine delivery systems may have the potential to benefit established adult smokers if used as a complete substitute for all smoked tobacco products.

Findings and Recommendations

SOURCE: E-Cigarette Use Among Youth and Young Adults. A Report of the Surgeon General

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

  • 4. Protect Clean Indoor Air

▪ The aerosol produced by electronic smoking devices is not harmless water vapor; it can contain nicotine and other

  • toxins. Exposure to nicotine can harm adolescent brain

development and can be toxic to fetuses. ▪ The standard for protecting the health of children and bystanders should be clean air, free of toxic secondhand smoke, as well as aerosol produced by electronic nicotine delivery systems.

Findings and Recommendations

SOURCE: E-Cigarette Use Among Youth and Young Adults. A Report of the Surgeon General

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

Findings and Recommendations

  • 5. Enact Rules and Policies to Restrict Use and Exposure

Federal Tribal State Municipal Schools Businesses Homes & Cars

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

The Immediate Impact of Policy

10 20 30 40 50 60 70 2012 2013 2014 2015 2016 2017

61 48 41 14 34 22

Nicotine poisoning related calls to the New Mexico Poison & Drug Information Center, increased from 2012–2014, then began decreasing after New Mexico legislated child-resistant packaging rules and established a legal age of purchase in 2015.

SOURCE: NMPDIC - Exposures to e-Cigarettes and Liquid Nicotine in NM

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

Surgeon General’s Advisory on E-cigarette Use Among Youth

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Recommended actions include:

▪ Raise and strongly enforce minimum-age-of-sales laws for all tobacco products, including e-cigarettes ▪ Incorporate e-cigarettes into smoke-free policies ▪ Reduce access to all flavored tobacco products by young people ▪ Sponsor high-impact media campaigns to educate public on harms of e-cigarettes among young people ▪ Increase price of tobacco products, including e-cigarettes ▪ Require tobacco retailer licensure

Source: CDC Surgeon General’s Report, 2016 , https://e-cigarettes.surgeongeneral.gov/documents/surgeon- generals-advisory-on-e-cigarette-use-among-youth-2018.pdf

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

As of December 27, 2019, a total of 2,561 hospitalized EVALI cases or deaths have been reported to CDC from all 50 states, the District of Columbia, and two U.S. territories (Puerto Rico and U.S. Virgin Islands). ▪ Fifty-five deaths have been confirmed in 27 states and the District of Columbia (as of December 27, 2019). For more information, visit the EVALI website.

BREAKING NEWS

Outbreak of Lung Injury Associated with the Use of E-Cigarette, or Vaping, Products

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

BREAKING NEWS

Federal minimum age of sale of tobacco products raised from 18 to 21 years December 20, 2019, the President signed legislation to amend the Federal Food, Drug, and Cosmetic Act, and raise the federal minimum age of sale of tobacco products from 18 to 21 years. It is now illegal for a retailer to sell any tobacco product – including cigarettes, cigars and e-cigarettes – to anyone under

  • 21. FDA will provide additional details on this issue as they

become available. FDA updates are available at https://www.fda.gov/tobacco- products/compliance-enforcement-training.

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

BREAKING NEWS

The FDA to enforce policy on the manufacture, distribution and sale of unauthorized flavored cartridge-based e-cigarettes On January 2, 2020, the FDA finalized enforcement policy on unauthorized flavored cartridge-based e-cigarettes that appeal to children, including fruit and mint. Companies that do not cease manufacture, distribution and sale of unauthorized flavored cartridge-based e-cigarettes (other than tobacco or menthol) risk FDA enforcement actions. For more information, visit https://www.fda.gov/tobacco- products.

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

For products marketed without FDA authorization, FDA intends to prioritize enforcement against: ▪ Any flavored, cartridge-based Electronic Nicotine Delivery System (ENDS) product (other than a tobacco- or menthol-flavored ENDS product); ▪ All other ENDS products for which the manufacturer has failed to take (or is failing to take) adequate measures to prevent minors’ access; and ▪ Any ENDS product that is targeted to minors or whose marketing is likely to promote use of ENDS by minors.

BREAKING NEWS

The FDA to enforce policy on the manufacture, distribution and sale of unauthorized flavored cartridge-based e-cigarettes

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

Emerging Responsibilities

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

What Is My Role?

Parents can:

▪ Learn about the different shapes and types of e-cigarettes and the risks of all forms of e-cigarette use for young people ▪ Talk to their children about the risks of e-cigarette use among young people. Express firm expectations that their children remain nicotine-free ▪ Set a positive example by being nicotine-free

SOURCE: https://www.cdc.gov/tobacco/infographics/youth/pdfs/e-cigarettes-usb-flash-508.pdf

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

What Is My Role?

Educators can:

▪ Learn about the different shapes and types of e-cigarettes and the risks of all forms of e-cigarette use for young people ▪ Develop, implement, and enforce tobacco-free school policies ▪ Reject youth tobacco programs sponsored by the tobacco

  • industry. These programs have been found to be

ineffective for prevention youth tobacco use

SOURCE: https://www.cdc.gov/tobacco/infographics/youth/pdfs/e-cigarettes-usb-flash-508.pdf

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

What Is My Role?

▪ Ask about e-cigarettes, including devices shaped like USB flash drive, when screening patients for the use

  • f tobacco products

▪ Warn patients about the risks

  • f all forms of tobacco

product use, including e- cigarettes, for young people ▪ Provide brief intervention for nicotine users

Pediatric Health Care Providers can:

SOURCE: https://www.cdc.gov/tobacco/infographics/youth/pdfs/e-cigarettes-usb-flash-508.pdf

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

Emerging Resources

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

National Campaigns and Resources

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

Environmental Strategies that encourage and reinforce tobacco-free lifestyles and behaviors

Youth Engagement: Advocacy Policy Development: Tobacco-Free High Schools Policy Development: Point of Sale Policy Development: Tobacco-Free College Campuses Mass Media: Awareness and Education

TUPAC Campaigns and Resources

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

TUPAC Campaigns and Resources

Online Training for Health Professionals Health Systems Change Training and Outreach Program Comprehensive Cessation Services for those who want to quit—includes youth protocol ages 13-17

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

WWW.NMTUPAC.COM

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

Emerging Questions

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1190 S. St. Francis Drive • Santa Fe, NM 87505 • Phone: 505-827-2613 • Fax: 505-827-2530 • nmhealth.org

Contact Information

David Tompkins Community Health Initiative Manager 505-841-5874 David.Tompkins@state.nm.us www.nmtupac.com