Tobacco use

Ohio to spend $4.1 million to combat youth e-cigarette use, feds mull banning all vaping products

The Trump administration and the Ohio Department of Health both shared new plans to reduce youth vaping, amid an urgent public health investigation into 450 cases of lung illness across the U.S. associated with e-cigarettes (Source: “Ohio to spend $4.1M on initiatives aimed to fight youth vaping,” Dayton Daily News, Sept. 11, 2019).

Dr. Amy Acton, director of the Ohio Department of Health, announced $4.1 million in new initiatives to prevent youth vaping. President Trump said Wednesday that his administration is working on a plan to ban all non-tobacco-flavors from vaping products.

State and local public health officials in Ohio have confirmed that 10 reports of severe pulmonary illness are likely due to vaping and are investigating an additional 14 reports of illness. In 33 states, the CDC says that it’s aware of more than 450 possible cases of severe pulmonary illness after vaping and six deaths.

The DeWine administration has already worked on several initiatives to curb teen vaping. This includes raising the purchase age to 21 starting Oct. 17 and placing an excise tax on e-cigarettes, which in the past were not subject to an excise tax. Raising the price of tobacco through an excise tax is an evidence-based way to reduce consumption.


Michigan to become first state to ban flavored e-cigarettes

Gov. Gretchen Whitmer of Michigan said Wednesday that her state would be the first to outlaw the sale of flavored e-cigarettes, part of a national crackdown on vaping amid a recent spike in illnesses tied to the products (Source: “Amid Vaping Crackdown, Michigan to Ban Sale of Flavored E-Cigarettes,” New York Times, Sept. 4, 2019).

Whitmer said the decision came in response to increased e-cigarette use among teenagers and marketing that she said targeted youths.

The move in Michigan is part of a wave of growing pressure from politicians around the country for more regulation of e-cigarettes and their use by teenagers. Several state attorneys general have called for the federal government to ban flavored e-cigarettes, and bills to stop sales of flavored vaping products have been introduced in California and Massachusetts.

In recent weeks, public health agencies have reported a number of serious illnesses believed to be tied to vaping, including a death in Illinois, raising questions about the products’ safety at any age. This week, Oregon health officials said they were investigating the death of another person, who had used a vaping device containing cannabis. The health department in Milwaukee and the Illinois attorney general have issued statements urging people not to use e-cigarettes. This year, San Francisco became the first American city to ban the sale of the products.


New state budget raises Ohio smoking age to 21

Ohioans must wait until age 21 to legally buy cigarettes, cigars, vape pens and other tobacco products, under a provision in the state budget bill signed Thursday morning by Gov. Mike DeWine (Source: “Ohio raises legal smoking age to 21,” Cleveland Plain Dealer, July 18, 2019).

The new law also applies to rolling papers, filters, blunt wrappers, liquids and other accessories involved with smoking or vaping. DeWine on Thursday vetoed a provision that would have phased the higher age in for anyone who turns 18 years old before Oct. 1.

The state budget also creates a new tax on vaping products assessed at 10 cents per milliliter.


U.S. Senate committee Oks bill aimed at lowering health costs

The U.S. Senate health committee approved a package of bills this week aimed at lowering the cost of medical care, from ending surprise medical bills to curbing prescription drug price surges, with a rare bipartisan vote that could vault it toward final passage (Source: “With Rare Comity, Senate Panel Advances Bills to Lower Health Costs,” New York Times, June 26, 2019).

The cost-cutting legislation is a priority of Senator Lamar Alexander of Tennessee, the health committee chairman who will retire next year and is seeking a victory after his bipartisan plan to stabilize the ACA insurance markets failed last year.

The new package includes a plan to eliminate surprise medical bills, which have become a hot political cause this year, targeted by President Trump and lawmakers from both parties. It also addresses the rising cost of prescription drugs, with a set of provisions that limit pharmaceutical companies’ ability to protect monopolies on the drugs they sell.

Other proposals seek to chip away at the opacity around medical prices, a goal that Mr. Trump also seized on with a new executive order this week intended to require insurers, doctors and hospitals to inform patients how much their care will cost before they receive it. The package also includes a measure from Senator Mitch McConnell of Kentucky, the majority leader, to raise the smoking age in every state to 21 from 18.


U.S. Senate takes up tobacco 21 legislation

Senate Majority Leader Mitch McConnell, whose home state of Kentucky was long one of the nation’s leading tobacco producers, introduced bipartisan legislation Monday to raise the minimum age for buying any tobacco products from 18 to 21 (Source: “Senate GOP leader would raise age for buying tobacco to 21,” Associated Press, May 20, 2019).

The chamber’s top Republican, who said he was making enactment of the bill “one of my highest priorities,” issued his proposal at a time when the use of e-cigarettes is growing and underage vaping has soared, raising concerns by health experts. The measure would apply to all tobacco products, e-cigarettes and vapor products and was co-sponsored by Sen. Tim Kaine, D-Va., whose state has also been a major tobacco producer.

Ohio Gov. Mike DeWine recently introduced a similar proposal to raise the legal age for tobacco purchases. Fourteen states, including Arkansas, California and Virginia, have enacted laws raising the minimum age for tobacco sales to 21, according to the anti-smoking Campaign for Tobacco-Free Kids. So have 470 municipalities, including New York City, Chicago, Boston and Minneapolis.


DeWine details plans to raising smoking age

Gov. Mike DeWine and his top administrators on Wednesday called for Ohio to increase the purchase age for tobacco and vape products to 21 (Source: “Gov. DeWine issues warning on vaping, wants to raise smoking age,” Dayton Daily News, April 17, 2019).

“This is a public health crisis,” DeWine said.

In his proposed two-year operating budget, DeWine included a provision to raise the tobacco purchase age, including vape materials, to 21. The current purchase age is 18, although more than 30 Ohio cities have passed local ordinances setting the age at 21.

Ohio ranks in the bottom quartile for adult smoking and children living in a household with a smoker, according to HPIO’s recently released 2019 Health Value Dashboard. Analysis of the rankings found that tobacco use and secondhand smoke exposure contribute to many of Ohio’s greatest health challenges, including infant mortality, cardiovascular disease, cancer and asthma.


Study: 1% drop in smoking among Medicaid enrollees could save Ohio $60 million a year

Researchers estimate that cutting smoking in each state by 1% in a year would lower the cost to taxpayer-supported Medicaid by $2.6 billion the following year, including more than $60 million a year in Ohio, according to findings of a new study (Source: “Cutting smoking could save Medicaid $2.6B during a year, study says,” United Press International, April 12, 2019).

According to the study, which was published in JAMA Network Open, a 1% drop would have median savings of $25 million for states each year, with California leading at more than $630 million.

The researchers looked at state-by-state rates of Medicaid recipients who also smoked. They figured that reducing smoking in that group by 1% would lower per-capita health care spending by 0.118%.

Researchers estimate that 15% of U.S. Medicaid costs are attributable to cigarette smoking. Fourty-six percent of working-age Ohio Medicaid enrollees were current smokers in 2017.


Ohio Senate considers banning smoking in cars with young children

Ohio lawmakers are considering a law banning drivers from smoking if there’s a passenger in the car under the age of 6 (Source: “Ohio may ban smoking in cars with young children,” Dayton Daily News, March 19, 2019).

Senate Bill 78, sponsored by state Sen. Tina Maharath, D-Canal Winchester, proposes a $500 fine for violators of the law, and for subsequent violations be fined $500 plus $250 for each additional violation.

The bill has been referred to the Senate Judiciary Committee. Similar bills have been considered in prior  legislative sessions. The law has been promoted to protect children from the health consequences of second-hand smoke, which can lead to asthma, ear infections and other health problems.

Ohio has a poor record when it comes to children exposed to the health risks of secondhand smoke. Ohio ranked 49th on the percentage of children who live in a home where someone uses tobacco and smokes inside the home, according to the Health Policy Institute of Ohio’s 2017 Health Value Dashboard. The 2019 Health Value Dashboard is set to be released early next month.


DeWine calls for raising legal age to buy tobacco to 21

Ohio would become the latest state to increase the legal age to buy cigarettes under Gov. Mike DeWine’s proposed two-year operating budget (Source: “DeWine calls for raising Ohio’s legal age to buy cigarettes to 21,” Columbus Dispatch, March 15, 2019).

DeWine wants to increase the threshold from 18 to 21 for all tobacco products in Ohio, including vaping and e-cigarette products.

“We know statistically that if we can get someone to 21 and they’re not smoking, the odds are very great that they’re not going to smoke,” DeWine said.

“Our smoking rates in Ohio are driving a lot of our Medicaid costs. They are harming families. Second-hand smoke is harming people. This is a public health issue.”

Seven states have raised the legal age to purchase tobacco to 21, as have about 450 local governments.


Surgeon General warns of rising e-cigarette use, especially among children

To curb the rising use of e-cigarettes among children, U.S. Surgeon General Vice Adm. Jerome M. Adams has sent out a public warning about the risks of vaping (Source: ”Surgeon general issues warning about e-cigarette 'epidemic',” UPI, Dec. 18, 2018).

Past 30-day e-cigarette use among high school students grew by more than 75 percent, and within the middle school ranks by 50 percent, between 2017 and 2018, according to data from the Centers for Disease Control and Prevention and the Food and Drug Administration's National Youth Tobacco Survey. That includes more than 37 percent of high school seniors.

The latest release from the Ohio Health Issues Poll found that 45 percent of Ohioans ages 18 to 29 have tried e-cigarettes and 23 percent of Ohio adults overall have tried them.