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Surprising Impact of COVID-19 Impact on Youth E-Cigarette Use

MedicalResearch.com Interview with:

Bonnie Halpern-Felsher, PhD, FSAHM (pronouns: she/her) Professor of Pediatrics Taube Endowed Research Faculty Scholar Professor (by courtesy), Epidemiology and Population Health Professor (by courtesy), Psychiatry and Behavioral Sciences Director of Fellows’ Scholarship, Department of Pediatrics

Dr. Halpern-Felsher

Bonnie Halpern-Felsher, PhD, FSAHM (pronouns: she/her)
Professor of Pediatrics
Taube Endowed Research Faculty Scholar
Professor (by courtesy), Epidemiology and Population Health
Professor (by courtesy), Psychiatry and Behavioral Sciences
Director of Fellows’ Scholarship, Department of Pediatrics
Director of Research, Division of Adolescent Medicine
Co-leader, Scholarly Concentrations, Pediatrics Residency Program

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: To examine adolescent and young adult e-cigarette use during the COVID-19 pandemic.

There were 4 main findings:

  • About 2/3 of adolescent and young adult ever-e-cigarette users reported either quitting or cutting back on e-cigarette use since COVID-19 began.
  • Users least likely to quit or cut back e-cigarette use were those showing higher levels of nicotine dependence and those who had used e- cigarettes a large number of times.
  • Adolescent and young adult e-cigarette users found it harder to access e-cigarettes, but unlike studies before COVID-19, the dominant source of purchasing e-cigs was online instead of brick-and-mortar during COVID-19 pandemic.
  • Youth below 21 years were able to purchase e-cigarettes without any age verification, and those whose age was verified were asked to physically show ID or provided an email, which are less effective means to prevent underage youth use.

MedicalResearch.com: What should readers take away from your report?

  • One of the reasons why adolescents and young adults quit or cut back on e-cigarette use is that they were worried about lung health, suggesting that discussing and educating about lung health can be a way to reduce / prevent use.
    • FYI I am the Founder and Executive Director of the Tobacco Prevention Toolkit, where we do discuss lung health and other topics to help prevent and reduce youth use of e-cigarettes and other tobacco products.
  • Regarding age verification: FDA should not permit online sales without age verification, and they should use their authority to deny premarket tobacco applications (PMTAs) that don’t demonstrate with evidence that the age verification is effective. Further, states and localities can also enact regulations regarding age verification, similar to what we did in California.
  • We need more resources for youth e-cigarette cessation. Currently we don’t have FDA approved nicotine replacement therapy for anyone under age 18 trying to quit e-cigarettes. Further, parents and healthcare providers need information, education, and resources to identify e-cigarette use and addiction and help youth reduce and/or quit using.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

  • How to implement age verifications effectively.
  • More research on NRTs and cessation tools for youth, including nicotine step-down approaches.
  • Whether reductions in e-cigarette use will continue, even when youth are back to school or in the work force.

MedicalResearch.com: Is there anything else you would like to add? Any disclosures?

  • Clinicians should screen, council and help treat or refer for cessation treatment all adolescents and young adults , and provide cessation tools for those using.
  • I am a paid expert scientist in some e-cigarette litigation and an unpaid scientific advisor and expert witness regarding some tobacco-related policies. None of the other authors have any conflicting interests.Citation:

Citation:

Gaiha SM, Lempert LK, Halpern-Felsher B. Underage Youth and Young Adult e-Cigarette Use and Access Before and During the Coronavirus Disease 2019 Pandemic. JAMA Netw Open. 2020;3(12):e2027572. doi:10.1001/jamanetworkopen.2020.27572

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