The Washington PostDemocracy Dies in Darkness

More states are targeting teen vaping, but health advocates say it’s not enough to curb use

Several states have or will implement "Tobacco 21" policies, which restrict the age of smoking to people 21 and older, and a U.S. Senate bill introduced in May aims to do the same. (Eva Hambach/AFP/Getty Images)

More restrictive smoking laws took effect Monday in Virginia, Illinois, Florida and Vermont — the latest in a line of legislative efforts designed to combat what some say is a teen vaping epidemic.

Virginia and Illinois joined six other states, the District of Columbia and hundreds of municipalities in implementing “Tobacco 21” policies, raising the buying age from 18 to 21. Eight more states are expected to enact similar laws by 2021, and a Senate bill introduced in May aims to do the same at the federal level.

The measures, which come just days after San Francisco adopted the nation’s first ban on e-cigarette sales, reflect growing concern that the popularity of vaping with teens will undermine a decades-long decline in youth-smoking rates.

E-cigs heat liquid to produce an aerosol that typically contains nicotine, flavoring and other chemicals. Health officials warn that nicotine can harm the development of young brains, including the parts that control attention, learning and impulse control.

According to data from the national Centers for Disease Control and Prevention, 1 in 5 high school students and 1 in 20 middle-schoolers have used electronic cigarettes in the past 30 days. And the trend is on the upswing.

[Senate panel approves bipartisan bill to raise federal smoking age]

A number of tobacco companies say they support raising the legal age, including Altria Group Inc., the Richmond-based giant that sells Marlboro, and Juul Labs, which dominates the e-cigarette market in the United States.

“Something had to be done to address the e-vaping issue,” an Altria spokesman said. “We want to make sure that we’re preserving the category for adults so we can recognize what harm reduction can really do.”

Altria, which shuttered its e-cigarette brands last year, has a 35 percent stake in Juul.

[Trump wants the e-cigarette industry to pay $100 million a year in user fees]

John Boylan, a senior equity analyst for Edward Jones, said that revenue-threatening legislation is something tobacco companies are used to and that the industry works to keep up through new products like e-cigarettes.

“It’s not just a tobacco-stick world anymore,” Boylan said.

[A teen’s injuries looked like he was in a ‘high-speed’ crash. Instead, a vape pen exploded in his mouth.]

Juul has made several changes to address teen vaping, including adopting a 21-and-older requirement for online sales and suspending the use of mango, fruit, crème and cucumber flavors. It also shut down its Facebook and Instagram accounts in the United States and said it works to remove social media content related to youth vaping from third-party users, according to a news release.

Separately, a pair of senators from big tobacco states have made a bipartisan push to raise the federal smoking age to 21. Last week, a Senate committee approved the Tobacco-Free Youth Act, which was co-sponsored by Senate Majority Leader Mitch McConnell (R-Ky.) and Sen. Tim Kaine (D-Va.). Kentucky and Virginia trail only North Carolina in tobacco output, according to U.S. Agriculture Department data.

“I’m grateful to my colleagues for advancing our legislation to help curb the spike of youth tobacco use,” McConnell said in a statement. “Because children are extremely vulnerable to becoming addicted to nicotine and suffering its lifelong consequences, we must do everything we can to keep these products out of their hands.”

But health advocates say raising the smoking age isn’t enough to curb youth access.

“Flavored products have been used to make the poison go down smoother and to attract kids,” said Erika Sward, an American Lung Association spokeswoman. “The tobacco industry has known that for decades.”

About 80 percent of those in the 12 to 17 age group who have used a tobacco product started with a flavor such as tutti-frutti, chocolate or watermelon, according to the Journal of the American Medical Association. In 2009, a federal law banned flavored cigarettes (not including menthol), but other flavored products are still legal.

The Food and Drug Administration issued a policy this year to restrict how and where flavored cigarettes are sold, calling underage vaping “an epidemic.” This initiative would hold companies responsible for limiting these sales to separate adult-only sections or stores that bar minors, in addition to tightening age verification and bulk sales online.

[FDA rolls out vaping policy to make it harder for minors to buy flavored products]

While some experts contend that e-cigs have helped reduce cigarette use in the United States, there isn’t much research available on the long-term effects of e-cigarette. In June, the American Lung Association received a nearly $25 million federal grant to research the lung health of millennials, in partnership with Northwestern Medicine scientists.