Out of the frying pan and into the pot
Seeming victory over Guam youth smoking turns to e-cig ashes
Sometimes it takes a law or an education campaign to help people kick a bad habit. Other times a more convenient or attractive vice comes along and undoes those earnest efforts.
Since 2014, youth smoking rates on Guam have dropped 5 percent — a feat that would be worth celebrating if it didn’t coincide with the finding that 35 percent of youth have picked up e-cigarettes.
It’s exactly what local public health advocates feared from the debut of e-cigs. “We knew that e-cigarette use was very alarming,” said Elizabeth Guerrero, a spokesperson for the Department of Public Health and Social Services.
The 2017 Guam Global Youth Tobacco Survey conducted by the U.S. Centers for Disease Control and Prevention will be used as a baseline to measure the effectiveness of the island’s tightened smoking regulations.
Over many decades tobacco companies figured out the tricks to peddling smokes to customers — young and old, legal and illegal. Now it’s the same game in a different guise.
Guerrero said DPHSS now has to fight against the “coolness” of vaping. An electronic cigarette vaporizes a nicotine-based liquid that is often scented and flavored. Though vaping products have been marketed as healthier alternatives to tobacco, medical professionals still question the longer term impacts of e-cigarette use.
Over many decades tobacco companies figured out the tricks to peddling smokes to customers — young and old, legal and illegal. Now it’s the same game in a different guise. DPHSS now has to fight against the “coolness” of vaping.
“The trends, the tricks they can do with it, how easily it is concealed, the flavoring—everything that shouldn’t be enticing to the youth is marketed (to them), so that they want to try it,” Guerrero said. “Once they try it, they get hooked because of the nicotine.”
If this sounds familiar, there are lots of incentives driving e-cigarette sales, just as there once were for cigarette sellers. E-cigarette lounges are open to all ages and there are no taxes on devices or vape-juice driving up the prices. Cigarettes are currently taxed $3 a pack.
Beginning in January, Guam joined several states and more than 300 municipalities to raise its tobacco smoking age from 18 to 21.
“Armed with facts instead of fear — young people, health care professionals and countless community advocates persisted, and, because of their work, this bill is now law,” Speaker Benjamin Cruz said when his bill lapsed into law without the governor’s signature in March 2017.
Vendors on Guam caught selling prohibited products to minors can be fined up to $10,000 and lose their license. Persons under 21 caught with tobacco products are required to take an educational course. Perhaps one of the biggest misunderstandings among the 18 to 21 population is that this law unfairly discriminates against them by stripping away an adult experience.
But Guerrero said she was moved by studies that indicate this is a critical time period in the formation of an addiction. “When we went out and we were doing education on the reasons why the age should be raised to 21, I think there was compelling data and compelling studies that showed because of the physiology and the brain development of the youth, they were more prone to that addiction which then lead to a longer period of adult addiction,” Guerrero said.
Laws or not, enforcement remains a central problem.
\In 2014, 15 percent of youth cigarette smokers bought their goods from a store. In 2017, that number rose to 22 percent. Additionally, 47 percent of youth reported that no one prevented them from purchasing cigarettes due to their age. “We have beautiful laws that have been created, but it’s just our enforcement aspect of it if you were to hit the nail on the head,” said Phil Cruz, a tobacco cessation specialist with DPHSS.
The Guam Behavioral and Wellness Center and the Department of Revenue and Taxation are jointly responsible for conducting unannounced at random stores to monitor compliance with tobacco access law. According to PEACE Guam’s 2016 statistics, Guam had a 4.7 percent violation rate in 2015.
A study published in the May issue of the American Journal of Public Health reveals the first look at the impact of New York City's groundbreaking law to raise the smoking age from 18 to 21 which came into effect in 2014. Analyzing NYC Youth Risk Behavior Surveys from 2008 to 2016, researchers found a decrease in youth smoking after the law was passed, but an increase in e-cigarette use, "suggesting uneven policy implementation, enforcement or compliance."
Other studies have found that increasing cigarette taxes, limiting advertising, and altering packaging can be linked to decreased smoking rates.
On quitting smoking, Cruz suggests enrolling in a cessation class but it comes down to, “The want. The want needs to be there, because if we put a million bucks and a pack of cigarettes in front of you, if you’re an addict, you’re going to bypass the million bucks and go for the pack of cigarettes.”
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