Bloomberg Philanthropies, in partnership with the Campaign for Tobacco-Free Kids, announced the formation of Protect Kids: Fight Flavored E-Cigarettes—aimed at ending the youth e-cigarette epidemic. AFSA has agreed to join as a supporting organization.

In response to alarming levels of e-cigarette use among youth in the United States—including a 78% increase among high school students in just one year—Bloomberg Philanthropies  announced it would invest $160 million in the initiative to end the youth e-cigarette epidemic.

The three-year program will be led by the Campaign for Tobacco-Free Kids, which will partner with other leading organizations, including parent and community groups like AFSA, concerned about the nation’s kids and health.

More than 3.6 million middle and high school students in the United States use e-cigarettes, accounting for about one-third of all U.S. e-cigarette users. E-cigarettes with kid-friendly flavors such as mint, mango, gummy bear and cotton candy are fueling this epidemic; 97% of kids who use e-cigarettes use the flavored varieties, and 70% report the flavors as the reason they use e-cigarettes. Teen smoking rates in the United States declined by more than 70% between 2000 and 2018, but the spike in e-cigarette use among youth threatens to undo a generation’s worth of progress.

The creation of the initiative comes as health authorities in 33 states are investigating more than 450 cases of severe respiratory illnesses associated with vaping, with many cases involving teens and young adults. A CDC health advisory released in response to these alarming incidents encourages e-cigarette users to stop using these products while investigations into the cause of these illnesses are ongoing. On Sept. 9, the Food and Drug Administration said that Juul, the leading e-cigarette company, has violated federal regulations by promoting its tobacco products as healthier than traditional cigarettes.

E-cigarettes are uniquely dangerous for kids due to nicotine’s highly addictive properties and its impact on their developing brains: adolescent exposure to nicotine can reduce attention, learning and memory. Juul—which now represents more than 70% of the e-cigarette market in the United States—delivers high levels of nicotine, with each Juul pod delivering as much nicotine as a pack of 20 cigarettes. There is also substantial evidence that e-cigarette use increases the risk of using combustible tobacco cigarettes among youth and young adults.

“E-cigarette companies and the tobacco companies that back them are preying on America’s youth. They are using the same marketing tactics that once lured kids to cigarettes, and the result is an epidemic that is spiraling out of control and putting kids in danger of addiction and serious health problems,” said Michael R. Bloomberg, Bloomberg Philanthropies Founder and WHO Global Ambassador for Noncommunicable Diseases. “The federal government has the responsibility to protect children from harm, but it has failed—so the rest of us are taking action. I look forward to partnering with advocates in cities and states across the country on legislative actions that protect our kids’ health. The decline in youth smoking is one of the great health victories of this century, and we can’t allow tobacco companies to reverse that progress.”

The initiative will support local advocacy efforts in cities and states, including legislative and regulatory measures to:

• Remove flavored e-cigarettes from the marketplace. Researchers have identified more than 15,000 e-cigarette flavors available online. In addition to the role flavored products have played in driving the youth e-cigarette epidemic, studies have found that some flavoring chemicals also may have health risks.

• Ensure e-cigarette products are subjected to review before they reach the market, and products now on the market are reviewed promptly. Under current law, the U.S. Food and Drug Administration is required to review all e-cigarette products before they are allowed to be sold. However, the FDA has significantly delayed this review process, allowing current products—including flavored e-cigarettes—to remain on the market for several years without a scientific review.

• End marketing practices that appeal to kids. Research has shown that the marketing practices of Juul have been “patently youth-oriented.” Nearly half of the public accounts following Juul on Twitter in 2018 were of people between 13 and 17 years old. Reports indicate the Federal Trade Commission is  investigating Juul’s marketing practices and the extent to which they were geared toward kids.

• Stop online e-cigarette sales until sales to kids can be prevented. E-cigarette companies currently have insufficient protections in place to keep kids from purchasing their products online, including the inability to properly verify the ages of purchasers through remote sales.

To track youth e-cigarette usage and inform this work, the CDC Foundation will collect and analyze information about e-cigarette retail sales, prevalence of teen e-cigarette use and attitudes of teens about the epidemic. Data collected will help evaluate the impact of state- and community-level flavored tobacco policies on youth access, initiation and use of these products.

“It is important to gain a deeper understanding of the long-term health effects of e-cigarettes on youth, and the CDC Foundation’s focus is on gathering and evaluating data to better inform effective policies,” said Judith Monroe, MD, chief executive officer of the CDC Foundation. “We appreciate the support of Bloomberg Philanthropies and partners in helping tackle this epidemic to protect our youth.”

“When it comes to individuals who have committed their lives to protecting kids from the dangers of tobacco products, Michael Bloomberg is second to none. We are deeply honored to partner with Bloomberg Philanthropies on this initiative,” said Matthew L. Myers, president of the Campaign for Tobacco-Free Kids. “Tobacco remains the number one cause of preventable death in the United States. This game-changing investment will provide critical resources to help the public health community stand up against Juul and other e-cigarette companies that peddle e-cigarettes to our kids and ensure that we don’t lose another generation of kids to nicotine addiction.”

“We should all be alarmed that after years of decline in the youth smoking rate, more and more young people are vaping, and many of them will become cigarette smokers," said Larry Merlo, president and CEO of CVS Health. "Vaping poses a public health challenge that we all need to work together to tackle, so we applaud Bloomberg Philanthropies support of our long-time partner, the Campaign for Tobacco-Free Kids, in this fight. The work to advocate aggressively to address youth vaping—especially by encouraging strong FDA action and prohibiting flavored e-cigarettes, a policy we strongly support—requires a strong chorus of voices that we can present working together.”

“Absent FDA regulation of e-cigarettes, tobacco companies are addicting a new generation to nicotine at a staggering pace and luring youth to use their products with appealing flavors,” said Gary Reedy, CEO of the American Cancer Society. “The American Cancer Society and American Cancer Society Cancer Action Network are proud to join Bloomberg Philanthropies and our public health partners in this new campaign to work to reverse the youth e-cigarette epidemic across the country by prohibiting flavored tobacco products, including e-cigarettes, and compelling the FDA to swiftly exercise its authority granted by Congress to aggressively regulate all tobacco products.”

“The health of America’s youth is not for sale, and we applaud Bloomberg Philanthropies for its commitment to helping end the youth e-cigarette epidemic," said Robin Koval, president and CEO of Truth Initiative. "This support is urgently needed as millions of young people are at risk of becoming addicted to nicotine every day through vaping, making them four times more likely to go on to smoke deadly cigarettes. Daily news reports about the negative health effects of untested and unregulated e-cigarettes underscore the urgency of the crisis and the reality that the tobacco industry, including Juul, is treating America’s youth like human lab rats for profit. Truth Initiative looks forward to partnering in support of this new project and its goals, including eliminating all flavored tobacco products, as we work to make tobacco use a thing of the past.”

“E-cigarettes pose a severe threat to children and adolescents, enticing them with appealing flavors and, in the absence of meaningful federal regulation, causing serious and fatal injury. We therefore applaud Bloomberg Philanthropies for leading a new effort to curb this public health epidemic," said American Academy of Pediatrics President Kyle Yasuda, MD, FAAP. "The more voices come together to join this fight, the more powerful our advocacy to protect children. We look forward to working with Bloomberg Philanthropies and our public health partners to ensure that children can grow up healthy and safe from the harms of tobacco and nicotine.” 

“The American Lung Association is deeply concerned about the youth e-cigarette epidemic and we applaud Bloomberg Philanthropies for its strong support for protecting our nation’s youth,” said Harold P. Wimmer, president and CEO of the American Lung Association. “This new project comes at a critical time, when a robust public health response must be mounted to end this epidemic. The American Lung Association looks forward to partnering in support of the project and its goals, as we work to eliminate tobacco use and tobacco-related disease.”