Countywide surveys last year show that nearly 1 in 3 teens in 10th and 12th grade have tried electronic cigarettes at some point, and 13.9% have used e-cigarettes in the last 30 days. While the survey shows what would otherwise be positive trends — use of cigarettes, cigars and most other tobacco products are down — e-cigarette usage has spiked in recent years.
"The bad news is that we are seeing one of the most rapid increases in youth use of nicotine-containing products in the country's history," said Nicole Coxe, program manager for the county's tobacco-free communities program.
Availability is at least part of the problem, according to the survey. Almost half of the teen respondents said they bought their own e-cigarettes, most commonly from vape shops, and more than two-thirds of those said it was "very easy" or "somewhat easy" to get their hands on an e-cigarette or vape pen.
The most pressing health issue leading to the county's ban on Nov. 5 is the sudden spike in vaping-related illnesses and deaths. More than 2,000 people have reportedly suffered lung injuries related to the use of e-cigarettes across the country, and 39 people have died, according to the U.S. Centers for Disease Control.
What precise compound or ingredient is making people sick is still under investigation, and the agency is recommending in the meantime that the public not use any vaping products that were obtained from illicit sources, and avoid using any vaping products that contain THC — the psychoactive component of marijuana and a common link between the illnesses.
"Smoking certainly kills, everyone knows that, but I do not recall ever hearing about smokers in their teens or 20s ending up in the emergency room or in the morgue," said Palo Alto resident Erwin Morton at the meeting. "This is new, and this is worse."
Palo Alto PTA Council President Jade Chao urged supervisors to pass the ban, adding that it could be coupled with stringent tobacco control policies that keep smoking out of schools, libraries, sports centers and other public areas. Parent Diana Pang said immediate action is needed to stop the prevalence of e-cigarette usage among students, which she believes are directly marketed to kids with appealing flavors and easily concealed designs.
The 5-0 vote at the meeting prohibits the sale and distribution of all e-cigarette products in unincorporated Santa Clara County, as well as eliminates exemptions that allowed retailers to sell mint and menthol-flavored tobacco products. Supervisor Cindy Chavez conceded in a guest opinion last week that it was the strongest action the county could take, yet it seemed "depressingly inadequate given the growing evidence of the product's harmfulness," particularly for youth.
At the meeting, Chavez instead turned her focus to what cities can do to curb the epidemic, asking staff to come back with a work plan to assist cities in adopting restrictions on the sale of tobacco products and stronger smoking prohibitions. A county report at the meeting showed that some cities have already approved strong regulations on where people can smoke and where tobacco can be sold, particularly Los Gatos, Palo Alto and Saratoga.
The report put Mountain View at the bottom, with no smoking restrictions at parks, public trails, multi-unit housing or "service areas" — shorthand for places that include bus stops, ATMs and ticket lines. The city also has a dearth of restrictions limiting the sale of tobacco products near schools and in pharmacies, and does not restrict the sale of flavored tobacco products.
Chavez said the county could consider offering grant funds to help cities research and draft ordinances with stronger smoking and e-cigarette restrictions, which she described as an opportunity to fill in the gaps among agencies lagging in the fight against the youth vaping epidemic. She also floated the idea of school districts adopting more stringent policies for curtailing e-cigarette use on campus, particularly detection devices in restrooms.
The county's report shows that the last substantive restrictions on smoking in Mountain View came in 2012, when the city adopted restrictions on smoking near outdoor dining areas and entryways, including a 25-foot buffer from workplaces, restaurants and public buildings where smoking is already prohibited. The outdoor dining and buffer zones won approval by a 4-3 margin by the council at the time.
Councilwoman Margaret Abe-Koga, who cast a vote in favor of the prohibitions in 2012, told the Voice she would be interested in revisiting the topic. She said it's concerning to hear how much teen use of e-cigarettes has gone up in recent years, and that more jurisdictions are responding with a mix of smoking restrictions and either partial or full bans on the sale of the devices.
Abe-Koga said her children have been forthcoming about their firsthand accounts on the prevalence of teen vaping, which indicate that it happens frequently and openly at school.
"I'm concerned when I hear stories about how kids bring their vape pens and charge them in class and no one says anything," Abe-Koga said. "There definitely seems to be concerns among parents and even some teens at the high schools."
It's a major problem affecting middle school and high school students in the area, said Suzy Heltzel, a member of the Los Altos Mountain View PTA Council. The trend seems to be skewing younger, to the point where older elementary school students are experimenting with vaping.
"This topic is more important than many realize," she said.
In order to get the word out, Heltzel's group scheduled a speaker series event with Dr. Bonnie Halpern-Felsher, a professor of pediatrics at Stanford University, at Los Altos High School on Thursday, Nov. 14. The group planned to delve into the epidemic, why adolescents are drawn to e-cigarettes and vaping products, and what can be done by parents and teachers to prevent exposure to addictive nicotine or THC products.
Abe-Koga said she wasn't aware of how many tobacco retailers were in Mountain View, but she said residents have raised concerns in recent months about e-cigarette manufacturer Juul Labs and its presence in the city. Earlier this year, the company shifted some of its operations into Mountain View amid heightened scrutiny in San Francisco, where the company is headquartered. Media reports from earlier this year say that the company now leases about 30,000 square feet for research and development at 420 N. Bernardo Ave. in the East Whisman area of Mountain View.
Juul, which has been deeply criticized for designing and advertising products with an eye toward hooking youth, announced a series of voluntary changes last month aimed at bringing down teen vaping. Juul CEO K.C. Crosthwaite said in an Oct. 17 statement that the company would be suspending its broadcast, print and digital advertisements in the U.S., as well as suspending the sale of certain flavored products pending an FDA review — mango, creme, fruit and cucumber.
Crosthwaite's statement also formally announced that the company was no longer supporting Proposition C in San Francisco, a failed ballot measure that sought to overturn an e-cigarette ban similar to the one passed in Santa Clara County earlier this month.
Though the studies into what causes lung injuries in e-cigarette users are still ongoing, the most recent discovery by CDC researchers on Nov. 8 indicates that vitamin E acetate is at least partly to blame. The oil is an additive in some THC products, and has been directly linked with lung injuries in 29 out of 29 fluid samples submitted across 10 states. Health officials told the Washington Post last week that the oil is normally innocuous, but could interfere with lung function when heated and inhaled.
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