Where were you when COVID hit? I was attending a national conference for pediatricians in February 2020 when news of a novel coronavirus began to circulate widely in medical circles.

I had been looking forward to the conference session on the vaping epidemic, which was growing more alarming by the day. By the time I settled into my auditorium seat that morning, more than 2,800 people across the country — mostly kids and young adults — had been hospitalized as a result of a new syndrome being called EVALI: e-cigarette or vaping associated lung injury. Among those hospitalized, 68 had died.

The lecture was inspiring. It felt like we were finally on the brink of actively disrupting what was certainly the tobacco industry’s most fiendish product line and marketing strategy to date — the sale of menthol-, mint-, candy- and dessert-flavored e-cigarettes to lure and hook kids.

My hope that action on the youth vaping epidemic was imminent was short-lived. The second lecturer of the day sounded the alarm on another newly emerging catastrophe: COVID-19. For most of us, responding to the vaping crisis was now put on the back burner.

There is no question, our collective “all hands on deck” response to COVID over the past year has been absolutely necessary. And now, as we slowly emerge from this worldwide emergency, we owe it to our kids to begin to shift our focus back to one of the greatest threats to their health and ability to thrive: nicotine addiction.

Like many parents and physicians, I’ve watched the explosion of youth e-cigarette use in my community. The negative impact on some of my young patients — on their health and readiness for school and sports — has been dramatic. Some of these vaping devices deliver much more nicotine, much deeper into the lungs. One Juul pod contains as much nicotine as a pack of 20 cigarettes.

E-cigarettes come in literally thousands of flavors, like Cotton Candy, Strawberry Shortcake, and Purple Haze. These flavors are clearly not for adults — they are designed to attract and hook new users. The science of menthol makes it the most dangerous flavored tobacco product. Menthol numbs the throat and masks the harsh taste of tobacco, making it easier to inhale, and inhale more deeply. People who smoke menthol show greater signs of nicotine addiction and are less likely to be successful in their quit attempts.

Smoking causes cancer, heart disease, lung disease, stroke, diabetes and COPD — it harms nearly every organ in the body. But let’s not forget the brain. Nicotine exposure during adolescence and young adulthood can cause long-term harm to brain development. Our brains are still growing until about age 26, making youth and young adults much more susceptible to nicotine addiction. If you haven’t started using tobacco by age 26, you are unlikely to ever do so. This simple fact is why the tobacco industry is continually looking for new ways to attract children and young adults — all with reckless disregard for their future health and well-being.

Our kids are sitting ducks for the tobacco industry, and this would not be happening without mint, menthol, candy, fruit, and dessert flavored tobacco.

Tobacco companies understand the science of addiction and the dangers of menthol. They are also masters of product marketing. They have targeted kids and marginalized populations for decades with carefully tailored ad campaigns. As a result, they have created health disparities that span generations. Among African American adults who smoke, more than 4 in 5 now smoke menthol. Tobacco-related health disparities are also particularly acute in people with behavioral health disorders and co-occurring mental health and substance use disorders. The nicotine dependency rate for individuals with behavioral health disorders is two to three times higher than the general population.

Addressing tobacco policy, particularly the tobacco industry’s use of flavored tobacco products, is one of the first things we can and must do to set things right — to recover from COVID and to begin eliminating preventable and deadly health disparities that are unjust and unfair.

We’ll all remember the start of COVID. What we must not forget is that our best response to COVID is to prevent the most significant risk factors for serious respiratory illness. Doing so will give our kids and grandkids a fighting chance to grow up tobacco free. I hope Maine lawmakers will support me, as well as family doctors all across our state, by getting flavored tobacco products off our store shelves.

Dr. Jeffrey Stone, D.O., is a pediatrician practicing in Waterville.


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