Page 10 - July Aug 2022 Newsletter Final_Neat

Continued from page 9 work, Nickelodeon, in Seventeen magazine and on websites, mobile apps and social media
used by teens (The New York Times 2-12-20). One interpretation of this marketing scheme has been that addicting
youth to nicotine will provide a life long stream of customers and income to E-cigarette manufacturers. In an echo of
the 1998 Master Settlement Agreement there are at least 200 law suits from 22 states against Juul, the leading E-
cigarette vaping manufacturer. These were consolidated in 2019 in U.S. District Court in California with Juul being
accused of copying the now illegal marketing strategies of the tobacco industry to target youth, leading to the epi-
demic of vaping among youth (Detroit Free Press 9-26-2019, and U.S Judicial Panel on Multidistrict Litigation: “Juul
Labs, Inc., Marketing, Sales Practices, and Product Liability Litigation” 01-02-2020).
Smoking remains an epidemic among youth in the U.S. “More than 3200 children 18 or younger smoke their first cig-
arette every day. Nearly 9 out of 10 smokers start before the age of 18. Every adult who dies because of smoking is
replaced by two young smokers. 5.6 million Americans younger than 18 today will die early from smoking related
illness” (2014 Surgeon General’s Report). E-cigarettes have been the most common form of tobacco/nicotine prod-
uct used by youth since 2014. According to the National Youth Tobacco Survey (NYTS), in 2019 10.5% of middle
school students and 27.5% of high school students reported they had used E-cigarettes in the past 30 days (MMWR).
And, in 2020 85% of high school and 74% of middle school students who used tobacco products in the last 30 days
reported using a flavored product (MMWR). The 2021 NYTS cannot be compared directly with earlier reports, be-
cause data collection techniques have been different due to COVID-19. That said significantly fewer youth (11.3% of
high school and 2.8% of middle school students) reported current E-cigarette use. It is thought that remote learning
may have affected access to E-cigarettes, and not being present when peers use E-cigarettes may have contributed to
reduced use (CDC Press Release 9-30-21). Anecdotal information suggests 19- to 30-year-olds may have started
smoking for the first time or resumed smoking in response to COVID-19 isolation, anxiety and re-socialization. 2020
was the first time in the past 20 years that cigarette sales rose (NYT 1-12-2022).

The battle against nicotine and tobacco is far from over. Progress has been made through legislation, legal challenges
to the tobacco industry, and vigorous public health research and educational efforts. Youth remain highly vulnerable
to the addictive properties of tobacco and nicotine. The 2021 U.S. Surgeon General’s Advisory on Protecting Youth
Mental Health encourages talking early with children about risks of alcohol and addictive substances, emphasizing
that the earlier substance use begins the greater the chances of developing a substance use disorder and the mental,
physical and social problems that follow. As psychiatrists we are often close to the lived experiences of our patients
and their families. We are in a unique position to inquire, explore, reflect, support and educate them about nicotine
addiction and the available resources to encourage abstinence and improved health.
Click here to view: Tobacco and Youth References

To respond to this article, CLICK HERE.

Child Focused News Briefs

Pediatric Mental Health Crises Increased After Pandemic Onset, Researchers Say
HealthDay (5/23) reports, “During the first pandemic year, there were increases in the proportion of pediatric pa-
tients presenting to hospital with suicidal ideation/suicidal attempts, depression, anxiety, eating disorders, sub-
stance use disorders, and obsessive compulsive and related disorders,” investigators concluded in a study that de-
scribed “psychiatric diagnoses and boarding among pediatric patients presenting to the hospital after the pandemic
onset in a retrospective chart review at a large Northeastern U.S. pediatric hospital.” The findings were published
online May 17 in the journal Hospital Pediatrics.

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NORTHERN CALIFORNIA PSYCHIATRIC SOCIETY Page 10 July/August 2022