Last week President Joe Biden signed legislation that allows the Food and Drug Administration to regulate synthetic nicotine, used in vape products popular among teens.

Kentucky advocacy groups say the state's high level of vape product use among young people is setting the stage for a serious public health crisis.

E-cigarettes or vapes typically contain as much or more nicotine than traditional cigarettes, but until now manufacturers have skirted government regulations by using a synthetic version of the chemical.

Dr. Scott Bickel - assistant professor of pediatrics in the Division of Pediatric Pulmonology, Allergy, and Immunology at the University of Louisville School of Medicine - explained that the nicotine and other toxic substances found in vape products can have substantial health consequences.

"Can lead to impulsivity, difficulties with brain development, and so on," said Bickel. "And then certainly the respiratory consequences of starting those things early can't be overstated."

Congress moved to give the FDA the authority to regulate synthetic nicotine in the $1.5 trillion spending bill that funds the government through September. Biden signed the legislation into law last week.

More than one in four Kentucky high schoolers use e-cigarettes. According to the Centers for Disease Control and Prevention, e-cigarette sales hit a record high last June, with more than 22 million units sold nationwide.

Allison Adams - vice president for policy with the Foundation for a Healthy Kentucky - said the experience of the coronavirus pandemic highlighted how tobacco can make individuals more susceptible to respiratory illnesses such as COVID-19.

She added the Commonwealth has one of the highest rates of tobacco use in the nation.

"And so knowing that we weren't coming into this pandemic as a healthy state," said Adams, "we were on a trajectory for loss and less ability to fight it off quickly and rapidly."

Adams said the state could allow local communities to make their own decisions about how tobacco products are marketed, sold and distributed at the local level to help protect the health of young people.

Hannah Abdon is a senior at Boone County High School. She said she believes her classmates have gravitated toward vape products because of heavy advertising in her community.

"On my drive to school," said Abdon, "I think I pass three different places, and these places all sell vapor products, and they have advertisements in their storefronts that I can see when I'm driving past."

Tobacco and e-cigarette industries spent more than $788,000 lobbying Kentucky lawmakers in 2020, according to state data.

Kentucky will soon begin licensing retailers who sell nicotine, which advocates have said will help regulate an industry and protect minors from addictive chemicals.

Gov. Andy Beshear signed Senate Bill 100 into law earlier this week.

Griffin Nemeth, a student and coordinator for the iCANendthetrend Youth Advisory Board coordinator at the University of Kentucky, explained the legislation is no different from what's currently in place for retailers who sell alcohol.

"We're really just trying to make sure that tobacco and nicotine products are on par with what is already expected of some of these other establishments," Nemeth explained.

In a state where about 5% of high school students smoke and almost 20% use e-cigarettes, according to The Campaign for Tobacco-Free Kids, advocates said the new regulations are a welcome effort to curb tobacco use among minors. Data show smoking costs the state more than $2 billion every year.

Under the new law, Kentucky will license all retailers who sell tobacco and vape products, empowering the Department of Alcoholic Beverage Control to inspect and enforce rules for the businesses. Nemeth argued licensing is a strong tool to protect youth at the point of sale.

"We're now starting to see an increase in use of alternative nicotine products, like oral nicotine pouches, and we're still seeing pretty significant use of vapes and e-cigarettes," Nemeth observed.

The new law will also fine retailers who sell nicotine products to minors, and give half the money collected to a youth prevention program.

This story is based on original reporting by Sarah Ladd for the Kentucky Lantern.

Nebraska needs to do better when it comes to tobacco use prevention and cessation, according to a newly released report.

In the American Lung Association's 2024 State of Tobacco Control report, Nebraska received an "F" in three of the five areas rated. One is for tobacco prevention and cessation funding.

Michael Seilback, national assistant vice president for state public policy for the American Lung Association, said Nebraska is spending vastly less than what the Centers for Disease Control and Prevention recommends.

"The fact is that the state is taking in these dollars, and we're saying, reinvest just some of them," Seilback explained. "You can easily meet CDC best practices with tens of millions of dollars to spare."

The report showed Nebraska's tobacco-related revenue is nearly $98 million per year. However, for fiscal year 2024, state funding for tobacco control programs is less than $4 million.

On the bright side, the state received an "A" for smoke-free air.

Responding to the report, a spokesperson with the Public Information Office at the Nebraska Department of Health and Human Services pointed to the Nebraska Quitline. It has received more than 100,000 calls since 2000, with Quitline users six to 10 times more likely to still have quit after seven months than those who try to quit cold turkey. The Nebraska Quitline number is 1-800-784-8669, and 1-800-355-3569 for Spanish speakers. Web-based coaching and texting and free "quit medication starter kits" are also available.

The state also received an "F" for tobacco taxes. Seilback called the state's cigarette tax of 64 cents per pack extremely low and supports Gov. Jim Pillen's proposal to increase it by as much as $2 per pack. He added the American Lung Association always pushes for increased tobacco tax dollars to be used for prevention and control and helping people quit.

"To be clear, even if not one dollar was spent -- and we wouldn't encourage it -- on its own, just increasing the price has an impact on the amount of people that use it," Seilback pointed out. "Increasing that price would help prevent kids from starting."

Nebraska's third "F" is on flavored tobacco products, as a result of having no state laws or restrictions.

Seilback commended the state for participating in the multistate lawsuit against e-cigarette manufacturer, JUUL Labs, with the settlement money going to programs to curb addiction.


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Widespread vaping among young Kentuckians continues to be a public health concern - and some local communities are coming up with innovative ways to tackle the issue. A big win in the battle against nicotine came when the Commonwealth raised the age limit to purchase nicotine products to 21.

Lauren Carr, director of the Graves County Agency for Substance Abuse Policy and Prevention, said local shops are still selling vapes to kids. Her county is incentivizing business owners not to sell to minors.

"We reward the clerks that do not sell with a gift card," she said. "So we say, 'Hey, thank you for not selling to the kids. Because that is preventing it from getting into the schools.'"

Experts say tobacco retail licensing can help protect youth from the harmful effects of vaping and can also improve equity among low-income and communities of color, often targeted by the tobacco industry.

According to Kentucky Youth Advocates, about 35 states require retailers to hold a license to sell tobacco products, but Kentucky is not one of them.

Sydney Shafer, a high school student in Scott County, said after her grandfather passed away from lung cancer, she became passionate about raising awareness among state lawmakers about the harms of vaping.

"Big vape companies are targeting younger audiences with fun flavors, like cotton candy and coffee," she argued. "It's deceptive and manipulative, and I would just want to educate other people and let them know that vaping is not as safe as they think."

Bruce Crouch, drug prevention officer with the Youth Coalition Prevention Group at Taylor County High School, said his school district recently received an opioid settlement grant from the state to expand drug prevention work.

"We actually started with our intermediate school, with fourth-graders," Crouch reported. "And we introduced a program, the 'Too Good for Drugs' program. So, they are actually getting that early education about the dangers of nicotine use."

Research from the CDC and FDA finds more than 2.5 million middle and high school students nationwide reported e-cigarette use in 2022. Nearly 85% of youth who vape used flavored e-cigarettes, and more than half used disposable e-cigarettes.


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