The Kentucky statewide student survey biannual evaluation to assess the extent of tobacco (nicotine), alcohol and drug use among 11- to 18-year-old adolescents was recently released. Vaping and e-cigarette use had doubled or nearly doubled in all four grades surveyed -- sixth, eighth, 10th, and 12th in the last two years. This unprecedented rise in vaping in Kentucky is much higher than the national average. The peak grades for first trying e-cigarettes and vaping are the sixth and seventh. This is much more popular than the use of alcohol or combustible cigarettes.

The FDA describes e-cigarette or JUUL use, the most popular nicotine or drug delivery device, as an epidemic among our youth. They clearly state that nicotine is not a benign substance but rather a highly addictive drug that has major detrimental effects on the developing immature adolescent brain. This disturbing and accelerating trajectory of use that is occurring in our youth and the resultant path to multi-drug addiction must end.

The FDA has launched the Youth Tobacco Prevention Plan to stop the use of e-cigarettes and tobacco products. The three key strategies are:

• Prevent underage access to tobacco products.

• Curb the marketing of tobacco products aimed at our youth.

• Educate teens about the dangers of tobacco, short-term and long-term.

The FDA is exploring ways to wean teenagers off nicotine as huge numbers of middle and high school students use JUULs and other electronic drug delivery devices that promote addiction. Doctors treating nicotine-addicted adolescents do not have a wealth of treatment data upon which to draw. Most of the treatment information comes from treating adults that are addicted to nicotine.

According to Dr. John Cecil and Dr. Caitlynn Cecil of The Cecil Clinic in Paducah, who see many adolescent patients, JUUL use is extremely common. Dr. John Cecil has treated nicotine-addicted adolescents with some adult treatment protocols. He estimates his success rates to be only 10 percent. He also observes that 80-90 percent of the adolescents who use JUULs have a parent or guardian who smoke tobacco products. Dr. Caitlynn Cecil also performs occasional drug testing as part of her evaluation for mood swings, depression or when she is otherwise suspicious. She states that if a patient is positive for THC, the psychoactive component of marijuana, then they virtually all use JUULs. She states many parents and grandparents are totally unaware about their children using e-cigarettes or JUULs. Most have no idea what the devices are because some resemble USB drives.

Making all Kentucky school campuses completely tobacco and e-cigarette free is critical to changing youth attitudes about tobacco products. This measure will help protect our children from one of the most addictive substances on this planet and allow them to learn and grow in a smoke and nicotine aerosol free environment.

Currently only 42 percent of Kentucky public school districts have adopted tobacco-free policies. This means 58 percent of school districts do not have a tobacco-free policy. A comprehensive tobacco-free policy that expands across the state, as proposed by House Bill 11, will help prevent a real student addiction risk. Faculty, staff and visitors will also avoid exposure to second-hand smoke, nicotine aerosol and residue.

The Senate passed House Bill 11 on the final legislative day of the year, with compromise being necessary for its passage. The law goes into effect the summer of 2020. The local school boards will implement the regulation of the law. They also may opt out of the tobacco prohibition law within three years after it takes effect. A statewide tobacco-free law takes away the sense that e-cigarettes and smoking are the norm. It also is a proven method to help keep adolescents from starting e-cigarettes or cigarettes which may quickly progress to addiction.

We should all support this common sense tobacco-free school law and encourage our school boards to embrace and strengthen the protection it affords our children. Many thanks to Rep. Kim Moser, Speaker David Osborne, Sen. Ralph Alvarado, The Foundation for a Healthy Kentucky and all the partners dedicated to advocating for a healthy Kentucky.

Dr. Pat Withrow is the director of outreach at Baptist Health Paducah. He can be reached at patrick.withrow@bhsi.com.

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