As the American Lung Association works to create a tobacco-free future, we have both reason to celebrate progress and much work yet to do. Tobacco use continues to take a terrible toll on our families, killing more than 480,000 Americans a year. For 18 years, our annual “State of Tobacco Control” report has tracked and graded efforts to reduce tobacco use by state and federal governments. The tobacco prevention and quit smoking policies called for in the report have resulted in a historic improvement in public health, driving down adult and youth cigarette smoking to record lows and saving lives. However, the dizzying rise in youth use of e-cigarettes threatens almost 20 years of nationwide progress.

Youth vaping remains an epidemic, with 2019 showing an alarming rise to 27.5% of high schoolers reporting e-cigarette use and middle school use rising to 10.5%. In total, vaping has risen by 135% among high schoolers and 218% among middle schoolers in the past two years.  At this rate, another generation is at risk of a lifetime of nicotine addiction and ultimately more tobacco-caused death and disease. This dramatic rise is a clear demonstration of how the federal government, including the U.S. Food and Drug Administration (FDA), has failed to protect our kids by using their authority to properly oversee all tobacco products, especially e-cigarettes.

The big question posed by our 2020 “State of Tobacco Control” report is, “Will 2020 be the year that federal, state and local lawmakers prioritize public health over the tobacco industry?” The report highlights some actions in 2019 that say “yes” and others that point to “no.”

As a result of successful lawsuits filed by the American Lung Association and other public health partners, the FDA will be required to take several important actions to protect the public health from tobacco products in 2020. These include finalizing graphic warning labels on all cigarette packs and requiring e-cigarettes, cigars and other tobacco products to submit applications to FDA to remain on the market. 

Congress also took an important step by passing a law to increase the tobacco sales age to 21 nationwide. Increasing the age for sale of tobacco products to 21 is a proven method to reduce youth access to tobacco products. This step earned the federal government an “A” grade in the report’s new Federal Minimum Age category this year.

Unfortunately, the federal government has repeatedly failed to take action to protect kids from flavored tobacco products. In January 2020, the Trump Administration announced it will allow thousands of flavored e-cigarettes to remain on the market, a reversal of the September announcement that they would “clear the markets” of all flavored e-cigarettes. Because of this and other lost opportunities, the federal government earned another ‘F’ grade for Federal Regulation of Tobacco Products in our 2020 report.    

Much like the federal government, 2019 progress in state legislatures to reduce tobacco use and help smokers quit was decidedly mixed. Some states led the way, such as Massachusetts, which became the first state to prohibit the sale of all flavored tobacco products, including e-cigarettes and menthol cigarettes. Thirteen states also passed Tobacco 21 laws of their own in 2019 prior to the federal Tobacco 21 law passing.

Despite some progress, this year’s report makes it clear that more needs to be done by states, communities and the federal government to stop the increase in youth tobacco use brought on by the youth vaping epidemic. In response the Lung Association has created a 12-Point Plan to Eliminate Tobacco Use and Tobacco-Related Disease. Implementing these key actions would lead to drastically lower rates of tobacco use, and the many lung diseases it causes or makes worse.

Our 18th annual “State of Tobacco Control” highlights our progress toward this goal and provides an urgent call to action for local, state and federal governments. We know how to save more lives, but we need policymakers to do much more. We call on lawmakers at all levels of government to put the health of our youth over the interests of the tobacco industry and put in place the proven tobacco control policies called for in “State of Tobacco Control” 2020.

The American Lung Association is working to protect Americans, especially our kids, from the dangers of e-cigarettes. Learn more about e-cigarettes, their health effects and what parents should know.

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