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Local Health Depts. Driving Change Toward E-Cigarette Regulation | Commentary

In 1964, the Surgeon General issued a warning that changed public health forever: Smoking is harmful to your health and can cause cancer. After a great reduction in smoking rates and many thousands of lives saved, decades of progress are now endangered by the new kid on the block — the electronic cigarette.

Despite the FDA’s long overdue ruling to regulate e-cigarettes, our youth are still in jeopardy. Advertising, online sales, and use of this popular nicotine delivery vehicle in public places promotes nicotine to a new generation and renormalizes the presence of tobacco products in our society. We already know children are highly vulnerable to these insidious marketing practices. The FDA’s important action is a first step that doesn’t go nearly as far as necessary to combat the threat of e-cigarettes to the public’s health and safety.

Local health departments have been a driver and key champion of e-cigarette regulation in the absence of FDA action. Local health departments have taken the lead, providing education, guidance and regulations to protect children. Major metropolitan cities such as Boston, Chicago, Los Angeles, New York City, Philadelphia, San Francisco and Seattle have already banned e-cigarettes in places where cigarettes aren’t allowed.

Coming up, the Big Cities Health Coalition, a project of the National Association of County and City Health Officials representing the public health officials from 19 of the largest city and county health departments will host a briefing on Capitol Hill with Sen. Richard J. Durbin, D-Ill., to discuss all aspects of the FDA regulations and share what they are doing locally around e-cigarettes.

But while local action is essential, it is no substitute for the impact of federal law.

Recently, a commissioned report by Senate Democrats, including Ohio’s Sen. Sherrod Brown, found that many manufacturers are using tobacco industry practices to market e-cigarettes to children, such as offering flavors like Cherry Crush and Grape Mint. The lure continues with celebrity endorsements during family programming hours on TV followed by product placement at local shopping malls.

As health commissioner for the Cuyahoga County Board of Health serving 850,000 Greater Cleveland residents, I know that regulation of tobacco products works. The implementation of Ohio’s Smoke-Free Workplace Act has yielded a nearly 30 percent reduction in the percentage of heart attack-related emergency department visits. Such regulations improve the health trajectory for our children, the future workforce in our communities.

Unfortunately, we are already seeing evidence that damage has been done.

The CDC’s National Youth Tobacco Survey found that the percentage of U.S. middle and high school students who use e-cigarettes more than doubled from 2011 to 2012. The dangers of smoking become all too real as young people begin to view e-cigarettes as a safe choice without realizing the potential impact of early and long-term nicotine addiction.

While proponents say e-cigarettes are the best alternative to quitting, known science doesn’t support that claim. As part of their job in protecting the health and safety of millions of Americans, local health departments support healthier community choices by helping smokers kick the nicotine habit with tobacco cessation programs, promoting smoke-free campuses and assuring compliance with existing laws. But continued marketing of e-cigarettes makes our jobs harder.

Can we say with certainty that without broader regulation we can continue to protect the public’s health and safety? Local health departments aren’t taking that chance, and neither should the FDA.

We need more Congressional support on both sides of the aisle to urge the FDA to move swiftly and broadly to finalize its ruling and expand its regulations. The road map already exists. It shouldn’t take another 50 years for us to do what we already know is right.

Terry Allan is president of the National Association of County and City Health Officials.

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