Advancing Tobacco Control Practices To Prevent Initiation of Tobacco Use Among Youth and Young Adults, Eliminate Exposure to Secondhand Smoke, and Identify and Eliminate Tobacco- Related Disparities: Request for Information.

February 11, 2019, National Center for Health Research

The National Center for Health Research (NCHR) is a non-profit organization which conducts
and analyzes research, policies, and programs on a range of issues, related to health and
safety. NCHR accepts no funding from companies that make products that are the subject of
our work.

Many local communities and school districts have developed effective strategies to
discourage tobacco use among youth and students. However, they have found that vaping
has more than made up for the reduction in smoking. It is absolutely essential that CDC
examine the link between smoking and vaping and target efforts to reduce both.

One anti-vaping effort in Fairfax, VA was described by a high school substance abuse
counselor who told a Capitol Hill audience assembled by U.S. Senator Richard Durbin (D-IL)
that vaping had tripled and was now more popular and a bigger problem than alcohol or
drugs in his school.1 The counselor’s office had developed a strategy to monitor the use of
vaping and e-cigarettes, which he noted was more difficult to detect than combustible
cigarettes, because they do not leave visible smoke trails like cigarettes.

However, the counselor noted more needed to be done, because as the use of e-cigarettes
and vaping has exploded in high schools and middle schools. CDC can and should do more
educational outreach in local schools and communities, to reduce the vaping epidemic and
prevent it from starting in areas where it has not taken hold.

It’s critical for tobacco prevention and vaping prevention strategies to be widely
disseminated on the Internet, as that is the communications vehicle of choice among much of
the middle school and teenage populations. Various social media such as Facebook, YouTube,
and Instagram are where much of the promotional activities by e-cigarette and vaping
manufacturers appears. It’s also on these same sites where young people exchange
information about Juul and other increasingly popular vaping and e-cigarette products.

CDC should greatly enhance its efforts to reach potential young smokers through these social
media sites with targeted warnings about the dangers of these tobacco and vaping products.
Many young people do not believe that vaping or the use of e-cigarettes pose a threat to
their health, nor are they aware that these products can result in an addiction to nicotine that
results in cigarette smoking.

Given that trend, CDC must work more closely with FDA to prevent the spreading use of these
products among young people and teenagers.

Despite industry claims, there is little evidence that the use of e-cigarettes is effective at
reducing smoking or helping people to quit. Many users of e-cigarettes continue to smoke
combustible cigarettes, or start smoking cigarettes after first using vaping or e-cigarette

One important part of CDC’s ongoing tobacco strategy should be to enhance the important
work of the agency’s Office of Smoking and Health (OSH), whose research has been
invaluable in examining all facets of smoking and its dire health consequences.

FDA discovered during its landmark investigation of the tobacco industry in the mid-1990’s
that the tobacco industry had spent many millions of dollars quietly sponsoring biased
research in an effort to downplay the very real health threats of secondhand smoke. Our
analysis of recent research on vaping indicates that industry-funded research continues to be
biased. That makes it more essential that the budget for OSH be increased substantially.

While CDC’s own studies have shown that secondhand smoke has declined significantly
during the past 30 years, one in four adults is still exposed to secondhand smoke, including 58
million Americans in 2013-2014. Secondhand smoke can cause sudden infant death
syndrome, respiratory infections, ear infections, and asthma attacks in adults and children, as
well as coronary heart disease, stroke, and lung cancer in adult nonsmokers.2

It is imperative that CDC encourages and helps to initiate measures to implement smoke-free
laws in workplaces and public places; adoption of smoke-free home and vehicle rules; and
continues to disseminate educational warnings about the long-hidden risks for secondhand
smoke exposure, especially among more vulnerable populations.


Please contact Jack Mitchell with any questions at



  1. E-Cigarette Presentation by the American Association for Cancer Research, Russell Senate Office Building, July 18.
  2. Exposure to Seondhand Smoke Among Nonsmokers—United States, 1988-2014, Centers for Disease Control and
    Prevention.; December 7 , 2018