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NACCHO Tells Congress to Address Youth Vaping


September 26, 2019

Washington, D.C., September 25, 2019 — Today, the National Association of County and City Health Officials, the voice of America’s nearly 3,000 local health departments, sent a letter to Congress to help inform their oversight hearings on youth use of e-cigarettes. On Tuesday, the House Oversight and Reform Subcommittee on Economic and Consumer Policy held a hearing entitled, “Don’t Vape: Examining the Outbreak of Lung Disease and CDC’s Urgent Warning Not to Use E-Cigarettes,” and on Wednesday, the House Energy and Commerce Subcommittee on Oversight and Investigations will hold a hearing entitled “Sounding the Alarm: The Public Health Threats of E-Cigarettes.”

NACCHO represents our nation’s county, city, metropolitan, district, and tribal health departments that are on the front lines of addressing tobacco use—including vaping and e-cigarettes—each day. Any tobacco product use, including e-cigarettes and other nicotine products, is unsafe, especially for youth. However, youth trends in tobacco use are going in the wrong direction. The Centers for Disease Control and Prevention has reported that in 2018, more than 1 in 4 (27%) high school students and more than 1 in 20 (7.2%) middle school students reported using an e-cigarette in the last 30 days. Even more concerning, among current tobacco product users, about 2 in 5 (1.68 million) high school students and 1 in 3 (270,000) middle school students used two or more tobacco products in 2018. E-cigarettes were the most commonly reported product used in combination with other tobacco products among both middle and high school students. While we are seeing trends of e-cigarette use skyrocketing among youth, the Journal of the American Medical Association reported e-cigarette use in adults — the intended users of the products — has remained stable and even showed signs of decline in use.

Local health departments are key partners with the healthcare system and non-governmental organizations to protect the health and well-being of their communities and are instrumental in ensuring public awareness about the dangers of tobacco use, including e-cigarettes, particularly among youth. For example, NACCHO’s recently released report, Tobacco Control Efforts in Rural America: Perspectives from Local Health Departments, found that nearly all respondents (90%) reported engaging in tobacco and cessation activities and initiatives in the community, including education, referrals to Quitlines, social marketing campaigns, and cessation support groups. This same study highlighted the particular challenge of e-cigarette use to their regions, with 93% of respondents noting that e-cigarettes were a threat in their communities. These numbers reinforce what we are hearing from health departments of all sizes across the country: youth e-cigarette use is a big problem, and it is getting bigger. Local health departments are tackling this issue through both programmatic and policy channels by raising awareness and disseminating educational materials, providing support to parents and schools, ensuring local policies support tobacco-free kids, and continuing to promote evidence-based approaches to combat use among youth.

While addressing the increases in youth e-cigarette use, public health departments are also currently working to address an outbreak of lung illnesses related to vaping, which has hospitalized 530 people and caused at least 9 deaths. While the causes of these illnesses are still under investigation, local health departments are working with their state and federal counterparts to raise awareness of the potential dangers of e-cigarette use, educate local healthcare providers about the warning signs, and track down evidence to help identify the root cause(s) of the outbreak. While these illnesses are not exclusive to the youth population, it is important to note that more than half of those cases identified have been in people under the age of 25, with 16% of cases being found in minors under the age of 18.

The alarming rise in e-cigarette use among youth calls for immediate federal action. Reports show that flavorings in e-cigarettes are a main contributor to the rise and appeal of youth vaping. That is one reason why NACCHO supports the FDA’s plan to ban flavored e-cigarettes, and why we urge the Agency to formalize the policy as soon as possible. Moreover, more education is needed at the local level to inform parents and children about the dangers of nicotine on the developing brain and damage caused to the lungs by inhalation of dangerous, highly addictive substances. We also need to ensure that there are programs and services available to help youth who are addicted to these products to quit—something that is receiving far too little public attention. And we call on Congress to do all it can to reduce the availability, appeal, and use of e-cigarettes among youth to protect them from the dangers of nicotine and vaping by supporting efforts to remove enticing flavored e-cigarettes from the marketplace immediately.

Please click here to see the complete letter and citations.


The National Association of County and City Health Officials (NACCHO) represents the nation’s nearly 3,000 local governmental health departments. These city, county, metropolitan, district, and tribal departments work every day to protect and promote health and well-being for all people in their communities. For more information about NACCHO, please visit


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