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Smoking cigarettes is silly, involving monetary and, extra importantly, important well being prices. Whereas there are a number of “drivers” to the smoking behavior, together with sociability and standing (particularly throughout these rebellious teen years), may we agree that nicotine is, by far and away, probably the most significant factor of chemical dependency?

An oz. of prevention

The overall perception is that prevention is extra profitable than subsequent therapy. The issue people who smoke have with quitting testifies to the reality of that concept. Public well being officers more and more have targeted on stopping the younger from starting to smoke, particularly by banning using flavors, a “gateway” to nicotine dependence. There’s a related push now on to ban menthol in cigarettes to nudge grownup people who smoke. 

In 2018, San Francisco voters authorised a ban on all flavored tobacco merchandise, combustibles, and vaping merchandise. A brand new examine in JAMA Pediatrics gives some preliminary outcomes. 

The graph is predicated upon the nationwide Youth Danger Conduct Surveillance System, a biennial survey of highschool college students and their dangerous habits. Roughly 10% of the 95,843 members with knowledge on their smoking habits got here from San Francisco. You may see that by 2017, tobacco use amongst SF’s teenagers declines on the identical charge as in different locales [1]. However that modified when SF started the ban on flavored tobacco merchandise. The speed of smoking, not vaping, elevated, rising to six.2% versus a 5.6% charge in these different cities. For individuals who like larger numbers, the SF ban on flavoring doubled the probability {that a} teen would smoke cigarettes.

Substitution

Plainly when taste is faraway from all tobacco merchandise (together with these for vaping) that vaping confers no explicit benefit, at the least within the malleable minds of teenagers. Within the phrases of the researchers, 

“This raises concerns that reducing access to flavored electronic nicotine delivery systems may motivate youths who would otherwise vape to substitute smoking. Indeed, analyses of how minimum legal sales ages for electronic nicotine delivery systems are associated with youth smoking also suggest such substitution.”

This admittedly early report of outcomes does increase considerations, and it could be useful to search out if this bump-up in smoking use is transient “noise” or will turn into a gentle “signal.” 

[1] Broward, Palm Seashore and Orange Counties, Florida; Los Angeles and San Diego, California; New York Metropolis, and Philadelphia. 

Supply: A Distinction-in-Variations Evaluation of Youth Smoking and a Ban on Gross sales of Flavored Tobacco Merchandise in San Francisco, California JAMA Pediatrics DOI: 10.1001/jamapediatrics.2021.0922

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By Chuck Dinerstein, MD, MBA

Director of Medication

Dr. Charles Dinerstein, M.D., MBA, FACS is Director of Medication on the American Council on Science and Well being. He has over 25 years of expertise as a vascular surgeon.


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