Dr. Bethea: Restrict Access to E-Cigs on School Property

TMA Testimony by Louise Bethea, MD

Senate Committee on Education
Committee Substitute to Senate Bill 96 by Sen. Juan “Chuy” Hinojosa

March 12, 2015

Good day, Chair Taylor and members of the committee. I want to thank you for the opportunity to testify today on behalf of the Texas Medical Association, the Texas Pediatric Society, and the Texas Allergy, Asthma and Immunology Society. We are in support of the committee substitute to Senate Bill 96 by Sen. Juan “Chuy” Hinojosa. I’m Dr. Louise Bethea, a board-certified allergist and immunologist.  

Texas physicians support CSSB 96 because it addresses one of medicine’s legislative priorities to restrict access of minors to electronic cigarettes (e-cigarettes). Texas is one of only 10 states that has not restricted the sale of e-cigarettes to minors. We believe prohibiting the use and possession of vapor products, also called” e-cigarettes,” on school property will help reduce access to these products among Texas youth.

While scientific research continues to broaden our understanding of potential health risks associated with e-cigarettes, several studies have identified some of the major components of e-cigarettes. These include nicotine, an addictive substance; propylene glycol; glycerin; and most recently, formaldehyde, a known carcinogen. There is no water in e-cigarettes. Due to the unregulated nature of these products and poor quality control, physicians and public health experts are concerned about the lack of information on the precise amount and type of compounds in the many different brands of e-cigarettes, and the potential short- and long-term health effects of the compounds produced by heating in these devices.  

The marketing of these products to young people worries physicians. We join others in expressing concern that young people using these products also will use other tobacco products. The Centers for Disease Control and Prevention has reported that e-cigarette use among U.S. students in grades 6-12 doubled from 2011 to 2012. And while cigarettes, little cigars, and spitting tobacco are the tobacco products most likely to be used by high school students, in 2013, almost 5 percent of high school students reported using e-cigarettes.  This is why the American Academy of Pediatrics, along with other health organizations, has called for prompt response from the U.S. Food and Drug Administration (FDA) on regulating e-cigarettes. Public health officials also have expressed concern that wider e-cigarette use will “normalize” this behavior and lead to greater tobacco use. 

The World Health Organization, American Cancer Society, Campaign for Tobacco Free Kids, American Lung Association, and American Heart Association urge caution in recognizing e-cigarettes as a tobacco-cessation or harm-reduction strategy for current tobacco users because of the lack of scientific evidence on the safety of these products. Also, FDA has not approved e-cigarettes as either a cessation or a replacement product for cigarettes. While regulations are expected from FDA on e-cigarettes in the future, the market for and use of e-cigarettes are growing rapidly. We must take steps today to curtail access to these products for minors. 

As you review CSSB 96 and other health-related proposals for schools, we offer our assistance in your work and will continue to encourage you to support a healthy school environment where children can learn and maintain their health. We must continue to respond to new public health threats to the health of our children, and we believe CSSB 96 is a responsible step to take in this direction. 

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June 17, 2016

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