Board of Health hears health concerns about use and access to tobacco and e-cigarettes

November 13, 2014

Multnomah County has one of the highest rates of illegal cigarette sales to minors in the country, health officials said Thursday, Nov. 13. And an increasing number of people under 18 report buying and using electronic cigarettes -- which are unregulated.

Dr. Jennifer Vines, Deputy Health Officer, delivered the news to the Multnomah County Board of Health at an hour-long briefing. The County Commissioners convened as the Board of Health for the presentation.

A 2012 federal Synar survey found that one in four retailers in the county illegally sold tobacco to minors. Dr. Vines said there are many reasons youth are drawn to tobacco and nicotine, including the celebrities they see smoking and the influence of their peers.

In addition, the number of tobacco and nicotine products being marketed has increased dramatically and she said that young people are particularly vulnerable to the candy-flavored onslaught. Cigarillos, chewing tobacco and electronic cigarettes are all marketed with flavors.

The Health Department reported that a 2012 survey of 1,700 youths in 17 Multnomah County high schools found that one in 15 teens reported they are daily users of cigarettes, and one in 25 use e-cigarettes.

E-cigarettes are nicotine delivery devices that heat up a liquid mix of nicotine, flavorings and other chemicals to create a vapor to inhale. Dr. Vines showed how users load the devices with flavored “e-juice’’ including Irish Creme, Gummy Bear, Captain Crunch.She showed area markets with shelves of the products, the current estimate is that there are 8,000 flavors of e-juice.

"Right now this is completely legal,'' Dr. Vines said. "All of these products are completely legal for anyone of any age.”

Calls to Poison Control centers nationally have increased around e-juice, rising from a month in September 2010 to February 2015. Young bodies and brains are particularly vulnerable to the effects of smoking and nicotine, she said.

“We’re seeing nicotine itself being distilled down and marketed to our youth,’’ she said. “It is a very seductive drug,  it is the primary addictive substance in all tobacco.’’

“When we talk about young people, we’re really talking about the brain, the young person’s brain is immature and particularly susceptible to the addictive effects of nicotine,” Dr. Vines said. Nicotine can saturate the brain’s receptors in a youth after just three puffs. The 2014 Surgeon General's report found that nicotine use can have an adverse affect on youth brain development.

A state survey found that use among Oregon 11th graders, tobacco use has dropped from 11.5 percent to 9.4 percent, but at the same time, e-cigarette use has risen, both in Oregon and nationally.

Yet the health impacts of flavored tobacco or flavored e-cigarette juice, are not well understood, said Dr. James Pankow, a professor of Chemistry and Civil and Environmental Engineering at Portland State University.

Scientists have studied how chemicals such as benzaldehyde are found to be safe to flavor Kool-Aid and candy a cherry flavor, for instance, but not their safety when they are heated and inhaled. The levels of these flavor  chemicals are quite high, even those that are known respiratory irritants.

Commissioners thanked the presenters, and Chair Deborah Kafoury directed the Health Department to return Nov. 25 to discuss the issue further. As a mother, she said she was particularly disturbed. “I sure didn’t know that a 14 year old could go an e-cig and smoke it.”