Showing posts with label tobacco retailers. Show all posts
Showing posts with label tobacco retailers. Show all posts

Thursday, January 23, 2020

Where Did Underage Vapers Get E-Cigarettes in 2019, and Why Did They Use Them?


The 2019 National Youth Tobacco Survey (link here) offers a wealth of critical data. In last week’s blog entry I noted that underage vaping increased over the prior year, as the number of frequent “virgin” vapers (those who never used other tobacco products and used e-cigarettes 20-30 days in the past month) rose from 95,000 to 172,000.  This negative news was accompanied by a dramatic decline in the use of cigarettes (2.6% to 0.8%) from 2018 to 2019, indicating that the eradication of teen smoking is within reach.

Recently, Congress enacted Tobacco 21 legislation, which the FDA implemented in December.  The agency also announced a partial ban on e-cigarette flavors. 

The 2019 NYTS survey collected information from high school vapers that is relevant to these policies.  It asked, (1) “where did you get or buy the e-cigarettes that you have used” (during the past 30 days); and (2) “what are the reasons you have used e-cigarettes?”  The results for underage current vapers are shown in the accompanying tables.  The percentages don’t add to 100, because participants could select more than one response for each question.  So the numbers indicate the relative importance of the various sources (i.e. friends versus a grocery store).


Table 1. Where Did Underage Vapers Get or Buy Their E-Cigarettes?
People
Friend62%
Other person14%
Family member10%
Places
Gas station/Conv store17%
Vape shop13%
Internet7%
Other place6%
Drug store2.9%
Mall2.8%
Grocery store2.4%

Clearly, most underage teens get their vape products from friends (62%), family members (14%) and/or “others” (10%).  I endorsed Tobacco 21 a year ago principally because it will diminish the black market supply by eliminating legal (age 18+) tobacco purchasers in the nation’s high schools.

Retailers supply significantly less vape products to underage teens.  Gas stations and convenience stores are the most popular in this category, with vape shops a strong second.  The internet was cited as a source by only 6% of underage vapers, while other brick-and-mortar stores were chosen less frequently.


Table 2. Reasons Underage Vapers Used E-Cigarettes
Curious about them50%
Use them to do tricks24%
Available in flavors23%
Friend/family member used them21%
Use them unnoticed at home/school18%
Other reason18%
Less harmful than other tobacco17%
Peer pressured into use8.9%
Try to quit other tobacco7.4%
Easier to get than other tobacco6.3%
Cost less than other tobacco5.5%
People on TV/online/movies use them4.1%

Unsurprisingly, underage teen vapers were mainly motivated by curiosity (50%).  That may be a response to the FDA’s poorly crafted vaping epidemic ad campaign, which was translated recently by Clive Bates: “Hey, time to get with the program. All kids, especially cooler kids are doing it...Everyone else is at it, except you...” 

Flavors (23%), with which the FDA is obsessed, placed in the second tier of reasons, along with tricks (24%). Friends and family, it turns out, are not just important suppliers, but significant influencers (21%), especially when combined with peer pressure (8.9%).  Friends and family are, in fact, dominant factors for all risky behaviors, but unlike retailers, they cannot be controlled by government regulation.

Clive Bates interpreted another portion of the FDA campaign as “… you can keep it hidden from mom,” and sure enough, the NYTS shows their use of vape products goes unnoticed (18%).  Additionally, despite a barrage of misinformation about exaggerated and fake e-cigarette illnesses, some underage vapers act on scientific reality, saying they use e-cigarettes because they are less harmful than other tobacco products (17%).

Wednesday, March 27, 2019

Tobacco Sales to Kids Is a Problem For States, Not Retailers


FDA Commissioner Scott Gottlieb recently threatened that “some flavored e-cigarette products will no longer be sold at all…other flavored e-cigarette products that continue to be sold will be sold only in a manner that prevents youth access…” (here)

Dr. Gottlieb blames the so-called youth vaping “epidemic” on illegal retail sales and “kid-friendly marketing.” (here)  Focusing so heavily on retailers, he ignores the fact that underage sales rates are extremely low in many states – Georgia (2.2%), Montana (2.7%), Hawaii (3.0%) and California (4.2%) for example, according to 2018 FDA inspection data – while violation rates in others is extremely high -- North Dakota, Michigan, Ohio and Nevada are close to 23% (here).

In order to explore the connection between retailers’ violations and state enforcement efforts, I downloaded FDA information on 26,000 inspections conducted in 2018 at national retail chain stores – Walgreens, Walmart, Rite Aid, Shell, Family Dollar, Dollar General, Circle K and 7-Eleven.  I calculated the rate of violations for these chains stores in each state (excluding Nevada and North Dakota, with very low numbers of inspections).   

The chart shows the combined results for these retailers.  Note that the x axis is the state rate, based on 146,000 inspections, and the y axis is the retailers’ rate, based on 26,000 inspections.  There is a strong correlation between violations in these chain stores and the state in which they were located (correlation coefficient, CC = +0.77).  The correlation is also seen with individual companies.  For example, Walgreens’ violation rate was 2.2% in Georgia (based on 46 inspections) and 17% in Ohio (with 229 inspections). 

Note that nearly all of the retailers’ rates are below the green diagonal line, showing that they were lower than the state rates in all jurisdictions except DC, Connecticut, Oregon, Minnesota, Alaska and Hawaii.

The FDA blames retailers for selling tobacco products to children, but it ignores the significant differences in violation rates among states.  Youths in Georgia, Montana, Hawaii and California can seldom buy tobacco products, suggesting that those states’ enforcement efforts are far more effective than the other 46 states. The simplest route to obtaining age restriction compliance seems to be FDA pressure for stronger state enforcement, rather than agency action against retailers or product categories.