1. ELECTRONIC GIGARETTES AND UTAH’S KIDS Prepared for public distribution by Practical Strategic Solutions - Utah

2. What Are Electronic Cigarettes?

3. Electronic cigarettes, also known as e-cigarettes, are battery-operated products designed to deliver nicotine, flavor and other chemicals. They turn chemicals, including highly addictive nicotine, into an aerosol that is inhaled by the user. Most e-cigarettes are manufactured to look like conventional cigarettes, cigars, or pipes. Some resemble everyday items such as pens and USB memory sticks.

4. What Are Electronic Cigarettes? One e-cigarette cartridge can contain as much as 120 mg of nicotine which is equivalent to the amount of nicotine in 100 cigarettes

5. What Are Electronic Cigarettes? The liquid used in e-cigarettes is a mixture of nicotine, flavors, and propylene glycol, glycerin or both. Bottles of e-cigarette liquid range in size from 3 - 50 ml. A 50 ml bottle of liquid could contain as much as 1,200 mg of nicotine, which is equal to the nicotine in 50 packs or 5 cartons of cigarettes. Flavors include gummy bears, fruit punch, peach, licorice, chocolate, mint, etc.

6. What Are Electronic Cigarettes? The only independent research on e-cigarettes available has been done by the FDA and was released on July 22, 2009. The FDA’s findings include the following: Nicotine in e-cigarette liquid is derived from tobacco. Tobacco-specific impurities suspected of being harmful to humans including anabasine, myosmine, and β-nicotyrine, were detected in a majority of the samples. Detectable levels of known carcinogens (nitrosamines, which are chemicals that cause cancer) were also found.

7. What Are Electronic Cigarettes? The on Myth: E-cigs produce only water vapor. Fact: An electronic cigarette fluid cartridge contains a cocktail of different chemicals. Exhaled vapor from e-cigarettes contains dangerous levels of these chemicals including highly addictive nicotine. Myth: E-cigs are a safe alternative product to use for those trying to quit smoking. Fact: There are no studies based in good science indicating e-cigarettes are an effective cessation tool. A vast majority of electronic cigarettes users still smoke cigarettes or use smokeless tobacco. Myth: There are regulations for what is put into e-cigs. Fact: The Food and Drug Administration (FDA) has not yet imposed e-cigarette regulations. E-cigs are not tested and there are no rules concerning what can be put in the products. Myth: E-cig labels are honest. Fact: Since there are no regulations about what can be put into an e-cigarette, labels can be deceptive. Nicotine levels have been found to be much higher or lower than the labels claim. Most bottles labeled as containing no nicotine do contain nicotine. ELECTRONIC CIGARETTE MYTHS

8. What Are Electronic Cigarettes? Law enforcement agencies increasingly report that e-cigarettes are being used to smoke cannabis in odor free liquid or wax forms.

9. What Are Electronic Cigarettes National sales are increasingly rapidly: $1B in 2013; $2.5 B in 2014; expected to reach $3.5B in 2015. Around 4.8% of Utah adults report that they currently use e-cigarettes. Among young adults in Utah (19-24 year olds), 25% reported that they had tried e-cigarettes and 9% reported that they were current users.

10. Electronic Cigarettes and Utah’s Kids

11. Electronic cigarette use among youth is growing exponentially in Utah

12. Electronic Cigarettes and Utah’s Kids PERCENTAGE OF STUDENTS GRADES 8, 10, AND 12 REPORTING CURRENT E-CIGARETTE USE, BY LOCAL HEALTH DISTRICT 2013 Vs 2015 Health District2013 2015 Bear River5.2% 7.4% Central1.8% 10.0% Davis8.9% 8.4% Salt Lake County5.3% 12.3% Southeastern3.1% 12.9% Southwest3.0% 11.2% Summit4.2% 9.3% Tooele5.9% 13.4% Tri-County4.2% 14.5% Utah County1.8% 7.6% Wasatch4.5% 7.5% Weber-Morgan19.9% 15.0% UTAH5.8% 10.2%

13. Electronic Cigarettes and Utah’s Kids HOW DO UNDERAGE YOUTH ACQUIRE E-CIGARETTES (In Order of Frequency) Purchase from friends or family members Purchase over the internet Direct purchase – e-cigarette shops, gas stations, mall kiosks Bum from friends Steal Parents

14. Electronic Cigarettes and Utah’s Kids E-Cigarettes Pose Great Danger to Small Children E-Cigarette solution (E-juice) is most often manufactured in bright colors and sweet flavors attractive to children. Most bottles of e-cigarette solution are not sealed nor do they have child proof caps. E-cigarettes do not have an on / off switch. If, mimicking an adult e-cigarette user, a child puffs on an e-cigarette, it will deliver a high level of nicotine to their system. E-juice is highly concentrated and can contain 500 to over 1,000 mg of nicotine in one 30 ml (about 1 oz.) bottle. A single milligram of nicotine is enough to cause mild nicotine poisoning in a small child, and 10 milligrams can lead to serious toxicity and even death in kids. E-cigarette poisoning calls in Utah for children 6 years old or younger increased from 16 in 2012 to 131 in 2014 and are on pace to be even higher in 2015.

15. Electronic Cigarettes and Utah’s Kids E-Cigarette Use Poses Great Danger to Adolescent Youth Nicotine exposure at a young age disrupts normal brain development and leads to permanent changes in the functioning of the prefrontal cortex, the area of the brain responsible for long-term planning, decision-making, attention and cognitive control. E-cigarette use can lead to regular nicotine use or use of other tobacco products. E-cigarette use glamorizes tobacco use, including exposing children to images of tobacco use. E-cigarette use exposes youth involuntarily to aerosolized nicotine or other psychoactive substances. E-cigarette use can result in poisonings through ingestion, inhalation, or absorption of nicotine liquid on the skin.

16. Utah Law and Electronic Cigarettes

17. Statutory AuthorityYes/NoCode Section if Yes E-cig use prohibited in indoor public places and cars Yes26-38-1 to 9 Schools prohibit e-cigarettes or paraphernalia on campus Yes53A-11-908 (2)(b)(ii) Providing e-cig to minorsYes76-10-104 E-cig purchase by minorsYes76-10-105 E-cigarette defined as a tobacco product No- Taxation of e-cigarettes like a tobacco product No- Ban internet sales of e-cigarettes No- Advertising regulations for e- cigs or paraphernalia No- Licensing of manufacture of e-cigarettes or e-juice No-

18. Utah Law and Electronic Cigarettes Goals of E-Cigarette Legislation for the 2016 Legislative Session Tax electronic cigarettes at minimum at the same level of Utah tax for tobacco products other than cigarettes (86% of Manufacturer’s Price). Extend internet sales prohibition to electronic cigarettes. Broaden municipal and county retail tobacco store licensing statutes to include all electronic cigarette related products and paraphernalia and standardize definitions across relevant code sections. Extend licensing and enforcement authority to the state and local health departments for the manufacturing of electronic cigarettes, electronic cigarette cartridges and electronic cigarette liquid, including the authority for application of civil penalties and fines for the violation of manufacturing requirements. Extend advertising restrictions for cigarettes and tobacco to electronic cigarettes, electronic cigarette cartridges and liquids and electronic cigarette paraphernalia. Prohibit the provision of electronic cigarette paraphernalia to minors.

19. Electronic Cigarettes and Utah’s Kids QUESTIONS

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