Teen smoking e-cigarette
A teen secretly smoking an e-cigarette. Photo via Pixabay

An end to the sale of flavored tobacco in the city of San Diego is in reach, much to the relief of school districts, youth-serving organizations, health practitioners, and parents. 

The SAAFE Act, introduced by Councilmember Marni von Wilpert, will end the sale of youth-targeted flavored vapes, flavored cigarillos, and menthol cigarettes if adopted. Hookah, premium flavored cigars, flavored loose-leaf tobacco, and non-flavored tobacco products will remain on store shelves.

The San Diego City Council will take up the ordinance on Monday, April 25, and observers anticipate an active meeting. 

The local tobacco industry’s lobbying arm, the Neighborhood Market Association, has been vocal in opposition to the ordinance, as sweet, fruity and minty flavors work to hook the next generation of tobacco users. They have previously cited research from a San Francisco study, falsely indicating that removing flavored vapes from the retail setting pushes youth to use cigarettes instead. 

Jonathan Winickoff, director of pediatric research at Massachusetts General Hospital’s distinguished Tobacco Research & Treatment Center, reviewed the study and disagrees. He notes that the study was completed before enforcement of San Francisco’s flavored tobacco ban had taken full effect — only 17% of retailers were compliant at the time of the study –- thus invalidating the analysis.

Winickoff and his colleagues cite data from Oakland that found regular cigarette use decreased after flavored tobacco restrictions, and even more importantly, point to research demonstrating that total tobacco use by young people aged 18-24 decreased by nearly 18% after San Francisco’s flavored tobacco sales restrictions. 

Upon examining what is driving higher vaping rates among youth, ending the sale of flavored tobacco makes sense. Consider the following facts:  

  1. Flavors hook kids. Young people are naturally drawn to sweet, fruity, minty flavors, and when an addictive substance like nicotine is masked in passion fruit or sour apple, it’s easier for them to feel comfortable experimenting.
  2. The amount of nicotine in each flavored vaping device is the equivalent of one to 10 packs of cigarettes. It is a very concentrated amount of nicotine in each device, and some teens vape an entire e-cigarette each day, effectively consuming the same amount of nicotine in 20-200 cigarettes.
  3. The adolescent brain is more easily addicted than adult brains because it is still developing. 

These points underscore why surveys show four in 10 high school students in the San Diego Unified School District have vaped.

But when policymakers stand with educators and enact policies that protect the mental and physical health of students, our young people have a better chance of resisting the allure of flavored tobacco. The trustees of San Diego Unified, Sweetwater Union, and the San Diego County Board of Education have all passed resolutions in support of the SAAFE Act, asking San Diego and Chula Vista city council members to address the vaping epidemic sweeping school campuses by ending the sale of flavored tobacco products.  

These elected school board members understand a simple but powerful truth grounded in data from the 110 California municipalities with flavored tobacco bans on the books: removing points of access to tobacco reduces the rate of youth use.

True to form, the Neighborhood Market Association’s commentary makes a second misleading claim: when one city ended flavored tobacco sales, neighboring cities saw an increase in the sale of these products. 

Before restricting tobacco purchases to customers over age of 21 became federal law, many municipalities adopted this policy as a local ordinance. Winickoff studied the effects of increasing the tobacco age to 21 in these cities and compared them to cities without the increased age requirement.

As the “Tobacco 21” policy gained national momentum, Big Tobacco lobbyists presented the same argument that the Neighborhood Market Association is presenting now: People will travel to other cities for tobacco. The research shows this customer migration did not happen.

In fact, Winickoff and his colleagues found that the “Tobacco 21” policy resulted in a 47% reduction in high school tobacco use, with no indication that youth were traveling to other cities to purchase the products.  

Youth are not travelling across city lines to purchase flavored tobacco. While neighboring cities may see a slight uptick in sales, within the city limits of those municipalities where flavored tobacco products are banned, youth use drops. 

This reality validates the rationale of the SAAFE Act to keep the addictive poison of flavored tobacco products out of our kids’ lungs. 

“It’s not rocket science; restricting flavored tobacco sales is an effective strategy to prevent youth from initiating tobacco product use,” Winickoff said.

But expanding the policy lens beyond youth access shows why flavored tobacco bans protect adults, too. It’s a fact that e-cigarette use causes inflammation in multiple organ systems in the body. Use also increases anxiety, impairs learning and memory, and causes severe lung damage and death in some cases. 

The purpose of the SAAFE Act is to protect youth, communities of color, college students, LGBTQ+ community members — in a word, everyone who is targeted by Big Tobacco’s predatory marketing tactics.  

The San Diego City Council has an opportunity to protect our youth and communities from the toxic brew of flavored nicotine-delivery products.

Big Tobacco and the Neighborhood Market Association may say otherwise, but history has shown what’s true: public health improves when polices are adopted that reduce the harm caused by tobacco products.

Who wouldn’t stand with San Diegans to champion healthy, resilient communities? We’ll find out when our elected city council representatives cast their votes for or against the SAAFE Act.

Cynthia Knapp is the program manager for the San Diego Smoke-Free Project, a program of SAY San Diego. Jim Crittenden is coordinator of alcohol, tobacco, and other drug prevention for San Diego County Office of Education.