Teen vaping is a critical public health problem in America. It is worse in Colorado — and worse still in Mesa County, where a staggering 51% of Mesa County high schoolers have used vaping products, including 32% of students who currently vape (higher than the state average of 26%). Even more concerning, over half of Mesa County students who vape have tried to quit but were unsuccessful due to nicotine addiction. Fortunately, Colorado voters have an easy choice to curb the problem this November.

As a Children’s Hospital Colorado pulmonologist practicing in Grand Junction, I see kids every day who struggle with asthma and other respiratory disorders as a result of smoking, vaping and second-hand smoke exposure.

Currently, the deck is stacked heavily against Colorado teens. Unlike traditional cigarettes and recreational marijuana, electronic cigarettes and other vaping products — despite containing much higher levels of nicotine than traditional cigarettes — are not taxed due to a loophole in current state law. This creates an uneven playing field by making vape products much less expensive and therefore more appealing and accessible to youth.

Proposition EE, on the statewide ballot for approval this year, closes this loophole by creating a tax for vaping products, while also raising the currently low tobacco tax in Colorado to be more in line with other states. Studies have shown that teenagers are extremely price sensitive, meaning an increase in price results in a dramatic decrease in vape use and nicotine addiction. The revenue generated by Proposition EE will provide much-needed funding for K-12 education in a time of severe COVID-related budget cuts and will fund universal pre-kindergarten to keep the future of Colorado bright. Just as importantly, these revenues will support tobacco and nicotine cessation programs and research that will improve our understanding and treatment of addiction in teens.

Big Vape companies clearly target our youth in their marketing. According to the 2019 Healthy Kids Colorado survey, 73% of Colorado high school students have seen ads for vaping products in the last 30 days. Juul and other Big Vape corporations first got teens hooked on nicotine with flavored vape products such as bubble gum and cotton candy. Vape companies enable students to vape during the school day by disguising vaporizers as common items such as USB thumb drives, pens and even asthma inhalers.

The health consequences of this trend are devastating. First marketed as a “safe” alternative to traditional cigarettes, vaping unquestionably harms the lungs and the developing brain. Additionally, nicotine is particularly harmful for teenagers during a crucial time of brain development. A single Juul vape cartridge contains as much nicotine as an entire pack of 20 cigarettes. Teens who use nicotine have impaired cognitive function, shorter attention span, increased impulsivity, and increased depression and anxiety in adulthood. Vaping “primes the pump” for addiction and substance abuse; teens who become addicted to nicotine through vaping are much more likely to transition to conventional cigarettes and other recreational drugs. This dangerous combination of lung injury, altered brain development and addiction causes life-long health complications in teenagers.

The anti-EE campaign, funded almost exclusively by millions of dollars in contributions from North Carolina-based tobacco corporation Liggett Vector Brands, aims to confuse voters by hiding the fact that Proposition EE is a vape and tobacco tax — just look at the anti-EE billboards strewn across the Western Slope that entirely omit this fact. Opponents also claim that Proposition EE disproportionately affects low-income communities. Indeed, low-income communities do have higher rates of smoking and vaping, because the industry has aggressively targeted them for generations. Increasing the price of these products can break the cycle of addiction: studies have clearly shown that low-income individuals and teens are the most likely to quit smoking and vaping when prices go up. That’s why Proposition EE will actually improve tobacco- and nicotine-related socioeconomic disparities, both by reducing smoking and vaping rates, and by reinvesting the revenue from the taxes into these communities through early learning, K-12, and public health programs that help people quit.

As a children’s breathing specialist, a concerned citizen of Grand Junction, and the father of two young children, I stand proudly with more than 130 local and national organizations including Children’s Hospital Colorado, the American Heart Association, and the American Lung Association in enthusiastically supporting Proposition EE. I encourage you to vote “Yes” on Proposition EE to reduce teen nicotine addiction and to ensure a brighter, healthier future for Colorado.

Dr. Hughes is a pediatric pulmonologist and sleep medicine physician at Children’s Hospital Colorado and an Assistant Professor of Pediatrics at the University of Colorado. He lives and practices medicine in Grand Junction, Colorado.


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