Resources to Combat Vaping

By: Chantel Hartman, Cessations Systems Coordinator at the Oklahoma State Department of Health

NOTE: Oklahoma acknowledges the traditional and sacred use of tobacco among American Indian people living in Oklahoma. Any reference to tobacco in this article refers to the use of commercial tobacco unless otherwise stated.

The addition of flavors and sweeteners to tobacco products provides a deceiving disguise to the bitterness of nicotine and the harshness of tobacco. The overall use of tobacco products can be attributed to the addictiveness of nicotine, attractive marketing such as packaging and promotions at the point of sale, and the popularity of various flavors. These tactics have been used by tobacco companies for decades to promote tobacco use, and are now being used by vaping companies as well. According to the Campaign for Tobacco-Free Kids, flavored e-cigarettes and vapor products were once sold in over 15,000 flavors and served as a catalyst to the youth vaping epidemic. More specifically, national surveys have found that young e-cigarette users credit flavors as a leading reason for their experimentation with e-cigarettes.

As healthcare providers who maintain lifelong relationships with patients from all backgrounds, it is imperative that dentists communicate the potential harm of flavored tobacco products, including e-cigarettes and vapor products, to their patients. More importantly, dentists can also offer insight into less commonly discussed risks associated with tobacco and vapor product use, such as nicotine poisoning. For example, the physical similarity of flavored liquid nicotine and its packaging to the flavors and packaging of frequently consumed household products may lead to young children mistakenly ingesting these highly toxic products. The

availability and use of flavored tobacco products in close proximity to young children also reduces harm perception related to their use.

The 2009 Family Smoking and Tobacco Prevention Act banned the sale of cigarettes with flavors such as strawberry, grape, orange, cinnamon, pineapple, vanilla, chocolate and cherry. Unfortunately, the Act did not prohibit the sale of menthol tobacco products or the use of flavors in smokeless tobacco, cigars, hookahs, or e-cigarettes. To reduce the appeal and availability of flavored vapor products, the Food and Drug Administration recently banned many flavors for cartridge or pre-filled pods. The following are a few examples of how you can educate your patients and staff on the dangers of flavored tobacco products and the importance of remaining tobacco- and vape-free: • Adopt a tobacco-free/vape-free policy. • Update patient intake forms to ask about tobacco and vaping use in plain language. • Utilize the “5 A’s” (Ask, Advise, Assess,

Assist, and Arrange) along with motivational interviewing techniques for teens and their parents. • Refer patients directly to the Oklahoma

Tobacco Helpline for free counseling and nicotine replacement therapy. Patients interested in quitting can explore options by calling 1-800-QUIT NOW (1-800- 784-8669) or visiting OKhelpline.com. • Post Oklahoma Tobacco Helpline promotional materials in your waiting room. You can order or download free promotional materials, including pens and posters, by visiting OKhelpline.com. • The entire dental team is confident in communicating the dangers of tobacco use, including the use of e-cigarettes and vapor products, and that no tobacco does not mean no nicotine. • Refer younger patients (13-17 years old) to the My Life, My Quit youth cessation program for free live text support, web chat, and phone coaching. To sign up, teens can text "Start My Quit" to 855- 891-9989 or visit MyLifeMyQuit.com. • Remind patients with small children in the home to never refer to medicine as "candy" or another appealing name. • Remind patients who use tobacco products, including e-cigarettes and vapor products, and have small children in the home to only buy liquid nicotine refills that are in child-resistant packaging and to keep tobacco products/ accessories out of children's reach. • Remind patients to save or post the

Poison Control number (1-800-222- 1222) on or near every home telephone and cell phone to ensure 24-hour-a-day, 7-day- a-week access in the event of possible nicotine poisoning. For more information about the appeal of flavors in tobacco products and how to reduce existing tobacco use through systemslevel and social norm change, please contact the OSDH’s Center for Chronic Disease Prevention and Health Promotion at OSDH. TobaccoPrevention@health.ok.gov. The Center also provides assistance and consultation regarding wellness to any Oklahoma business, organization, association, or coalition. We can provide the following services: • Sample policies related to physical activity, nutrition, and tobacco and health screening; • Resources on how to begin or enhance a wellness program, including the adoption of policies related to physical activity, nutrition, and tobacco; • Content expertise and information regarding best practices; • Information and technical assistance – trends, data, and best practices; • Training, materials, and tool kits; • Data related to chronic conditions, physical activity, nutrition, and tobacco; and • Best practices being implemented and/or suggested by the State of Oklahoma.

Center for Disease Control and Prevention- Dental Professionals: Help Your Patients Quit https://www.cdc.gov/oralhealth/publications/features/dental-pros-help-your-patients-quit-tobacco.html

Counter Tools- Flavored Tobacco Products https://countertobacco.org/resources-tools/evidence-summaries/flavored-tobacco-products/

Public Health Law Center- Flavored Products https://www.publichealthlawcenter.org/topics/commercial-tobacco-control/sales-restrictions/flavored-products

ABOUT THE AUTHOR:

Chantel Hartman currently serves as Cessations Systems Coordinator at the Oklahoma State Department of Health. Her duties include the management and oversight of collaborative, population-based cessation assessments and assistance programs for adults and youth in Oklahoma. Hartman received her Master of Public Administration degree with a concentration in Public Health Administration from Troy University and a Bachelor of Science in Biology from Auburn University Montgomery. In addition to completing the Centers for Disease Control and Prevention's Office on Smoking and Health Leadership and Sustainability School, Hartman is a Millennial Policy Initiative Commission on Healthcare Senior Fellow and abstract reviewer for the Alcohol, Tobacco and Other Drugs section of the American Public Health Association.

70% of Adult Smokers Want to Quit.

Show Them Where to Start

Encourage your patients to quit with help from the Oklahoma Tobacco Helpline.

- Each registrant gets at least a two-week supply of FREE NRT, 24/7 web or phone support, access to a Quit Coach and more. - Let your patients know medications combined with counseling doubles their chances of success.

- SoonerCare members qualify for additional medications when prescribed by their doctor. My Life, My Quit: Special Services for Teens Now, 13-17-year-olds can receive free live text, phone or web chat. To start, visit MyLifeMyQuit.com or text “Start My Quit” to 855-891-9989. Ask your patients about tobacco use and refer them to the Oklahoma Tobacco Helpline. For free promotional materials and information, visit OKhelpline.com.