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New Data Link Policies that Restrict Tobacco Sales to Lower Rates of Youth Tobacco Use in Providence

Fewer teenagers report using e-cigarettes and flavored tobacco products in Providence than in other cities following Providence's 2013 implementation of strict policies that restrict tobacco sales, according to new data released today by the Rhode Island Department of Health (RIDOH).

Since July 2013 local tobacco retail licenses have been required in Providence, and the city has restricted the sale of flavored tobacco in retail convenience stores such as gas stations, food markets, and pharmacies. Flavored tobacco products are often available in kid-friendly flavors such as strawberry, grape, bubble gum, and cotton candy. The city also banned tobacco discounting and coupons. Survey data collected in 2016 revealed that:

--3.2% of teenagers in Providence reported using flavored tobacco products within the past 30 days (i.e. current use), while 3.9% reported current use of e-cigarettes or electronic nicotine delivery devices (ENDS) --In neighboring Cranston, 7.6% of teens reported current use of flavored tobacco products, while 7.7% reported use of e-cigarettes or ENDS products. --In Woonsocket, flavored tobacco products were reportedly used by 12.7% of teenagers, while e-cigarettes or ENDS products were used by 14.4% of teenagers.

This is the first time that city-level tobacco use data are being compared in Rhode Island.

"Providence's policies that restrict tobacco sales were very likely a significant factor in the city's lower rate of tobacco use among teenagers," said Director of Health Nicole Alexander-Scott, MD, MPH. "By standing up to the big tobacco companies that continue to target youth and lower income communities with their dangerous, highly addictive products, Providence is establishing a model that can be replicated in every other city and town in the state. Every single young person in Rhode Island absolutely deserves an equal opportunity to breathe free and thrive."

"On behalf of the City of Providence, we're pleased to see the impact of our tobacco control efforts, including restrictions on the sale of flavored tobacco," said Ellen Cynar, Director of the Providence Healthy Communities Office. "The future of Providence is dependent upon the health of our youth. The more we can reduce Providence youth initiation of tobacco and nicotine products early on, the less likely they are to be addicted down the road."

As one of 10 Health Equity Zones (HEZs) in Rhode Island, Providence has focused on reducing its youth smoking rate. Bristol, another HEZ, recently prohibited smoking and the use of other tobacco products, including e-cigarettes, on town property. In each HEZ a wide range of organizations and individuals are working together on various projects that are narrowing health disparities by supporting healthy choices and safe living. In addition to tobacco cessation, other HEZs are focusing on preventing chronic diseases, improving birth outcomes, and improving the social and environmental conditions of neighborhoods.

Like other tobacco products, most e-cigarettes contain nicotine. Nicotine use by children and teenagers is particularly harmful because it can damage the developing brain and result in life long addiction. Tobacco use remains the leading cause of preventable death, killing 480,000 people in the United States and 1,800 Rhode Islanders each year. Most adult smokers get addicted to deadly tobacco use during adolescence.

Nationally, 24% of high school students report current use of e-cigarettes. Of U.S. middle school and high school tobacco users, 70% had used at least one flavored product in the past 30 days.

While teenage use of some tobacco products, such as cigarettes and cigars, continues to decline, more young people are turning to other highly addictive tobacco products, like hookahs and ENDS products, which are also available in candy-like and kid-friendly flavors. In a 2014 nationwide study of 12-17 year olds, the majority of those surveyed who ever tried tobacco first used a flavored tobacco product.

In Rhode Island, cigarette use among high school teens declined from 8.0% in 2013 to 4.8% in 2015—the lowest youth smoking rates in the country. Despite this reduction, 27.1% of all youth in Rhode Island in 2015 used some type of tobacco product (cigarettes, cigars, smokeless, hookah, or e-cigarettes). In Rhode Island, ENDS products (i.e. e-cigarettes or "vaping" devices) were the most commonly used tobacco product within the prior 30 days (19.3%), followed by hookahs (11.8%). One session of hookah smoking can have the impact of up to 200 cigarettes. Rhode Island youth also reported using, cigars (8.4%), smokeless tobacco (5.3%), and lit cigarettes (4.8%).

Parents and educators should address teen tobacco use immediately and, if needed, contact the child's pediatrician or school nurse for age-appropriate tobacco cessation support.

In Rhode Island, it is illegal to sell any tobacco product to anyone under 18, including e-cigarettes, ENDS products, and customized "vaping" devices, e-liquids, and related components. As of August 2016, Food & Drug Administration (FDA) regulations also ban online sales of all tobacco products to anyone under 18, as well as free sample giveaways and marketing claims related to smoking cessation benefits without prior FDA authorization.

The data being reported today were generated from two surveys conducted of teenagers in 2016, the Rhode Island Student Survey and the Annie E. Casey Evidence to Success Youth Experience Survey.

The Rhode Island Smokers' QuitLine provides free and confidential information and counseling to tobacco users: English: 1-800-QUIT-NOW (1-800-784-8669); Spanish: 1-800-8-DÉJALO (1-800-833-5256)

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