By Madeline Rothfield
ROCKVILLE – The American Lung Association said the state of Maryland must do more to reduce and prevent tobacco use among youth in order to help end the nationwide e-cigarette epidemic.
Maryland earned a grade of “F” in the minimum age category in the ALA’s 17th annual “State of Tobacco Control” report, a result that has stemmed from the large increase in e-cigarette use among youth under 21. The failing grade is also the result of Maryland’s failure to create legislative mandates to increase the minimum tobacco sales age to 21, according to the ALA.
The grade was released before April, where the Maryland legislature passed a bill to raise the legal age to buy tobacco from 18 to 21.
“If Maryland would increase funding for tobacco control programs, they would have a powerful opportunity to help further reduce and prevent tobacco use, including supporting communities that still use tobacco at higher rates and who have been targeted by the tobacco industry,” Eastern Division Communications Director for ALA, Ewa Dworakowski wrote in the report.
Data for the report is compiled from, “publicly available, quality-assured data from monitors operated by the states, counties, federal agencies and tribes across the nation.” E-cigarette use has seen a 78 percent rise between 2017 and 2018 among high schoolers nationwide, according to the Center for Disease Control’s (CDC) 2018 National Youth Tobacco Survey. The report states that elected officials must do more to prevent the rise of smoking, and the recommended action is to raise the minimum sales age for tobacco and e-cigarette products.
“In Maryland, our adult smoking rate remains at 13.8 percent, while the high school smoking rate is 8.2 percent. Tobacco use is a serious addiction and we need to invest in the proven measures to prevent and reduce tobacco use,” Lance Boucher, The ALA’s Eastern Division Senior Director for State Advocacy, said.
The Maryland Department of Health (MDH) responded to the report card grade by noting that the state has taken measures to increase the minimum tobacco sales age to 21. Two bills have been introduced during the Maryland 2019 legislative session to raise that age to reduce smoking in general and to prevent the rise of e-cigarette use in teens, said Brittany Fowler, Deputy Director Media and Content Strategy Office of Communications of the MDH.
“The MDH has taken the e-cigarette epidemic among youth seriously and has ramped up efforts to reduce use,” Fowler said.
Fowler said the MDH has communicated the effects of electronic smoking devices (ESDs) to youth, parents, health personnel and practitioners and educators across the state through “presentations and information-sharing” of source materials provided by the FDA, CDC, Surgeon General and curricula such as the free Stanford Tobacco Prevention Toolkit.
The report additionally graded each individual county on “High Ozone Days”, “Particle Pollution” and included data on “Groups at Risk”. This category included total population by county and amount of people with pediatric asthma, lung cancer, diabetes, and other conditions.
The majority of counties in Maryland received similar grades, for example, Montgomery County received a grade of “A” for particle pollution and a grade of “C” for high ozone days.
The e-cigarette epidemic has gained national attention, with responses and actions being taken by the U.S Food and Drug Administration. The issue has become incredibly pressing, forcing action by the top administrators in the U.S.
“I use the word epidemic with great care,” FDA Commissioner Scott Gottlieb said. “E-cigs have become an almost ubiquitous — and dangerous — trend among teens. The disturbing and accelerating trajectory of use we’re seeing in youth, and the resulting path to addiction, must end. It’s simply not tolerable.”
While the federal government begins a plan of action to end the epidemic, the state has continued to fight it as well. Maryland has taken action to stop tobacco addiction in youth through the implementation of “The Quitline”, a confidential and customized youth protocol targeting ages 13 through 17 for tobacco users, including e-cigarettes.
The Quitline provides residents with phone counseling, web- and text-based support, and free nicotine replacement therapy (patch, lozenge, gum) 24 hours a day seven days a week.
The state received an “A” grade for Smokefree Air. This is partially due to the state’s enforcement of smoke-free bars and restaurants, a measure celebrating its ten-year anniversary, reported Fowler.
“Maryland also received a “B” for Access to Cessation Services, significantly improving upon grades from previous years,” said Fowler. “This new grade reflects improvements in cessation access and a reduction of barriers for state employees and Medicaid participants in Maryland to receive FDA-approved cessation medication.”