COLUMBUS, Ohio -- Deaths and hospitalizations linked to e-cigarette use made headlines in 2019, and health experts say it isn't too late to make a New Year's resolution to kick the habit.

In Ohio, nearly 80 cases of illnesses linked to vaping have been investigated by state health officials. And federal data show a 48% increase in vaping among middle-school kids, and a 78% increase among high-schoolers in 2019.

Zach Gerber, director of marketing and communications with the American Cancer Society in Ohio, explained the long-term effects of using e-cigarettes are still unknown.

"E-cigarettes do contain high levels of nicotine, which is addictive and can negatively impact mood, concentration and even brain development," Gerber said.

Last week, federal officials announced a ban on the sale of fruit, candy, mint and other flavored vaping oils, but critics warn it doesn't go far enough.

E-cigarette companies have said their products aren't intended for kids, but for adults trying to stop smoking traditional cigarettes. However, Gerber noted e-cigarettes have not been deemed a safe and effective smoking cessation product by the FDA.

Gerber admitted quitting tobacco and nicotine products is difficult, and said support from family and friends is important. He also encourages those who want to quit to tap into resources in their local community, as well as online at cancer.org.

"No one can really achieve this alone," he said. "Thousands of people are impacted by smoking each day and each year, and that kind of support that's already kind of 'gone through the ringer,' so to speak, can be very, very beneficial to those that are struggling to quit smoking."

Smoking cessation coaching is also available at no cost through the Ohio Tobacco Quit Line at 1-800-QUIT-NOW.

This story was produced in association with Media in the Public Interest and funded in part by the George Gund Foundation.


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Widespread vaping among young Kentuckians continues to be a public health concern - and some local communities are coming up with innovative ways to tackle the issue. A big win in the battle against nicotine came when the Commonwealth raised the age limit to purchase nicotine products to 21.

Lauren Carr, director of the Graves County Agency for Substance Abuse Policy and Prevention, said local shops are still selling vapes to kids. Her county is incentivizing business owners not to sell to minors.

"We reward the clerks that do not sell with a gift card," she said. "So we say, 'Hey, thank you for not selling to the kids. Because that is preventing it from getting into the schools.'"

Experts say tobacco retail licensing can help protect youth from the harmful effects of vaping and can also improve equity among low-income and communities of color, often targeted by the tobacco industry.

According to Kentucky Youth Advocates, about 35 states require retailers to hold a license to sell tobacco products, but Kentucky is not one of them.

Sydney Shafer, a high school student in Scott County, said after her grandfather passed away from lung cancer, she became passionate about raising awareness among state lawmakers about the harms of vaping.

"Big vape companies are targeting younger audiences with fun flavors, like cotton candy and coffee," she argued. "It's deceptive and manipulative, and I would just want to educate other people and let them know that vaping is not as safe as they think."

Bruce Crouch, drug prevention officer with the Youth Coalition Prevention Group at Taylor County High School, said his school district recently received an opioid settlement grant from the state to expand drug prevention work.

"We actually started with our intermediate school, with fourth-graders," Crouch reported. "And we introduced a program, the 'Too Good for Drugs' program. So, they are actually getting that early education about the dangers of nicotine use."

Research from the CDC and FDA finds more than 2.5 million middle and high school students nationwide reported e-cigarette use in 2022. Nearly 85% of youth who vape used flavored e-cigarettes, and more than half used disposable e-cigarettes.


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The Food and Drug Administration will be releasing guidance on its proposed menthol cigarette ban by month's end. In Virginia, these cigarettes make up 45% of the state's menthol cigarette market.

Several states - including California, New York and Rhode Island - have implemented menthol bans in recent years. As beneficial as this move may be for people's health, law enforcement officials aren't as celebratory.

Diane Goldstein, executive director of the Law Enforcement Action Partnership, said the only kind of ban that would work is no ban at all.

"I don't care if it's a tobacco product, a caffeine product, an alcohol product, or the unregulated illicit market that we currently have," she said. "People are always going to find a way to get the drugs that they want."

She noted that enforcing such a ban could be problematic for already disenfranchised communities. The FDA has said its new proposal won't penalize individual smokers - rather, it will penalize distributors. The hope is the ban will improve health across the state and the nation, especially as Virginia ranked poorly in the American Lung Association's 2023 State of Tobacco Control Report.

Goldstein said she feels there should be additional studies done before the proposed rules are finalized to ensure that disenfranchised communities with higher smoking rates won't be so harshly affected. She described the kind of approach she'd want to see taken as part of a ban.

"You have policies that have been in place for years, that include, we need more harm-reduction in the state products for adults," she said. "We need more education, we need better cessation support, we need better youth tobacco prevention."

An analysis of several studies by Quit Now Virginia found that 25% to 64% of adult smokers would quit if menthol cigarettes were banned in the United States.

Virginia is one of several U.S. states that could see low-nicotine cigarettes rolled out by year's end. Created by 22nd Century Group, these cigarettes contain 95% less nicotine than normal cigarettes. This comes as Virginia ranked poorly in all categories of the American Lung Association's 2023 State of Tobacco Control Report.

John Miller, Tobacco Division president for 22nd Century Group, said these are just one more form of nicotine replacement therapy for people to consider using it.

"There's been gums, nicotine gums and lozenges. But, with all of those things, there's still roughly 35 million people that smoke in the United States, and still 190 billion cigarettes sold," he explained. "So, there is not a silver bullet, and I applaud the FDA for really seeing that. You can't only have one solution for such a diversified group."

This month, the low nicotine cigarettes will be available in California, Florida and Texas, with plans to expand to 18 other states later this year. Although some groups are worried about how the Food and Drug Administration will regulate these, research is already showing how effective they are. A 2022 study finds reducing nicotine in cigarettes to very low levels reduces cigarette addiction and toxicant exposure.

During the past year, these cigarettes underwent market testing, which Miller said provided insight into how retailers would sell them. One priority in that time has been safety. Another thing becoming apparent is that youth smokers are not interested in this product.

"It's obvious that the youth smoking issues have switched to vapor more than anything now," Miller said. "So, we know we have no appeal to youth. So, we really try to be clear in those buckets on safety and who's the consumer."

The Campaign for Tobacco Free Kids finds more high school students used e-cigarettes in 2022 than other tobacco products. Additionally, the group finds a little more than 11,000 Virginia kids younger than 18 try cigarettes for the first time each year.