FRANKFORT, Ky. - More than a third of Kentucky middle and high schoolers say the pandemic has increased their use of e-cigarettes or vapes and other tobacco products, according to a recent survey.

The survey of 400 middle and high-school students across 22 counties was conducted in November and December by the Foundation for a Healthy Kentucky, in partnership with Kentucky Youth Advocates.

At the start of the COVID-19 crisis, said Abigail Birman, a junior at McCracken County High School in Paducah, many kids were out of school and relied on vaping to pass the time.

"They found it as a way to cure their boredom," she said. "There was nowhere to go spend money on clothes or food, or anything. They could go spend their money on tobacco products, because the gas stations remained open, and it was just a way to be social in those times of not going to school."

E-cigarette use among children and teens in Kentucky doubled between 2016 and 2018. Emerging research has shown young people who use them are up to seven times more likely to get COVID-19 than non-e-cigarette users.

State lawmakers have filed legislation -- Senate Bill 81 and House Bill 147 -- that would allow cities and counties to set standards on tobacco-retailer density in neighborhoods, and create buffer zones between those retailers and schools and playgrounds, among other local tobacco-control measures.

Mahak Kalra, chief policy officer at Kentucky Youth Advocates, said she believes local control is needed to stem the tide of vaping among the next generation of Kentuckians.

"The perspective of these Kentucky preteens and teens shows us that we, as a society, still have so much work to do to help protect our youth from e-cigarettes and other tobacco products," she said.

Meanwhile, Birman said she believes tobacco addiction among her friends is worsening.

"It's like, every single day it's, 'OK, gotta go to the gas station.' The next day, 'I'm out, gotta go again.' Like, it was bad before, but it's just continuing to get worse," she said.

The Coalition for a Smoke-Free Tomorrow, made up of more than 200 groups across the state, is to host an online rally today, asking state legislators to restore local tobacco control to cities and counties and increase funding for tobacco prevention and cessation programs.

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.