tv House Oversight and Reform Subcommittee Hearing on E- Cigarettes PART 1 CSPAN July 29, 2019 8:01pm-9:52pm EDT
from congress and beyond. a lot has changed in 40 years. it is more relevant than ever. c-span is your unfiltered view of government so you can make up your own mind, brought to you by your cable or satellite provider. announcer: last week a house panel held two days of hearings. we will first hear from child advocate, medical professionals and two high school students who testified on beeping, the risk of nicotine addiction and how the marketing disproportionately targets young people. >> good morning. the subcommittee will come to order.
28,etween 2017 and e-cigarette use and youth rose 78% in one year to the point where over 20% of high school students now date. the lingering question is why and what was the role of dual -- juul? the panel assembled today will help us address these questions and frame our discussion for part two of this hearing tomorrow at 2:00 p.m. when the juul founder will testify.
what makes it irresistible to children? tobaccominent advertising scholar will help us to answer that question. after today, we hope to understand how it peeled -- appealed while avoiding detection from. we will hear about how they marketed directly to kids. personnelr all school left the assembly room, unfortunately, the presenters told children that their vaping tools were safe. we will hear from the parents of children who sat through one such presentation. two mothers were so angry that they pounded a nationwide advocacy group. i suspect that out of all the schools, they regret going to
that one the most because it incited the righteous anger that only comes from parents who believed that their children were being exploited. we will hear about the targeting of vulnerable populations was not only towards kids. tribe tod to pay a give free started kids to members. they tried to push that is healthy and tried prescribing its medical professionals. they thought they could get away with this on tribal land and tried to ensure that nobody else found out about it. highroduct itself contains nicotine levels, three to six times that of the e-cigarette that came before it. thatinated the harsh taste would have accompanied that much ticketing and further mastic with labors that appealed to the youth. children do not grasp this.
do not know that it contains nicotine. they think it only contains flavorings and believe that the product is not harmful. perhaps we can better understand what led to parents sending letters like one from june of last year stating, my daughter theighly addicted to nicotine. it has occurred quickly over the past several months. she is 16 and now has behaviors -- she never had before juuling. she lies and speaks at night to get a nicotine fix. about --isheartened talking about how desperately
they needed to be. she expressed concern about children using it to self medicate for mental health issues like anxiety and depression. we will also examine what about the device makes it so attractive to teenagers? that noscrete in a way other cigarette was. it smelled does not linger. it is small. parents could have looked right past it thinking it was a thumb drive. i have had one in my hand during this entire statement. they have not provided satisfactory answers for these open questions. it is my sincere hope that our hearings today and tomorrow will help us better understand the role in this terrible epidemic and prevent teen vaping addiction.
thechair now recognizes distinguished ranking member from texas, mr. cloud for an opening statement. >> thank you for appearing this morning. we have known that smoking is dangerous and needs cancer. these deaths are only preventable if individuals are able to stop smoking. on years smoking has been the decline, but we are far from eradicating it. turkey, using or patchesmb -- gum are not enough. electronic cigarettes could be part of the broader control strategy and could be considered viable. cigarettes -- a
commission found that they were 95% less harmful than tobacco cigarettes. some smokers have wanted to turn to e-cigarettes as a cessation aid. they have determined that they are effective for this purpose. others found that it was associated with nearly twice the rate than other nicotine replacement therapies. we need to be clear about one thing. loving one's children to use tobacco. or for was kids vaping the companies to target children with their advertisement. act of 2009control also apply to e-cigarettes. members of congress passed that they should always begin with strict
fidelity towards research. the questions i hope to have answers to today are, what are the public health benefit to e-cigarettes? can electronic cigarettes be part of a control strategy? if so, how do we do so in a way that make sure that the kids are protected? i hope that we hear the answers to these today. two thirds of adult smokers have stated that they want to quit. they know that it is hard and they have probably tried many times to quit. two thirds of smokers want to quit, which is a great thing, members of congress should be cautious moving forward, with making transitions more difficult than it already is. is access to marijuana or alcohol, the first
is engagement of parents, schools and local communities to educate children about the risk. i hope we have a productive discussion today. >> i would like to turn to our witnesses. thank you all for joining us today. we appreciate you taking time out of your busy schedule. thank you to those in the audience for coming here on an otherwise slow news day. againstunder of parents even thing -- vaping. a member of the turtle mountain and -- band. jonathan, a member of the american academy of pediatrics, dr. robert jacklin, who is the professor and departmental chair
at stanford university medical school and a practicing surgeon. thelly, dr. raymond of department of social and behavioral sciences at new york university. thank you all for coming. if you would all please rise and raise your right hand, i will begin by swearing you in. swear or affirm that the testimony you are about to give is the truth, the whole truth and nothing but the truth, so help you god? thank you. let the record show that the witness has answered in the affirmative. without an objection, your written statements will be made part of the record. with that, you are now recognized for five minutes. explain thequickly
lighting system here. you have five minutes and this is a countdown on the clock. green means that you are in good shape. yellow means speed up and read means stop. please again. >> not stressful at all. good morning. thank you for your words. i am meredith burkman and i represent parents against eve vaping -- vaping cigarettes. we were founded by three concerned mothers. we have activated parents across the country from california to new york and places in between. we have people from texas, georgia, virginia, new york, new jersey et cetera. my cofounders are behind me with
members of our families and between us we have nine children between the ages of seven to 19. friend, we are here in response to the epidemic that has come out of nowhere. experts consider it one of the most. public health crises our country has faced for decades. voiceal today is to give to the 3.6 million teenagers who are vaping, most of them juuling. this figure is already outdated. between 2017 and 2018, there was a 78% rise in the use of these products by high school students. believe that the new figures due this fall will likely be much higher because nothing has happened to have them go down. we hear from desperate parents every day to contact us seeking
information and help for their addicting children. there is not yet any fda approved treatment for this addiction. i will share very briefly one or two stories because they are heartbreaking and come from every representative here on the panel. from massachusetts, our paid ,dvocate speaking about her son a hockey player. he developed a cough and complain she was not able to breathe while skating. , ahad extreme bouts of anger very common thing that people report. the home environment was toxic. he has restrictive lung disease. pot a day, smoking a and equivalent of war than a pack of cigarettes a day for years.
one addiction was so severe he spent 39 days as an impassioned -- inpatient in california. they began leaving with a stranger. was the extreme anger. it turned out the 14-year-old had a substance abuse problem and that substance was juul. i want to tell you a story about how juul went after our children and their friends without the knowledge of the school or concerned parents, they sent a representative to talk to our children about its product under the guise of education. 15-year-old son caleb told us there had been an anti-addiction talk for the ninth grade. teachers left the room and a man
gave a confusing talk about juul that it was not for kids but for adults, that it was much further than cigarettes and fda would approve it any day. was forted that it adults, not children and he took showed them how it worked and called it the iphone of vapes. that is when we decided to fight back. we discovered a few months before that our children were juuling at home. it does not mean that you are a bad parent. it is still my design. , we learned the deceptive behavior seemed to be part of the strategy.
a retired school superintendent was offering schools money if they would implement the juul-jew -- anti- curriculum. disclaimer that we realized was in reference to them taking information that it should not have. none of this is surprising. it is stealth by design. it no longer restocks orders of flavors that research has proven is attracting the kids. intoone block radius different stores, i was able to podsango pie that -- no longer ons is
the market. they should immediately remove all flavors from the market, including menthol and mint. they will stop spending millions of dollars on lobbyists to thate sensible legislation our coalition partners are fighting for all over this country to restrict access to juul and other products. we hope this motivates congress on both side. we all care about the kids. to hold them accountable for the epidemic and its predatory practices, for causing harm to so many in this country. if we do not take action now, we face an entire generation of children addicted to nicotine, who are human guinea pigs for the experiment overall. >> thank you.
on -- ms.ry, you are o'leary, you are on the clock. >> thank you. witnessving as a representing the tribe. i am the founder of the coalition which is a grassroots anti-tobacco coalition. it opposes the use of all commercial tobacco products because of the historical targeting of american indians that has contributed to death on the cheyenne river reservation. in january and february, representatives used the historic tactic by handing out free products to decision-makers . the proposed health care professionals from the department refer smokers 20 years old or older to the program. it would enroll online by
entering personal data and health behaviors. they proposed self-starter kids for five dollars apiece. -- tribe would turn around throughout the presentation, they made claims that their product is effective and less harmful than tobacco products. actionsaims and their are violations of the tobacco control act. initially, some tribal members were commenced that could help then quit smoking eventually resulting in fury health care costs to the tribe. the health committee members widely requested written augmentation of the proposal. it would not provide written
documentation as requested. the nondisclosure agreement was not signed. as a result, they have not returned to the tribe. the health committee approved a resolution that says that they will not accept nick lee -- nicotine elated -- this is being considered by the tribal council as well as several other tribal nations. the coalition emphatically reasons,or many including safety concerns. a known but probable long-term health risk. even though the program is intended for adult smokers, there is great concern that
american indian youth will start using. this is supported by the data that american indians and middle school students are using e-cigarettes three times more than their white counterparts. smokingt safe for cessation. they smoke more and quit less. some have quit smoking while juul.e-cigarettes like they and other e-cigarettes are being used for more than alternatives smokers. they may like what -- we may couplede an easy target with our genetic propensity for addiction, but maybe they were drawn to us because of our young
face. i would challenge the members of the subcommittee to look into why they are interested in partnering with tribes and how it will improve lives, as they claim it will. , i am puttingoman my words on the record that the scenario of the tobacco industry exploiting tribal sovereignty has played out for far too long. i put a great deal of thought into the steering today. in the end, it was the belief that helped me reach my decision to testify. important not to be shared. it is time to take action to on att juul from praying on at-riskying populations.
decision, leaders must consider how it will affect us in the future. >> thank you. have five minutes. >> thank you. i am a practicing pediatrician at the hospital and i have over 20 years of the arian caring for children and adolescents. i am here representing the ,merican academy of pediatrics a medical organization representing over 76,000 across the u.s. juul use has reached epic proportions. every one of my teenage patient and even many of my preteen patients either uses e-cigarettes or has friends that use them. have the incorrect belief
that juul is harmless. health benefits. they have an addiction to nicotine and carcinogens. e-cigarettes are not good for growing lungs. they are bad for children with asthma and can cause serious lung conditions. the fda has publicly warned about increasing reports of seizures in children who use e-cigarettes. my patients are often not aware of the massive nicotine content and that one pod contains as much nicotine as 10 cigarettes. nicotine addiction can take hold in only a few days, especially in the developing adolescent brain that is particularly vulnerable to addiction.
use of e-cigarettes can lead to use,stible tobacco compared to those who do not use e-cigarettes, they are three times more likely to be smoking traditional cigarettes. many of my patients find it impossible to stop. nicotine withdrawal can cause headaches, anxiety and repression. the only surefire way to eliminate e-cigarette use is to stop it before it starts. luckily, we already know what needs to be done. we need to make them more appealing -- less appealing to children and make them regulated appropriately to the fda. we need to address the flavors. the pods come in a number of sweet flavors. theh surveyed said one of
main reasons they try it is it makes -- they have chosen to keep mint and menthol flavored pods available everywhere. canes to toothpaste, children are introduced to mentor from a young age. , they coolproducts the throat and make it easier for children to inhale the poison. when they removed some of the other flavors from stores, i thought the majority of my patients switching to mint. children are still gaining access to other flavored pods, even though they are now sold online. if the product is available for sale somewhere, children will get their hands on them. we must eliminate child friendly flavors from all products. we urge congress to pass
legislation to prohibit flavors from tobacco products. juul is a fatally flawed product. 15 to 17-year-olds are 16 times more likely to report juul use the 20 to 24-year-olds. of the product into the hands of children, it is time that we declare it a failed product. thismerican academy says is a threat that must be removed from the market as soon as possible. --y are voting the product progress we have seen. progress we have seen. they must be held to account for the epidemic that they have -- and in congress
congress and the administration must take action. >> you have five minutes. thank you for the opportunity to testify before your subcommittee today. begins in smoking adolescence. typically commencing between the ages of 12 and 19, it would be a very 40-year-old that would wake up and say, i think i will start smoking today. once they become hooked, it is exceedingly difficult to quit. from the beginning, they professed a noble mission of improving the lives of smokers. they have spurred an epidemic amongst youth. added they stray so far from their stated mission? -- theyty of smokers
should have designed their advertising to appeal to middle-aged users. can we get the slides? ok. -- cities across america. people were young given free juuls. heard it was designed by an advertising agency whose goal was to create a cultlike following. they featured moms in their 20's and exhibiting behaviors of underage teens. knowno advertisers have that these target underage kids
through just last week, the that the claimed campaign only lasted less than six months and it was lifestyle oriented and had no impact on sales. iswe can see the images, it obviously user oriented. bragged we are the fastest-growing e-cigarette company in the world and so today they say the only advertising made no difference, but at the fact, they were bragging. this is revisionist history or intentional deception. advertisenception, to on social media, especially
instagram. toy paid social media stars juul. julie -- under intense regulatory pressure, but halted its own social media postings in november 2018. however, this was a hollow gesture. viral promotion assured massive visibility of their products. for example, after they quit its postings, community postings searched. claims they were completely surprised by the usage of the product to it --
product. company,a data-driven know the market to whom the products are distributed and qiagen n.v. of the customers. -- that are times distributed and [no audio] professes to be a to technology disruptor. they made many compromises to their grand vision for it what should have become an offering to adult smokers has become an on-ramp for nicotine addiction among teens threaded from a policy point of view, the best way to eliminate adult smoking is to keep teens from starting in the first place.
the agreement specifies joint marketing is of great concern. has been unmatched for its hypocrisy. by to makethey stood no efforts to contain the fire and even stilted and when the fire department came expressed shock and dismay while protesting their actions had absolutely nothing to do it. >> thank you. you are on the clock. >> thank you. mr. chairman & the committee, thank you for in hold -- holding this important topic on the .ation's health
i'm here to testify the challenges we face on e-cigarette use for it i'm a clinical psychologist at the health of global public at new york university and i have spent my entire career understanding and treating tobacco dependence. concerns about the tobacco use including vaping. for the record, they should not be using any tobacco court nicotine product or any drug for that matter. we should do all we can to use and by making it difficult to purchase such products. i believe become is that an sellre -- manufacture and
should make sure it is only for adult smokers. during the fall of 2018, the fda expressed a concern about youth vaping when they looked at national surveys and this prompted dr. scott to declare that it is an epidemic. was reinforced by survey in 2018. or the data eventually released, we looked at it and confirmed
that past 30 days vaping had increased. while an increase in use of concern shows that was occasional and most regular use was concentrated. importantis is an point. yes, we need to be concerned about vaping, but also use of other tobacco products. hadlso looked at youth who never used tobacco products and thankfully vaping rates were quite low. again, this is not to minimize the importance of concern about youth vaping. smoking remains a major concern here in the united i wouldf america and
like to emphasize another point which is that e-cigarettes have the potential to help adult smokers stop smoking and we have seen evidence accumulating showing that adult smokers can cigarettes. regular studies have came out indicating the same. just last week, a report said smokers who switch to e-cigarettes were more likely to quit smoking compared to those who did not. these results are important because we know that despite their effectiveness, smokers don't often use quitting methods . as they stand now, it is proving to be very popular with smokers and helping them to actually quit smoking cigarettes to
quitting smoking is the number one priority in we need to use all the tools available to help reduce this burden which prematurely claims the lives of over half a million americans every year. currently, about 38 million adults in the u.s. smoke , thisttes and clearly ought to be a huge public health authority. i would like to close by saying teen years and been a cause have of one another and they should not be. i think we are smart enough to do both, but we don't have all the answers yet. thank you very much. i recognize myself for five
minutes questioning. first of all, after you discovered a representative toing jule -- the group inform parents around the country about e-cigarette use. as a parent of three young children including myself, i was juul jule hear that continues to partner with youth organizations across the country comes so it is important to understand what outreach looks like on their part. philip and caleb, can you come to the table for a couple of minutes?
i would like to first address caleb. what grades were you and philip in the year of the juul presentation? >> ninth-grade. >> what were students told about the presentation before begin? mental,re having a addiction seminar and the teachers are told to leave the room so it is a safe place for kids to talk. >> did most classmates believe juul was safe prior to the presentation? >> i think many kids have doubts, but i think a lot of kids still thought it was possibly dangerous. everd the presenter mention his connection to juul
and were teachers in the room when he spoke? >> he mentioned his connection to juul and the teachers were not in the room. >> did the presenter call you totally safe more than once? >> yes. >> what impacted the comments have on your classmates? >> for my classmates who already started to fade, it was a sigh of relief because they do not , it any concerns -- vape was a sigh of relief because they no longer had any concerns. [inaudible] after this meeting, kids were more inclined because they just thought it was a flavored device that did not have any harmful substances. >> you and philip approached the presenter. what motivated you in the first place?
>> i believe he was sending ised messages by saying juul and also saying we don't want your customers to read i think he was playing the rebellious side were teens are more likely to do something there told us to do. >> what was your experience speaking to the presenter? hime went up and talked to and caleb asked the question about what you can do if your friend is addicted to nicotine. >> were you addicted at the time of the presentation? >> i was. asked what a friend should do, was the referring to you? >> he was. >> [inaudible] >> he was not specific.
the speaker thought he was talking about figures and he should mention juul to his friend because it is a safer alternative been smoking cigarettes and would be better. to switchanted you from a combustible cigarette to juul? >> yes. disturbinga very behavior to say the least. outrson connected pulled the device and lied about the product you totally safe. did he say anything about whether the government had approved it? >> you mentioned the fda was about to come out and say 99% .ave -- safe
>> thank you. let me ask philip's mother to say a couple of words here. thank you for coming. gestated he was addicted for how does -- how to his addiction and your family? >> it was difficult. at first, we did not understand what was going on. he was interested in someway different things at the young 14-year-old and i started to find these flash drives in green plastic caps and i did not know what it was a first come a get saying they belonged to a friend and we had fights about it because i figured out what it was. spending, he started
moody. his room, became we had a very contentious he didnship and i think not understand what was going on himself and neither did we. let me recognize ranking member cloud for time of questioning. >> thank you. i'm curious to the reaction and i seem to approach school board, principal, what was the reaction? idea thatool had no the outside group had brought a juul representative into the school. the outside group was naive, but in good faith because
when i called to ask about the , the staffer said you found the right person. i was researching anti-juul education online and i can julie henderson who was no longer listed on the and she called and she says i have the perfect person. >> thank you. dr., could you explain the difference from a health perspective? is there one? >> yes. traditional cigarettes consists of preparation of tobacco leaves which when burns create smoke that contains roughly 7000
different chemicals, most of which are not good for the human body. the cigarettes contain far fewer gradients -- ingredients. this general is the difference in terms of the number of makesnds in e-cigarettes the e-cigarettes in general safer, although it can very from product to product. depends one safety temperature control for example. toxic.nd to be less we have known cigarettes for a while cause cancer. i remember third-grade seeing
from sitting in a jar someone who have passed away from cigarette use. what i'm trying to get down to is where the health effects of the combustible side and the nicotine side? >> that is an important point to raise. if we look at nicotine and another itself, it is not risk-free, but probably a lot less toxic than compared to the other chemicals that come out of cigarette smoke. for example, nicotine does not cause cancer. it may have some small effect on disease cardiovascular and so forth. the brain might have to adapt to .aving a drug on board
itself is not itself when it comes to things like cancer terrific >> we seem to have a competing set of facts . we have data that shows teen e-cigarette use has gone up. you mentioned that a lot of it is transitional. clarify that [inaudible] >> a lot is cross-sectional. we see kids using one or two are and what we need
studies that track kids over time. once again, we don't know what the applications are and i want to emphasize that i share the concern that an -- kids should not be trying the rocks and using them on a frequent basis. >> cdc data shows over 2 million high school students and hundreds of thousands of middle schoolers have activists and become a user. if you start smoking today, it .s dirty, 40 years
it is an experiment. we will find out years from now the results. the compounds we put into our food that are safe in your intestinal tract, when you free the men, the classic example is microwaved butter popcorn. it causes severe lung disease. the flavor and chemicals, cotton candy, mixed them with that and they are exposed over and over. we don't know the long-term results. there's no doubt my mind that taking a safer than conventional smoking, but that doesn't mean it is safe. i now recognize congress know -- congresswoman to leave --
talib. >> i can censor frustration. rhetoric to it discredit a lot of things we are pushing for you i just want you to know the truth is on your side or it be stronger for that studies.n't need more washe few years after juul founded, it dominated the market through a targeted campaign. it now accounts for 76% use of the e-cigarette market your it when i find troubling is that in the same timeframe, the rate of teen nicotine usage skyrocketed. the cdc found a 75% increase in use among high school students
between 2017 and 2018, so it is no question that teens who use e-cigarettes almost exclusively refer to the activity as juul ing. shouldn your expertise, they have been aware of its marketing use when it comes to teens? >> absolutely. huge teenage fads do not happen by accident. agencies and at they understand the difference ,etween marketing baby boomers --io broadcast tv and jen spend all their
time looking on their phones. inside report from the new york times validates it. i don't think there's any question that juul they were perpetuating it. >> you were a professor at stanford. james monthly?et -- muncie? >> yes. interesting. .e thanked us for the database he said they were very helpful as they designed the advertising. the seven of us left the two-hour meeting the very first thing we talked about. it was the first time he indicated juul was allowed in
traditional advertising and we knew having studied that it [indiscernible] the methods by the tobacco industry to target young people which include marlboro. ofy are direct derivatives the advertising. the lives to improve of the one billion a bill smokers. year, their ads became more calibrated to an adult audience. may have now switched campaigns in imprinted newspaper. no longer are they promoting on social media.
this only happens long after it was a youth epidemic and it was because the unwanted attention by regulators. they were also concerned about investors, particularly companies like ability who did not want to be associated with products widely seen -- >> no, it all's -- always leads to profits. >> the explosion on the market already had an impact on youth. additional marketing campaigns influence teens today? >> it did not stop all of the ags. branded hasht there were about a quarter million posts with those.
since then, it has doubled. what astounded me the most is it fromete instagram, but happy users are under age 18. >> just because you delete them does not mean it never happens. >> thank you. cromer. mr. >> thank you. the topic is used of electronic cigarette. , ahas been mentioned today potential possible correlation with tobacco and cigarettes. you conducted a lot of research and studies on this topic. predictor isof up current use?
>> there is a statistical association between use of e-cigarettes and subsequent cigarette smoking. is the health at study which is funded and sponsored by the fda and nih. we did find that and also found that if kids had started with a cigarette, they were 20 times more likely to continue to smoke the sacred. the message we take from this is the use of all or any nicotine tobacco containing products will increase the risk. the worst thing to start with would be a combustible product like a cigarette. >> has the rate of smoking
since 2010 increased when e-cigarettes started to rise in popularity? declinese seen steady in both youth and adult populations of cigarette smoking which should be taken as good news. we certainly have more work to do and yes, there is a diversion e-cigarettes with and use of cigarettes going down and that is the area of active research to see if those two things are actually connected with one another. >> if e-cigarettes for a gateway to smoking, would that show existential increase? decrease ineen a use of other tobacco products, so right now, it doesn't appear
that they are translating into subsequent use of cigarettes, at least as far as we can tell right now. >> is evidence show that teens are diverting to e-cigarettes? questions an important that we need to address. kids are trying a lot of different products, including vaping and we need to understand more about who are the high-risk kids who might try a lot of , may inadvertently become more addicted to nicotine. we need better understanding of those factors so that we can do a better job at doing some kind of intervention. >> i just want to make a point that i'm certainly opposed to
youth vaping. i'm not a smoker and never have been. representmer and i probably the biggest tobacco in this -- to back her district in america. beenis something that has a big economic boon to kentucky. having said that, we recognize the risk and the dangers and effects of cigarette use. has triedry i think to do things to curb underage smoking. i know senator mcconnell has a bill that i support to raise the minimum age to purchase cigarettes and i think that is something that needed to be mentioned today.
and tobacco is still legal i know this is about e-cigarettes and i have to conclude about this because it is a big industry my district. in kentucky, you're not able to grow fruits and festivals, so you are limited to what types you can grow. it -- as long as it .s a legal industry certainlyd that, i want to work with my colleagues use of e-cigarettes goes down and i have always been a proponent of doing everything we can to prevent underage smoking. with that, i yield back. >> congresswoman pressley, you
have five minutes. >> thank you to all of our witnesses. in addition to the experts and those here, i wanted to acknowledge the control leadership council and we thank you for your good work. epidemic has taken the commonwealth by storm across the state an estimated nearly 15 high schoolers and one in 20 middle school kids are using the products. into juulhave turned lounges and have spent the last 10 years of my life advocating for a school nurse and we have learned from our school nurses that 80% of high school students are vaping and that is from the
youth risk surveys. levels whothe state are going to initiate the investigation into the market looking to push for hearing, but we have to act on a federal level. i would be remiss not to how many of them seems to be right out of the tobacco playbook. almost 90% of black smokers use medals. .- menthols disturbing.ely we have been here before. we don't need a buddies.
run the risk of seeing ahead of us, so this is very disturbing. it is even worse for children. they found that e-cigarettes only contain flavors as we learned from the youth and thank you for telling the story. elimination [inaudible] why are tobacco products exploited in the context of e-cigarettes? >> they have a long history of targeting menthol products to african-american people and children. it shows the majority of americans believe that minted menthol should be banned as a flavor in tobacco products. therestingly, contrary to
tobacco industry and the tobacco product industry. if you just look at the opinion of blacks and african-americans, and even -- even greater authority believe it should be banned. theside from preying on black community, have targeted children and populations. you are so disturbed that you created an organization to spread awareness. we thank you for your advocacy. what have parents told you about how juul's marketing has influenced their children? >> when you see the sexy, young
influencers giving the products away. when you see the old tobacco ads, they are almost identical. juul knew what they were doing and what we tell parents is you are not a bad parent because as you have said, everyone is doing it and in this case, it is true. upset.very these are kids who would otherwise not have -- not what have initiated tobacco use. kidse talking about knowing harm to potential benefits to health. kids who can't make those decisions for ofmselves through the use social media.
make any claims about helping people quit smoking? did they claim the products were healthy? >> you can see slide 21 for my attachment, they have smokers that cannot quit. thathave created a program helps them quit. i think that the other claim was the harm reduction in the elimination of combustible cigarettes to reduce harm. to point out that it was done with not just juul, but
other e-cigarettes that had less nicotine content. and my time or do i still have time -- am i at time or do i still have time? >> thank you. >> congressman miller, you have five minutes. thank you. and thank you all for being here today. virginiatate of west rates among the top states in the nation for the highest 26%entage of adults, about of our population. 38 million people in united states smoke. i agree we need to ensure we keep nicotine products like e-cigarettes out of the hands of the youth, but we must also ensure that we do not over regulate the industry to the point that they are no longer
available for people of legal age who would like to use them recreationally or as a means to quit smoking. when i was a child, one of my chores was to empty the trash everyday. both of my parents were smokers. that was really achy. if anything would keep you from smoking, it would be emptying ashtrays ever single day. i believe it was in 1963 when the surgeon general came out and said sigrid smoking causes cancer in both of my parents quit. my father quit cold turkey and my mother smoked three quarters half,igrid come a than then a quarter. she did it so late. the ashtray thing is what cap me from ever wanting to smoke and coming into a house that smelled like smoke. it was really nasty.
research, do you find fate --t to they -- vape use other tobacco products as well? >> yes, close to the recorder -- three quarters have also tried or using other tobacco products. is it correlated by smoking cigarettes later in life? >> that is the million-dollar question that we are all concerned about. as i mentioned, there is some statistical correlation. i don't know if we can say that one causes the other. that is a pretty high bar, but nonetheless, i have maintained kids should not
be using any tobacco or nicotine containing products. , often i went to college times, i felt is it more of a crutch because you wanted to do something with your hands because it really was addicting. often, younger people, they want to carry keys or save this has something to do with their hands and that is more of an observation than a question. in your testimony, you talk about protecting youth from excessive nicotine products. andhouldn't be a trade-off we can use both of these things at the same time. how youu elaborate on think we could accomplish both these goals? >> i wish i had all the answers, but i'm hoping that the fda,
tobacco power of the control can work hard and figure out how to achieve both goals which is to minimize use and of thee the ability adult smokers to access safe and effective products. i think we are still in the early stages of figuring out which e-cigarette products are the most useful. that is what the fda is and use their scientific powers to determine which products are fit >>. >. >> how can the health risks be medicated by the use of
e-cigarettes? ifthe major thing is cigarette smokers can switch completely to an e-cigarette product, we know that will changesn pretty quick that areical markers normally associated with smoking cigarettes, so no doors, we had signals that they are getting better at approving -- improving. at least in the short-term, it looks like people switch to the products, they are actually in some ways of proving their health. >> you mean by coughing? >> more like biological markers associated with high risk of cancer, things like that. >> thank you.
thank you for having this hearing. the longer you have these political jobs, the more humansing when you see beings doing things. it 30rn up to remember years ago. i remember a public health ordinance and are hearing showed retailersly it is across the country where they put their advertising. research showing when kids came in and i also remember owning multiple liquor licenses when we went against
mothers against drunk driving. liability,o assume [inaudible] why would we want to be in business. we passed laws that have helped with that. i have had again and some fairly regular group of young people in my district in the san francisco bay area. they are trying to do similar things in getting young people .o help advocate there is a reinforcement from the market from peer-to-peer that it is not dangerous and people have taken care of all that. you've had the same experience i take it? group in sanvaping
francisco. we are working all the time. even now, when there has been so much talk about harmful content podsese jewelbox -- juul still don't get it. they think it is water vapor. we have been here before and we should not be here again. we don't want our kids to be guinea pigs for this experiment, especially when we saw what happened the first time around with big tobacco. we cannot wait. this is a race against time. flavorsn't act soon, continue to hook kids, then this
is a generation of nicotine addicts and worse. is research that has given evidence of cardiovascular damage caused by e-cigarettes, so there is no damage to healthy brains, but also cardiovascular. these are kids. bid seeingd got for what happened the first time around, we don't have that time. thank you. >> secondhand smoke, it strikes as a public health issue to employees. >> having been in the restaurant business, you could not wear clothing a second day because of the stench of tobacco.
why should it take long for us to look at the content of what today's products and measure against secondhand smoke? context, we have some smokers who have gotten the smoke outside, but parents will be vaping right next to their child. the particles are getting into .heir children's songs -- lungs the entire surface of the home becomes coated in nicotine and other chemicals. kids interact with their environment in a very intense way. they breed from close down to the floor and they may only way a tent as much -- a 10th of a so they end upt
breathing toxic aerosol that is probably 20 times higher than a non-adult household will get. use regulations need to be parallel. aherwise, smokers will use workplace and recreational places and automobiles with kids and that is not a good thing. local policies are important. about how thek industry has targeted native americans in the travel community -- and the tribal community? >> [inaudible] ishink the main thing getting the product to the reservation. i think the to the product feels invisible. on the reservation, we have no
compliance by the fda. there is great concern about coming to the reservation and trying to hide behind nondisclosure agreements. i've heard there are multiple other tribes that have been approached, but really struggled to find anyone. i think it is ruthless, the attempts they're going to embed the everest operation. >> thank you, i yield back. congressman grossman, you have five minutes. i know a lot of people use e-cigarettes. you don't see them as much, but vapesne person who
credits this with stopping smoking cigarettes and i wonder, do you feel it is effective? ofld you respond to the idea is it an effective way to stop smoking? there is certainly potential that electronic cigarettes, particularly those high nicotine , when a user reads them in has -- breeds the m [inaudible] scientifically. use both andill keep nicotine levels high, so it can be a deterrent.
certainly, probably better than patches or gums. >> we have not seen strong evidence that it is necessary for adults to stop smoking and i developsa manufacturer flavored e-cigarettes and provides data, then the manufacturer is able to ask the fda to approve it or authorize it as a new tobacco product, but for now, the evidence is strongly in favor of taking the product off the market. i just take issue with the notion that there is not strong evidence that we have the result of a randomized controlled trial which is the standard for scientific evidence in probably the most prestigious medical
demonstrating smokers to manage who switch to thoserettes compared to with replacement therapy. , so iidence is building don't think we can say we don't have these products that can help. >> we are told that america is supposed to be a free country. what is the reason for other people to not want to use e-cigarettes if there is strong evidence? what is their motivation? >> i think a lot of this has to do with these are relatively new products and there are a lot of unknowns. the tendency to
methods such as medications and replacement therapy, but this is a product that has taken things by storm and again, we are seeing signals that are positive, so from my point of view, this is a product that is actually consumer friendly and more apps to be used by smokers compared to other products, then we ought to look for ways to leverage the opportunity. , sure this is right or not. -- not sure this is right or not , 20% of high school students va pe. it says only 6% use it for more than 20 days and only 4% are
daily users. does anyone think the numbers are wrong? that is exactly how to select areas -- >> that is exactly have tobacco use starts. the gold standard for current use is past 30 days, so nothing usual. i'm a mother of four children and i tell you that this is rampant. we are trolled, harassed. .e want the flavors >> you are saying when i have 4% vape everyday
, using the data is wrong? and someon't admit it of the early studies, unless you ,sk someone if they are vaping basic kids do not associated -- associate it and there have been articles written about this and studies written about this. kids don't think they are using e-cigarettes, they just think they are juuling. >> would you say that nicotine addiction goes way after a couple of days? >> i don't know. i don't have an opinion. have two final lines of questioning, three minutes each. this could be a little bit of a
lightning round here. >> thank you for being here and i want to get to the majority of my time. that juul came before the health committee of your tribe. one of the things i would love for you to talk about is the which is toat said promote juul as a healthy way for patients to quit smoking. they wanted to provide the juul .tarter kits free if you can talk about that and who was in the room, i know people have a right to come forward and disclose.
hasink for the record, juul misled the american people, has lied, has used the system to target and and we can continue to say we are going to study. kids ask me what i do for a living, i tell them i make laws and things. i said when i went to a restaurant, they would say how many people in your party, they would ask smoking or nonsmoking sections. i said, they used to smoke in restaurants. no way. they used to schmoe on airplanes. in hospitals. and it's like these kids think we are crazy, but they used to gaslight us that second-hand
smoking. and i'm not going to allow this committee to be used even by the other side that e-cigarettes, vaping or juul is not killing people. it is leading to addictions that are going to hurt people. i'm sorry. you can have the rest of my time. i wanted to put it in the record what they did in your tribe. >> when they came, it was in front of initially the tribal council and handed out free products to our decision makers, free products and we have council members who are regular users of juul. they were then rerouted to the committee level of the tribal government system and went to the health committee and at that meeting is when they made claims of less harm and smoking cessation. and i'll reiterate that's not allowed. they cannot claim less harm at this point.
i want to say there has been a lot of questions about that it might be effective for smokers but there is data that suggests for every one person who is able to quit using juul, 81 kids will start. smokers finding this product as helpful, it is the uptick we are seeing in our youth. and yule specifically targeting like american indians and african-americans. there is no end in sight unless there is some regulations that take place. ms. tlaib: i hate calling it regulations. it's called accountability. >> thank you congresswoman. and final three hive minute line of questioning, mr. cloud. up cloud: i wanted to clear
the data, teen vaping use is up. we talked about that. overall teen's cigarette use is down. in the latest year, for the first year -- >> teen use is increasing in the last year according to national data from the c.d.c. mr. cloud: there are different sets of data? >> a flat line, but it's not increasing. >> the data shows it's increasing. mr. cloud: overall tobacco use, i would be interested to see the study. >> it's in my written testimony. mr. cloud: why the increase, why the decline? >> i think what we would have seen had juul not been around, i think we would have seen a steep
decrease in adolescent tobacco use. and unfortunately what we have seen is a flat line. a slight upparticular in the past year. this is a problem because -- r. cloud: when i ask kids -- finish what you are saying. >> if you look at the patterns over the past four, five years, again, we are at record lows for youth smoking, which is hard to reconcile with the fact that teen vaping is up. those are just the facts. mr. cloud: that includes -- >> cigarette smoking. mr. cloud: total product use is up dramatically. >> that includes vaping. a cloud: you touched on for
cond on patches and other -- touch 20 seconds on e-cigarettes compared to patches, what have you? >> nicotine patches are a form of nicotine replacement therapy proven to help smokers quit. this one study appears to show that e-cigarettes are even better than nicotine patches. my interpretation of that is e-cigarettes is a form of nicotine therapy. they are better at doing it compared to products like patches. mr. cloud: we are talking about the context of teens. >> adults. mr. cloud: how can we make sure that electronic cigarettes are available for smokers wanting to make a transition while limiting
the access to youth, what are your recommendations? >> i don't have any concrete recommendations. we are seeing a lot of suggestions coming out from folks in terms of different types of restrictions in terms of where products can be sold and restricting flavors. these are important conversations that we ought to figure out to get to the best road forward. >> i'll let dr. jackler finish. from nicotine products juul should be available for adult smokers. i care about adult smokers and would like products to help them quit and it is superior, but should not be on the market to bought over the counter in
sweet and fruity flavors. >> thank you for the first panel. if you could come back, we are going to switch out and we are going to have our final panelists, senator dick durbin and we'll hear from him. we'll take a two minute break to switch out the panelists. and audience, please stay seated or senator durbin. well, welcome senator dick durbin to the committee on oversight and reform, subcommittee on economic and consumer policy. my favorite senior senator from my home state of illinois. he needs no introduction on the advocacy is valiant youth on smoking among
and to combat smoking in general. on the author of the ban america, flights in which came into being in 1990, 29 years ago, when he was a member of this house. and at that time, powerful interests in the tobacco industry fought his efforts to put this law into place. but now we know the tremendous positive impact of that law. and we have senator durbin to thank. and he has been an outstanding advocate on the issue of fighting e-cigarettes for youth. so we welcome him to our committee. without objection, sir, your written statement will be made part of the record. with that, senator durbin, you are now recognized.
senator durbin: thank you for holding this important hearing and good to be back in the peoples' house and in a hearing. seems like old times. i know today you are looking at the role of juul and f.d.a. and reached this point where we are facing in the words of the f.d.a. a vaping epidemic. last year alone, 80% of high school students vaping and today because of devices like juul and the accompanying kid-friendly flavors, four million children nationwide are vaping. juul and other e-cigarette companies claim it is for adults to quit cigarettes. here's the starting point. there is no clinical trial proving that juul devices help
add utilities quit cigarettes. despite the marketing claims and the paid testimonials, there is no credible medical evidence of juul's most fundamental marketing claim. none. further, more than 20% of children under the age of 18 are using e-cigarettes compared with less than 3% of adults. juul knows exactly where the money can be found and not from add utilities looking to quit smoking, it's kids. the epidemic is an old battle. i won't go into the details, but on friday, november 13, 1959, one week before my 15th birthday i stood at my fat's hospital died who died from lung cancer, two packs of camels a day. he was 53 years old.
we have had some successes. in 1987 in my third term in the house, second term on the appropriations committee, i suck iffully an appropriations amendment banning smoking on 80% of airline flights in the united states. it was a major miracle. no one expected this young congressman from illinois with the opposition of both republican leadership to pass this measure on the floor. what they failed to understand is the house of representatives is the largest frequent flyer club in america and second sick smoke. smoke. cond-hand the bill was signed into law by president reagan, they called my intrusion on individual rights. you may have echoes of this. it was the first step. i didn't realize that eliminating this inconvenience was a tipping point.
but it was. it turned out that a lot of people thought if second-happened smoke is dangerous on a plane, why isn't it dangerous in a theater, restaurant or bowling alley. we made cigarettes more expensive with taxes. that is the single greatest deterrent to children turning to cigarettes. we dumped joe camel and the marlboro man. we prohibited kid-friendly flavor like strawberry and grape and since these historic changes, the percentage of youth smokers declined from 28% in the year 2000 to less than 8% today. anyone who believed that the multi-billion dollar industry would go quietly ignored the power of their greed. losing their market share, big
tobacco put their marketters to work. first they needed a new product that didn't carry the moral taint of cancer causing tobacco. f it looked like a usb flash drive. they needed a campaign that included an unproven positive health claim such as juul's current make the switch slogan. ey relied on $12.8 billion investment from an old stand by, formerly known as phillip morris. they needed a special strategy focused on kids because they knew that children for a variety of reasons, the more susceptible new users of products, it worked with cigarettes and was going to work with juul and vaping. how did they lure the kids? i have a bag full of them here, all of the different flavors. but they include fruit medley,
gummy bear, whipped cream, union corn poop, razz will berry and cotton candy. tell me that is about add utilities switching from cigarettes and vaping. they needed the food and drug administration to look the other ay as their empire mushroomed. unform the f.d.a. has been happy to serve. delaying commonsense legislation by years refusing to remove illegal products in the market and standing silent in the falls health claim by juul. i have made it clear to the acting administrator that f.d.a.'s hapless spectatorship has to come to an end. so what has been the result of big tobacco combined with the
f.d.a.'s abject failure to regulate the industry. between 2017 and 2018, the number of teenagers increased by 40%. this was the largest single year increase in tobacco use ever. that's right. all of our significant hard-earned gains to reduce are being reversed because of juul. and all of the full-paged juul ads decrying children, you know where you see them, you see them "the hill," "roll call" "washington times". when we said lay off the kids, they bought full-paged ads saying we don't want kids to smoke cigarettes. how many kids get up in the morning to read the "wall street
journal"? this is a pure campaign, once by big tobacco to try to say they have a business model that isn't directed at kids. the facts tell us otherwise. i urgeat today's vaping, to crack down on e-cigarette kid-friendly flavors. i'm joined by senator murkowski. our safe kids act would give the companies one year. companies would have to prove that their products help add utility cigarette smokers to quit, they have to prove that their product doesn't harm and they would have to prove their products do not cause children to start nicotine. if the bill moves this year, it's imperative that the legislation includes strong provisions to crack down on
kid-friendly e-cigarette flavors that are addicting our kids. as someone who lost his father as a kid, i hoped that e-cigarettes would prove to be a smoking cessation for adults. there is no proof. the candy dessert families are causing children to develop this addiction than hepping add utilities stop smoking study. it leads to 81 new smokers for every one smoker who quits. according to the twuth initiative 15-17-year-olds are 60 times more likely to use juul. a recent study published in the american journal of the medical association, they are three times more likely to go on to smoke cigarettes and consider this, juul is widely popular
with kids and accounts for 70% of e-cigarette sales in the united states. make no mistake, juul now partnered with the tobacco industry is driving this epidemic as they come before this committee. congress waited far too long to start protecting children. history is now repeating itself. our inaction combined with f.d.a.'s come placensy is dooming a new generation of children. most parents care when their teenager is lost in a cloud of vape smoke. i look forward to work with you on a bicameral crisis to address this epidemic. i never dreamed after taking cigarette smoking off of airplanes that in my third term in the house that i had a chance to win, but i did. the net result of it because of unforeseen developments was a dramatic change in america in
their view towards smoking. we stepped in and took on big tobacco. the question is can we work with bipartisan political will to take on big vaping now for the benefit of the young people sitting behind me and those across america. thank you, mr. chairman. >> thank you very much, senator durbin for that eloquent statement and thank you for your life-long efforts to combat nicotine use. i want to thank the panelists and the time you took to be here. part 2 of this very, very important hearing is tomorrow when we have the founder of juul before us at 2:00 p.m. in this very same room. i ask unanimous consent to insert the following items into the official record of the hearing. fell tements from dr. sheer of stanford university, a
statement from president of teach -- teens against vaping and a letter from the university of california, irvine. hearing no objection, so ordered. we are adjourned. [captions copyright national cable satellite corp. 2019] captioning performed by the national captioning institute, which is responsible for its caption content and accuracy. visit ncicap.org
>> if you want more information on members of congress order crmp span's congressional directory available online at c-spanstore.org. >> james monsees co-founder of juul labs testified the next day before the subcommittee answering questions about juul's marketing to youth and the steps he says the company is taking to eliminate vaping and the use of their product by