Government policy

How should the epidemic of e-cigarettes among teens be addressed? Health experts weigh in

On December 18th, the Surgeon General announced an advisory on e-cigarette use. In it, he called the rise in popularity of products like Juul an epidemic. Juul and its competitors in the e-cigarette industry have come under fire for potential health risks their products impose on users (largely teens). E-cigarettes contain addictive levels of nicotine, yet they appeal to youth with kid-friendly flavors in ways regular cigarettes often do not, presenting a unique challenge for public health experts.

In an interview with the chief medical officer of the Association of State and Territorial Health Officials, U.S. News covered various efforts to reduce the use of e-cigarettes. Experts have drawn many ideas from successful policies with traditional tobacco products, like taxation. Experiences with conventional cigarettes have taught us that price is important: where cigarettes cost more, people smoke less. When it comes to youth, who generally have a lower incomes than adults, a tax-induced price hike could be even more effective. Other time-tested interventions include smoke-free indoor air policies and reducing flavors with “blatant appeal to children.”

The medical officer also noted how regular cigarettes were once marketed as sexy, like Juul and its new technology are attractive to kids today. Yet social acceptance of cigarettes has reversed as cigarette health threats were exposed—the same change in norms could be possible with e-cigarette consumption.  

Other health experts caution against conflating traditional cigarettes with e-cigarettes. After all, there are notable differences between the two: the amount of nicotine in e-cigarettes varies widely; current laws allow e-cigarettes in many areas where traditional cigarettes are prohibited; and, unlike traditional cigarettes, users can stop and restart “smoking” e-cigarettes (e-cigarettes “burn” using a battery rather than flame, meaning users take take single puffs at a time rather than committing to an entire cigarette).  Mirroring e-cigarette policy with traditional cigarette policy in ways that fails to account for these differences could render the new interventions ineffective.

Ultimately, more research is needed on the health risks e-cigarettes impose on teens before effective interventions will be made possible on a nationwide level.

#WhereAreTheChildren: concerns for the well-being of immigrant children in the age of viral hashtags

As #WhereAreTheChildren flooded Facebook and Twitter posts this past week, CHIL is taking a closer look at the role of social media in issues like child immigration policy and why such policies are relevant to children’s health in the first place. Given the nuanced nature and diverse moving parts, we will cover this topic in a series of posts.

There are millions of immigrant children living in the U.S., some of whom have undertaken incredibly risky journeys along the way. From on-the-ground Border Patrol agents to broad, federal immigration policy, how our government treats minors upon arrival can impact their health and well-being. The #WhereAreTheChildren trend caught America’s attention by exposing the alarming number of 1,475 children unaccounted for on the part of the Department of Health and Human Services (HHS).

Much confusion followed this news. The New York Times clarified that the 1,475 are a fraction of 7,635 children who migrated mainly from “Honduras, El Salvador and Guatemala, and were fleeing drug cartels, gang violence and domestic abuse, according to government data.”  

So where are these 1,475 kids?

In the worst-case scenario, some kids may have fallen victim to smugglers or human trafficking. However, experts caution many of these children are likely still safe with their sponsors, who are often parents or family members already living in the U.S. Eric Hargan, secretary for HHS, said in a statement that often sponsors cannot be reached because they themselves may be living as undocumented immigrants and are hesitant to talk with federal authorities.

The lack of sponsor communication raises concerns about the health and safety of the children for whom they’re responsible. Even if a child is out of harm’s way, the sponsor could still fear using beneficial federal resources for the children. For example, undocumented children have the same right to public education as American citizens. In some states, there are federally-funded health clinics which are required to treat all people regardless of documentation status. However, if sponsors are reluctant to use federal systems in effort to avoid governmental authority, they and their children lose access to necessities like basic education and medicine. The 1,475 missing follow-up calls manifest the prevalence of this reluctance.

Moreover, while interest in the well-being of immigrant children has spiked in recent weeks, the issue itself is decades old. Albeit much misinformation followed #WhereAreTheChildren, at the very least the hashtag drew much-needed attention to this vulnerable population of young kids. It forces us, as children’s health advocates and more broadly as Americans, to reflect on how we can better fight for the health of vulnerable populations; that is, fight for vulnerable populations not based on the media or political attention they accrue but rather based on their genuine need for allyship and aid.

In the coming weeks, CHIL will take a look at current immigration policies in place to protect the health of immigrant children. Stay tuned.