Going to show you some of the recent debate in congress and at the white house on the issue of vaping and underage use of ecigarettes. We are joined by andrew siddons, who covers health care for cq roll call. Tell us why the issue of underage vaping became a bigger issue in 2019. Andrew i think it was a combination of factors that really drove this to the front of the policy debate this year. One was just the year over year increases in the number of teens who are reporting ecigarette use. Thats been increasing for several years, but 2019, we saw another significant increase over last year. Another was interrelated, but a sort of distinct issue that we saw, starting over the summer with vaping related illnesses that were beginning to emerge, that weve now seen thousands injured and dozens dead from this. Thats related to illicit thc vaping, which is distinct from the problem of ecigarette use. But the urgency of those illnesses i think really prompted policymakers to want to respond more broadly to the vaping issues were dealing with in the u. S. Host and the Administration Starts the new year, starts with 2020 an announcement about vaping and ecigarettes. Andrew siddons, you are covering this story. What did they say . Andrew so, the Administration Says that in early february, products like juul, which are the most Popular Among Young People and use nicotine filled pods or cartridges, they will only be able to be sold and flavors like tobacco or menthol. Previously, juul had been available in flavors like mint, mango, fruit, and otherwise. The companys already taken those products off the market a few months back because of public pressure and anticipation of these flavor restrictions. And vuse,ts like njoy similar to juul, other things that are pod or cartridgebased, they will have to take their flavors off the market. The other type of ecigarettes products available, there are these devices that have tanks that the users can refill them with liquid nicotine themselves. These tend to be more popular among adults. Theyre harder to conceal than products like juul, and the shops that sell the flavors for those will continue to operate as they currently have as long as they have strict age verification procedures in place, and as long as theyre not selling flavors that are obviously marketing to children. So they wouldnt be able to sell things like flavors based on cereal or Something Like that. So, those shops will continue to operate as they normally have. Host President Trump was at maralago over the holiday break, and on new years eve, he previewed the announcement, speaking with reporters. Lets take a listen. Pres. Trump yeah, the vaping is coming out. We are just going to be announcing it very shortly. Some people already know about what were doing. We have to protect our families. At the same time, its a big industry. We want to protect the industry. And, as you know, well be taking it off, the flavors for a period of time. Certain flavors. Were going to protect our families, our children, and our industry. Hopefully, if everything is safe, they will be going quickly back onto the market. For the flavors well, off. So the flavors will come off. They will be checked. People have died from this. Theyve died from vaping. We think we understand why, but were doing a very exhaustive examination and hopefully everything will be back to the market very, very shortly. Look, vaping can be good from the standpoint you look at the ecigarettes, you stop smoking. If you can stop smoking, thats a big advantage. Back on we will get it the market very, very quickly, but we have to protect the children. We have to protect the families. At the same time, we have a very big industry. It has become a very big industry. Were going to take care of the industry. Host were going to show you some of President Trumps public deliberations on the issue a little bit later. Right now, part of a House Oversight subcommittee hearing from july. Well hear from High School Students and their parents. Two of the students say a representative of the eCigarette Company juul gave a presentation to their ninth grade classroom and said that ecigarettes are totally safe. Im meredith berkman, and i represent parents against vaping ecigarettes, we call it pave, a Grassroots Group founded over a year ago by three concerned moms. We already have groups of activated parents across the country, from california to new york and places in between. We have people with us today from texas, from georgia, from virginia, new york, new jersey, etc. My cofounders are behind me with members of our families. Between us, we have nine kids between the ages of seven to 19. Along with our friend mimi, also here, we created pave to the the juulingse to epidemic that has seemed to come out of nowhere. Yet experts consider one of the most serious adolescent Public Health crises our country has faced in decades. Our goal today is to give voice to this 3. 6 million teens who are vaping, most of them juuling. This most recent figure from the cdc is already outdated. As you said, between 2017 and 2018, there was a 78 rise in the use of these products by High School Students, and 48 rise in use by middle school students. And experts believe the new figures this fall will likely be much higher because nothing has happened to have them go down. We hear from desperate parents every day, who contact us seeking resources, information, and help further juul dependent, for their juuldependent, nicotineaddicted kids, but there is not any fda approved treatment for this addiction. I will share very briefly just one or two stories, because theyre heartbreaking and they come from every state represented here on the panel, and probably every state of people in this room. From massachusetts, our pave advocate speaking about her son, cade, a hockey player, described how he developed a cough and was complaining he could not breathe while skating. He became distant, moody, irritable, and had extreme bouts of anger, a very common thing people report. The home environment was toxic. And it turns out that cade has restrictive lung disease. He needs inhalers and oral steroids. He had been smoking a pod a day, the equivalent of a pack of cigarettes a day for three years. Kelly from North Carolina is here with her son, luca, whose addiction was so severe he spent 39 days as an inpatient in a Rehab Facility in california. And kelly said, we began living with a stranger. Our straight a students grades dropped to f. It was the extreme anger. It turned out our 14yearold had a Substance Abuse problem and that substance was juul. And now i want to share a personal story, a story about how juul went after our kids and their friends by coming into their School Without the knowledge of the school or of us concerned parents, juul sent a representative to talk to our kids about its product under the guise of education. On april 3, 2017, my then 15yearold son caleb, whos here, told me there had been an antiaddiction talk. The teachers left the room and the man gave a confusing talk about juul, telling them it was not for kids but for adults. It was much safer than cigarettes. The fda would approve it any day. When he was done, caleb and his friend philip went up to talk to him. He repeated juul was for adults, not kids. Then he took out this sleek looking juul, showed the boys how it worked, and called it the iphone of vapes. And thats when we moms decided to fight back. We had discovered a few months before that our kids were juuling at home, right under our noses, which is also very common. It doesnt mean youre a bad parent. It is stealth by design. We knew that nicotine was harmful to our kids brains. And as we researched and put pieces together, we learned that juuls Deceptive Behavior seemed to be part of this marketing strategy. In california, a retired superintendent was offering schools in his state and in massachusetts money that they would implement the antijuul curriculum that he was offering on juuls behalf. We came across the stanford medical schools tobacco prevention toolkit with an odd disclaimer that we immediately realized was a reference to juul taking information it shouldnt have. None of this is surprising. As i said, juul is stealth by design. Juul says it no longer restocks retail orders of flavors that research has proven are hooking the kids. Yet just the other day, in a one block radius in two different stores, i was able to buy these menthol sorry, these mango pods that juul says are no longer on the market, but they are still online. And thats the problem. If juul really wants to slow the youth epidemic and keep young kids from starting, they will immediately remove all flavors from the market, including menthol and mint, the most popular kids flavors, and stop spending millions of dollars on lobbyists to oppose sensible legislation that pave parents and our Many Coalition partners are fighting for all over this country, to restrict youth access to juul and other products. We hope todays hearing motivates members of congress on both sides. We all care about kids to hold juul accountable, not only for the epidemic, but for its predatory practices and causing harm to so many kids in this country. It is not a political issue, but a moral one. If we dont take action now, we face an entire generation addicted to nicotine, who are human guinea pigs for the juul experiment overall. Thank you, mrs. Bergman. First of all, after you discovered that a presenter representing juul gave a closed assembly at your childrens school, you researched the issue and formed an Advocacy Group to inform parents around the country about the dangers of adolescent ecigarette use. Thank you for your continued advocacy. As a parent of three Young Children myself, including a teenager, i was shocked to hear juul had access to children without the presence of teachers or administrators, and without parental permission. Juul continues to partner with youth organizations across the country, so its important to understand what outreach looks like on their part. Mrs. Berkman and mrs. Furman, id like to ask a couple of questions of your sons, if thats ok. Yes. Philip and caleb, can you please come to the table for a couple minutes . Id like to first address caleb. Caleb, what grades were you and philip in in the year of the juul presentation . Ninth grade. Can you speak directly into the microphone . Ninth grade. Thank you. What where students told before the presentation began . We were told we were having a Mental Health addiction seminar that we have three times a year. And the teachers are told to leave the room so it is a safe space for kids to talk. Did most of your classmates believe juul was safe prior to the presentation . I think many kids were already juuling and had their doubts. But i think a lot of kids still thought it was possibly dangerous. Did the presenter ever mention his connection to juul, and were your teachers in the room when he spoke . He did mention his connection to juul and my teacher was not in the room when he spoke. Did the presenter say juul was safe . Yes. Did the presenter call juul totally safe more than once . Yes. What impact did those totally safe comments have on your classmates, some of whom may have already started vaping . For my classmates who are already vaping, it was a sigh of relief because now they could vape without any concern. Erewere their kids w there kids who had never been juuling that were more likely to try after hearing it was totally safe . I cant say for sure, but i believe that after this meeting, kids were more inclined to vape because now they thought it was just a flavor device that didnt have any harmful substances in it. You and philip approached the presenter when the assembly concluded. What motivated you to even approach him in the first place . I believed the presenter was sending mixed messages by saying juul is totally safe, and following up every totally safe statement with, but we dont want you as customers. And i saw a mixed message being sent and i believe the presenter was playing on the rebellious side of teens, who when they are told not to do something, they are more likely to do it. Philip, let me ask you a couple questions. What was your experience speaking to the presenter . So, we went up and talked to him and caleb asked a question about what can you do if your friend is addicted to nicotine . Philip, were you addicted to juul at the time of this presentation . I was. And when caleb asked the presenter what he should do if he had a friend who was addicted to nicotine, was caleb referring to you . He was. How did the presenter answer calebs question . Since caleb was not specific on what kind of nicotine he was addicted to, whether it was in ecigarette or cigarettes, the speaker thought he was talking about cigarettes. He said he should mention juul to his friend because thats a safer alternative than smoking cigarettes and it would be better for the kid to use. So let me get this straight, he wanted you to switch from a combustible cigarette to juul . Yes. Did the presenter demonstrate the product to you . He didnt use it but he did take it out and show it to us. Ok, this is very disturbing behavior, to say the least. A person connected to juul pulled out a juul device to demonstrate its safety to teenagers, and then lied about the product being totally safe. Did he say anything else about whether the government had approved juul . He mentioned that the fda was about to come out and say that juul was 99 safer than cigarettes, and he said that would happen very soon, and that it was in fda approval while the talk was going on. Thank you, caleb and philip. Let me ask dorian, phillips mother, to say a couple words here. Dorian, thank you for coming today. Thank you. Your son philip just stated he was addicted to juul. Yes. How did his addiction impact your family . It was difficult. And at first, we didnt understand what was going on. As a young 14yearold, he was interested in so many things, from surfing to cooking to his little sister. And i started to find these flash drives and these green plastic caps in his pockets. And i didnt really know what it was at first. So he kept saying they belonged to a friend. And we would have fights about it. And i figured out what it was because i googled the name on the side. It was difficult. He changed kind of overnight. He started spending a lot of time in his room in the dark. He became moody. We had a very contentious relationship. I became very suspicious, obviously. And i think he didnt really understand what was going on himself, and neither did we. Thank you, dorian. Let me now recognize Ranking Member cloud for five minutes of questioning. Thank you, chairman. Ms. Berkman, im curious to the reaction. I assume you approached the school board, the principal. What was the reaction . The school had no idea that the outside group had brought a juul representative into the school. The school had hired a group yes. And we believe the outside group was naive, definitely, but in good faith. Because when i called to ask about this presentation, the staffer who answered the phone said, oh, you found the right person. I was researching antijuul education online, and i came across the name of a woman named julie henderson, who was listed then and no longer on the juul website as a youth prevention coordinator. Then she called and this woman says, i have the perfect person, and sent allie. Ok, thank you. Dr. , could you doctor, could you explain the difference, from a health perspective, between a traditional cigarette and an ecigarette . Is there one . Yeah, there are many differences. Traditional cigarettes consist of a preparation of tobacco leaves, which when burned, create smoke and contains roughly 7000 different chemicals, most of which are not good for the human body. Ecigarettes contain far fewer ingredients in addition to likeine, usually something li e commonly found ingredients in foodstuffs and some flavorings. And this, in general, the difference in number of compounds in ecigarettes versus cigarettes makes ecigarettes, in general, safer, although they can probably vary from product to product. A lot of the safety of these ecigarettes depend on temperature controls. So, for example, if products have adequate temperature control, they tend to be less toxic. Ok, weve known cigarettes for a while cause cancer. Talking about prevention, i remember in third grade seeing seeing lungs sitting in a jar third grade seeing lungs sitting in a jar that had somebody who had passed away from cigarette use. But i guess what im trying to get down to is, what are the Health Effects of the combustible side of it and what are the effects of the nicotine side . Yeah, and thats an important point to raise. So if we look at nicotine in and of itself, its not riskfree but its probably a lot less toxic compared to the other chemicals that come out of cigarette smoke. For example, nicotine probably does not cause cancer. It may have some small effects on existing cardiovascular disease and so forth. The brain might have to adapt to having a drug on board, neural adaptations, which are true for any drug. But the nicotine itself is not the culprit when it comes to things like cancers, at least as far as we know. Ok, we seem to have a kind of competing set of facts here. We have data that shows teen ecigarette use has gone up a tor, youthen, doc mentioned a lot of that is transitional. Is it not . Is it new use . I guess if you can clarify that a little bit for us to have a better understanding of what is new use, transitional use. Yeah, thats an important question that i dont think we have a good handle on yet, because a lot of the service we look at are crosssectional, meaning a slice in time. We see kids that report to us that they are using one or two days or every day and so forth. What we need are studies that track kids over time to actually see whether the ones who are starting out one or two days go on to use more. But once again, we dont know what the real implications are of these different patterns of use and i want to emphasize, share the concern that kids shouldnt be trying these products and they shouldnt be using them, certainly shouldnt be using them on a frequent basis. The cdc data shows huge use, over 2 million american High School Students and many hundreds of thousands of middle students. A fraction of them experiment. Others b