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Mark Horowitz, M.D., is the kind of newspaper reader who always writes letters to the editor.
He is also a family doctor in New York, specializing in adolescent health.
And so, the day after a story(Www.nytimes.com) "F.D.A., alarmed by adolescence, targets vapors" The New York Times, the newspaper answered Horowitz's question(Www.nytimes.com) to the article in its Opinion section.
"Just this week, taking a story from a 19-year-old man, I asked him if he was smoking cigarettes," wrote Horowitz. "The answer was no, so I asked him if he had smoked."
The patient told Horowitz that he had been blowing "continuously all day" using a JUUL e-cigarette. And he said that he would not stop smoking, even though he had been told now the risks of this habit.
Horowitz quoted the patient: "Everyone is doing it".
The federal government has noted: The adoption of electronic cigarettes by teens, said FDA Commissioner Scott Gottlieb, MD, in a statement on September 12.(Www.fda.gov) has reached "an epidemic proportion of growth".
"Epidemic" is a strong word, but Horowitz is in agreement. "Absolutely, no doubt," he said. News from the AAFP.
"We have developed a new form of nicotine delivery to young people, so that young people can start using the drug without having to worry about the harmful aroma of the drug," he said.
The table of flavors(Www.tobaccofreekids.org) Associated with vaping reminds Horowitz of menthol cigarettes that were heavily advertised in the neighborhood of East Harlem where he completed a teenage-medicine fellowship in the mid-1980s.
According to Ms. Horowitz, adolescence is "a time of risky and impulsive behavior when children think they are indestructible and it is important to be part of a cool group". These factors have always fueled teen smoking. What's different now, he says, is that adolescent patients that he sees do not consider vaping with smoking.
"The way I take a story from a young person has changed, especially with regard to substance use," he says. "We have a method of delivering flavored nicotine – fruity JUULs – and that means young people do not think about smoking."
As Gottlieb says in his statement, "the risk of young people is paramount," time is running out for five major electronic cigarette manufacturers, including leading JUUL laboratories. The FDA has notified companies – JUUL, Vuse, Blu, Logic and MarkTen – 60 days to determine how they plan to reduce the use of vapors by miners.
If companies fail to reverse the trend of youth use, Gottlieb said, the FDA could decide to remove flavored products from the market. He also drew attention to what he called a "crackdown" crackdown targeting online and online retailers selling electronic cigarettes to minors.
Critics of the agency, including a litigator in a lawsuit accusing the FDA of dragging its feet on the application of a rule regarding the regulation of new tobacco products, claim that the latter efforts are still not enough.
Robin Koval, CEO and President of the nonprofit anti-smoking initiative Truth Initiative, said in a statement on September 13(Truthinitiative.org) "The FDA's claim that five electronic cigarette manufacturers plan to tackle the problem of e-cigarettes among youth in the next 60 days is tantamount to asking the fox to recommend plans to protect the chicken coop."
For her part, Horowitz lobbies her teenage patients one at a time.
"At first contact with a young person, on the whole, they are completely in denial," he said. "I can say," Hey, there are things you're trying to do that are not safe for you, "and they probably think," Give me a break, doc. "But the degree to which I pass increases over time, and my chances improve on subsequent visits."
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