This most recent Kentucky Health Issues Poll (KHIP) also found
that 24 percent of Kentucky adults have tried e-cigarettes, about the
same as in 2016 when KHIP first included the question. One-third
of those who’ve tried e-cigs now use them regularly - that’s about
8% of the total Kentucky adult population. Nationally in 2017, just
3% of adults currently use e-cigarettes.
The only group, according to KHIP, among which e-cigarette use
increased significantly was among youth age 18 to 29. Forty three
percent of Kentucky’s young adults tried e-cigarettes in 2018, six
percentage points higher than the 37% who had tried them in 2016.
According to the CDC National Youth Tobacco Survey, the
use of e-cigarettes among young people has surpassed the use of
conventional cigarettes since 2011. Use of e-cigarettes among US
high school students increased from 11.7% in 2017 to 20.8% in
2018, a 78% spike.
Although the FDA limited public sales of e-cigarettes to those
age 18 and over in 2016, there are still no federal regulations on
advertising. E-cigarette manufacturers are now directing their ef-
forts to social media channels like Instagram and Twitter. A recent
survey found that 37% of respondents said they were exposed to
e-cigarette marketing via ads on social media, a higher percentage
than through any other method.
According to a 2018 report from the National Academies of
Sciences, adolescents who use e-cigarettes are more likely to tran-
sition to traditional cigarettes. This report, coupled with the 78%
rise in e-cigarette use among high school students from 2017-18
cited above, indicates that a public health crisis is forming that could
wipe out decades of declining smoking rates in the US.
To protect the non-smoking and non-vaping public from the
harmful health effects of secondhand exposure to toxins emitted
from e-cigarettes and to discourage vaping, particularly among
young people, GLMS, the Board of Health, the Department of
Public Health and Wellness and numerous health care systems
and community groups have also advocated that these products
be prohibited in indoor public spaces. We were successful, and in
2017 e-cigarettes and hookah products were included under the
Louisville’s Smokefree Ordinance which now prohibits smoking
and vaping in indoor public places and worksites.
The next steps in policy change to curb the deadly effects of to-
bacco use include continuing to raise the tax on cigarettes, imposing
an excise tax on e-cigarettes, raising the age to purchase tobacco
products to 21 and banning the use of tobacco products, including
e-cigarettes, in schools, on school grounds and at school events.
PUBLIC HEALTH
We need to be taxing e-cigarettes the same way we tax tradition-
al cigarettes and other tobacco products. GLMS, the Foundation
for a Healthy Kentucky and the Department of Public Health and
Wellness have also advocated for this.
A new poll conducted last December by Mason-Dixon Polling
and Research, Inc. indicated that 73% of Kentucky voters support
adding a state excise tax on e-cigarettes. This support was strongest
among voters identifying themselves as Republicans with 77%
favoring an excise tax on e-cigarettes. Men (76%) were more sup-
portive than women (70%), and even 37% of those who had tried
e-cigarettes said they would support the tax.
Louisville also needs to join the more than 425 “Tobacco 21”
cities in 23 states across America that now require individuals to be
age 21 or older to purchase cigarettes, e-cigarettes or other tobacco
products. More than 95% of smokers started before age 21 and an
estimated 350 teens become addicted each day in the United States.
The Centers for Disease Control (CDC) projects that, without a
trajectory change, nicotine addiction and tobacco use will dramat-
ically shorten the lives of 5.6 million children alive today. Raising
the age to purchase tobacco to 21 will help stem the tide of teen
addiction and prevent them from taking up the habit.
In Kentucky, individuals can currently purchase tobacco prod-
ucts at age 18, and state law preempts municipalities from raising
the age through local initiatives. To make “Tobacco 21” a reality in
Louisville, we will have to either raise the age to purchase tobacco
to 21 throughout the entire state or get rid of preemptions which
are holding Louisville back from making healthy policy changes on
numerous fronts. We can and will accomplish this!
We also need to be protecting students. Jefferson County Public
School campuses are already smoke-free, including e-cigarettes. For
the past several years, there have also been bills before the Kentucky
legislature to prohibit the use of such products on school property
and at all school events throughout the state. Finally, this year, on the
very last day of the 2019 legislative session, this legislation passed,
and the governor has signed it.
Working together, we will continue to push for policy change
to reverse Louisville’s and Kentucky’s long history of adverse health
caused by nicotine use. The Department of Public Health and Well-
ness and GLMS, along with partners from across the community,
will continue to implement policies to achieve health equity and
improve the health and well-being of the people we serve.
Dr. Sarah Moyer is the director of the Louisville Metro Department of Public Health
and Wellness.
Currently, e-cigarettes are subject only to sales taxes in Kentucky,
while traditional cigarettes and other tobacco products incur both
sales and excise taxes. From a public health perspective, it’s important
that we raise the cost of these products to prevent youth as well as
adults who would never have even tried traditional cigarettes from
getting hooked.
JUNE 2019
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