THETOBACCOINDUSTRY
HAS A
KIDS MENU
FlavorsHookKids.org

THE
RUNDOWN
The tobacco industry hooks kids on vaping by using fun flavors thatspark curiosity and make tobacco taste good. That puts teens at risk
for a lifetime of nicotine addiction, health problems, and permanent
brain changes.
Here’s what we know:• In the last 2 years, vaping increased by 218% among middle
schoolers and 135% among high schoolers.
• 96% of high school kids in CA who vape use flavors.
• Teens are nearly 7x more likely to vape nicotine than adults.
• Marijuana vaping among youth increased by 58% in a single year.
• Teens who vape are 3x more likely than non-vapers to become
daily cigarette smokers.
• The average age of youth and young adults who try smokelesstobacco, like chew or snus, for the first time is 16.
Use this guide to help you keep your kids safe from flavored tobaccoand vaping. Share it with parents, school leaders, and other decision
makers. You’ll find resources for helping teens quit, a list of telltale signsof vaping, and a visual guide to vape products. Get advice for talking tokids about vaping, find out how schools are combating the problem, andlearn how to help your community fight back against the powerfultobacco industry.

CLICK TO JUMPCALIFORNIA’S FLAVORED TOBACCO LAW
KNOW THE SIGNS OF VAPINGTIPS FOR TALKING WITH TEENSBE PREPARED FOR EXCUSESHELP KIDS UNCOVER THE FACTS
WHAT IF MY TEEN IS ADDICTED?
WHAT SCHOOLS ARE DOING ABOUT THE PROBLEM
VAPING, TEENS & COVID-19
SOURCES*CALIFORNIA’S FLAVORED TOBACCO LAW
New law ends the sale of flavored tobaccoEnds the sale of most flavored tobacco, including vapes
and menthol cigarettes, at retailers.
Protects kids from the tobacco industry’s flavored death- anddisease-causing products.
Because this new law includes menthol cigarettes, it protects
communities that have been ruthlessly targeted andkilled by the tobacco industry for decades – like the African
American/Black community.
Holds the tobacco industry accountable. Violations will
result in a penalty and fines for tobacco retailers who sell
these products.
Protects communities of color from further police harassment.
The law was intentionally written to focus on the sale offlavored tobacco products, and it does not punish or criminalize
individuals for possession, use or purchase.

Does not apply to the sale of flavored shisha/hookah,premium cigars over $12, and loose-leaf pipe tobacco.

KNOW
THE
SIGNS
OF
VAPING

Are there sweet, fruity, or
menthol smells coming frombehind closed doors?

Is your teen spending more money
than usual or making unexplainedpurchases?

Are there flash drives or otherschool supplies you don’t recognize
in your kid’s backpack or room?
How about small vials or eye
dropper bottles?

Have there been changes in yourkid’s behavior such as increasedmood swings, irritability, anxiety,impulsivity, or learning difficulties?

Have you come across unfamiliar
chargers, coils, or batteries?

Is your teen suffering from more
frequent headaches or nausea?

TIPS FOR TALKING WITH TEENSLISTEN

BLAME FLAVORSTALK SCIENCELEARN MORE

Whether or not your kids have tried
vaping, they’ll benefit from a goodtalk. And a good talk starts withlistening. Let the kids tell you what
it’s like to be surrounded by teens
who vape. These starter questions
are a simple way in:

How has vaping grown so fast?
Blame flavors. 96% of high school
kids in CA who vape use flavors.
Most say flavors are why they use
vapes. No surprise, since fun flavors
trick kids into thinking vaping isharmless. Yet the chemicals thetobacco industry uses to create
those flavors may damage yourlungs, too. Some flavors may
increase the likelihood of addiction
by messing with dopamine, thebrain’s "feel-good" chemical. Help
kids understand that by hooking
them on flavors, including menthol,
the tobacco industry profits.

The main things kids (and adults)
know about nicotine is that it’s
addictive. But addiction is only the
beginning. Teens should
understand that nicotine is brain
poison. It changes the way
connections form in the brain,
making it harder for kids to learn
and pay attention. As if teen years
weren’t hard enough, nicotine canalso increase anxiety, mood swings,
and irritability. Getting hooked on
nicotine puts kids at risk for
addiction to other substances, too.

Visit PAVe (Parents Against Vaping
e-cigs) for a fact-filled toolkit andlinks to helpful websites and videos.

Do you have friends who vape?
Are you curious about it?
Have you been offered a vape?
Have you tried it?
If so, what made you say yes?
If not, what made you say no?
As kids move through middle andhigh school, they’ll face newchallenges. Support them every
step of the way by keeping theconversation going. Did you everfeel pressured to smoke? You could
talk about your experience,
including how hard it was for you toquit. An open dialogue is far more
effective than one big lecture.

Use Stanford’s anti-vaping toolkit
to get downloadable presentations,worksheets, and activity guides.
Get the California Department of
Education’s e-cigarette toolkit.
Learn from the American Heart
Association partnership about the
tobacco industry’s insidious role inhooking kids.
Get tips from the U.S. Surgeon
General on how to talk to your kids
about vaping.

BE PREPARED FOR EXCUSES
Kids are getting a ton of misinformation about vaping online.
Here’s how parents can respond to some common excuses.

KID:

KID:

KID:

KID:

It’s not mine.

Vaping is safer
than smoking.

Nicotine’s just alittle buzz.

It’s not nicotine. It’s justwater and flavors.

ADULT:ADULT:ADULT:ADULT:

I hope it’s not yours, but I get thatyou might be tempted to try
vaping. I’m worried because
vaping can be addictive and canchange the way your brain works.
Plus, I know the tobacco industry
makes vapes that look like flash
drives so they’re easy to hide. It’s
not that I don’t trust you, but you
should know that I’m paying
attention.

There’s actually nothing safe
about vaping. It’s not water vapor
like some people think. The vapor
is actually aerosol that contains
metals, particulates, and toxic
chemicals. And many vapes use
nicotine salts rather than regularnicotine. Salts are inhaled moreeasily and absorbed faster thanregular nicotine.

Nicotine does release a chemicalcalled dopamine in the brain,
which might make you feel good
temporarily. But don’t be tricked.
Nicotine is a neurotoxin, whichmeans it’s a poison that affects
the brain. When you’re young andyour brain is still developing,
nicotine can do lasting, evenpermanent, damage.

It’s not obvious to kids, or evengrownups, that something thattastes minty, fruity, or sweet isactually an addictive drug that
can have long-term effects on a
kid’s developing brain. The
chemicals the tobacco industry
uses to create those flavors may
damage your lungs, too.

HELP KIDS UNCOVER THE FACTS
When it comes to learning the facts about vaping,
help kids figure it out their way.

GOOGLEIT
Teens are digital natives, and aquick Google search will show them
how the tobacco industry has
marketed vapes to kids. Seeing how
Juul and other companies set out
to trick kids into vaping might
trigger your teen’s BS radar.
If you’re going to lead the exercise
with your kid, do some reading
yourself first. Start with this article:
Juul bought ads on Cartoon
Network, other youth sites, suitsays. Or download this PDF from
Stanford researchers so you cansee what Juul was up to from thevery beginning.

Use the PDF to point out thefollowing marketing tricks to kids:
Youthful models
Their body language
Their outfits
Sex appeal
The colorful, trendy backgrounds
Hashtags all over social media
Juul’s presence at music fests
Juul’s free sampling events
Ask teens to decide for themselves
who they think Juul was trying toreach. Chances are, they’ll spot the
hypocrisy in a flash.

HISTORYREPEATING

BIG KIDS
UNITE

Teens (and adults) might besurprised to learn the tobacco
industry has a decades-long historyof trying to market to kids. In the70s, the federal government
mandated that cigarettecommercials be taken off the air.
In the 90s, the cartoon “Joe Camel”
was abolished. In 2009, flavoredcigarettes (except menthol) werefederally banned. And in 2019, newrestrictions were put in place by the
FDA, albeit with dangerous
loopholes. Visit the Smithsoniansite to give teens a glimpse of
the past and to show them how
the e-cig industry is using Big
Tobacco’s playbook.

Maybe teens want a shot at
impacting the epidemic
themselves. With more and morekids vaping, high schoolers could
model safe behavior. Connect with
California’s Friday Night Live forideas on how teens can tackle thishealth topic. Or have teens reachout to their school administrators orcounselors for other ways to get
involved. It could be a science orhealth project, or it could beapplied to community service
hours. Ask your teens if they’d
be up for putting their leadershipskills to work for California’s
greater good.

WHAT IF MY TEENIS ADDICTED?
CALL OR TEXTA HELPLINEDOWNLOAD
AN APPENLIST THE
PEDIATRICIANBESUPPORTIVE

Kick It California connects yourkid (or you) to a trained Quit Coach.
Text “I Can Quit” to 66819
or call 800-300-8086.

This Is Quitting is text-message
support app for teens. Text
“DITCHJUUL” to 88709.

Ask your pediatrician to talk about
vaping with your teen. Doctors
often explain things in a way kids
will listen.

Quitting is hard. As many nicotine
addicts and recovering addicts willtell you, it usually takes more than
one try. Keep encouraging andempathizing with your teen. Reward
the incremental progress andaccept the setbacks as part of theprocess.

My Life My Quit connects kids witha supportive, knowledgeable coach.
Text “Start My Quit” to855-891-9989 or call.

Smoke Free Teen has tools forquitting, including what to expect
during the first few days.

WHAT SCHOOLS ARE DOINGABOUT THE PROBLEM
Even during the pandemic, thetobacco industry has continued
to target teens. Which meansthat as schools reopen,
teachers and administrators
have even more things to watch
out for. Here are some of themany ways schools are
addressing the vaping crisis.

ADMINISTRATORS

STAFF

PARENTS

Adopting a tobacco-free policy that
includes e-cigarettes in thedefinition of “tobacco product” andlaying out enforcement and other
implementation procedures.

Educating teachers, counselors,
nurses, coaches, custodians, andother staff so they know what thedifferent e-cigarette/vaping
products look like. These devices
are changing all the time.

Hosting virtual or in-person
informational parent nightsfeaturing public health experts,
local doctors, and law enforcement
representatives.

Sharing resources such as thisprintable guide or
FlavorsHookKids.org withadministrators to spread the wordon school Facebook pages,
websites, or in email
announcements to parents.

Posting “No tobacco” signs andannouncing reminders at sporting
events and other gatherings.

STUDENTSEngaging students in media literacy
to counter the tobacco industry’s
influence.
Encouraging kids to visit the nurse/
wellness counselor at school forquitting resources like helplines(1-844-8-NO-VAPE) and apps
(thisisquitting.com).

Enlisting the Parent Teacher
Student Association (PTSA) toadopt an anti-vaping resolution;
host educational sessions or
activities about vaping; hosteducational forums for parents,
students, and community
members; and improve campus
security with more frequentmonitoring of locations wherestudents vape. Be sure to attend tovoice your concerns.

VAPING, TEENS & COVID-19

fi

We need toprotect their lungs.
The tobacco
industry wants toprotect its pro ts.

Saying that vaping is bad for human lungs is anunderstatement. It has become clear that vaping
can harm lungs at the cellular and organ levels
and worsen the body’s ability to fight off
respiratory infections, just like smoking can. And
with COVID-19 unlikely to disappear any timesoon, this means anyone who vapes is atincreased risk.
We know that smoking and vaping are associatedwith an inflammatory process in the lining of thelungs, the very place where highly contagious
COVID-19 causes its most serious damage. We
also know that teens vape nicotine at a higher
rate than adults, and that in the United States,
COVID-19 devastated minority communities. Thisputs teens, and especially teens of color, at risk
for more severe COVID-19 complications.

When the pandemic began, the tobacco industry
could have paused pushing its deadly productson these populations. Instead, it continued tomarket kid-friendly vape flavors like Cotton
Candy and Blue Razz. And they’ve been selling
menthol cigarettes to Black communities as
aggressively as ever. Would they admit it? Hardly.
The tobacco industry has run disinformation
campaigns for decades, lying to people to boost
their own profits.
Not even COVID-19 stopped the tobacco
industry from promoting products that cause
serious harm and even death. But we won’t let
their actions go unanswered, and until they’re outof business we’ll keep providing Californians thefacts they need to stay healthy and safe.
Click for an update from UC Davis’s Dr. Tongon how smoking and vaping can lead to
COVID-19

Ambrose BK, Day HR, Rostron B, et al. Flavored
Tobacco Product Use Among US Youth Aged 12-17
Years, 2013-2014. JAMA. 2015;314(17):1871–1873.
doi:10.1001/jama.2015.13802

Centers for Disease Control and Prevention. World
Map. cdc.gov. https://www.cdc.gov/coronavirus/
2019-ncov/global-covid-19/world-map.html. Updated
May 7, 2020. Accessed May 7, 2020.

Aubrey A. Parents: Teens Are Still Vaping, Despite
Flavor Ban. Here’s What They’re Using. NPR.https://www.npr.org/sections/health-shots/
2020/02/17/805972087/teens-are-still-vapingavors-thanks-to-new-disposable-vape-pens.
Published February 17, 2020. Accessed March 11,
2020.

Cleveland Clinic. Here’s the Damage Coronavirus(COVID-19) Can Do to Your Lungs. clevelandclinic.org.
https://health.clevelandclinic.org/heres-thedamage-coronavirus-covid-19-can-do-to-yourlungs/. Published March 20, 2020. Accessed April 8,
2020.

Becker R. Juul’s nicotine salts are dominating themarket — and other companies want in. The Verge.
https://www.theverge.com/2018/11/21/18105969/juulvaping-nicotine-salts-electronic-cigarettes-mybluvuse-markten. Published November 21, 2018.
Accessed March 13, 2020.
Brandt AM. Inventing con icts of interest: a history of
tobacco industry tactics. Am J Public Health.
2012;102(1):63 71. doi:10.2105/AJPH.2011.300292
Cascella M, Rajnik M, Cuomo A, et al. Features,
Evaluation and Treatment Coronavirus (COVID-19)[Updated 2020 Apr 6]. In: StatPearls [Internet].
Treasure Island (FL): StatPearls Publishing; 2020
Jan-. Available from: https://www.ncbi.nlm.nih.gov/
books/NBK554776/

Cullen KA, Ambrose BK, Gentzke AS, Apelberg BJ,
Jamal A, King BA. Notes from the Field: Use of
Electronic Cigarettes and Any Tobacco Product
Among Middle and High School Students — UnitedStates, 2011–2018. MMWR Morb Mortal Wkly Rep.
2018;67(45):1276-1277. doi:10.15585/mmwr.mm6745a5

CDC Foundation. Monitoring U.S. E-Cigarette Sales:
State Trends. Atlanta, GA: CDC Foundation; 2020.

Dai H, Leventhal AM. Prevalence of e-Cigarette UseAmong Adults in the United States, 2014-2018[published online ahead of print, 2019 Sep 16]. JAMA.
2019;322(18):1824–1827. doi:10.1001/jama.2019.15331

Centers for Disease Control and Prevention.
Outbreak of Lung Injury Associated with the Use of ECigarette, or Vaping, Products. cdc.gov. https://www.cdc.gov/tobacco/basic_information/ecigarettes/severe-lung-disease.html. Published2020. Accessed February 18, 2020.

‐

fl

fi

fl

fi

fl

fi

fl

fl

fl

‐

fi

fi

Centers for Disease Control and Prevention. Quick
Facts on the Risks of E-cigarettes for Kids, Teens, andYoung Adults. cdc.gov. https://www.cdc.gov/
tobacco/basic_information/e-cigarettes/QuickFacts-on-the-Risks-of-E-cigarettes-for-Kids-Teensand-Young-Adults.html. Reviewed February 3, 2020.
Accessed May 8, 2020.

fl

Crawford C. NYSAFP: Ban Tobacco/Vaping Products
During COVID-19 Pandemic. American Academy of
Family Physicians. https://www.aafp.org/news/
health-of-the-public/
20200407nysafptobaccoban.html. Published 2020.
Accessed April 15, 2020.
Cullen KA, Gentzke AS, Sawdey MD, et al. e-Cigarette
Use Among Youth in the United States, 2019
[published online ahead of print, 2019 Nov 5]. JAMA.
2019;322(21):2095–2103. doi:10.1001/jama.2019.18387

Centers for Disease Control and Prevention. Cases in
U.S. cdc.gov. https://www.cdc.gov/coronavirus/2019ncov/cases-updates/cases-in-us.html. Published2020. Accessed April 15, 2020.

fi

fl

*

SOURCES

Diaz MC, Donovan EM, Schillo BA, Vallone D. Menthol
e-cigarette sales rise following 2020 FDA guidance[published online ahead of print, 2020 Sep 23]. Tob
Control. 2020;tobaccocontrol-2020-056053.
doi:10.1136/tobaccocontrol-2020-056053
Edney A. Juul’s Marketing of Device May Have
Violated Law, FDA Says. Bloomberg.
https://www.bloomberg.com/news/articles/
2019-09-09/juul-warned-by-fda-over-claims-itsvaping-devices-are-safe. Published September 9,
2019. Accessed May 8, 2020.
Etter JF, Ussher M, Hughes JR. A Test of Proposed
New Tobacco Withdrawal Symptoms. Addiction.
2012;108(1):50-59. doi:10.1111/
j.1360-0443.2012.03981.x

Froeliger B, Modlin LA, Kozink R V., et al.
Frontoparietal attentional network activation differs
between smokers and nonsmokers during affective
cognition. Psychiatry Res Neuroimaging.
2013;211(1):57-63. doi:10.1016/
J.PSCYCHRESNS.2012.05.002

Karlis N. The e-cig industry poured money into
lobbying prior to Trump’s reversal on vaping ban.
salon.com. https://www.salon.com/2019/11/18/the-ecig-industry-poured-money-into-lobbying-prior-totrumps-reversal-on-vaping-ban/. Published
November 18, 2019. Accessed February 21, 2020.

Sully E, Brody B. Juul Spent Record $1.2 Million
Lobbying as Regulators Stepped Up. Bloomberg.
https://www.bloomberg.com/news/articles/
2019-10-22/juul-spent-record-1-2-million-lobbyingas-regulators-stepped-up. Published October 21,
2019. Accessed February 21, 2020.

Gaiha SM, Cheng J, Halpern-Felsher B. Association
Between Youth Smoking, Electronic Cigarette Use,and Coronavirus Disease 2019. J Adolesc Heal.
August 2020. doi:10.1016/j.jadohealth.2020.07.002

Karni A, Haberman M, Kaplan S. Trump Retreats From
Flavor Ban for E-Cigarettes. The New York Times.
https://www.nytimes.com/2019/11/17/health/trumpvaping-ban.html. Published November 17, 2019.
Accessed February 21, 2020.

Truman P, Stan ll S, Heydari A, Silver E, Fowles J.
Monoamine oxidase inhibitory activity of avoured ecigarette liquids. NeuroToxicology. 2019;75:123-128

Gentzke AS, Creamer M, Cullen KA, et al. Vital Signs:
Tobacco Product Use Among Middle and High SchoolStudents — United States, 2011–2018. MMWR Morb
Mortal Wkly Rep. 2019;68(6):157-164. doi:10.15585/
mmwr.mm6806e1
Gotts JE, Jordt SE, McConnell R, Tarran R. What are
the respiratory effects of e-cigarettes? BMJ.
2019;366. doi:10.1136/bmj.l5275
Volkow ND. Collision of the COVID-19 and Addiction
Epidemics [published online ahead of print, 2020 Apr
2]. Ann Intern Med. 2020;M20-1212. doi:10.7326/
M20-1212
Guan WJ, Ni ZY, Hu Y, et al. Clinical Characteristics ofCoronavirus Disease 2019 in China. N Engl J Med.
2020.
He er M, Gartner CE. The tobacco industry in thetime of COVID-19: time to shut it down? Tob Control.
2020;0(0). doi:10.1136/tobaccocontrol-2020-055807
Hughes JR. Effects of abstinence from tobacco: Validsymptoms and time course. Nicotine Tob Res.
2007;9(3):315-327. doi:10.1080/14622200701188919
Huttunen R, Heikkinen T, Syrjänen J. Smoking andthe outcome of infection. J Intern Med.
2011;269(3):258–269. doi:10.1111/
j.1365-2796.2010.02332.
Johnston LD, Miech RA, O’malley PM, Bachman JG,
Schulenberg JE, & Patrick ME (2019). Monitoring the
Future national survey results on drug use 1975−2018:
Overview, key ndings on adolescent drug use. Ann
Arbor, MI: Institute for Social Research, University ofMichigan. Published January 2019. Accessed March
12, 2019.

Masadeh MM, Hussein EI, Alzoubi KH, Khabour O,
Shakhatreh MA, Gharaibeh M. Identi cation,
characterization and antibiotic resistance of bacterial
isolates obtained from waterpipe device hoses. Int J
Environ Res Public Health. 2015;12(5):5108–15
Mehta H, Nazzal K, Sadikot RT. Cigarette smoking andinnate immunity. In amm Res. 2008;57(11):497 503.
doi:10.1007/s00011-008-8078-6
Monitoring U.S. E-Cigarette Sales: State Trends.
https://www.cdcfoundation.org/State-ECigaretteSales-DataBrief-Dec27?inline. Published
December 2020. Accessed May 13, 2021.
Of ce of the U.S. Surgeon General. Know the Risks.
E-cigarettes.surgeongeneral.gov. ecigarettes.surgeongeneral.gov/knowtherisks.html.
Accessed March 11, 2019.
Pepper JK, Ribisl KM, Brewer NT. Adolescents’interest in trying avoured e-cigarettes. Tob Control.
2016;25(Suppl 2):ii62-ii66. doi:10.1136/
tobaccocontrol-2016-053174
Pierce JP, Chen R, Leas EC, et al. Use of E-cigarettes
and Other Tobacco Products and Progression to Daily
Cigarette Smoking. Pediatrics.
2021;147(2):e2020025122. doi:10.1542/
peds.2020-025122
SB-793 Flavored tobacco products.
leginfo.legislature.ca.gov. https://
leginfo.legislature.ca.gov/faces/billTextClient.xhtml?
bill_id=201920200SB793. August 28, 2020

UCLA Center for Health Policy Research. AskCHIS
2021. Current e-cigarette use status. https://
ask.chis.ucla.edu/. Accessed 11/3/2022.
US Food and Drug Administration. FDA nalizes
enforcement policy on unauthorized avored
cartridge-based e-cigarettes that appeal to children,
including fruit and mint. https://www.fda.gov/newsevents/press-announcements/fda- nalizesenforcement-policy-unauthorized- avoredcartridge-based-e-cigarettes-appeal-children.
Published January 2, 2020. Accessed February 4,
2020.
US Surgeon General. Surgeon General’s Advisory on
E-cigarette Use Among Youth. cdc.gov. https://www.cdc.gov/tobacco/basic_information/ecigarettes/surgeon-general-advisory/index.html.
Published December 18, 2018. Accessed May 8, 2020.
Williams M, Villarreal A, Bozhilov K, Lin S, Talbot P.
Metal and Silicate Particles Including Nanoparticles
Are Present in Electronic Cigarette Cartomizer Fluidand Aerosol. PLoS One. 2013;8(3). doi:10.1371/
journal.pone.0057987
Zhao-Shea R, DeGroot SR, Liu L, et al. Increased CRF
signalling in a ventral tegmental areainterpeduncular nucleus-medial habenula circuit
induces anxiety during nicotine withdrawal[published correction appears in Nat Commun.
2015;6:7625]. Nat Commun. 2015;6:6770. Published2015 Apr 21. doi:10.1038/ncomms7770
Zhu S-H, Braden K, Zhuang Y-L, Gamst A, Cole AG,
Wolfson T, Li S. (2021). Results of the Statewide
2019-20 California Student Tobacco Survey. San
Diego, California: Center for Research andIntervention in Tobacco Control (CRITC), University ofCalifornia San Diego.