What parents should know about the ‘huge epidemic’ of vaping

(CNN)With the news from the US Food and Drug Administration that vaping is skyrocketing among American youth, parents might be wondering how concerned they should be and what they should do if they catch their child using an e-cigarette.

Health experts say behavior changes are keys to look for, as more and more children and young adults become addicted to nicotine, causing physiological changes to their brain.
“It’s just this huge epidemic,” said Marcella Bianco, the program director for CATCH My Breath, which works to prevent the spread of e-cigarette use.
    Steven Kelder, a professor of epidemiology with the University of Texas Health Science Center at Houston who also serves as a lead investigator for CATCH, said every parent needs to be aware of the dangers of vaping.
    “Kids have a hard time quitting or even wanting to quit, thus causing family disturbances,” he said. “Nicotine interferes with parental relationships and pushes children towards delinquent behavior. Raising a teen is hard enough without nicotine addiction.”
    Here are important takeaways for parents raising teens.

    What is vaping?

    E-cigarettes, or vaping, work by heating a liquid containing nicotine until it vaporizes. Experts say the huge increase in teen use is the result of a single company, Juul, which they say grabbed up market share with an assortment of flavors, high nicotine content and devices that look like USB drives.
    Juul gives users a flavored nicotine fix without the smell and smoke of combustible cigarettes.
    “I think parents should be proactive and talk to their kids about vaping,” Kelder said.
    Kelder said most of the flavors marketed by Juul contain 5% nicotine — “a very high dose of nicotine.”
    Juul vowed this week to halt most retail sales of flavor products while restricting flavor sales to adults 21 and older on its secure website. The company also announced that it was shutting down some of its social media accounts.
    Juul has said that it designed its products for adult smokers trying to switch from combustible cigarettes. Ashley Gould, the chief administrative officer for Juul Labs, previously told CNN its popularity among youth has been “devastating to us.”
    “This is not a product for youth. It’s a product for adult smokers,” Gould said.
    If you catch your child vaping, Kelder said, you’ll need to wean them off slowly, bringing them down to a vape with 3% nicotine.
    “If their child has been using 5% [nicotine] for any length of time, they are probably addicted and will be resistant to quitting. The withdrawals at that high level will be too strong,” he said. “Normalizing their blood nicotine content to a lower dose is a big first step towards quitting. Once at 3%, then quitting altogether will be much easier.”

    How do I know if my child is vaping?

    Teens are very good at hiding vaping from parents, coaches and school administrators, experts say.
    Bianco said parents need to check to make sure USB drives really are USB drives. Many times, they’re actually Juuls, with kids taking them to school and using them in bathrooms and locker rooms.
    “Parents need to take a look at what’s being charged: Is it a USB drive or not?” she said. “Unfortunately, that’s where we are [as a society].”
    Other signs to look out for: Has your child been asking for more money than usual? Does he or she have dry mouth and/or nosebleeds?
    “Nearly all teens vape fruit or candy flavors,” Kelder added. “You may notice a sweet scent on your child.”

    What are the health effects of vaping?

    Nicotine changes the brain, interfering with development up to the age of 26. So, experts say, the skyrocketing use of vaping among America’s youth should be concerning not to just parents but to public health officials across the country.
    The outcome of nicotine addiction, Kelder said, is “mild reductions in cognitive function in the prefrontal cortex, leading to poor decision-making, reduced impulse control, increased mood disorders such as anxiety and depression.”
    Pregnant women could also unknowingly harm their fetuses by vaping, because “nicotine is neurotoxic to a developing fetus.”
    “Sudden infant death syndrome, SIDS, is a real worry,” Kelder added.
    Bianco said parents frequently complain of behavior problems with their children who vape. “They’re having a hard time sleeping,” she said, “because they’re doing Juul so much in schools and throughout the day.
    “We know what nicotine does, and 99% of the e-cigarettes have nicotine. We know how nicotine changes the brain, especially for developing youth,” Bianco said.
    Another key point: the many unknowns from chemicals like glycerin and propylene glycol in some vapes.
    “That’s the scary part,” she said. “We don’t know the long-term health effects these kids are going to have in future years.”

    How did this happen?

    Juul’s rapid rise in the past year shocked public health officials, Bianco said. It’s easy to buy online, she said, resulting in astronomical sales and skyrocketing use among youth.

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      “It took us all by surprise,” Bianco said. “I wish we knew ahead of time that this was coming aboard. We have a huge epidemic on our hands.”
      Kelder said simply, “Juul delivers the highest level of nicotine available. I believe that is the reason why the rates are rising so quickly. The addiction potential with Juul is much higher than with previous e-cig versions.”

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      FDA threatens stores that sell Juul and flavored e-cigarettes to kids

      (CNN)The head of the US Food and Drug Administration took aim Wednesday at Juul and other e-cigarette manufacturers, warning that they must show in the next two months how they’ll keep the devices out of the hands of young people.

      Noting an “epidemic” surge in teen use of e-cigarettes, FDA Commissioner Dr. Scott Gottlieb warned the FDA might require companies to change their sales and marketing practices; stop distributing products to retailers who sell to kids; and remove flavored e-cigarette products from the market.
      “I use the word epidemic with great care,” Gottlieb said. “E-cigs have become an almost ubiquitous — and dangerous — trend among teens. The disturbing and accelerating trajectory of use we’re seeing in youth, and the resulting path to addiction, must end. It’s simply not tolerable.”
        Juul, MarkTen, Vuse, Blu and Logic control 97% of the e-cigarette market, the FDA said. In the next 60 days, the FDA plans to investigate the five e-cigarette companies’ marketing and sales practices, with possible “boots on the ground inspections,” Gottlieb said.
        The agency will also be increasing federal enforcement actions on e-cig sales to minors in convenience stores and other retail sites, Gottlieb said. On Wednesday, it announced “historic action” against more than 1,300 retailers who illegally sold Juul and other e-cigarettes to minors during a crack down on retailers this summer. Gottlieb called the action the largest coordinated enforcement effort in the agency’s history.
        The FDA will also look closely at “straw purchases,” in which adults visit web-based stores and buy in bulk to resell to minors. Federal law prohibits the sale of e-cigarettes to people younger than 18.
        “If young adults go online and buy 100 units of a product to sell to teens, that activity ought to be easy for a product manufacturer to identify,” said Gottlieb. If manufacturers aren’t willing to do the research, he said, the FDA will do it for them, with appropriate consequences.
        “Let me be clear: Everything is on the table,” said Gottlieb. “This includes the resources of our civil and criminal enforcement tools.”

        A generation addicted?

        E-cigarette makers argue the devices help adult smokers give up cigarettes — potentially saving them from related illnesses — by giving a nicotine fix without the smoke and smell of combustible cigarettes. The scientific consensus, however, is still out on the long-term health effects of vaping.
        The FDA recognized the impact its actions might have on adults trying to stop smoking, Gottlieb said, but emerging research on how flavored products encourage excessive use by young people shows action must be taken.
        More than 2 million middle and high school students were current users of e-cigarettes in 2017, the FDA said, and e-cigarettes were the most commonly used tobacco product by youth. Youths are more likely than adults to vape, according to the US Centers for Disease Control and Prevention.
        “I’ll be clear. The FDA won’t tolerate a whole generation of young people becoming addicted to nicotine as a tradeoff for enabling adults to have unfettered access to these same products,” Gottlieb said Wednesday.
        “We’re especially focused on the flavored e-cigarettes. And we’re seriously considering a policy change that would lead to the immediate removal of these flavored products from the market.”
        Juul Labs, which controls about 70% of the market, said in its statement that “appropriate flavors” play a role in adults changing their smoking habits, but added that they “are committed to preventing underage use of our product, and we want to be part of the solution in keeping e-cigarettes out of the hands of young people.”
        Several other manufacturers targeted by the FDA — MarkTen, Vuse, Blu and Logic — also issued statements agreeing with the need to limit access to minors and announcing their willingness to work with the FDA to reach a solution.
        The Vapor Technology Association, which says it represents over 600 vaping manufacturers and distributors, also supports limiting teen access, but added that the new actions by the FDA ventured “into dangerous territory” by not being in the best interest of public health.
        In a statement, VTA Executive Director Tony Abboud asked: “Does FDA really want millions of Americans to return to smoking cigarettes?”

        A change of plan

        Last year, the FDA announced that it would delay regulations that could have halted the sales of many e-cigarettes. Instead, the agency gave extensions till August 2022 to new and existing vaping products. The agency said it allowed the extra time to strike an appropriate balance between regulation and encouraging the development of innovative tobacco products that may help older smokers quit.
        At that time of the extension, Gottlieb said Wednesday, the agency didn’t foresee the “epidemic'”of adolescent use that has become one of the plan’s biggest challenges.
        “Today we can see that this epidemic of addiction was emerging when we first announced our plan last summer,” said Gottlieb. “Hindsight, and the data now available to us, reveal these trends.”

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        Since Wednesday’s action did not change the current 2022 timeline for regulatory review, some said the agency’s action fell short.
        “We need to go further,” said Michael Bloomberg, the billionaire philanthropist who has worked for years to reduce tobacco use.
        “The FDA should immediately move to regulate flavored e-cigarettes, instead of waiting until 2022, as it is currently planning to do,” Bloomberg said in a statement.
        The Campaign for Tobacco-Free Kids also called for stronger action.
        In a statement, Matthew Myers, the campaign’s president, said the FDA’s action would only represent a turning point if it “reverses its policy and requires that all of these products undergo agency review now, not four years from now.”
        The American Medical Association’s Dr. Barbara McAneny also said the FDA could do much more, pledging that the association would “continue to advocate for more stringent policies.”
        U.S. Senate Democratic Whip Dick Durbin and Republican Sen. Lisa Murkowski also asked the FDA to end delays. In a statement, they called for support for their bipartisan legislation, introduced in July, which would ban flavored cigars and place stringent controls on e-juice flavorings.

        FDA actions so far

        In April the agency launched a Youth Tobacco Prevention Plan, designed to address some of the known public health risks, such as flavors, that contribute to adolescent use of e-cigarettes.
        Shortly after the launch, the FDA cracked down on e-liquids marketed to resemble kid-friendly foods like juice boxes, candy and cookies. As part of today’s action, the agency sent an additional 12 warning letters to another 12 companies that continue to sell the products.
          The FDA also targeted Juul retailers this spring, issuing 56 warning letters and six civil monetary penalties. Today’s effort notches up that action, becoming, said Gottlieb, the “largest ever coordinated initiative against violative sales in the history of the FDA.”
          The agency said it plans to unveil a new e-cigarette public education campaign targeted to youth next week, and will soon announce wider access to new nicotine replacement therapies to help more adult smokers quit cigarettes.’

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          Love and heroin don’t mix: how these newlyweds survived a harrowing romance

          Augusta, Georgia (CNN)There’s nothing sweet or adorable about the way newlyweds Brittany and Ryan Coleman first met — no “meet cute” like in rom-com movies or romance novels.

          It was 2015, and Brittany bought heroin from Ryan in a parking lot, and Ryan cheated her. Brittany called him some choice names, and Ryan shrugged his shoulders and walked off.
          Despite that inauspicious beginning, and the many years of drug abuse that precededit, the Colemans want to get out this message: There is life and love after drug addiction.
            They want to give hope to those whose lives have been ravaged by the opioid epidemic, which kills more than 115 people every day in the United States.
            “You just have to find the right people to get connected to to kind of show you the way out,” said Brittany, 29.

            Addiction, rehab and relapse

            When Brittany Hokrein was 11 years old, her parents divorced, and she and her brothers and mother moved from Georgia to Pennsylvania.
            She struggled emotionally, and at age 14 she started to use marijuana and alcohol so she wouldn’t feel the hurt. Soon, pain pills became her drug of choice, and by age 18 she was addicted.
            Ryan, now 37, was born into a military family, moving from Georgia to Germany to Texas and then back to Georgia. Like Brittany, he had a loving family, but as a teenager, he felt like he didn’t fit in, and he started to smoke pot at age 14.
            “I found that I could medicate that feeling. Life was great once I got high,” he said.
            By the time Ryan was 17, he was smoking pot every day, and he dropped out of high school senior year. He moved on to LSD and cocaine. By the time he was 20 he was hooked on painkillers.
            His father, an Army drill sergeant, and his mother, a high school teacher, begged him to go to recovery. They told him a recovery program had saved his mother from alcoholism when Ryan was a child. But he rebelled and rejected everything his parents stood for.
            By 22, he was strung out on heroin. “I had to have it,” he said.
            Over the next 10 years, Brittany and Ryan unknowingly led parallel lives. Hopping from city to city, they both used heroin, methamphetamines, prescription opioids, Xanax, cocaine and alcohol.
            Brittany overdosed three times, and Ryan overdosed five times. Ryan got arrested 16 times, mostly for stealing so he could get money to buy drugs. Brittany stole, too, and had a stint at prostitution.
            Their parents loved them and helped get them into rehab programs. Each stint ended in a relapse.
            By 2016, both Ryan and Brittany had moved back to Augusta, Georgia.
            They happened to end up at the same recovery group meeting. Eight months had passed since they’d met at that drug deal in the parking lot.

            A forbidden love (and with good reason)

            He’s cute, Brittany thought when she met him again at rehab.
            She’s beautiful, Ryan thought. Really beautiful. And she looked so familiar.
            He realized she was the woman he’d cheated in the drug deal.
            “I thought, ‘This was fate.’ I walked right up to her and told her I needed to apologize for ripping her off,” Ryan remembered. “I did want to make amends, but I also had an ulterior moment. I wanted to date her.”
            Dating was discouraged in their recovery program — and Brittany and Ryan found out why.
            As they fell in love, they spent all their time together and their lives became intertwined. At first they both stayed sober but then slowly, imperceptibly, Ryan slipped away, taking Brittany with him.
            After about four months of dating, one Friday morning Ryan told Brittany he was going down to a park by the Savannah River to think about his life.
            But instead, he drove two hours to Atlanta to buy heroin and cocaine.
            He called her on the way and told her the truth. Brittany stood there with her phone in her hand. She wrote out a text that she knew she shouldn’t send.
            It said that Ryan needed to bring back some drugs for her. She stared at the text for a while. Then she hit send.
            And everything fell apart.

            Giving up heroin — and each other

            For the next week, Brittany and Ryan went right back to heroin, right back to cocaine, right back to meth, sometimes all at the same time.
            “I even romanticized it, saying f*** all the rules, we’re going to be heroin junkies together, all that ‘Trainspotting’ bull****,” he said, referring to the 1996 film about young Britons on heroin. “Addicts have a sick way of romanticizing their drug use.”
            Then on October 3, 2016, they both overdosed on meth and heroin. Medics found Brittany lying on the floor of a gas station bathroom, and Ryan right outside, unconscious in his car.
            The medics gave them doses of Narcan, the drug that reverses overdoses. Brittany had done so much heroin she needed two doses.
            Ryan was wracked with guilt. He felt personally responsible for Brittany’s near death in that gas station bathroom. He was the one who’d driven to Atlanta to get drugs when they were both working so hard to be clean. He was the one who said ‘yes’ when she asked him to bring some back for her.
            “I had almost killed the person I loved the most,” he said.
            Brittany returned to Hope House, a treatment center for women in Augusta.
            Ryan visited here there. Surrounded by his sponsor from his recovery group and Brittany’s counselors, he got down on his knees — and apologized.
            “He held my hand and apologized to me in front of all those people,” Brittany said, crying at the memory of it. “He was shaking and I was shaking. He said how sorry he was for putting me through all this and how scared he was to almost lose me.”
            They then had to do something they describe as just as hard as giving up heroin: They had to give each other up. For a month, they had no contact at all.
            “The only way for us to survive was to focus only on our recovery, and not on each other,” Brittany said. “It was the only way it would work.”
            Brittany then left Hope House, and the two met up at their recovery group’s Thanksgiving dinner. They started back dating slowly, and then a year and a half later, on February 24, 2018, they were married.

            Two years sober

            Next month marks two years of sobriety for both Brittany and Ryan, and today they live in a small house with four cats in Augusta. Ryan works at a vape store, where he’s advanced from part-time clerk to assistant manager to manager. Brittany works at a rehab center, helping others overcome their addictions.
            They volunteer to help others in recovery and have also spoken at programs that train people how to use Narcan, the drug that saved both of them so many times.
            When asked how they survived addiction where so many have died, they say it was the grace of God and to a large degree luck — luck that those Narcan doses were available right when they needed them.
            They also say they let other people guide them: their families, who never gave up on them; the rehab counselors who stuck with them; and their recovery mentors who showed them the way, including that they needed to focus on their individual recoveries and not on each other in order to survive.

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            All of those people joined them on their wedding day.
            “It was really a culmination of all the good things going on in our lives finally really coming together,” Ryan said.
            Sometimes Brittany can’t believe she’s alive, much less in a loving, stable relationship.
            “It’s unbelievable. I don’t think that I would have ever imagined that I would be married and happy and just planning a future with another human,” she said. “I didn’t ever picture that for myself.”
              They want people in the throes of addiction to see that despite the dire statistics, there can be hope.
              “I want them to see people like us and realize that we were in that same place at one point in our lives — and we got out,” Ryan said.

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              5 things to know for November 16: Wildfires, Cambodia, North Korea, Florida recount

              (CNN)

              Can’t get geared up to plan Thanksgiving dinner? Here are 10 places to just sit back and be served (if you can get a reservation). And here’s what else you need to know to Get Up to Speed and Out the Door. (You can also get “5 Things You Need to Know Today” delivered to your inbox daily. Sign up here.)

              1. California wildfires

                The numbers just keep shooting up. The death toll from Northern California’s Camp Fire is now at 63, after the remains of seven people were found. But the real eye-popping stat is the number of people listed as missing. That soared to 631 after investigators added information from callers who reported people missing to the dispatch center the day the fire erupted. There do appear to be duplicates on the list, and some people who evacuated may have unreliable cell phone service due to the fire. Meanwhile, some survivors say they never got emergency alerts on their phones that could have warned them of the fire.

                  Cell phone videos show drivers fleeing fire

                2. Cambodia

                Two senior members of one of the most murderous regimes in history had their day of reckoning. Nuon Chea, 92, and Khieu Samphan, 87, were found guilty of genocide by an international tribunal, a landmark verdict that may bring closure to millions of Cambodians. The pair are the senior surviving members of the Khmer Rouge, the tyrannical communist faction that killed more than 1.7 million people — about a fifth of Cambodia’s population — during the 1970s. Both men were sentenced to life in prison.

                  Khmer Rouge officials found guilty of genocide

                3. North Korea

                North Korea has tested some kind of weapon, and the world is trying to figure out just what it is. The North’s state media said it was a “newly developed ultramodern” weapon. Whatever it is, it’s a sign North Korea is ready to go back to a more antagonistic relationship with the US if nuclear disarmament talks continue to go poorly. The weapon could have been a piece of long-range artillery like “a multiple rocket launcher,” a South Korean government source told CNN. Meantime, Vice President Mike Pence said the US has dropped a key demand of the North, which will not have to provide a full list of its nuclear and missile sites before President Trump meets early next year with its leader.

                  North Korea media: Kim inspects new weapon

                4. Florida recount

                Florida’s putting the machines away and will start recounting ballots by hand in its hotly contested US Senate race. The manual recount is needed because after the machine recount, Democratic Sen. Bill Nelson was within the 0.25% margin required for a hand recount in his race against Republican Gov. Rick Scott. Still, it looks like Nelson’s odds of winning look pretty slim. That’s because Scott picked up a few dozen more votes during the first recount. Meanwhile, the governor’s race looks like it may be done. After a machine recount, that race is still outside the margin required for a hand recount, so it’s likely former GOP Rep. Ron DeSantis will be the state’s next chief exec.

                  Fact-check: False Florida recount claims

                5. Weather

                Eight people are dead and nearly 300,000 are without power as a wicked winter storm plows through the eastern US. The icy weather contributed to traffic crashes that left eight people dead in several states and stranded drivers for hours on Manhattan’s George Washington Bridge. Today, more snow, sleet and freezing rain hit from the Central Appalachians through the Northeast. Parts of Pennsylvania and New England could see up to a foot of snow.

                  Sleet or freezing rain? See the difference

                BREAKFAST BROWSE

                RIP, Roy
                Before hosting “Hee Haw,” Roy Clark was a music star in his own right, one of the first to land singles on both country and pop charts. He was 85.
                Underpriced no more
                Guess you don’t have to die to rake in the big bucks as a painter. A David Hockney painting sold for $90 million, a record for a living artist.
                Power plays
                She won $350 million last month playing Powerball. Now, she’s paying it forward with a half-million-dollar donation to a veterans group.
                Banding together
                What did Kanye West and Mark Zuckerberg sing when they jammed together at a karaoke bar? Well, here’s a hint: Think of ’90s boy bands.

                HAPPENING LATER

                From the bench
                After a delay, the judge in the CNN v. President Trump lawsuit now says he’ll announce his ruling this morning in the First Amendment case.

                  Trump argues he can limit journalists’ WH access

                TOTAL RECALL

                Quiz time
                The 2018 Oxford Dictionary Word of the Year is …
                A. Youthquake
                B. Bougie
                C. Toxic
                D. Democracy
                Play “Total Recall: The CNN news quiz” to see if you’re right. And don’t forget, you can also find a version of the quiz on your Amazon devices! Just say, “Alexa, ask CNN for a quiz.”

                TODAY’S NUMBER

                80%
                That’s how much vaping has increased since last year among high school kids. And it’s up 50% among middle schoolers. Now, the FDA wants new regulations on flavored nicotine products that have fueled vaping’s rise.

                  FDA is proposing these new rules on vaping

                IT’S THE WEEKEND, BABY

                Two new Netflix shows come out today. Michael Douglas ages grudgingly in “The Kominsky Method,” while “Narcos: Mexico” moves the drug-war drama to an new locale. In theaters, Potter-mania continues with “Fantastic Beasts: The Crimes of Grindelwald,” and Viola Davis heads up a group of fierce “Widows.”

                AND FINALLY

                  Slow down
                  You’d think the Slow Mo Guys would run out of stuff to film, but they always prove us wrong. This time, they capture rainbow-colored Jell-O getting sliced by a tennis racket, in super … slow … motion. (Click to view.)

                  Read more: http://edition.cnn.com/

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                  19-year-old dies after inhaling deodorant spray to get high

                  (CNN)A 19-year-old died after inhaling deodorant spray to get high, according to a new case report, and doctors who treated the man in the Netherlands are using the case to highlight the fatal consequences of inhaling chemicals.

                  Kramp explained that because deaths from deodorant inhalation are not common among the general population, the “consequences aren’t really known,” causing people to continue this dangerous behavior.
                  The patient, who had a history of psychotic symptoms, had been admitted to a rehabilitation center for cannabis and ketamine abuse and was taking antipsychotic drugs.

                    Fascinating, mysterious, and medically amazing case files. This series is the most interesting education into the world of medicine and disease and the human body.

                    During a relapse in July, he placed a towel over his head and inhaled deodorant spray to get high, according to the report, published Thursday in the BMJ. He became hyperactive, jumping up and down, before blood flow stopped suddenly, causing him to go into cardiac arrest and collapse, the report says. He was admitted to the hospital and placed in a medically induced coma when staff failed to revive him.
                    The “patient did not had enough brain function to sustain life,” Kramp said. Nine days after he was admitted, doctors withdrew care, and the man died.
                    There are three theories about what caused the cardiac arrest, Kramp said: The inhalant could have oversensitized the patient’s heart, which can make any subsequent stress, like getting caught by a parent, cause cardiac arrest. Also, inhalants decrease the strength of contraction of the heart muscle. Another possibility is that inhalants can cause spasm of the coronary arteries.
                    The patient’s hyperactivity could mean he was experiencing a “scary hallucination,” Kramp said, adding that if that was the case, the first theory would be applicable.
                    Solvent abuse is not a new phenomenon, the report points out, and is primarily found in “young and vulnerable people,” according to Kramp.
                    The group most affected by solvent abuseis 15- to 19-year-olds, studies show. People in rehabilitation centers or prisons are more likely to abuse household products, the report added, meaning there could be a greater risk of cardiac deaths in these environments.
                    In these secure environments, people have less access to other substances, and household products are easily available, explained Roz Gittins, director of pharmacy at the British drug charity Addaction, who was not involved in the report.
                    The toxic chemical butane, often used in sprayable household products, has a similar effect to alcohol, Kramp said. “The intention of abusers is to experience feelings of euphoria and disinhibition.”
                    Other health effects of inhalants include liver and kidney damage, hearing loss, delayed behavioral development and brain damage.
                    Chemicals like butane have a very quick and short-acting effect, which can make people want to take more, Gittins said.
                    The report’s authors hope increased awareness will help reduce further inhalant-related deaths, through education in schools around the fatal consequences of solvent abuse.
                    “To stop the abuse, we can only try to increase awareness about the possible dramatic consequences of inhalant abuse among youngsters, parents, medical personnel,” Kramp said.
                    Up to 125 deaths are caused by inhalant abuse every year in the United States, according to the report.

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                    Stephen Ream, director of UK-based charity Re-solv, said that in 2016, “there were 64 deaths associated with these products,” with butane gas accounting for at least a third of those.
                    “The breakdown by product is more difficult to establish, but we would suspect that about four or five deaths a year are associated with aerosol products,” he said.
                      “Solvent abuse is also more of a problem in the northern regions of the UK, with rates particularly higher in Scotland and the North East of England.”
                      According UK drug advice organization Talk to Frank, more 10- to 15-year-olds were killed from abusing glues, gases and aerosols than from illegal drugs combined between 2000 and 2008.

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                      Fox News’ Laura Ingraham Hosts Hacking ‘Vape God’: ‘I’ll Blow Whatever’

                      Laura Ingraham’s Fox News show got smoked by an employee of bro blog Barstool Sports who trolled his way through a segment on the dangers of vaping by blowing puffs of smoke, joking and coughing.

                      Tom Scibelli, who also goes by the name Tommy Smokes, appeared on “The Ingraham Angle” Thursday night wearing a “Vape God” hat and touting his love for the electronic cigarette Juul.

                      “There’s nothing cooler than blowing a fat cloud like that,” Scibelli, 22, said as he exhaled. “They call me the ‘Colossus of Cloud.’ It helps my swag. It helps my drip. I just love walking around. It’s really good for getting chicks, too. I started about a year ago and haven’t looked back since.”

                      The Food and Drug Administration, alarmed at the growing public health menace of young people using e-cigarettes like Juul, threatened in September to ban the devices. The regulator on Thursday backed down, but said e-cigarette sellers had to keep them in areas inaccessible to teenagers.  

                      Scibelli told HuffPost he was invited on Ingraham’s show by producers who told him they saw his Barstool Sports Juul tricks video on Instagram and wanted him “to represent the youth in a debate about the art of vaping.” 

                      The anti-vape view was represented by Dr. Janette Nesheiwat, who listed health risks that can eventually put users on oxygen tanks to breathe. As she spoke, Scibelli deeply inhaled, coughed, and hit two Juuls at once.

                      “Tommy is over there gasping for air,” Nesheiwat pointed out.

                      “It’s a sign of strength,” responded Scibelli. “Cigarettes are bad for you. I would never do anything that’s bad for your lungs or anything. I just stick to Juul.”

                      When Nesheiwat mentioned the possibility of e-cigarette-induced “popcorn lung” from scarring and inflammation, Scibelli interrupted. “Ah, I love popcorn,” he said. “Popcorn’s delicious!”

                      Ingraham closed the show by saying: “We’re going to check in with Tommy Smokes in about six years and see how he’s doing.”

                      Scibelli said he hopes his appearance “proved to her that vaping is a lifestyle.”

                      He tweeted about the experience after the show, saying he overheard someone ask if anyone did research on him before inviting him. He also said a producer told him to stop vaping on air.

                      “I didn’t stop,” he wrote.

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                      Weed Growers Not High On Vicente Fox’s Goal To Add Pot To NAFTA

                      Former Mexican President Vicente Fox is planting a seed as far as trade agreements go: He wants to add marijuana to North American Free Trade Agreement.

                      Fox currently sits on the board of Vancouver-based medical marijuana producer Khiron Life Sciences Corp., and he believes cannabis should be treated like any other form of produce, according to Bloomberg.

                      Mexico legalized medical marijuana in 2017, and Fox predicts recreational weed will become legal in the country next year. He’s high on the idea, saying it could help curb drug cartel violence.

                      “We can change criminals for businessmen, we can change underground, illegal non-taxpayers into an industry, a sector of the economy,” Fox told Bloomberg on Thursday. “I think it should be part of NAFTA and that’s what I’m pursuing.”

                      But that possibility gets marijuana growers like Jamie Warm all out of joint.

                      Warm, the CEO of Henry’s Original, a Mendocino, California-based cannabis company, believes making pot part of NAFTA could be devastating to American agriculture.

                      “U.S. farming has collapsed as it has been outsourced everywhere,” he told HuffPost. “How is that fair? But cannabis is one crop that small farms have relied on for income.”

                      Although the cannabis industry is growing, Warm said it’s also become more corporate, making the barriers to entry into the market more difficult for small farmers.

                      Allowing cannabis from other countries could nip the industry in the bud since “U.S. farmers have to deal with environmental regulations and worker protections that other countries don’t have.”

                      Lex Corwin, the founder of Stone Road Farms in Los Angeles, also sees big problems with Fox’s proposal.

                      “NAFTA is a federal trade agreement and marijuana is federally illegal, therefore marijuana can’t be included until it’s federally legalized,” he told HuffPost.

                      But even if cannabis does become legal on a federal level, Corwin doesn’t think it should be included in international trade agreements.

                      “Small cultivators and manufacturers are struggling enough with California’s excessive regulation and constantly changing legal framework,” he argued. “If we add foreign-grown, low-cost marijuana to the equation, it would be a death sentence for many American marijuana businesses and the tens of thousands of well-paying jobs this industry provides.”

                      Kenny Morrison, president of the California Cannabis Manufacturers Association, holds out hope that pot smokers will ultimately prefer quality above cheap weed, but he added that legally available Mexican marijuana could impact the industry.

                      “There will always be a market for California craft cannabis, but could Mexico disrupt it to a large degree? Yes. it happened to kale, why not cannabis?”

                      Some pot industry people think a NAFTA deal could be considered in the future, but not in the current climate.

                      Matthew Nathaniel, the general manager of Heavy Grass, a Los Angeles-based vape company, said trade agreements could be the future of cannabis production, but he added that Mexico, Canada and the U.S. are just too far apart on legality.

                      “Additionally, none of the three have a proven regulatory system, with all three having struggles in the early stages of market development,” he told HuffPost. “There’s still much to do before a deal of this scale can be a reality.”

                      But while many in the pot industry are hesitant about including marijuana crops in NAFTA, some investors believe the benefits outweigh the potential downside.

                      Wil Ralston, the president of SinglePoint, a publicly-traded cannabis and technology holding company, believes allowing the import and export of legal cannabis would create huge growth in the industry.

                      “While I understand that there might be concerns from U.S. cultivators, I do see an agreement like the one Vicente Fox proposes greatly expanding the potential U.S. market size for exports, in addition to opening a new and lucrative supply chain between U.S. and Mexican companies,” he told HuffPost.

                      Meanwhile, Leslie Bocskor, President of Electrum Partners, an advisory services firm specializing in medical and recreational cannabis, said he’s certain that marijuana won’t be added to NAFTA anytime soon ― and so is the guy who is suggesting it.

                      “President Fox knows that the Trump Administration will never add Cannabis to NAFTA at this time,”Bocskor told HuffPost. “However, he does know that the timing to have this conversation for the first time is now.”

                      CORRECTION: An earlier version of this story incorrectly cited a quote from Leslie Bocskor as being from Erik Knutson.

                      Read more: http://www.huffingtonpost.com/

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                      FDA Cracks Down On Juul And E-Cigarettes Sold To Teens

                      The Food and Drug Administration on Wednesday issued a dire warning to Juul and four other manufacturers of popular e-cigarettes, giving the companies 60 days to submit plans showing how they will do a better job keeping the devices out of minors’ hands. 

                      FDA Commissioner Scott Gottlieb said in a statement his agency has seen “clear signs” that use of vaping devices has reached an “epidemic proportion.” Of specific concern are tobacco products flavored to resemble “kid-friendly” foods, the agency said.

                      The FDA specifically targeted Vuse, Blu, Juul, MarkTen XL and Logic devices, which together represent the vast majority of the U.S. e-cigarette market. If the brands fail to comply with the order, the FDA may order their products taken off shelves.

                      Although vaping exposes users to far fewer toxic chemicals than traditional cigarettes, the addictive component used in such devices ― nicotine ― is present in greater amounts. Juul, a product so popular it became a verb, offers nicotine pods with flavors such as mint, mango, cucumber and creme brulee. 

                      E-cigarette advocates argue that the flavors help adult smokers switch to the electronic alternative. 

                      While e-cigarettes have proven to be a means of weaning adults away from traditional cigarettes, the devices’ popularity among teens has spiked, introducing a new generation of young people to nicotine.

                      In its sweeping declaration, the FDA stated that it “won’t allow the current trends in youth access and use to continue, even if it means putting limits in place that reduce adult uptake of these products.”

                      “It’s an unfortunate trade-off,” Gottlieb told The New York Times.

                      The agency has already issued 1,300 warnings and fines to retailers it says have sold the vaping devices to minors, including 7-Eleven, Circle K and Walgreens stores, and shops at Shell and Mobil gas stations. Fines imposed on some locations ranged from approximately $280 to $11,200. 

                      The regulator’s so-called enforcement blitz was conducted from June through August and targeted both brick-and-mortar and online stores. Gottlieb said it was the largest such effort in the FDA’s history. 

                      More than 2 million middle school and high school students used e-cigarettes in 2017, the agency said. 

                      Juul was quick to express support for the government’s action on Wednesday. 

                      “We are committed to preventing underage use of our product, and we want to be part of the solution in keeping e-cigarettes out of the hands of young people,” the company said in a statement. 

                      Manufacturers of Blu and MarkTen devices emphasized commitments to keeping tobacco products out of kids’ hands, as well.

                      Efforts to curtail the products’ availability to teens could mean the companies cut off sales to retailers with a history of selling to minors. The FDA also suggested eliminating online sales entirely, or removing the flavored products until they are vetted by the agency.

                      The crackdown on e-cigarettes comes more than a year after the FDA announced a new plan to combat tobacco-related deaths in the U.S., which stand at 480,000 annually, according to the Centers for Disease Control and Prevention.

                      This article has been updated to note comments by Blu and MarkTen.

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                      FDA To Restrict Sales Of Fruit And Candy-Flavored E-Cigarettes

                      Los Angeles, Nov 8 (Reuters) – The U.S. Food and Drug Administration next week will issue a ban on the sale of fruit- and candy-flavored electronic cigarettes in convenience stores and gas stations, an agency official said, in a move to counter a surge in the teenage use of e-cigarettes.

                      The ban means only tobacco, mint and menthol flavors can be sold at these outlets, the agency official said, potentially dealing a major blow to Juul Labs Inc, the San Francisco-based market leader in vape devices.

                      The FDA also will introduce stricter age-verification requirements for online sales of e-cigarettes. The FDA’s planned restrictions, first reported by The Washington Post and confirmed to Reuters by the official, do not apply to vape shops or other specialty retail stores.

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                      The ban means only tobacco, mint and menthol flavors can be sold in convenience stores and gas stations.

                      There has been mounting pressure for action after preliminary federal data showed teenage use had surged by more than 75 percent since last year, and the FDA has described it as an “epidemic”.

                      “E-cigs have become an almost ubiquitous ‒ and dangerous ‒ trend among teens,” FDA Commissioner Scott Gottlieb said in September. “The disturbing and accelerating trajectory of use we’re seeing in youth, and the resulting path to addiction, must end. It’s simply not tolerable.”

                      That growth has coincided with the rise of Juul, whose sales of vaping devices grew from 2.2 million in 2016 to 16.2 million devices last year, according to the U.S. Centers for Disease Control and Prevention.

                      The agency threatened in September to ban Juul and four other leading e-cigarette products unless their makers took steps to prevent use by minors. The FDA gave Juul and four big tobacco companies 60 days to submit plans to curb underage use, a compliance period that is now ending.

                      The planned restrictions on flavors in convenience stores are likely to have the biggest impact on Juul, which sells nicotine liquid pods in flavors such as mango, mint, fruit and creme, previously called creme brulee.

                      The only other e-cigarette competitors sold at convenience stores are those marketed primarily by tobacco companies such as Altria Group Inc, British American Tobacco Plc, Imperial Brands Plc and Japan Tobacco Inc .

                      Those products, sold under the MarkTen, blu, Vuse and Logic brands, have lost market share as Juul has risen to prominence over the last year, growing from 13.6 percent of the U.S. e-cigarette market in early 2017 to nearly 75 percent now, according to a Wells Fargo analysis of Nielsen retail data.

                      E-cigarette products represent a small share of revenue for major tobacco companies, whereas Juul’s business is built entirely on the vaping devices. Revenue from e-cigarette devices made up less than 1 percent of British American Tobacco’s global revenue for the first six months of 2018, according to a company filing from July.

                      Altria last month announced it would stop selling its pod-based electronic cigarettes, generally smaller devices that use pre-filled nicotine liquid cartridges, in response to the FDA’s concerns about teen usage. The company also said it would restrict flavors for its other e-cigarette products to tobacco, menthol and mint.

                      Representatives from Altria, British American Tobacco, Imperial Brands and Japan Tobacco did not respond to requests for comment Thursday evening. A Juul spokeswoman declined to comment.

                      The companies have previously said their products are intended for adult use and that they work to ensure retailers comply with the law.

                      Juul has previously said the company wants to be “part of the solution in keeping e-cigarettes out of the hands of young people” but that “appropriate flavors play an important role in helping adult smokers switch.”

                      Meredith Berkman, a founder of Parents Against Vaping E-cigarettes, which seeks to curb underage use, said the agency’s move was a “good first step,” but added that “the final step should have happened yesterday.”

                      “Why not do away with flavors altogether, why not do away with online sales altogether?” she said.

                      E-cigarettes have been a divisive topic in the public health community. Some focus on the potential for the products to shift lifelong smokers onto less harmful nicotine products, while others fear they risk drawing a new generation into nicotine addiction.

                      Last year the FDA, under Gottlieb, extended until 2022 a deadline for e-cigarette companies to comply with new federal rules on marketing and public health.

                      Read more: http://www.huffingtonpost.com/

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                      FDA plans to launch new restrictions on e-cigarette flavors

                      (CNN)Taking on epidemic levels of teen e-cigarette use, the US Food and Drug Administration is expected to announce new restrictions on the sale of e-cigarette products an agency official confirmed Thursday.

                      Gottlieb is also expected to propose a ban on menthol in regular cigarettes.
                      The new restrictions were first reported by the Washington Post.
                        The convenience store ban on flavored e-cigarette sales would not include menthol. Because the FDA will continue to allow the sale of menthol in regular cigarettes, the agency doesn’t want to give cigarettes an advantage over e-cigarettes.
                        E-cigarette makers argue the devices help adult smokers give up cigarettes — potentially saving them from related illnesses — by giving a nicotine fix without the smoke and smell of combustible cigarettes. The scientific consensus is still out on the long-term health effects of vaping.
                        About 6.9 million adults used e-cigarettes in 2017, according to a US Centers for Disease Control and Prevention report released Thursday.
                        But the FDA says it didn’t foresee the “epidemic” of youth e-cigarette use. More than 2 million middle and high school students were current users of e-cigarettes in 2017, the FDA said, and e-cigarettes were the most commonly used tobacco product by youth.

                        Sign up here to get The Results Are In with Dr. Sanjay Gupta every Tuesday from the CNN Health team.

                        The FDA announced in September it would investigate major e-cigarette makers Juul, MarkTen, Vuse, Blu and Logic, including reviews of marketing and sales practices. It also said it cracked down on 1,300 retailers who illegally sold e-cigarettes to minors.
                        Juul declined to comment on the new restrictions.
                          The FDA recently launched a massive education campaign aimed at the nearly 10.7 million teens at risk for e-cigarette use, taking the message that vaping is dangerous into high school bathrooms and social media feeds.
                          “E-cigs have become an almost ubiquitous — and dangerous — trend among teens,” Gottlieb said in September. “The disturbing and accelerating trajectory of use we’re seeing in youth, and the resulting path to addiction, must end. It’s simply not tolerable.”

                          Read more: http://edition.cnn.com/

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