Public Health, Welfare and Labor Committee- House & Senate
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| Bill | Title | Sponsor | Status |
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SB571
· 1 mention in transcript
Matched: “of senate bill 571 was seven and a half million dollars for vaping tax but tha…”
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TO PROVIDE FOR AN INDIVIDUAL INCOME TAX REDUCTION; TO PROVIDE FUNDING FOR THE INCOME TAX … | J. Hendren | Sine Die adjournment |
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We have an agenda that's pretty specific today, and so I want to make a few comments before we get started. You know, there's been a lot of discussion, there's a lot of unknown, and I'm excited to have the presenters that we have here today. There's one presenter that's listed on the agenda that's not able to be here today, but we will have her back for future meetings, Dr. Pebbles-Fagan, and I look forward to what she has to say, but we will have her at a later time.
I also have Dr. Smith will also be here. She is here. Oh, she is here. Okay. There you are. Okay. There you are. Great. I'm so glad you're here.
Things changed. Okay. But with that, I just wanted to kind of make a few comments about the situation that we have in front of us. And I think it's important for us to reasonably study these issues and study what's going on and then have a greater grasp and understanding of what may be happening and I think there
is a place for government to act. I don't think many of us would disagree that there are things and steps that this government has taken for many, many, many, many years about how we restrict or regulate anything within our society for common sense purposes. With that, you know, I go back to we are in a different age right now with social media and marketing.
Marketing is very individualized. It's very targeted based on individuals' data. I remember a time where you used to get up on Saturday mornings when you were a kid and watch cartoons. Well, during cartoons on Saturday mornings, you know, it was very clear that there were serial ads, But there weren't ads for adult-type products that were played during that Saturday morning cartoon time. We've really changed a lot in a society, obviously, from that period of time to where we are now. So for us to be able to understand this issue, talk about this issue, and all the aspects around this issue is our job.
And it's also our job to understand what's a reasonable approach out there and what's our end goal. I mean, if the end goal is for us to make sure that vapes are not being used by teens and youth and children, then that's our end goal. Then how do we meet our end goal? So with that, and that's just one aspect of this issue, but I'm happy to have these meetings and to conduct these meetings because I think they're in the best interest of the state of Arkansas and the citizens that we serve, and it's a constituent issue for me.
I hear about it every single place I go, from school officials to parents. My son last night said that one of his best friends in college, she couldn't speak for a week because her lungs were so injured. That's troubling that a 19-year-old would have a whole week where she couldn't speak and her lungs were hurting because of vaping. so you know it's it's something that we need to fully understand so with that I
won't waste any more time I would like for Senator Hendren if he can come to the table and present his I at our ISP representative ferguson do you
have any comments okay senator hindron you're recognized thank you
Senator Jim Hendren
Unverified
3:46
madam chairman members of the committee i won't take up
a lot of time because i think we you had
the interim study handed out to you at the last meeting but it's in a position now where it's ready to be hopefully adopted, and we can continue down this road of trying to gather more information so that we can make good decisions. So I do want to make a couple comments, though, again, about why it's necessary. There's not a lot that both Republicans and Democrats and from Northwest and Southeast and all parts of the state come together and agree upon in the course of legislating actions down here, but I think there is one thing today that we all agree that there is a problem.
there may be some who absolutely refuse to acknowledge it, but they haven't been to a school or they haven't talked to the principals or talked to the parents of kids who are growing up in this environment. I think most of us, if not all of us, agree there's a problem. And that's what we're sent down here for, is to solve problems. The difficult thing we have today, as you all know, is the only way we have the ability we have to really solve problems is to take action, which means we need to be in session. this problem is getting worse every day and if it were not for that fact this could wait till 2021
we could take a lot of due diligence and make sure that we have everything exactly exactly right but the problem is every day more and more kids are getting addicted to a product that has potentially devastating health care consequences every single day that we wait so if there is a time for us to try to find a solution for a problem it is it is today many times in the legislative process we start from a fixed position and we have a choice we can either find a way to get to yes to consensus or we can continue to look for excuses to say no so what I'm asking
us to do as legislators for the next weeks and maybe months depending on how long it takes us to get there is find a way to get to yes that means you may not get everything you want there may be some things you don't like but in the good of solving the problem you're going to you're going to continue to try to negotiate to find a way that we can offer a solution while it may not be your perfect solution it is something that moves us in the right direction the fact is this is one of those rare times where there will be no solution if we don't work together if we don't find a way to compromise and and accommodate the interest of different folks we will not get the support
necessary there will be no special session we'll talk about this for a year and a half and thousands and thousands more kids will become addicted to this product so I am hopeful that we can find a way to get to a solution as you all know I emailed every one of you a draft of a piece of legislation last week and I want to be clear that's a starting point there is so much work that needs to be done that piece of legislation but but we had to have somewhere to start i am open to suggestions i've
already had many members contact me about things they'd like changed or added or deleted and those are this is certainly nothing that is set in stone because again i can't do this senator irvin can't do this representing ferguson we have to come together and get overwhelming support or we're going to do nothing so i ask you to look at that legislation and the problems that you have with it let's discuss and let's and let's talk about in hearings and through this interim study process and see if there's things that we can adjust that we can get to a point where we can offer
a solution to the folks out there who are asking for one probably the most controversial part of that that legislation that proposed draft is what it does with regard to taxes on vape i've got a handout that has been put on your desk talks the title of it raising cigarette taxes reduces smoking especially among kids i now at the risk of offending some of my democrat colleagues it was ronald reagan who said a long time ago that if you want more of something subsidize it and if you want less of it tax it and this this paper demonstrates that that principle
to be true the fact is less kids will smoke if it's more expensive if it is if there are taxes included but let me just also say this about you guys probably have known me for a while no i'm not a big tax increaser but i also would tell you that i'm about fairness and this whole thing with me started back during the tax reform task force and i saw the incredible tax burden that the people of arkansas are carrying because of the health effects related directly related to tobacco use
to about the tune of four or five hundred million dollars a year and i'm all for people having individual rights and liberties to do what they want to do but there ought to be personal responsibility where the costs associated with those choices follow that decision and right now they're not and we're getting ready to do the same thing in vaping so here's my here's my reason why i think it's only fair that we level the playing field on these nicotine delivery products right now you deliver more nicotine per volume in many of these vaping products than you do in cigarette
taxes but we don't tax it the same because instead of being called a cigarette it's called a vaping device so it is a clever way to avoid the typical excise tax that we have put on products that we know have a cost to society with regard to where those funds go I put in there what again has been an interest that has been brought to me as I've talked to schools leaders and parents which is they're worried about school safety I've had several resource officers reach out and tell me there are things they would like to do to improve the security of their schools but they don't have
resources to do it so the attempt of this bill is to say let's solve two problems at once let's find some resources for school safety and let's also protect and put in good policy that will decrease this epidemic in vaping in our schools you heard testimony here last week a 400 increase in the last couple years in in one particular school district i think you'll hear that from almost every school that means again every day that we wait more and more kids are getting addicted to to this product so with that I would ask that the interim study proposal be
adopted that we do a thorough job of due diligence to gather information so that we can come up with a policy that we can maybe not all like but that we can all support because again I think we all would agree there's a problem and we need to do something so madam chairman again thank you for having me and I would hope that the the committee would
adopt the interim study proposal thank you um are there any
questions for the interim study proposal to be adopted is
that what your question's on did you have a question okay we have one question then we'll entertain a
Senator Trent Garner
Unverified
10:39
motion senator garner thank you madam chair senator henner do we have any idea what the fiscal impact will this be will be similar to your bill last time and that fiscal impact would be a new one have to be done by dfna
Senator Jim Hendren
Unverified
10:50
we will we have that information anytime soon anytime soon is you know hard to define i will tell you the fiscal impact as you said for the last time when we the first draft
of senate bill 571 was seven and a half million dollars for vaping tax but that is part of the details that we have as a group to work out how is how is this tax uh loophole going to be closed is it going to be at the wholesale level it's going to be the retail level and that would certainly have an impact on the fiscal analysis so I guess what I would tell you is until we agree first off that we're going to do something to tax it in a similar way that we tax other tobacco products we've got to know the method and then we'll get a fiscal impact but based on
what we did before you're talking somewhere between I would say six and ten million dollars and
that's part of the interim study yes ma'am process representative Ferguson you're recognized I want to make
a motion that we accept the interim study proposal but also I would like for us to keep any discussion on this ISP in the full joint Public Health Committee instead of subcommittee motion is
there a second Senator Wallace second all those in favor say aye aye and opposed I have it
motion is adopted thank you Senator Hendrick thank you madam chair okay with that we have an update from the Arkansas Department of Health and if they can come to the table Dr. Nate Smith and I thank you for being here Dr. Smith. I know you have patients this morning so we appreciate the
different hats that you wear. If you will recognize yourself for the record and they may proceed with
Speaker 31
12:27
an update. Dr. Nate Smith, Secretary of Health. Thank you Madam Chair. Currently
Arkansas Department of Health has been
Speaker 32
12:36
notified of nine patients with vaping associated pulmonary illness these are the severe illnesses that have occurred after vaping three cases are confirmed three are probable three are still under investigation of the six cases that have been interviewed two vaped nicotine only two vaped THC only and two vaped both nicotine and THC the age range for
these cases is 18 to 54. The majority of them, though, are in the 18 to 24-year-old range. Six of the nine are males. Eight of nine have been hospitalized. The Department of Health is working with CDC to investigate these cases, including collecting and reporting the medical information and vaping history. The Health Department is also coordinating with the FDA, U.S. FDA, to test any leftover vaping substances or devices.
On a national level, as of most recent report, yesterday CDC had 380 cases that were either confirmed or probable in 36 states as well as the U.S. Virgin Islands. There have been six deaths reported due to vaping-associated pulmonary illness. The exact cause is still under investigation. Most patients have reported using THC in their vaping devices,
but many have used both, and some have only reported using nicotine. CDC is continuing to collect information from states to refine their case definition to characterize the clinical course of the disease and investigate possible causes. FDA is also working closely with CDC as well as with states to collect leftover products, both devices and the substances used in those devices, and to test them for a wide range of chemicals and possible contaminants.
Vitamin E acetate has gotten a lot of press. It has been found in many samples containing THC, but it's not been determined to be the cause of the illness. It's not been found in all cases. A brief summary of federal actions on Monday, September 16th, the CDC activated its Emergency Operations Center to enhance interagency response to the investigation. The CDC and FDA are working very closely together on this,
as well as working with state health departments. And the FDA is gathering information on the products. They have an online portal, FDA safety reporting portal, that can be used by the public to report any concerns about tobacco products. And since President Trump announced his intention to ban flavorings on e-cigarettes on September 12th, The FDA has also announced its plan
to ban all the flavorings except for the tobacco-flavored products and is finalizing their plans. An announcement is expected in the coming weeks.
What was the FDA safety reporting online? Do you
Speaker 32
16:11
have that website? It's called the FDA Safety Reporting Portal. And
Speaker 31
16:18
I can provide that link,
but if you put that in, Google, it should
come up. Okay, are there any questions, Dr. Smith?
Representative Ferguson? Can you tell us about any research that's going on? I think everyone
who's involved in healthcare has, I mean, I knew this was a problem six or seven years ago when my daughter was in college and said, You know, people aren't smoking anymore. They're using e-cigarettes. I think we all have incidental findings, and it's going to take a while for research to catch up.
Is there research going on that's not being funded by
Speaker 31
17:00
tobacco? Yes, ma'am. There's quite a bit of research. Although
Speaker 32
17:05
the hope or the hype from the industry when these products first came out is that they would be free of many of the toxins and carcinogens of tobacco smoke, which is true, we have seen increased risk of acute myocardial infarction, heart attack, associated with the use of vaping devices.
I've talked before to this group about the effect of various flavorings, which were FDA approved for ingestion, but not for inhalation. And we know that some of them can have long-term effects on the lungs. And, of course, we've got these acute pulmonary injury cases as well. You know, unfortunately, there are so many different flavorings with so many different chemical compounds that have not been tested through the inhalation vehicle that there are going to be health effects that we don't know about.
We're sort of doing a massive experiment, unfortunately, with a lot of our youth. when I came in to your point about this has been a problem we've known about for a while when I came in Scott Smith with Medical Society handed me an article I wrote that sounds like it was written this past summer in the last several years electronic nicotine delivery systems have begun to penetrate the Arkansas environment these devices known as e-cigarettes e-cigars vaping devices, e-hookas, etc., usually have some type of nicotine base in a suspension, often
mixed with flavorings, including menthol. Since these are relatively new products, there's a lot of uncertainty and misinformation surrounding them. There are many reasons why electronic nicotine delivery systems should be avoided. That was written in 2014, so it's been a while. do we have
any data on how many of these people move from vaping to
smoking to the progression to smoking i mean i think the tobacco people want to sell the smoking cessation but i mean just
like i said incidental incidentally i see that people are starting with vaping and then moving to smoking and do we have data
Speaker 32
19:25
very preliminary data we can see movement both ways. The biggest concern has been with youth because there's been such a dramatic increase in the number of underaged vapers, and there is evidence that some of them will
go from vaping to using combustible products as well, although the majority of youth are vaping using electronic cigarettes you know the hope was that people who were using who had been using combustible cigarettes you know for many years would would get off of them and and go to vaping or e-cigarettes there is some evidence that that does occur although not strong evidence that they're very
good at getting people off nicotine altogether. The FDA-approved products for smoking cessation are really designed to provide a steady-state nicotine level to where people can gradually decrease the nicotine exposure and then get off nicotine addiction altogether. The electronic nicotine delivery systems, the e-cigarettes, the vaping, they give a pretty sudden jolt of nicotine that tends to reinforce addiction.
Some people will actually increase their nicotine addiction when they switch to them. Some people will be able to cut down, but there's not good evidence that people actually effectively move completely away from nicotine addiction using these devices, which is why they're not FDA approved for that purpose. Of
course, my concern is that, you know, just like 50 years ago with tobacco, we don't have the luxury of waiting on the research to catch up to this trend, and we're going to have a whole generation of young people addicted to nicotine, but thank you.
One of the things in your article you wrote in 2014, Dr. Smith says, among the public health concerns related to the use of these products is nicotine poisoning. Since January 1st of 2014, there have been 30 calls to the Poison Control Hotline in Arkansas related to poisoning from the liquid nicotine, so-called e-juice, used to fill these e-cigarette or vaping cartridges. 17 of those 30 were for children under the age of 5.
liquid contained or used in e-cigarettes or vapor devices obviously should not be accessible to children but it's actually toxic and it's a poison risk for small children i mean it's embarrassing to me that this was reported by you in 2014 and we really didn't pay attention to it so far this
Speaker 32
22:21
year we've had 80 uh calls um i haven't updated that number from from last month but as of last month we had 80 calls to the poison control center for this this calendar year okay thank you
i'm going to recognize representative brown thank
Speaker 51
22:41
you madam chair um dr smith notwithstanding the report that you did in 2014 one thing that really it's kind of raises a question for me not any doubt that this is important but just a question what has happened to all of a sudden it seems like it's a sudden spotlight that's been focused on e-cigarettes? Has there been an uptick in the number
Speaker 53
23:05
of negative responses and deaths, or are we just beginning to pay attention?
Speaker 32
23:12
There are really two main things that have driven the urgency of this. One is, as you alluded to, the dramatic uptake in youth use of these devices, even though the sale is restricted from children under the age of 18, that's the group that has had the most rapid growth in the use of these devices. And we don't just see those in the numbers. The people who are working in our schools
are seeing that every day. So there's been a dramatic increase in use of these devices, largely related to the packaging and the flavoring. But the other thing that has given this additional urgency is these cases of acute, severe pulmonary illness that I just reported on that have ended up with people in the hospital on ventilators and in some cases dying. The exact cause is unknown. It looks like, from what we know at this point, that there may be more than one substance
involved, more than one device involved, and there may be actually more than one roots of injury. So these devices have been suspect in terms of long-term problems, but now we have this problem where people can start vaping and within a week
Speaker 44
24:33
or two end up in the hospital or on a ventilator. Push your button
one more time. One quick one. We've got a big agenda.
Speaker 51
24:46
Okay. Go ahead. So these acute cases, that's a recent phenomenon? Yes, ma'am.
Thank you. Thank you, Representative Brown. Representative
Representative Julie Mayberry
Unverified
25:01
Mayberry? Thank you. I received a phone call from the athletic director at our school district, and he said that one of the things that it's very troubling, years ago when you could look for cigarettes, you could easily find them as the faculty member
the teacher or whatever you could find them you knew what they looked like but identifying them in a school setting is very difficult because they look like a fountain pen or they look like a USB drive and he said he's even seen some that look like fidget spinners and so it makes it really difficult so I didn't know if there's been any thought on changing the shape of the devices and if that would help so that it could be more easily identified and not thought of as a USB drive,
which certainly you want your children carrying a USB drive if they need it at school. Well,
before you answer, we are gonna have on the agenda some folks from the Mountain Home School District to talk about exactly what you're talking about. But you can go in and answer that. It's a manufacturing, I think, issue. Right, as a
Speaker 32
26:10
parent, I can confirm that. I have a 13-year-old daughter who told me about one of her classmates who just hides her vaping device in her bra when she goes to school so they can't find it.
These are very easy to hide because of their shapes, their sizes. I have not seen that as a major policy option put forward, but it certainly seems like something that would be consistent with the goals of reducing youth
Representative Julie Mayberry
Unverified
26:35
vaping. Okay. And if you can give me one more question, I'm sorry. would a school nurse on every campus who can share information about the hazards of vaping with our students on a more regular basis help the situation i can't see that it would hurt in
any way okay thank you thank you all right thank you so much dr smith we appreciate you being here for the update if you don't mind leaving your notes or ever your report with us just so that can get it out to other members of the committee that weren't here today that would be helpful thank you thanks all right next i want to um have dr stellica and dr fagan if you'll both come to the table
and just before you get started i wanted to i have your okay
thank you for being here um i wanted to read their bios but i cannot pull them up right now
hold on just a second there they are thank
you um dr stellica specializes in thoracic oncology with an emphasis on lung cancer esophageal cancer and other tumors of the chest and is experienced in minimally invasive thoracic surgery he previously served as an instructor in the department of thoracic and cardiovascular surgery at md anderson cancer center in houston He is board certified by both the American Board of Surgery and the American Board of
Thoracic Surgery. He's an associate fellow of the American College of Surgeons, a member of the International Society for Minimally Invasive Cardiothoracic Surgery, and a member of the Society of Thoracic Surgeons. He specializes in cardiothoracic surgery, esophageal cancer, lung cancer, minimally invasive thoracic surgery, surgery, general surgery, thoracic surgery, and tumors of the chest. So I'm so happy to have
Dr. Matthew Stelaga here with us. He is an associate professor with the Department of Thoracic Surgery at UAMS College of Medicine. We also have with us Dr. Pebbles Fagan. She has her PhD and Masters of Public Health. She is professor and director of the Center for the Study of tobacco. She is in the Department of Health and Behavior and Health Education with the UAMS Fay Bozeman College of Public Health. Dr. Fagan has more than 20 years of experience in conducting
research into tobacco prevention and control and cancer prevention and control. She has an extensive background in research that aims to reduce health disparities. She is a doctorate in health education from Texas A&M University, a master of public health in a health education Communication from Tulane University School of Public Health and Tropical Medicine, and a bachelor's degree in Rhetoric and Communications and Afro-American Studies from the University of Virginia. Previous to UAMS, Dr. Fagan conducted research as an associate professor in the Cancer Prevention
and Control Program at the University of Hawaii's Cancer Center, University of Hawaii at Manoa in Honolulu. She has also served for 10 years as a health scientist at the National Cancer Institute in Bethesda, Maryland, and a postdoctoral fellow at Dana-Farber Cancer Institute and the Harvard School of Public Health in Boston. We very much appreciate both of you being
here and we recognize you to present. Thank you. Go first. All right.
Thank you very much. Just push your buttons and pull your mic right up to you. There
Speaker 76
30:56
you go. And it has a green light. There you go. Thank you very much. You're welcome.
Speaker 77
31:01
It's a pleasure to be here. As we were introduced, I am Matthew Stelga, Associate Professor of Surgery and the Head of Thoracic Surgery, that's chest surgery, at the Rockefeller Cancer Institute. I don't have any conflicts of interest or disclosures. I work for UAMS. I do have a lot of different roles, a lot of different hats I wear. I'm a physician. But not only at UAMS, I also, and me and my group, practice and see patients at Baptist
Health, and we work in the community. I'm also a dad. I'm an educator. I'm a concerned citizen. Pull your
mic up right to your, there you go, so we can hear you. Pull the mic up right here. Okay,
Speaker 77
31:39
I'm sorry. Thank you. No, it's okay. Go ahead. Well, just a quick pathway on how I got here and what my interests are. So I'm a thoracic surgeon. I work on cancers inside the chest, a lot of lung cancers, and other pulmonary diseases that aren't cancer, inflammatory diseases, infections, and injuries to the lungs.
I've been faculty at UMS for 10 years and been working at Baptist for the last couple of years. I was looking for ways to get better outcomes for my patients and help them get through surgery safer and smoother. I sought out additional training as a certified tobacco treatment specialist at the Mayo Clinic several years ago, and we've integrated a great program into our cancer center. I'm the physician lead for our smoking cessation program at the cancer center, and we help dozens and dozens and dozens of people every year. We have research that we're doing on smoking cessation in our cancer center,
both in surgery patients and lung cancer screening patients. we've been asked to present that both the FDA which was a pleasure to do that this past summer and we're going back again in the spring and also at national international academic meetings so of all also of interest I've been asked to be a member of the tobacco prevention cessation program advisory committee and currently the secretary that and so a quick thing on electronic cigarettes I don't think there's any one single expert on every aspect of
electronic cigarettes they affect the lungs they affect the brain they affect lots of different parts of the body and they affect our society so we need to have experts of public health toxicology addiction behavioral science pulmonary diseases etc etc etc list could go on I'm sure pediatrics needs to be in their primary care and and everybody else and if I've left anything off it's not on purpose but it's pretty exhaustive of everybody who could be involved in this but I'll share some perspectives for myself and so electronic cigarettes we
talked about the different shapes design sizes there's everything from small things that look like cigarettes on one side there's refillable containers that have liquid in it we heard about the poisonings a bit and one thing about the poisonings from e-liquids that's that's of note the liquid can be absorbed transdermally we know that nicotine goes across the skin that's why patches work so that liquid yes it can be ingested but it can also be causing toxic problems transdermally so and going along these devices they can get larger and there's
modifiable devices with variable energy sources battery powers tanks etc and they can be changed modified and different things can be added to them or put in them and finally on the far side is the rechargeable USB shaped device the biggest market share is Juul and we see that has reusable pods in it so terminology can be kind of varied some people refer to as e-cigarettes or electronic cigarettes vaping devices a lot of the research studies we see are
called ENDS in their literature electronic nicotine delivery systems etc so a quick a quick word on some of the research do these help people quit smoking that's one thing I hear about they can help people quit smoking and and they can help some people quit smoking in some scenarios but we have to look at see what that exactly means there was a article in the New England Journal of Medicine that was a randomized study they gave some people nicotine replacement, patches and gum, some people electronic cigarettes, and they saw what happened.
There was a difference, 10%, 9.9% of people could quit with the traditional nicotine replacement, and 18% of people who were smoking could quit with these new devices, that's a significant increase statistically. But what's of note to me is of the people who quit, those who quit with the traditional devices and they could get rid of the cigarettes, most of them were able to get off of their nicotine replacement a year later. Only 9 percent were still using it. People that were
using the e-cigarettes to quit, 80 percent were still on it a year later. Okay, I'm glad they're not smoking. That's great. But what's the long-term effect of these devices and what's the long-term use? If we look further at studies, I said there's a lot of conflict in different studies that are on electronic nicotine delivery systems, we have a meta-analysis. And so a study is done either retrospective where we look back or prospective where we give people two different treatments and see what happens.
But a meta-analysis is where researchers take an area that may not have clear answers, gather many different studies, and combine all the results and see what they can learn from that combination. So this graph shows little boxes and lines. And if they're on one side or the other, it favors or doesn't favor e-cigarettes as a quitting aid for our patients. And this is done in real world settings, not just in a controlled research study. And so overall, these studies kind of go back and forth.
Some might show a little benefit, some don't, and many are inconclusive. Most of them are inconclusive. But overall, the e-cigarette data from this very large meta-analysis shows that they were not helping people quit smoking. And a lot of times what I worry about is people can use these devices at times when the traditional cigarettes aren't allowed at home, at work, or in the car with children or other things, and their bodies get used to more nicotine and can be even harder to quit.
So something I hear a lot from my patients and their families is it's just nicotine and water vapor, right? Well, technically it's not a vapor, it's an aerosol, and nicotine by itself doesn't dissolve real well in water. This big clunky looking molecule is a nicotine molecule, and it has a lot of hydrogen ions on it that don't mix real well. It's like oil and water, and they don't mix real well with the water directly. So the nicotine needs to be changed into a salt or bonded with a benzoate salt
or mixed with a carrier agent. And we can use propylene glycol, glycerin, polyethylene glycol. The literature can kind of refer to these as PG or VG or other things, but there's other things mixed with it where it's not just water and nicotine. We add to that flavorings and even anti-irritants. But then that concoction isn't just what it starts as in the device. By the time it gets to lung tissue, it's been heated and aerosolized. When we heat those chemicals, they can change.
So the different things that are added to it, they are FDA approved, generally recognized as safe. But we can't just listen to that part. It's generally recognized as safe food additives. these things have been looked at to be eaten ingested digested and absorbed through your gut that's really different than heating things up and sticking them in the lungs so what happens to them and are they safe in the lungs so we do know
there's some toxicology studies out there that say if we look at certain specific carcinogens cancer causing substances that we know are in cigarettes we have less of that in e-cigarettes that's good but just for that perspective less carcinogens than regular cigarettes that are combustible but does less means safe and that's not all that's in there there's other issues that we might face besides just cancer we're seeing these inflammatory lung diseases and and scarring in the lungs both long-term and short-term acute
changes we talked a little bit about the recent recognition of these vaping related illnesses and these are some images from the New England Journal of Medicine recently a CT scan is a three-dimensional x-ray that's done to look at the inside of people's lungs we look at these all the time I look at dozens of these every single day to look for lung cancers or infections or injuries normal lung tissue should be is the mouse showing up there no it's normal lung tissue should be that very dark area
with little tiny white speckles in it that are blood vessels. That big, patchy, blobby, white area, that's not normal. That is not normal. And that is either infection or inflammation or other substances that have congealed or consolidated in the lungs or caused injuries. Some of that can be short-term, acute injuries that we see in people, and some can be long-term and chronic issues. Here's more pictures of it. and there's other plain film x-rays or other CT scans that show pretty widespread injury to
otherwise healthy good lungs so I want to keep this kind of short on my part so we have time for for questions but electronic cigarettes they might contain less carcinogens than combustible tobacco that's just part of the picture some people can quit with e-cigarettes there are anecdotes of that that has happened but the data on the large groups is it conclusive does it help a lot of people quit or does it sustain nicotine addiction longer and
make it harder for people to quit and the whole youth issue is it an on-ramp for nicotine addiction for this next generation and what are we setting ourselves up for in the future are there other non-cancerous diseases we're not just looking at lung cancer here there's a lot of different things that can go on with the lungs and we can't just think about the short term but also the long term risks of it. I know that the vaping related illnesses leading to people on ventilators, that's very serious. It's also very rare. What I worry might be more common is the chronic
issues that we might see in years to come. So I think, unfortunately, I might have raised more questions than answers, but I really appreciate your time. And I want to hand over to Dr. Fagan to
Speaker 83
41:54
give more perspectives on this. Yes, Dr. Fagan. And then at the
end, we'll have time for questions. Okay. Thank you for the opportunity
Speaker 85
42:05
to be here this morning and listening to some of the things that we have to say. And thank you for that wonderful introduction.
I'd like to add that I have also been conducting research on secondhand smoke exposure among women and children and have a project here in Phillip and Lee County to better understand how do we reduce secondhand smoke exposure among women of disadvantage. A large portion of the research that I conduct also aims to better understand electronic cigarette use behaviors, and I have been working with a large team of individuals across the
nation on an FDA and National Institutes of Health funded grant to understand e-cigarette behaviors. We've had that grant for the last seven years now, and we are one of 10 centers funded around the country by the Food and Drug Administration and the National Institutes of Health to conduct what we call tobacco regulatory science, which is the science of understanding how do we better regulate tobacco use and my specific center which includes multiple academic
institutions around the nation specifically focuses on e-cigarettes only. In addition to that I have also served on the Food and Drug Administration's Tobacco Product Scientific Advisory Committee from 2015 to 2018. That committee is mandated by the Secretary of Health and Human Services, and that committee provides advice to the FDA on regulatory issues and reviews new products that are coming out on the market.
I also serve on an advisory committee that is examining T21 laws across the state and how they have been effective. To add to what Dr. Selica has mentioned and some of the questions that were raised earlier, One of those 10 centers that is funded is American Heart Association in Dallas, and they are specifically looking at cardiovascular toxicity related to e-cigarettes. There are a wealth of papers that have come out over the last five to six years that look at cardiovascular effects.
and I just want you to know that they're close by and in addition to the pulmonary issues that Dr. Stelaga has mentioned there are people who are looking at cardiovascular toxicity and we know from some of the studies that have been published that people who use electronic cigarettes compared to those who do not have an elevated risk of heart attacks. So there are a couple of points that I would like to share with you today, some of which you may have heard last week if you were here, but I want to bring
attention to a few points that are related to that. As Dr. Smith said earlier, electronic cigarette use is epidemic among youth, while less than 6 percent of adults in Arkansas use electronic cigarettes. The Centers for Disease Control data also show that at the national level, less than 4% of adults currently use electronic cigarettes or vaping devices
Speaker 86
45:30
and over the years since we have been monitoring use rates the fluctuations among youth among adults that is is has not
really happened but we have seen dramatic increases among
Speaker 85
45:45
youth so despite all of the Advertising and promotion that has been done by tobacco industry since these products came on the market to target adults, its youth, who have actually uptaken this behavior while adults' use rates have remained quite low. Some other points I want to make about the use rates is that the proportion of e-cigarette users who report using e-cigarettes on at least 20 or more days in the last month has increased from 20 percent in 2017 to 27 percent.
That is an astounding increase in
Speaker 86
46:32
just one year for those people who we call our frequent users. Again, those are people who use e-cigarettes on
Speaker 85
46:41
at least 20 days or more out of the month. We also know that from 2017 to 2018, the current use of any flavored e-cigarette increased among e-cigarette users from 60% to 67% in just one year.
We also know that the current use of mint or menthol-flavored e-cigarettes increased among e-cigarette users from 42% to 51% in just one year. So we're very concerned about what we'll see in the next coming years given those recent increases that we've seen. And as Dr. Stelaga mentioned earlier, Juul takes up a large proportion of the market. But there are other pod-like devices that are growing in popularity as well,
including Soarin and a number of others that have been introduced into the market. So that's a little bit about the epidemic among youth. I know that we have a draft of a bill that has been proposed, and I want to speak to some of the elements that are there. It is very important, and I was pleased to see, that there is proposal to expand clean indoor air laws to include e-cigarettes.
I think that is a step in the right direction to protect children and families from the harms of the aerosols that Dr. Stelaga mentioned earlier. In addition, we know that restrictions on advertising and promotion of tobacco products can help youth who are the primary users of these products. There is an evidence base on the kinds of restrictions that can be done that are quite helpful.
One is I'd like for the committee to consider giving back local authority to regulate advertising and promotion at the local level. In addition to that, other states have moved towards restricting the number, the location, the density and types of vape and electronic cigarette outlets that can be in the state of Arkansas.
So for example, zoning laws could specify that vape shops cannot be located within 1,000 feet of public or private schools, which is in your draft legislation. In addition, it could be expanded to daycare centers, foster centers, youth centers, parks, Libraries, community centers, or any other public or private centers that focus on youth. In addition to that, zoning laws could also state that vape shops cannot be located in residential areas
Speaker 86
49:42
or within a certain feet of residential areas where we know youth live. In addition to that, licensing laws
Speaker 85
49:53
could be expanded to actually place a cap on them. Other states are doing that now, including the state of Massachusetts, such that no more new licenses can be issued to retailers. In addition, some other states, what they're doing is that a retailer actually has to close
in order for a new retailer to actually get a license that has to do with the caps that are placed on licensing in certain states. Also for consideration is to increase the cost of license. Some states also, as part of that licensing, specify that there are no discounts or coupons, including sent-off, dollar-off, coupon redemptions, buy one, get one free, as part of the licensing. In addition, as part of that licensing, some states are considering and are including that that license
Speaker 86
50:48
specify that they cannot sell flavored tobacco products, including e-cigarettes of any kind.
And as you heard earlier, the FDA, the federal government, is looking into banning the sales of flavored products. So those are some of the restrictions on advertising and
Speaker 85
51:05
promotion that can be done, that are recommended, that have been shown to be effective in other locations. And there are just a few more points I want to make before I turn it back over. One thing I think is important to recognize is that when we talk about these
Speaker 86
51:23
products being on the market, none of these products are approved by the FDA, not a single one.
When the Family Smoking Prevention and Tobacco Control Act was passed by the federal government in 2009, it gave the FDA the authority to regulate the manufacturing sales distribution of tobacco products. What they did as part of that legislation is that any product that was on the market before 2007 is grandfathered in. All the products that you see on the market, including Juul, including Soarin, and thousands of others,
including the devices and the liquids or the juices, are not legally on the market. What FDA has said is that by 2022, if your product has not been grandfathered in, every single company must submit a pre-market application to the FDA by 2022 to get approval to keep it on the market. So when we talk about FDA commercially available versus black market, none of it is legal, but they will have to apply to keep it on the market by 2022.
Speaker 85
52:50
So I think that's important for us to recognize. We also just want to bring attention to the fact that
Speaker 86
53:00
as you consider various components of legislation, that you also think about the fact that there are new products being approved on the market. As part of my duties as a member of the FDA's Tobacco Product Scientific Advisory Board, I had the privilege of reviewing the product called ICOS, or IQOS, which just became available on the market this summer.
It was approved by the FDA, and it is a battery-operated device, just like other e-cigarette and vaping products that you are familiar with. with but it is a heated product that is operated by a battery and it contains rolled tobacco paper and so as you're considering what language you will include think about language that may cover other new products that are coming on the market such as IQ you IQ OS
Speaker 85
54:03
or ICOS as some others refer to so again
thank you for the opportunity to speak today thank
you one of the things and I'll come back to Dr. Stelaga's presentation but
one of the things that I am concerned about is the marketing of these products and the way that they're designed manufactured because you know I'm not sure if I know of a single 13 year old that was smoking a pack of cigarettes yesterday that dropped the pack of cigarettes and decided to use this as a tobacco cessation product to
quit you know a pack of cigarette a day habit that's not happening amongst a 13 year old or even 12 year olds or 14 16 year olds they're not switching so to me this product is in a gray area so you know is it I mean there are questions is it a tobacco cessation product for adults well that's one thing but it's not really marketed that way it's not really manufactured that way it's not
designed that way it's actually designed manufactured to be a cultural phenomenon or a cultural trend that has occurred and that's why you see this increase in youth vaping that is I guess considered now epidemic CDC standards is that correct so the cdc has now has designated this an epidemic based on the factual research and scientific data they've collected so when you talk about the marketing of those you know i pulled up
one that's called lucky charms it's a device called lucky charms and it it basically states which is incredibly concerning to me. With sweet marshmallow and cream, this breakfast treat is as good to start the day as it is to finish it. I mean, that is not marketed towards adults. That is marketed, targeted towards children.
I mean, to be quite frank, I mean, lucky charms. So, you know, I think we have to kind of figure out and define what this actually is. If it's going to be a tobacco cessation product, okay, fine. But it needs to be marketed that way. It needs to be designed and manufactured that way. It needs to be treated that way. It needs to be regulated that way. And it needs to be appropriately used that way in order to decrease nicotine addiction. And I don't see that happening. I see a completely different perspective and different picture
because we're talking about gummy bear flavors. We're talking about cotton candy, cocoa puffs, Lucky Charms. You know, that's one thing. And then the second thing is that really, really concerns me, and it gets back to what your presentation is with what's happening in the lungs. You have acute pulmonary injuries. That is incredibly different than a long-term cancer effect due to carcinogens. but we also don't know what the long-term effect of all the vaping of all these chemicals and as
to your point when you heat these they chemically become something different if you've taken any level of chemistry um classes and so but for me when you have a 19 year old that has to be intubated because of a collapsed lung are they going to become oxygen dependent for the rest of their life or you know when you see those those lung scans and those lung CT scans I mean what is the long-term effect of that clearly there is a short term effect but I know I've asked a lot of questions there and both of you can
respond to all of my comments but you know I think we have to get to a point of definition and then we need to figure out what the goal is and then figure out
Speaker 85
58:14
the plan to attack the goal so you can respond so thank you for your concerns and your questions the Food and Drug Administration has a process for approving devices that claim to be cessation
Speaker 86
58:27
devices and so any of these
companies have the opportunity to submit their applications to that division
Speaker 85
58:35
of the Food and Drug Administration to get them approved as a cessation device to date none of those products have been approved as cessation devices that
Speaker 86
58:49
process is the same as getting a nicotine patch approved nicotine gum or or the lozenge, or any other type of cessation aid.
Speaker 85
59:01
And so their process exists. Everyone has the opportunity to utilize that process to get their products approved on the
Speaker 86
59:11
market as cessation devices. The other part that I just want to speak to related to the health effects, which Dr. Stelaga, of course, is the expert on that, is that even when these liquids are unheated, you can detect aldehydes, like formaldehyde,
and traces of carcinogens. In 2017, we published a paper on sugars and aldehydes in electronic cigarette juices that were unheated. And so even before it gets to the process of being heated, of being heated, you still find harmful chemicals in these products.
Speaker 80
1:00:01
Thank you. And about the long-term effects,
Speaker 77
1:00:05
I mentioned there are these short-term effects that we see young, healthy people intubated on ventilators with acute respiratory failure. And even if they get through that, their lungs may be damaged permanently, long-term. And even for the people that don't have the acute effects, there may be long-term pulmonary damage. And what does that look like? Well, I see people in my office for lung biopsies due to respiratory failure quite a bit. Now, some of them may have used e-cigarettes
or other devices, some have smoked, and some have had other kinds of inhalation of drugs or other things, but we do see people who have long-term respiratory failure. And what it looks like is last week I had a 42-year-old man who could no longer work. He's walking around with a portable oxygen concentrator. He's got a grade school kid and a spouse. Yeah, that's what that can look like. And that's not just one person being sick or one family that's affected,
but think about the cost to society of his health care, his disability, I mean, that's just one person with lung problems, and if we are not understanding the long-term chronic effects of this, I mean, people can smoke for decades before there's increased risk of cancer that we can definitely prove, but we know it's there, and people can smoke and generate risk over time that develops cardiovascular risk.
We don't know the long-term projection of these devices. could be much bigger risks than we even know about, because they haven't been on the market long enough. And so, I mean, I think, yeah, there's terrible effects. And it's not, and it is awful that there's deaths due to this. But the disabilities, I worry, are going to outweigh those deaths. And those disabilities can be pretty costly in terms of people's quality of life,
Speaker 83
1:02:08
in terms of the impact on them, their family and society, and financially.
Thank you. Representative Ferguson. Yeah, for one thing, if I could ask Dr. Fagan, could you get us a list of those recommendations that you had so that we could have them in writing and send them to the committee? I also had a question for Dr. Stella about the, it bothers me that JUUL is really using that New England Journal of Medicine article to say that JUUL is a smoking cessation product i i remember reading it at the time i think it was a british study of like less
than 900 people and uh they also had behavioral health counseling once a week and were paid to participate in the study so i'm not sure that without those ancillary services that research is reproducible with even the 18 rate uh you you know you might address that it bothers me a lot of times, you know, the devil's in the details that a lot of these companies for all types of things use these journal articles in what I consider inappropriate
or absolutely almost misrepresenting the study. Yes, absolutely, and
Speaker 77
1:03:30
you said, the devil is in the details, and we look at research to learn about what can happen, but that has to be generalizable from that cohort of that group to our society. And yeah, behavioral intervention, structured counseling, routine follow-up, and incremental checking on people
is very different than the real-world free market kind of uncontrolled use. And when we looked at that one graph with all the different studies that they look at, That's why we don't see a reproducible, reliable quit rate in people who use them. I might add,
Juul, I just looked it up, they did $2 billion in revenue last year on Juul.
So, I mean, there's no doubt we're, you know, it's all about the money, obviously. But would you suggest that any e-cigarette or nicotine product be prescription? then if they're saying it's smoking cessation absolutely prescription
Speaker 77
1:04:39
if it goes to the FDA regulatory process I mean we give nicotine prescriptions to people for patches gum lozenges there's even a nicotine nasal spray there's a mouth spray and there's an inhaler that's not a heated inhaler the
difference with that is the heated inhaler puts other agents and chemicals with it that go deep in the lung the prescription inhaler is a room temperature device and it delivers it into the mouth and tongues and tongue and gums area and it's absorbed that way so so yeah we would absolutely prescribe nicotine if it's gone through the regulatory process i don't feel comfortable prescribing devices to people that haven't been studied long term that we don't know the effects and also we don't know the doses reliably
A lot of these liquids have variable concentrations, even from what's on a package. When they study it, it could be variable. One thing that's good about the nicotine gum or lozenge, it's four milligrams and two milligrams, and you know how many pieces you chew a day. You can decrease it. You can go to a smaller dose, go from a 21 patch to a 14 to a seven. And so things that are FDA approved, there's an off-ramp. There's a plan, and there's a way to count down and get off of it. And so that's kind of the side of nicotine that I think is helpful for people
because we've proven that with data.
Is that? Thank you. Senator Garner, you recognize for a question? Thank you,
Senator Trent Garner
Unverified
1:06:12
Madam Chair. So we saw from Dr.
Smith earlier that out of the six confirmed or likely cases in Arkansas of there being major health problems, that four out of that six were related to THC or cannabis-related activities. Is there any kind of long-term data on THC or drug usage or black market usage of this
and that being contributed to
Speaker 83
1:06:40
the health decline? I mean, I don't know
Speaker 85
1:06:48
if there's any long-term data on any of that, but Dr. Fagan?
Speaker 86
1:06:53
In terms of long-term data, I think that's developing. But there was a study that was published in 2008 using some of the national data to examine what the risk for respiratory illness is among those people who did not use any cannabis or tobacco-related product compared to those who were using electronic cigarettes alone.
electronic cigarettes in combination with cannabis and basically what that study found is that of course your risk for respiratory illness is much lower if you don't use any of these products but if you compare people who are using electronic cigarettes plus a cannabis related product that their risk for respiratory illness is greater than that if they were using
e-cigarettes alone. Now, I mention that because we know that youth and young adults are what we call dual users, not just of tobacco products, but of marijuana and tobacco products together. So when they are using these devices, which there are over thousands of various kinds of devices that are on the market right now, they can be using nicotine-based juices or liquid alone, they could be using cannabis-based liquids alone, or they can be using them in combination.
And we know that, particularly among young populations, that the use of multiple substances is popular among this particular group. Thank you. I think what's also troubling,
though, to me is you can go on YouTube, and the way
that many of these devices are designed and manufactured allows for the mixology of illicit drugs plus the nicotine. That's a design choice by the manufacturer to allow those cartridges to be refilled.
Is that not correct? So, and there are plenty of YouTube videos out there that shows how to extract the THC and then to mix it with the bases that you put in your, you know, the chemical bases in order to inject it into the cartridges and mix your own. and so if that's done with thc it could be done with fentanyl is that correct or other type of illicit drugs i'm sure methamphetamines i'm sure it
Speaker 76
1:09:37
absolutely could if it's done with one substance
Speaker 77
1:09:40
people are creative and and people have a hard time quitting substances would find different ways to use it so i'm not an addiction specialist and i don't know if that's actually happened with fentanyl but i'd worry if it did because fentanyl is incredibly potent deadly thanks for raising
Speaker 85
1:10:03
that point I can't respond to the fentanyl component of it but the reason why I was smiling
Speaker 86
1:10:08
is because I do research on social media so I watch a lot of YouTube videos every
single week okay where we're actually looking at how they are promoting e-cigarette devices and products. And so that is part of this grant that we have from the Food and Drug Administration and the National Institutes of Health is to use social media to better understand what is being marketed and what these, we call them aliases or characters in the YouTube videos, are promoting and educating young people to do.
We know that young adults are the most common users of YouTube videos, and we know that YouTube videos play a large role in peer-to-peer education on how-tos. And are you using
any of that research time or opportunity to look at where these companies, like jewel are marketing where are they spending their marketing dollars because i think that is
would be highly indicative to me as to who they're targeting we have
Speaker 86
1:11:23
not done that particular research but there are other people for instance looking at
that how many people in this room use tiktok that app anyone no probably because we're all a little bit older than 25 years old but i mean it's just it's just an example and I'm not sure if they're advertising on that or not or snapchat or you know all these other different but I know that whenever I text somebody and I
pull up a gif that I might want to send them and when I type in the world word you know one of these words of these vape companies you know advertisement pops up immediately so it just seems to me and that there is there is a directed targeted marketing approach towards youth in
my opinion but that's an opinion not backed by dollars I mean I'd share an
Speaker 76
1:12:15
opinion with that as well I have patients who come to my office with cancer and they're
Speaker 77
1:12:20
unable to quit smoking we try
to counsel them and give them approved methods and they say I want to try this e-cigarette none of them who are smoking a pack a day that are 75 years old say, give me the mango or the tutti frutti or gummy bear flavor. I mean, if people who are addicted to cigarettes genuinely want to quit, I mean, I don't see them reaching for those flavors that we hear about, like the cotton candy and Lucky Charms. I mean, I think that the marketing, even with the
Representative Julie Mayberry
Unverified
1:12:55
designing of the flavors is targeting you and that's what i see thank you representative mayberry thank you so much for letting me ask this question because i was looking over the ingredients here and i may be throwing this ball way out into left field and this has no bearing whatsoever but i've just got to ask the question i see in the ingredients it says glycerin i am allergic to glycerin. I'm allergic to it because I have an allergy called alpha-gal, which means that I'm
allergic to mammal ingredients. And how that was discovered was actually because people were dying from a cancer drug. It wasn't because people were dying or having anaphylactic reactions to eating a hamburger or pork. They were dying from a cancer drug. Actually, the first one here in the state of Arkansas, forgive me if I pronounce it wrong, Cetuximab, C-E-T-U-X-I-M-A-B, yes. And anyway, you know, as studies went on, they realized that people were dying from
this medication because they had an unknown allergy that the people did not know that they had this allergy to alpha-gal. And so I just kind of wonder if maybe some of the people who have died and have suddenly had this acute lung disease that has come upon very quickly if they're breathing in this glycerin that they don't know that they're allergic to just throwing an idea out
Speaker 77
1:14:27
it it could be an allergy to that a lot of these agents glycerin propylene glycol etc they are present in a lot of foods
already so I think if people would have an
Speaker 76
1:14:39
allergy to some of these things they may know about it but they might not that's that is a possibility but
Representative Julie Mayberry
Unverified
1:14:45
it's also going directly into their lungs as opposed to maybe
a small amount of glycerin that is in your food you know and there are so many people who have this allergy and don't realize that they have the allergy they're they think it's a gi issue that they just can't seem to solve or or whatever not everyone has it to the level that i've experienced so i'm just throwing that idea out there i know we have
officials from the Department of Health. I don't know if that's just a crazy, crazy idea, but to my knowledge, there's no real source on what has taken place and why they're dying, and I do know that people have died from alpha-gal allergy being in a medication, so I'm just throwing that out there. Yeah, thank you. Thank you, Representative. All
right, no other questions? We so much appreciate your testimony today. Thank you so much for being here, and if you can, we've got your presentation, and then if you could leave your remarks and your suggestions, that would be great.
Thank you so much for being here. Appreciate it very much. We're going to move
down. I have Dr. – I mean, I'm sorry. I'm going to – I've got – I know that Circuit Judge Tom Smith, Thomas Smith, is here, and he has to get back to Northwest Arkansas, just like Dr. Stelica has to get to his surgeries. So I'm going to go to him next. If you can come up, yes, Circuit Judge Thomas Smith, and then after that, we will hear from Mr. Sutton and the officials from the Mountain Home School District.
Judge Smith is the circuit judge from Division III in Benton County, presides over the juvenile court, drug court, veterans court, family law, and probate cases, and I reached out to myself and wanted to present his thoughts on this issue, and so with that, if you'll state your name for the record, you're recognized to proceed. Thank you. Thank you very much. all right tom smith circuit
Speaker 117
1:16:45
judge in benton county i appreciate the opportunity to come
down and join in on this conversation and i appreciate you all taking up i probably won't give you many answers but i just want to tell you what we're observing in court uh being one of the circuit judges in benton county i actually have the whole juvenile division the drug court the veterans court, the family court. So I deal with all the addictions side of this. And I'm glad to follow up our last two speakers because they really are hitting on where I am with this issue. We're already learning now that the nicotine side of this is dangerous. What's causing this?
Who knows, but it's been declared an epidemic. You've heard that over and over again. My concern, I've had schools law enforcement we work with a lot of people in juvenile court to keep young people from having these issues and they've been sounding the alarm for a while they've been telling me they have a problem with this vape with vape with vape and I'm glad we're all paying attention and I'm here just to encourage you to move forward with whatever you finally decide
uh to do it quickly because we have some issues and the data is new but i want to share with you what we're learning uh first of all we have to get the vape away from the kids and right now it's legal and thank you all in the last session for going up to age 21. it's legal above 21. it's easy for me to tell you to ban it but that's a different issue that's your call right but even with it being 21 what's still happening it's with our kids if you go talk to any school
across the state and i'm only here speaking for benton county i believe we didn't talk about this yet just so you know our juvenile judges meeting is in hebrew springs in november we will be talking about this issue to see what's happening but i'm here in benton county and all of my schools tell me we have a problem because it's been decided that it's cool to vape look at what those pictures you keep saying those items are supposed to be cool that's what the kids are seeing all the advertising you are talking about it's cool just like the camel days so where's your target it's
the kids and so it's illegal to be in possession for the kids for them to have it but guess what They have it. Well, let me tell you what else is coming, and this is the part I'm really here to talk about. It's not just vape. I wish you could say vape with nicotine is totally separate from vape with marijuana. It is not. If you don't think this issue is going to be coming with the same marijuana issue, we're sadly mistaken in pretending what's coming ain't coming.
It's coming. I now have kids in the schools and this is what's happening now and don't get me wrong let me let me clarify some things I'm not here trying to tell you all the whole world's coming to an end I'm proud of our kids if you look at the data drug use has been fairly flat and actually declined a little so we've been working hard as a community as an estate to not have this epidemic get out control but what I've seen this year is and I could and I before I came up and we did this kind quick last year drug offenses in benton county this time versus this year and once again they're
pretty flat but here's the change now the school arrest for drug offenses is actually more than last year but here's the part that's spooky a lot of those possession charges are now vape devices all right well first of all it's not even legal to have vape devices for marijuana in arkansas so your question is where's that coming from and why is it accessible and i know it's easy
to say well we've had tobacco around forever and you know we've had these issues we survived but look how long it took to get uh and how many billions of dollars of lawsuits and all the time it took to get it to where we had a reduction in smoking right are we really going to go through that with this marijuana and i and i'm not telling you what's going to happen in the future but let's pretend for a minute that this marijuana thing passes to recreational use let's pretend for a minute that that happens soon and now we have a whole set of young people thinking it's
cool to vape well there is a little bit of data on this and the facts are i think it's three times as likely if you're vaping you're going to vape marijuana i think there's some data out there i know it's all new and I know it's all happening but that's the market that's the real sale that's why the kids are being advertised as you all have noted correctly it's not the adults this is for the adults it's pretty steady where's the market it's the kids and they're not supposed to have it
but nobody's been able to stop it yet and once again y'all have some tough decisions and I understand and I appreciate you all looking at it but if we can't get the kids away from the vape is it really worth having it at all is that much good being done because I'm really afraid that if it comes down to the marijuana vape as accessible as this regular vape nobody's shown me yet that we can keep it out of the kids hands because it's there right now and we're already
seeing kids get arrested for it now and i don't know that we've even been able to acquire all the data uh statewide for sure fortunately uh i have some people that are busy bodies that look i could just say find out so they were able to give me that this morning driving down we know our school arrests for drugs have gone up it's flat across the county but part of that is vape arrests and there's not even supposed to be uh marijuana vapes in arkansas and i don't know what the rest
of the state's going on but that's my concern and there's going to be talk and i fully understand uh we could probably criminalize this vape regular vape use fortunately the marijuana vape is criminal so we can take really good action on that when the law enforcement spends their time and schools spend their time but the vape there's going to be calls to criminalize these kids okay so we're about to make 25% of all of our kids criminals for vaping because I think some of the data shows that's how many are using it all right is that the right way to do this because
we're trying to keep kids out of the court system and not be that repeat offender when they get older we've been doing these reforms the study knows we don't want that we may have to do that as part of this just for the nicotine vape but why is there got to be access why penalize the kids get it away from the kids get it totally gone it's easier said than done i'm just a judge in one county but i'm telling you what i'm observing and i'm observing this is a real problem and let me tell you why it's not going to stop i also run the drug court and the veterans court right now i
have one of my drug court participants locked up trying to decide what to do with them you know what he got in trouble for while in drug court the vape pens the marijuana so however it's getting here and wherever it's coming from that's coming I hope I'm dead wrong and I hope I'm giving you something that goes that judge Smith kind of I'm really a glass half-full kind of guy but I'm worried about this that's why I drove down this morning and I appreciate you giving me the time to
tell you my concerns and I'm sure you are going to be looking at this from the judicial side to see what type of ideas are out there on how we can help because like I say I'm the same as you all if you can find some school that tells me this isn't a big deal or some law enforcement officer tell me this isn't a big deal I'd like to know where they are because I don't have them in
my area trail I had do you have any questions about that I do the you said
that the individual in drug court is now in jail because of the vape pens did he or she
have the marijuana was in they did they mix it themselves were they
selling them I don't have any of those details all I know is once I heard he got arrested I was angry
Speaker 117
1:25:17
said he's gonna sit there until we can deal with it and are when staff the whole thing and learn more about it because one thing you're not allowed to do and he might not have been dealing them just looked that way I I just don't allow people to deal drugs while in drug court. No, I think that's pretty reasonable. So that's why
Speaker 122
1:25:36
I said I got mad. There's a reason why I locked them up.
I hope so. There's a reason why I locked them up. But, I mean, I think we all realize that this
Speaker 117
1:25:45
potential, if it was to be legalized, we're going to have the same debate. How are you going to keep it out of the kids' hands, right? Right. And we've worked so hard to get the drugs to where they're not increasing the use. But now we're letting them all think that this is the way to go. And the data is showing that you will do it more. I hope we never get that far. But this is dangerous enough.
And you bring up a point that I'm really concerned about. Again, it goes back to what's the manufacturing. How are these devices designed? You know, I mean, it's clearly a nicotine delivery system, but lots of them are designed not to be necessarily a nicotine delivery system, but to allow for the mixology of marijuana or the THC, the cannabis, to be mixed into it and then filled.
and so that creates a whole nother market share i guess for drug dealers and let me tell you i
mean that's what you're saying right yeah and let me create a
Speaker 117
1:26:53
whole nother scenario let me tell you why i'm so scared about this and you all have probably already learned this when you were going through the medical uh marijuana act when we were talking marijuana let's just use the 60s because that's i guess the first time all right so you had your 15 concentrate marijuana field pot okay 15% maybe that's more addictive than or not addictive but let's talk
about where we are now I'm pretty sure and I haven't seen the latest data the marijuana is supposed to be under this medical card is probably 30% concentrate I don't know for sure but I'm sure that's the kind of marijuana that's being used if you get your card in these areas you may check my data on that here's what's spooky about this form that gets in these vapes with the dab in the oils they can make this stuff 80 to 90 percent concentrate that's not your old-fashioned Woodstock pot that's addictive that's a one hitter and is
dangerous and that's out there and some I was saying earlier the
stuff's not regulated right right thank you are there any other questions for Judge we appreciate so much you coming and sharing your thoughts driving all the way down here for this and
we know that it's our job to partner with the judicial branch and others to make sure we understand fully the ramifications of what's actually going on and how we combat it we do have one question
Representative Jim Dotson
Unverified
1:28:26
representative Dotson judge thanks for coming down just for the benefit of the committee and everyone here we were talking a little bit earlier and could you go through and just say what you can do right now with regards to if this marijuana vape you have some tools that you can use to combat that right now because it's illegal could you just go through that for the benefit of the committee what you can do what the what the penalties are and and for minors
especially and if we were to expand that to be the same sort of illegality for
Speaker 117
1:29:09
like right now if you get caught with and we get a call from the school which is typically where these come from it sometimes law enforcement may get it at traffic stop if we learn it it's actually a marijuana type vape that's actually already illegal right it's now you've got drug paraphernalia which typically is a misdemeanor sometimes if
you can actually and we send this in to the lab testing for oil and stuff that could actually be some type of position control substance also a misdemeanor but at least you could take some max to get into our risk assessments and help the young people through a probation period training drug screening drug testing to where hopefully that ends it. Doesn't always end it, but we try to end it. You know, the issue you have with the vape that's not marijuana related is it's really treated as a
fine. I think it's $25 to a hundred. And to be, I'll be honest with you, I'm sure most judges and most people will tell you up until this thing has hit us all because a lot, not like a lot of people, thought that this was fairly safe when it started. It wasn't as big a deal as it is. But that little fine enforcement, it really limits you on what you can do. Now we're probably going to be looking at new ways to expand that to get them into maybe some other diversion programs. But the reality of it is, once again,
if we take the same acts with this regular vaping, we can add more to it and maybe address it, but let's do the numbers on the kids we're about to affect. That's one way to do it. And I'm going to support anything y'all pass. That's our job, right? You all have to make these tough decisions and pass these laws. We enforce it. And so that's probably part of the school frustration is what do you do? And I know the schools have different policies on how they deal with it.
Where my concern is really arising, and I'll go back to it, is we're now jumping. It's not just vape. You're starting to see
the other. Thank you. Thank you.
Thank you, Representative Ferguson. i know like if someone gets a speeding ticket or has a traffic ticket they can go to the school to i guess to keep it off their insurance or something is there any is there a program like that to send kids to if they're caught vaping to make them go to class all for several hours
Speaker 95
1:31:40
on saturday or something to explain to them
Speaker 117
1:31:45
the problems with i think there are some now as far as just the nicotine on how that's being handled we're we're now evolving like everybody else probably on a fast track of what the right solution is uh several of our schools uh when they have issues uh for this type of deal we've partnered with them and we actually bring kids in on saturdays uh to do different types of trainings and where this fits in and what we do
uh my answer today is it'll probably be totally different in a few months on how we're handling this because of where it's headed to i think we all agree this isn't just like you have a bunch of kids vaping it'll go away no we have a lot of kids vaping we now know the health concerns that are out there don't have all the answers but there's also going to be
what else but there's no statewide educational program that they would be required to
Speaker 117
1:32:40
go to not that i'm not that i know of typically uh typically each jurisdiction probably handles this a little bit differently
but really it's treated like a tobacco possession of a tobacco right now for our purposes and there's not full uh services i think probably where some judges will be looking i don't want to speak for anybody because we haven't met yet but you know you always have fins cases and things that you can put in some supervision for for different acts that could have been charged or not charged it may fall into that for multiple offenders uh but the rowdy of it is
these these kids are being sold a bill of goods that it's neat and cool to do and we've kind of been buffaloed ourselves by not realizing how what what we're now hearing right you now have this epidemic status with all these health things we probably haven't been responding or doing as much as quickly as we could I don't think we recognize where it's all gone now I think everybody's fully aware this is the problem we have now made smoking cool again for kids just in a
different form that's your market that's gonna present its own problems what I'm worried about is we also know you have this secondary thing coming because it's already here the vaping on the marijuana side we're already starting to fight that now what happens if it ever does become legal because so far the e-cigarettes are legal and we haven't done been able to get it out of the kids hand we've been learning that with all this data they're the ones that have it right they're the market they're the increase so what's going to be any
different with these same things that look the exact same if that becomes legal you know that's that's really I'm just trying to make us think how do we stop what might come and let's hope it never comes but the reality of it is sorry right
no it's already here and it's it's it just complicates this issue even more and this is an area that really
has not been discussed yet so you're it's so important that you're here senator garner thank you madam chair so you
Senator Trent Garner
Unverified
1:34:55
mentioned that if somebody's caught with the nicotine only e-cigarettes or vaping products that they're usually a fine associated I saw a story this morning that the school district of Villanueva is going to start automatically referring that out to a prosecutor I think every single time they catch somebody would you say for obviously the marijuana side is a different because you do have drug drug related charges for the e-cigarettes that are nicotine related only do you think there's needs to be changes in the law for stricter
or tougher enforcement of that or do you think the law is currently good it's just not been applied until this recent understanding of the epidemic of teen sex so as a policy consideration should we increase the penalties give judges and prosecutors more leeway and more ability to go after it or is it something that we should be able that the judicial system itself needs to enforce and already has the tools to do it um then i don't
Speaker 117
1:35:52
want to i don't go too far in what i think you should do yet on that issue just because uh we're now looking at a whole new set
of issues that come from this right what i will tell you is if you're asking me is there a whole whole lot you can do for just the e-cigarette uh charge you don't have the same tools in the tool belt that you have for like i was saying if it did involve marijuana right you could you have the full gamut of probation fines and costs and resources even locked up if you get that far and i did in fact i spoke with the judge on the way down about that about what they're doing there i'm all for
and this is kind of thinking outside the box we're all going to have to be doing is what are the schools and the courts how are we going to combat this uh and i guess if you have people that get high enough risk and uh keep violating the law there's some criminal accountability y'all will be looking at and you'll have to change the law to do that it's not there now uh but i go back to and this is going to be a big part of this discussion are we just going to blame the kids
and turn them into criminalizing the acts which might be a part of it or are we going to take on the money I say we hits your tough
Speaker 139
1:37:11
call but that's the question and maybe it's a little
Speaker 117
1:37:15
bit of both and we're gonna have to look and see how to handle that would I look at you and say when I hear these numbers and I have 25 percent of our teenagers now using this sometime if I look at the numbers and say do we really want to look at the cost of 25 percent of all teens in our juvenile
court system that's going to be costly in of itself if everybody get caught in jars but I think that's the numbers we're talking about or close to it so if it's that much of an epidemic we need some we need we probably need to look at what we can do about it on our side it's probably one of the discussions we're gonna have in a few weeks and they'll probably have to be some changes coming with the law that you all look at as you and I'm just glad you're looking at these issues because we're kind of thinking outside the box right that's
gonna be one element of what you look at but I'm gonna bring it right back to you it's easy to it's easy to criminalize a kid that's easy right okay well that's illegal but therefore kid you suffer but is that where this thing started is that really where this all started no it's not now is it part of solution to help get these kids an idea he bet and i'll support you 100 do whatever y'all tell me to do to enforce the laws i'm just encouraging you it shouldn't be available for these kids
and it is and we haven't figured out
Speaker 127
1:38:43
how to stop it and until we stop it do the pros outweigh the cons that's the million dollar question or maybe 100 million
thank you thank you you. I hear you loud and clear, and I understand this. I mean, after working on
juvenile justice reform with you and all the juvenile judges, really that's a whole aspect that we hadn't even discussed yet and approached. I mean, you're going to penalize and criminalize these
kids. However, you know, it's really being targeted, marketed, designed, packaged towards them how do we keep it out of their hands so that they don't go down that path either and it's a great
point it could be a new area
Speaker 117
1:39:26
that while we're discussing all these things we look at uh what do we do and how do
Speaker 143
1:39:30
we handle it and what things do we put in there as tools in a tool belt so
so i just i would love for y'all to continue to track as much information as you possibly can i think that's really going to be beneficial if you can get the word out to the juvenile judges
all across the state for us i think it's really important that we track um how many drug offenses that are occurring in schools and if that's rising not just in your area but across the state and then how many incidences of those are illegal drugs within vaping devices i think that would be good information that we need to have if i need to send this directive maybe to administrative offices of the courts or whomever we can do that but starting to to really see
what's happening in just a year's time I think would be beneficial and then you know as always I think it's it's a collaboration process so and this is an area that really we hadn't discussed yet thank you so much thank you very much and I appreciate your all's time safe drives back home thank you and with that we have our last presenters, Matt Sutton, if he's here, and Mr. McCarn. They are from the Mountain Home School District, and happy that they are here. Mr. Sutton, he's got lots of initials behind
his name that are written on, and so I'll let him introduce himself, or I'll let them both introduce themselves but they've been really on the front lines they are both Mr. McCarn I refer to him as Coach McCarn or known him for a long time so I so much appreciate y'all being here if you'll just state your names for the record and then you may
Speaker 146
1:41:17
proceed thank you and my name is Matt Sutton and this is Kyle McCarn I coordinate
Speaker 147
1:41:22
school-based mental health services for our district in
mountain home and kyle is a junior high principal our junior high principal at mountain home it's an honor to get to represent our school and also just other schools around the state so thank you for hearing us out today we need three minutes and then we'll answer questions we want to just kind of speak a little bit on just kind of the front lines of this thing and what we see just on a regular basis at the ground level we brought in a bag that that mr mccarn literally five minutes before we left threw 40 of these things from one of his desk drawers all different shapes
sizes colors everything imaginable and we brought that bag just in case anybody wanted to see this is what this is what's happening and what we continually struggle with is at the school level we are not we don't have detectives we don't have phlebotomists on staff to do talk screens we don't but yet we're required to manage these things and to educate our kids about these things So we get tons and tons of these things and we confiscate and we don't know what's in them either, but our kids definitely don't know what's in them.
And we have continual drug tests being failed for things like THC and even other things like amphetamines and things where kids swear they haven't done any type of marijuana smoking or anything like that, but they've hit a vape that was a friend's or whatever else. And this is a big difference than back in the day when you opened a pack of Marlboros and gave somebody a cigarette from that pack. This is now, do you want to take a hit from this vape that I have? And a kid has no idea what that kid has put in that cartridge and what it's laced with.
And as somebody mentioned earlier, it's a simple YouTube click away to be able to learn how to put THC oil into a cartridge. So this is just kind of the typical stuff. They're small. They're very difficult to pick up. And I'll let Mr. McCarn talk about just the time it takes in his day to just try to police this thing on a school campus. Yeah, so let me
Speaker 150
1:43:26
say thank you for letting us be here. First of all, I appreciate the opportunity to talk to you all and address our concerns.
As Matt was talking here, we have many different things that I just pulled from my desk drawer before leaving this morning. all different shapes sizes colors part of the difficulty for us whenever we encounter this at the school is determining what exactly is in these products as is mentioned before they so many times are there they're not regulated and we will get information at the school at the school level with a teacher report or a report from another student saying how you know the
individual in question has a vape and they have a liquid that contains THC or methamphetamine and so we'll begin to to investigate that and go through that which could easily take you know a half a day with myself and the assistant principal to be able to fully investigate that but then the other thing too is we have very limited resources to determine what is actually in the liquid and so these are these are some examples of you know things i actually took these off of a student
last school year and as you can see they are definitely refillable with very little marking on them to determine what is actually the contents in the liquid and those kind of things and so the other the other point that i would like to point out as well the jewels and the boulders are I have an example of a boulder here that looks like this if you haven't seen a boulder it's a jewel type thing with some very minor things here's another
example of a jewel type device that we took off of the student at school but but what we're running into now the jewels and the jewel top devices are becoming more popular because they are refillable and so we've actually caught students now at school with these kind of bottles or these kind of bottles and they will actually be selling a refillable jewel pod to the their fellow students out of their locker or out of the bathroom for a couple of five
dollars or whatever and so they will actually we will catch them with these and they'll be be refilling those and then again the difficulty for us like I said before is determining what's what's actually in the liquid because we get reports that that it's just not nicotine and of course the students tell me all the time that it's just it's just a vapor it's just water vapor and and we know it's not and but determining what is actually in the liquid for us is
difficult when we actually get the device and those type of things the other the other thing that I would say the reason why these devices are getting a whole lot more popular we have not I have not confiscated one of these in school and it's been probably two years I would say but the concealment of these is is why and like it was mentioned before a lot of times we will know a a student will have these on campus but they will put them in the bra or put
them in the crotch of their pants and so that's why these and these have become more and more popular with our kids is for the concealment issue of it they will also make sure and wear long sleeves and put them in their sleeves and conceal it that way and so there are a lot of a lot of concealment issues there too with that so on on the
Speaker 147
1:47:18
other end that we wanted to speak to and then we can maybe answer questions if you have any and we have time we we have this this continued desire on our campus to be proactive in this area and what
we continue to run into is a lack of staff availability to implement curriculums and programs that we think would be great in being proactive here but we're having to be so reactive on a regular basis as our students are continually either failing drug tests or being caught with these on campus. So we have a scenario in our district where we implemented that the student and the family will have to come see me for five counseling sessions. That's part of our process now.
Anybody that gets caught with a vape or any other type of substance comes to me. So I'm one person. and I'm the school-based mental health therapist for our district. We also contract with some agencies, but you can imagine when you see this many of these devices how often this is coming through, and it's impossible for one person to try to get involved at the family level with our students here. So what I typically get, and this is what I want to speak to on the mental health end, I get two answers from every student that comes to me
that's the struggling with these devices and and I when I ask them why it's two things one is stress so they say that it it is a is a stress reliever and they are very stressed to the max we can talk about some research that we've done even recently to talk about the stress that our kids are under so this is something that's a very quick fix for their stress and they've been told it helps stress they continue to use it for stress and the other thing is peer pressure so we just we started an initiative just this this school year mr. McCarn and I at the junior high and I went and spoke to 700 8th and 9th graders and I looked them in the eye and I
apologized to them and I apologized to them on the behalf of adults in their life and I apologize that we constantly preach to them about how bad vapes are and how sick they can make you and how bad of a decision it is but we spend very little time educating them on healthy coping skills for stress and very little time educating them on how to deal with peer pressure in a very positive way in a healthy way. So what we're trying to do, again, at the junior high level is try to teach those skills, to build those skills so that they don't need a vape cigarette to be able to cope
with stress, but rather they understand how to deal with stress in healthy ways. Again, this is an initiative that we need about 15 of us to be able to do. We need our school counselors freed up to be able to help in that. So it looks good on paper, but again, I don't know how effective it's going to be. We're just in a situation where we've got to try something because nothing is not working for us so anything else that we need to say specifically mr
Speaker 150
1:50:05
mccorm um some data on that um you know we pulled like he said we surveyed all of our eighth graders and i think it was in
the neighborhood of about 80 of our eighth graders um felt like they were stressed or overwhelmed uh with just any anything in life you know with the stress of school and the stress of what's going on at home so i would i would put that out there it was right about 80 of our eighth graders that were that were filling that the items
that you have those are confiscated from the junior high yes ma'am which is
Speaker 150
1:50:40
grades what we have grades eight and nine uh at the junior high
and we average our typical class size is about 300 we're a little above average this year we have about 340 in eighth grade and about 320 in ninth grade okay so we have the eighth and ninth grade in our building so this is this isn't even high school level this is junior high level
yes ma'am that we're talking about i mean the same thing that's happening correct we could have brought a bag in from middle school as
Speaker 149
1:51:06
well if you know if we went to that campus and the middle school is what
Speaker 146
1:51:12
grades that would be six seventh eighth no six and seven six and seven yes ma'am
um will you tell me about you know a lot of times we say well this
is a parenting issue can you can you kind of talk about the type of kids that are using this I'll speak to
Speaker 147
1:51:31
that first and then you can um really really there's there's it doesn't discriminate I can say it that way in a pretty simplistic manner it it is it is across the board and what also doesn't discriminate is the amount of parents who are also vaping and who purchase these devices for their children and are upset with us for confiscating these expensive things and want them back and those types of
things so that's another thing from their parents correct correct um again we've spoke a lot today about um everyone initially believing this was safe and that this wasn't such a serious issue and then only recently we're noticing how bad it is so so
Speaker 162
1:52:11
no discrimination there on our end as far as mountain home
Speaker 150
1:52:14
goes uh you would probably say the same right yeah i would say that this epidemic has no bias it is affecting every social economic class even our most influential families that that you and I would go to and say that those are
really phenomenal parents and the students are really good students who have very little school issues no write-ups through school all A's and B's are getting caught with these at school and it's surprising the parents I had a case last year from from that same thing with very influential family and our in our community of very wonderful people and their their student got caught with
vapes at school and in hindsight and working through that with the family they realized that the child had been vaping at home too but they just didn't realize it because it had been masked with a a fruity smell or a perfume and so they thought that the that the child was just using a lotion or a body spray or some kind of perfume and and very successful people in our community and all that I did want to note too that this bottle I
brought it because it is the the flavoring or whatever on it is
Speaker 147
1:53:38
skittles skittles skittles That bottle is also one from, I think we have five major vape sales stores in our small town. And that's one from one of those. From one of the vape stores. We have huge, big advertising vape stores. I think we have five of them. Yeah. And the parking lot's always full.
Speaker 149
1:53:57
And I don't think it's adults there. No.
Okay. Thank you. Representative Mayberry. thank you thanks so much for letting me ask so many questions absolutely a
Representative Julie Mayberry
Unverified
1:54:11
topic I mean my school has contacted me directly as I as I mentioned my athletic director as a matter of fact says he spends a good portion of his day doing this and that's not at all what I would think our athletic director is supposed to be doing during the day but got it got it just have a question for you I'm a big advocate on making sure we have more school nurses so I want to ask specifically
on your campuses have you engaged your school nurses um in helping with this because this is a medical issue it's not just a mental issue and i realize that's what your you know your background is but um this is a medical issue as well and i think that we could use our school
Speaker 147
1:54:53
nurses more in helping with education i'll speak to the side of using school nurses um to help with we had we had five instances on campus within the last two weeks, three of which required emergency
personnel through ambulance to take kids of ours to the hospital because of what we believe to be the nicotine toxicity stuff that's happening. So seizures, elevated blood pressure, those types of things. Our school nurses were right there. They were the ones making those calls in those circumstances. So school nurses are incredibly helpful in those circumstances. And I'll let Mr. McCarn speak to, you know, his school nurse and what they're part of kind of this agenda that we're pushing as
Speaker 165
1:55:32
far as education goes. So I wouldn't disagree with anything you're pushing toward there with nurses being involved.
Speaker 150
1:55:38
Yeah, our nurse, I do rely on our nurse very heavily to get information out to the kids about the dangers of it, but also to help me determine too whenever we do get a report of a kid vaping to help me make that determination if they have taken illicit drug or not to be able to determine, you know, if their pupils are dilated or not. And so I rely heavily on her to be able to help me make that determination for sure.
Representative Julie Mayberry
Unverified
1:56:10
Second question, just to follow up. Do you have a full-time nurse there Monday through Friday on your campus or is your
Speaker 150
1:56:18
nurse shared with another campus we have her
full-time on our campus okay good sorry can you repeat that you have had five
Speaker 149
1:56:28
incidences in the last two weeks right and those were at high school alone
Speaker 147
1:56:33
in Mountain Home High School yeah I believe three of those required emergency personnel and transportation through ambulance the problem with those and again being able
to to pinpoint was that vape related we have evidence that that would that would steer us that direction but we don't have a camera that showed this happened right before and it wasn't on the person so so the we weren't able to do that and then if it as a school we can't request a talk screen you know for when we when we send somebody that direction so we don't we don't know in particular when that student comes back was it vape related was it the the the nicotine syndrome that we're seeing again part of the struggle for the school is we're
supposed to solve this problem but don't really have the ability to do so we don't have somebody on staff that can they can test these things it's very expensive to get tests ran on these things anyway to see what's
in there and and and those types of struggles do you have any reporting mechanism as to who you're supposed to report these things to or do you report them to anything does Is there, I mean, there's really no
Speaker 150
1:57:44
reporting mandate, is there? There is no real reporting mandate for me other than, you know, when they do receive a disciplinary referral, you know, for having a vape on campus and violate that policy, then that is entered into e-school and the state system for that.
but as far as like a reporting system for when reports are made to me or when we confiscate or number of
Speaker 152
1:58:07
confiscations we do not have a reporting system necessarily for
that okay okay that'd be interesting to find out okay are there any other questions I have one more you're
Representative Joe Cloud
Unverified
1:58:25
recognized dr. cloud thank you madam chairman thank you guys for being here today just a question in general
about schools y'all kind of outlined how y'all are addressing this and aside from the medical emergencies when a student is caught obviously it's it's illegal and it's against the rules is there any overall way that the school systems are dealing with this uh because what i what i'm getting from some of my school systems is some just turn a blind eye to it because they don't want to suspend students and then others are so
Speaker 147
1:59:04
to speak throwing the book at them i can tell you in general what we tried to do and mr mccarron that is actually a big part of the the handbook committee and getting those changes so i'll let him speak to that too but what we really tried to push in general is um and and our juvenile judge was a big part of that push through our drug task force team was was to be less punitive and and more on the end of recovery and getting our students help and helping them make better choices and that's where I came in and those five
brief intervention counseling sessions between the the student and the family came into play so so our push really over the last two years has been away from just suspending a kid so that they can go do more drugs or don't go do more vaping and more keeping
Speaker 165
1:59:49
them involved in school and getting their work done but also being able to get educated on these things do you
Speaker 174
1:59:56
want to speak to the handbook yes and we we address the handbook each
Speaker 150
2:00:01
and every year i was actually the assistant principal at the high school before i
became the junior high principal and so this has been a topic of conversation in our handbook committees every spring I can tell you that probably three four years ago the disciplinary consequence for this was an after-school detention and a Saturday school we have definitely made that increase that to go to to further disciplinary consequences we do additionally to we require students that are caught with this type of thing to do the counseling sessions but also do a
tobacco education program and so that has been a big tall order and so that's held on Saturday morning every other Saturday morning from 8 to 11 and so the students are required to attend that to receive information on the dangers of this type of thing the problem being with that is revamping the curriculum of that because it is something that has been in place in Mountain Home for years but the curriculum was for chewing tobacco and the combustible cigarettes
and those type of things and so our school resource officers have really gone through that and revamped that to to make that more of a vamping or vaping curriculum to address those things and so we have gone more that route within
Representative Joe Cloud
Unverified
2:01:29
our handbook follow-up please so I'm just curious from the Arkansas Department of Education is there any mandate that our school systems have if the student is caught with this then you will at least do this the minimum not
Speaker 176
2:01:45
that I'm aware of so it's up to each individual
school as to how they deal with this correct thank you so yeah
and I think it's so as you can see this is an incredibly collaborative situation that we're facing it involves the Department of Health it involves counseling it involves Department of Education involves every school district involves our juvenile judges and our juvenile court system I mean that's separate and apart from are we or are
we not going to ban the flavorings or how is it going to be taxed I mean this is just a hugely complex issue but with the main goal I think we can all state is how do we keep them out of the hands of our youth period and then we've heard the whole other part of mixing who knows what and selling it on school campuses and refilling their cartridges that's a whole nother level of illegal
drug activity that we have not even wrapped our heads around yet but that's here because of what judge smith's testimony is and what these gentlemen's testimony is today so with that i really very much appreciate the time that you came down from mountain home appreciate what you're doing on the front lines it is going to require information so as much information as you can collect and continue to report even though you're not mandated to do that i think it's really going to be beneficial for the policy changes that we're going to be looking at and trying
to explore. And we need those suggestions from you. What kind of policy, what can we model if it's working? Can we model that and explore that throughout? I have one more question. Representative Speaks. It's for you, Senator. Thank
Representative Nelda Speaks
Unverified
2:03:37
you for taking my question. Why is it we cannot just ban this altogether. There are states that have done that and I don't see why then parents can't get a hold of it. You know, if we could just ban the thing
I think that would be better because you can tax things as high, I mean, but people will still buy them, they'll still have them in their hands. I mean, so there's all kinds
of policy ideas out there and solutions and i think you know clearly it's our job as legislators i wish more people that were in the legislature were here today i do too um but you know this is our job and we need to take it seriously um and so and and we have to explore all the different options
what the other states are doing um you know do we ban the manufacturing of of these type of products that can be interchangeable. You know, if it's really a tobacco cessation product, then they need to go through the FDA process in order to say that it is and then be regulated as such. The companies aren't willing to do that. And, you know, they have a very strong lobbying group that's on the ground right now, which may be why people aren't here. Representative Mayberry. Thank you.
Representative Julie Mayberry
Unverified
2:04:58
If you're taking just kind of a general statement or question or thought, I hope you don't mind me entertaining this, But I know that the proposal is for a tax, and I would hope that we could look at a whole bunch of other solutions. My fear is that if we tax this, then we become dependent upon it. And when we become dependent upon it, and we want people to get off of it, how do you handle that? So I just, in general, love some of these other ideas
and other alternatives. So to that point, what we've adopted in this committee is the interim study proposal
that includes every single aspect of it, to both of your points. So that's the intention of the Public Health Committee, is to really look at what's going to work and all aspects of that. So all policy suggestions are on the table, not just one. But thank you for that. Any other comments you would like to make? You're good. Thank you all. Thank you for your time. Thank you so much for what you're doing. out there i really appreciate the level of attention and concern that you're bringing
to this whole situation and um and and those students are very very um lucky to have you guys well we're thankful you guys are
Speaker 147
2:06:10
thinking this through thanks appreciate it we'll work we'll
continue to work together to find these solutions that we need thanks all right with that i have nothing else on the agenda thank you so much for the members that are here and with that we're We are adjourned.
Unknown speaker
2:06:55
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Agenda
A. Call to Order
B. Consideration to Adopt Interim Study Proposal 2019-138 – “Study the Impact of Vapor Products, Alternative Nicotine Products, and E-Liquid Products on the Citizens of Arkansas” (Exhibit B)
D. Adjournment
Documents
| Title | Type | Pages | Source |
|---|---|---|---|
| Agenda — PUBLIC HEALTH WELFARE AND LABOR COMMITTEE - SENATE AND HOUSE, Sep 18, 2019 | Agenda | 1 | Official source ↗ |
| Handout 1 | Exhibit | 5 needs OCR | Official source ↗ |
| Handout 2 | Exhibit | 8 needs OCR | Official source ↗ |
| Interim Study Proposal 2019-138 | Exhibit | 4 needs OCR | Official source ↗ |
Speakers
Senator Missy Irvin Chair
Unverified
Senator Jim Hendren
Unverified
Senator Trent Garner
Unverified
Representative Deborah Ferguson Chair
Unverified
Speaker 31
Speaker 32
Speaker 51
Speaker 53
Speaker 44
Representative Julie Mayberry
Unverified
Speaker 76
Speaker 77
Speaker 83
Speaker 85
Speaker 86
Speaker 80
Speaker 117
Speaker 122
Representative Jim Dotson
Unverified
Speaker 133
Speaker 95
Speaker 139
Speaker 127
Speaker 143
Speaker 146
Speaker 147
Speaker 150
Speaker 149
Speaker 162
Speaker 165
Speaker 152
Representative Joe Cloud
Unverified
Speaker 174
Speaker 176
Representative Nelda Speaks
Unverified