Health reporter Jayne O'Donnell speaks to the Food and Drug Administration representative about opioids, cigarettes and addictions.

The US surgeon issued a guidebook on Tuesday that urged new local restrictions including taxation and internal prohibition of combating e-cigarette consumption in adolescents, a crucial development given its global importance the Office in the enforcement of tobacco use.

The move of Surgeon General Dr. Jerome Adams came one day after the National Institute for Drug Abuse published new data containing nearly 21 data. Percentage of high school graduates said they had vapourized a nicotine product in the last 30 days, compared to 11 percent a year ago from the annual Survey The Future "survey on drug use among adolescents was the largest for any substance use in the 43-year history of the survey.

"There is no more credible or influential voice on nicotine and tobacco than that of the US Surgeon General," says Dr. Josh Sharfstein, a former Maryland health secretary who is now Professor of Public Health and Vice Dean at Johns Hopkins University. "Today's advisory is a warning to the nation that e-cigarettes are leading millions of teenagers into nicotine addiction and expose them to an unacceptable risk of injury."

More than 2 million middle school, high school, and college teens use this battery. Devices that can heat liquid nicotine to an inhalable vapor – more than one in three high school seniors and nearly one in three university students say it vaporized at least once in the past year, the new report noted. Up to 30 percent have evaporated for 20 or more days in the last 30 days, a "clear sign of addiction," says Matthew Myers, president of the campaign for tobacco-free children.

Nicotine is "very and clearly harmful to the developing brain," says Adams. It may affect the learning and memory of people under the age of 25, stimulate the brain to addiction to other substances, and increase the risk of it becoming flammable Tobacco is just as smoking has reached a record low. He cites research that shows that steaming teens two to eight times makes more use of cigarettes in the future.

Even worse, children who are the least likely to quit smoking become potential smokers, says Myers.

The data prompted Adams, the father of two middle-school students and an eight-year-old, to publish the second Surgeon General Advisory his 16-month tenure. The first, in April, urged people to wear the overdose Naloxone. It is also just the fourth advisory panel since Surgeon General issued two in 2005 – against alcohol use during pregnancy and a warning about the health risk of radon exposure in indoor air.

The advisory panel follows stringent proposals and rules from last month's Food and Drug Administration (FDA), but Adams urged state and local governments, including tribes and territories, to go further. In particular, he asked officials to consider banning vapors in public places, making e-cigarettes more expensive through taxes and restricting access to flavored tobacco products for young people.

Adams also urged parents, teachers and the healthcare industry to be more pro-active against youth vaping, particularly the use of Juul's easy-to-hide USB devices. About three quarters of adolescents who smoke e-cigarettes use Juul, which quickly led to a large fan base in social media.

About two-thirds of Juul users aged 15 to 24 do not know Juul always contains nicotine, according to a Truth Initiative nonprofit study in April.

In addition to recognizing how vape devices look, Adams says parents should ban the use of tobacco or e-cigarettes in their homes or vehicles by children and quit smoking. He also urged them to ask the doctors if they could talk to their children about the risk of smoking and fuming.

Dr. Josh Sharfstein is a Pediatrician and Professor at Johns Hopkins University and Vice Dean for Health Practice and Community Engagement. [Photo: Johns Hopkins University]

He also says that teachers need to recognize the tiny devices and develop tobacco-free school policies and prevention programs at their schools that have no impact on industry.

More: Teenagers addicted to vapors: FDA outweighs a ban on flavored e-cigarette liquids

Myers crushes no words when he claims Juul to be almost universally epidemic young steaming. The company "can not be taken seriously when it says it had no idea that its product would appeal to children," says Myers.

"In less than two years, Juul changed the trajectory in a way that could undermine all of the work reducing adolescent tobacco use over the last three decades," says Myers.

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