FRANKFORT, Ky. -- The Food and Drug Administration recently approved a new heat-not-burn tobacco product called IQOS for sale in the U.S., but some Kentucky public-health officials say consumers are being left in the dark when it comes to knowing what the side effects and long-term health risks of new products are.

Elizabeth Anderson-Hoagland, health promotion section supervisor with the Kentucky Department for Public Health, noted the tobacco industry is focused on creating more high-tech purported alternatives to traditional cigarettes.

"The more products introduced in the marketplace, the more confused the public is going to be," Anderson-Hoagland said. "Because, how do you keep straight what tobacco product is what, what the side effects are, what the consequences of use are?"

She said low-income Kentuckians tend to disproportionately use tobacco products. According to the latest state data, 46% of low-income adults and 42% of those with less than a high-school education currently smoke cigarettes.

Bonnie Hackbarth, vice president for external affairs with the Foundation for a Healthy Kentucky, said the state takes in close to $500 million a year in tobacco-tax revenues. Big tobacco spends another $280 million marketing its products in the Commonwealth, yet Kentucky spends only $3.3 million annually on helping people quit.

Hackbarth said she doesn't think that's enough.

"And we need to be able to have more funding to reach these kids with prevention programs, and also to help adult tobacco users quit," she said.

The state's Department for Public Health currently runs three quitline services and also offers free nicotine replacement therapy for people who are uninsured or are on Medicare.

Hundreds of millions of American young people are exposed to vaping and smoking in popular movies, TV shows and music videos each year, according to the 7th annual "While You Were Streaming" report from the nonprofit Truth Initiative.

Tobacco depictions are down in the most popular Hollywood shows but they are heavily featured in programs like The Bear, Euphoria, and Stranger Things.

Dr. Jessica Rath, a behavioral scientist and senior vice president of Truth Initiative, said youth and young adults are three times more likely to start vaping when exposed to tobacco imagery in shows.

"Animated shows remain a consistent offender," Rath emphasized. "Five out of six of the top 15 animated shows contain tobacco depictions and those are more popular with Gen Z than any other demographic."

The report found in 2023, 70% of binge-watched streaming shows contained tobacco imagery, a 6% increase from the year before. Shows fueling the increase included "American Dad," "Law & Order SVU," "Never Have I Ever," and "South Park."

Rath noted her organization is working with entertainment companies and state attorneys general to get information added before or after the shows, like you might see for suicide prevention.

"Companies can roll advertisements with tested prevention messaging or quit line resources up in the top corner when the content that they're showing contains tobacco," Rath suggested.

The good news is youth vaping is actually at its lowest rate in a decade but smoking in entertainment threatens to reverse progress.

Truth Initiative developed a free resource to help people quit: Text "EXPROGRAM" to 88709.

Kentucky will soon begin licensing retailers who sell nicotine, which advocates have said will help regulate an industry and protect minors from addictive chemicals.

Gov. Andy Beshear signed Senate Bill 100 into law earlier this week.

Griffin Nemeth, a student and coordinator for the iCANendthetrend Youth Advisory Board coordinator at the University of Kentucky, explained the legislation is no different from what's currently in place for retailers who sell alcohol.

"We're really just trying to make sure that tobacco and nicotine products are on par with what is already expected of some of these other establishments," Nemeth explained.

In a state where about 5% of high school students smoke and almost 20% use e-cigarettes, according to The Campaign for Tobacco-Free Kids, advocates said the new regulations are a welcome effort to curb tobacco use among minors. Data show smoking costs the state more than $2 billion every year.

Under the new law, Kentucky will license all retailers who sell tobacco and vape products, empowering the Department of Alcoholic Beverage Control to inspect and enforce rules for the businesses. Nemeth argued licensing is a strong tool to protect youth at the point of sale.

"We're now starting to see an increase in use of alternative nicotine products, like oral nicotine pouches, and we're still seeing pretty significant use of vapes and e-cigarettes," Nemeth observed.

The new law will also fine retailers who sell nicotine products to minors, and give half the money collected to a youth prevention program.

This story is based on original reporting by Sarah Ladd for the Kentucky Lantern.

Nebraska needs to do better when it comes to tobacco use prevention and cessation, according to a newly released report.

In the American Lung Association's 2024 State of Tobacco Control report, Nebraska received an "F" in three of the five areas rated. One is for tobacco prevention and cessation funding.

Michael Seilback, national assistant vice president for state public policy for the American Lung Association, said Nebraska is spending vastly less than what the Centers for Disease Control and Prevention recommends.

"The fact is that the state is taking in these dollars, and we're saying, reinvest just some of them," Seilback explained. "You can easily meet CDC best practices with tens of millions of dollars to spare."

The report showed Nebraska's tobacco-related revenue is nearly $98 million per year. However, for fiscal year 2024, state funding for tobacco control programs is less than $4 million.

On the bright side, the state received an "A" for smoke-free air.

Responding to the report, a spokesperson with the Public Information Office at the Nebraska Department of Health and Human Services pointed to the Nebraska Quitline. It has received more than 100,000 calls since 2000, with Quitline users six to 10 times more likely to still have quit after seven months than those who try to quit cold turkey. The Nebraska Quitline number is 1-800-784-8669, and 1-800-355-3569 for Spanish speakers. Web-based coaching and texting and free "quit medication starter kits" are also available.

The state also received an "F" for tobacco taxes. Seilback called the state's cigarette tax of 64 cents per pack extremely low and supports Gov. Jim Pillen's proposal to increase it by as much as $2 per pack. He added the American Lung Association always pushes for increased tobacco tax dollars to be used for prevention and control and helping people quit.

"To be clear, even if not one dollar was spent -- and we wouldn't encourage it -- on its own, just increasing the price has an impact on the amount of people that use it," Seilback pointed out. "Increasing that price would help prevent kids from starting."

Nebraska's third "F" is on flavored tobacco products, as a result of having no state laws or restrictions.

Seilback commended the state for participating in the multistate lawsuit against e-cigarette manufacturer, JUUL Labs, with the settlement money going to programs to curb addiction.


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