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These excess medical care costs among exclusive e-cigarette users totaled $1.3 billion annually

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Native community members can advocate to decrease the influence of the commercial tobacco industry on reservations and the Native community at large using point-of-sale policies such as price increases, minimum pack sizes, limiting retailers in close proximity to schools through licensing and zoning, and restricting flavored and menthol products

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That was the year that Scott Gottlieb, then commissioner of the Food and Drug Administration (FDA), responded to the NYTS data by announcing that youth vaping was an epidemic. This pronouncement threw vaping into the headlines, making it Public Enemy Number One as panic over youth use exploded