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PHILADELPHIA -- The American Heart Association (AHA) declared a multi-million dollar war on the electronic cigarette industry, and use of e-cigarettes by youth.

The AHA announced at its annual meeting "an aggressive, involving research, policy advocacy and youth activation intended to urgently address the epidemic of youth e-cigarette use," according to a press release.

The "End the Lies Youth Vaping and Nicotine Research Initiative" will receive $20 million initially -- an amount that is 40 times larger than the typical AHA grant, the association noted.

According to the CDC, 3.6 million U.S. teens used e-cigarettes in 2018. The agency also reported in October that the case count for vaping-related lung injury stood just shy of 1,300. Deaths confirmed as part of the outbreak total 26.

"It is going to take a big, unparalleled, and urgent commitment by national and community level stakeholders if we are going to beat big tobacco," said Robert Harrington, MD, AHA president, at an AHA press conference. The initiative is an "unprecedented effort to drive scientific discovery, and is designed to help end the vaping and nicotine use in this country."

The "End the Lies" initiative "will focus urgently on the impact of vaping and nicotine use on youth, funding two or three scientists who will work intensely over the next two years to address the fact that there is no knowledge about the long-term health effects in youth," according to the release.

Two other key components of the AHA strategy are:

• The nationwide #QuitLying () youth, school and community engagement and awareness campaign "designed to hold e-cigarette companies publicly accountable for their lies."
• A multi-year fund "dedicated to public policy change at all levels of government to prevent youth vaping and nicotine addiction." Kaiser Permanente, which will provide additional support, has teamed up with the AHA to create the "Preventing Youth Nicotine Addiction Policy Fund."

At the press conference, speakers lashed out at the FDA for a failure to regulate vaping products from companies such as JUUL (Altria Group, formerly Philip Morris, acquired a 35% stake in JUUL Labs for $12.8 billion in 2018). In April 2019, the FDA did issue a warning that identified a potential seizure risk associated with e-cigarettes, mostly in teens and young adults.

Harrington urged the FDA to "exercise its regulatory authority over these e-cigarettes, such as by removing all flavored e-cigarettes, including mint and menthol, from the market and prohibiting flavored tobacco products of any kind." In September, the Trump administration announced plans to ban all flavored e-cigarette products in response to an "epidemic" rise in e-cigarette use among youth and increasing reports of vaping-related illness and death.

AHA CEO Nancy Brown noted that the association, along with other professional societies, are involved in an the FDA for failing to fully regulate the vaping industry.

"We are horrified to see the uptick of e-cigarette use by youth, estimated to have grown from 1% to 27% in a decade. Our worst nightmare plus has come true," she said.

"We thought the FDA was going to do something about smoking and e-cigarettes...We were not prepared for the FDA not doing its job," commented Regina Benjamin, MD, former U.S. surgeon general.

Benjamin told 麻豆传媒 that "We believe that instead of waiting to ban a product when it is proven harmful, we should ban it until it is proven safe."

While some research has suggested that e-cigarettes could play a part in helping smokers , Benjamin said she has never recommended that her patients trade one addiction (standard cigarettes) for another (e-cigarettes).

Martha Gulati, MD, of the University of Arizona in Phoenix, and a spokesperson for the American College of Cardiology (ACC), also chided the federal agency: "I think the FDA has let us down on this. We know what happened with [combustible] cigarettes. Why didn't we learn from that?," she said, adding that the ACC does not endorse e-cigarettes as an alternative to combustible cigarettes.

Gary Gibbons, MD, director of the National Heart, Lung, and Blood Institute, told press conference attendees that the NIH is "committed to addressing this public health threat." He added that the agency is working to "fill in the gaps in the science about what we don't know about vaping."

Former vaper Katelyn Quezada, 16, of Los Angeles spoke at the press conference. She said that she started using e-cigarettes in sixth grade under intense peer pressure to try the different flavors. "Before I tried it, I knew it was something I shouldn't be doing. After [she was caught and stopped], I was just very disappointed in myself," Quezada said.

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