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FDA bans Juul e-cigarettes tied to teen vaping surge

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FDA bans Juul e-cigarettes tied to teen vaping surge

By MATTHEW PERRONE

WASHINGTON (AP) — Federal health officials on Thursday ordered Juul to pull its electronic cigarettes from the U.S. market, the latest blow to the embattled company widely blamed for sparking a national surge in teen vaping.

The action is part of a sweeping effort by the Food and Drug Administration to bring scientific scrutiny to the multibillion-dollar vaping industry after years of regulatory delays.

Parents, politicians and anti-tobacco advocates wanted a ban on the devices that many blame for the rise in underage vaping. Supporters say they can help smokers cut back on regular cigarettes.

The FDA noted that Juul may have played a “disproportionate″ role in the rise in teen vaping and its application didn’t have enough evidence to show that marketing its products “would be appropriate for the protection of the public health.”

The agency has granted some e-cigarette applications. Since last fall, the agency has given its OK to tobacco-flavored e-cigarettes from R.J. Reynolds, Logic and other companies.

But industry players and anti-tobacco advocates have complained that those products account for just a tiny percent of the $6 billion vaping market in the U.S.

Regulators repeatedly delayed making decisions on devices from market leaders, including Juul, which remains the best-selling vaping brand although sales have dipped.

Last year, the agency rejected applications for more than a million other e-cigarettes and related products, mainly due to their potential appeal to underage teens.

To stay on the market, companies must show that their products benefit public health. In practice, that means proving that adult smokers who use the products are likely to quit or reduce their smoking, while teens are unlikely to get hooked on them.

E-cigarettes first appeared in the U.S. more than a decade ago with the promise of providing smokers a less harmful alternative. The devices heat a nicotine solution into a vapor that’s inhaled, bypassing many of the toxic chemicals produced by burning tobacco.

But studies have reached conflicting results about whether they truly help smokers quit. And efforts by the FDA to rule on vaping products and their claims were repeatedly slowed by industry lobbying and competing political interests.

The vaping market grew to include hundreds of companies selling an array of devices and nicotine solutions in various flavors and strengths.

The vaping issue took on new urgency in 2018 when Juul’s high-nicotine, fruity-flavored cartridges quickly became a nationwide craze among middle and high school students. The company faces a slew of federal and state investigations into its early marketing practices, which included distributing free Juul products at concerts and parties hosted by young influencers.

In 2019, the company was pressured into halting all advertising and eliminating its fruit and dessert flavors. The next year, the FDA limited flavors in small vaping devices to just tobacco and menthol. Separately, Congress raised the purchase age for all tobacco and vaping products to 21.

But the question of whether e-cigarettes should remain on the market at all remained.

The FDA has been working under a court order to render its decisions; anti-tobacco groups successfully sued the agency to speed up its review.

FDA regulators warned companies for years they would have to submit rigorous, long-term data showing a clear benefit for smokers who switch to vaping. But all but the largest e-cigarette manufacturers have resisted conducting that kind of expensive, time-consuming research.

While Juul remains a top seller, a recent federal survey shows that teen have been shifting away from the company. Last year’s survey showed Juul was the fourth most popular e-cigarette among high schoolers who regularly vape. The most popular brand was a disposable e-cigarette called Puff Bar that comes in flavors like pink lemonade, strawberry and mango. That company’s disposable e-cigarettes had been able to skirt regulation because they use synthetic nicotine, which until recently was outside the FDA’s jurisdiction. Congress recently closed that loophole.

Overall, the survey showed a drop of nearly 40% in the teen vaping rate as many kids were forced to learn from home during the pandemic. Still, federal officials cautioned about interpreting the results given they were collected online for the first time, instead of in classrooms.

The brainchild of two Stanford University students, Juul launched in 2015 and within two years rocketed to the top of the vaping market. Juul, which is partially owned by tobacco giant Altria, still accounts for nearly 50% of the U.S. e-cigarette market. It once controlled more than 75%.

On Tuesday, the FDA also laid out plans to establish a maximum nicotine level for certain tobacco products to reduce their addictiveness. In that announcement, the agency also noted that it has invested in a multimedia public education campaign aimed at warning young people about the potential risks of e-cigarette use.

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AP Health Writer Tom Murphy contributed to this report.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.

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Twins record second shutout in three days in win over Rockies

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Twins record second shutout in three days in win over Rockies

Puffy white clouds filled the blue skies above Target Field and sunlight bounced off buildings that make up the Minneapolis skyline. It was the kind of summer night at the ballpark that Minnesotans dream about throughout the long winter months.

It was the perfect night at Target Field and the hometown team, well, they were nearly perfect, too. Twins pitchers gave up just one hit (and five walks), and the team captured a first-inning lead on its way to a 6-0 win over the Colorado Rockies on Saturday night at Target Field.

A day after getting shut out for the 10th time this season, tying the league lead, Luis Arraez and Byron Buxton made sure early on that the Twins wouldn’t suffer the same fate. Arraez snapped an 0-for-11 stretch to begin the game and Buxton, back in the lineup for the first time since Tuesday, followed that up with his first triple since 2019.

After missing time this week after his knee flared up, Buxton turned on the burners, with a sprint speed of 29.3 feet/second (30 ft/sec is elite) on the triple, losing his helmet along the way. When he reached the base, he pounded his chest a couple times, smacked his hands together and let out a roar.

While the Twins left Buxton on third, they added on throughout the game, tacking on a run in the second on Arraez’s second hit of the game, two more in the fifth and two more in the seventh.

Alex Kirilloff drove in three of those runs, one on a sacrifice fly and the other on a double off the right field wall, bringing home Max Kepler — who walked three times in the game — and Kyle Garlick. The double was his fourth in eight games since being recalled from Triple-A.

All that offense came in support of Chris Archer, who worked five innings and allowed just one hit — a single to former Twin C.J. Cron in the second inning — and a walk in his outing.  Archer pitched out of that second-inning jam, retiring the next three batters in a row, the first of 12 straight that he sent down to conclude his start.

His start was followed by a scoreless inning each from Jharel Cotton and Griffin Jax and two from Tyler Thornburg. Twins pitchers have now thrown two shutouts in their past three games, and in Friday’s loss, they gave up just one run.

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A Pride timeline: Gay rights in Minnesota from 1858-2022

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A Pride timeline: Gay rights in Minnesota from 1858-2022

1858: Joseph Israel Lobdell, born Lucy Lobdell, is arrested for “impersonating a man.” A judge in the rural camp community of Forest City, Minn., sided with Lobdell, ruling that he did not act unlawfully.

1877: Minneapolis rules crossdressing as illegal, putting gender-nonconforming Minnesotans at risk for imprisonment.

1969: The Stonewall riots begin in New York City after police raids occur in the gay-friendly bars and community spaces of Lower Manhattan. These riots serve as a public turning point in American LGBTQ+ history.

May 18, 1969: University of Minnesota alumni found Fight Repression of Erotic Expression, or FREE, the first LGBTQ+ rights organization in the state. Founders Jack Baker and Michael McConnell become the first same-sex couple in the nation to apply for a marriage license, an application that is rejected by Hennepin County. Their legal case is dismissed by the U.S. Supreme Court in one sentence.

1972: The first Twin Cities Pride celebration is held in Minneapolis’ Loring Park.

Dec. 9, 1972: Minnesota state Sen. Allan Henry Spear indicates he is gay in an interview with the Minneapolis Star, making him the first openly gay state legislator in the United States.

June 1982: Bruce Brockway becomes the first documented recipient of an HIV diagnosis in Minnesota. After his diagnosis, he founded the Minnesota AIDS Project to provide resources to HIV-positive Minnesotans.

1993: Gender- and sexuality-based discrimination is outlawed in Minnesota, making it the first state in the nation to adopt the policy.

1997: Sicaŋgu Lakota man Nicholas Metcalf and his partner, Korean-American Edd Lee, found the Minnesota Men of Color, an organization that focuses on the well-being of men, women and gender-nonconforming people of color.

2012: Amendment 1, which limits marriage rights to only heterosexual couples, is rejected by the majority of Minnesota voters. Same-sex marriage is legalized in the state.

June 2015: The U.S. Supreme Court releases a decision in Obergefell v. Hodges finding that same-sex marriage cannot be banned in any state and must be recognized nationally. Gay marriage is legalized.

June 25-26, 2022: After two years of pandemic-related cancellations, the Twin Cities Pride parade and festival returns to Minneapolis.

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Ramsey County official recalls Pride marches in the early 1980s: A time of AIDS, discrimination

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Brian Theine, manager of St. Paul Social Services, in his office overlooking the Mississippi River in St. Paul on June 23, 2022. (Bryson Rosell / Pioneer Press)

Growing up in the 1970s in small farming communities outside of Milwaukee and Madison, Wis., Brian Theine knew three things: He was gay, he wanted to help people, and he wanted to live in a more cosmopolitan place.

Theine would go on to become a social worker and land in Minneapolis in 1982, toward the height of the AIDS epidemic. Instead of Minnesota Nice, he said he discovered profound rejection. Some 100 to 200 members of the gay and lesbian community would gather annually at a beach by the area then known as Lake Calhoun for a solidarity walk to Loring Park. Along the way, the insults and jeers from bystanders came hard and fast, and they were relentless.

Celebrating Pride meant suffering through verbal assault, and sometimes real punches.

Gay media at the time carried news accounts of men who had been badly beaten as they were arrested by police for loitering in the park, and the graphic image of a Black man who’d had his teeth knocked out still haunts Theine some 40 years later.

“It was sort of a feeling of, ‘What kind of place did I come to?’ ” he recalled.

This weekend, during the 50th anniversary celebration of Twin Cities Pride, Theine is spending at least eight hours each day manning a Ramsey County Social Services booth in Loring Park, encouraging members of the GLBTQ community and their allies to become foster parents and open their doors to young people who may be struggling with their gender identity or who have faced rejection at home and bullying in school.

Underscoring the degree to which the social landscape has changed, some 400,000 people are expected for the Ashley Rukes GLBTQ Pride Parade on Sunday down Hennepin Avenue. The parade had been canceled for two years in a row during the pandemic.

While social acceptance and legal rights may be more widespread than in the 1980s, Theine considers the issues confronting many GLBTQ youth to be no less profound. Theine, a manager in Ramsey County Social Services, oversees foster care licensing for children and adults, adoptions and other family services. The following interview has been edited for length and clarity.

It’s the 50th anniversary of Twin Cities Pride. A lot more people are openly gay today than 50 years ago. Is it safe to say we’ve come a long way?

I made that leap in the late ’70s, and it was a time of HIV and AIDS awareness impacting the community hard, and a difficult journey for the next 10 years of my life. In my job life here at Ramsey County, I led a mobile crisis team for 10 years, and part of what I did was make the rounds with police. We reached out to them to make a bridge. We said hey, we have social workers, I’m a social worker. Let’s work as a mental health team and change what’s happening in the community. In these later years, I had a much different relationship with the police. I would never have approached the police like that in 1984, whereas I feel much more comfortable doing that today.

Back in the early 1980s, how many folks would attend Pride?

Maybe 100 to 200. I have nothing against the parades of today, but they’re long, a huge number of people come to the park. In a good year, 400,000 people come to the park. It’s great. It’s a different feeling now than in the 1980s. There was sort of an area known as the gay beach, and there was a part of the beach where African-American people would gather up. That’s where the parade would start out from. It was grassroots.

You mentioned arriving in the Twin Cities during the HIV and AIDS epidemic. What was that like for you at the time?

Brian Theine, manager of St. Paul Social Services, in his office overlooking the Mississippi River in St. Paul. (Bryson Rosell / Pioneer Press)

At that time, I had friends and people who I had actually dated who ended up with HIV. It was a scary time, because there was not a lot known about it, services weren’t available to get help. Friends of mine who had been diagnosed at that time were told they had two years to live. One of my friends is still living with HIV. He lost a couple doctors along that way who died of it. Friends I’ve known have suicided. We were sort of the pariah because of HIV.

It was isolating, and making our community feel alone, but it was actually sort of unifying, too. Our lesbian sisters came to help their gay brothers when others wouldn’t do so. I was part of the founding of OutFront Minnesota — which in 1987 had a different name, the Gay and Lesbian Community Action Council of Minnesota — because there weren’t a lot of support services at that time. We ran the hotlines, helping people get to therapy and direct care and making sure they had services in the home to try to have some quality of life. In a different job I was doing, I had to get people to volunteer to work on the floor of the nursing home where people went to rehab after the hospital, because finding staffing was a struggle.

A lot has changed legally, like the national legalization of gay marriage in 2015. And I’m sure a lot hasn’t changed depending upon where you are and what situation you’re in. Talk about your vantage point working in youth social services.

In the last three years or so, I came into this department of Children and Family Services to take on being a manager. There were people interested in this area of foster care and adoptions who wanted to work with the GLBTQ community to see if there was more they could do. The staff in our foster care and adoption unit also started showing up at Pride five years ago. At the same time, the department in social services here was getting consultation with the Human Rights Campaign, trying to figure out how to approach policies and procedures and change policies that needed to be refreshed.

If services didn’t join with our values, we wouldn’t place kids there. Today, we have had to move kids out of a foster home, or out of a residential treatment facility because of conflict with our policy. We all want to be accepted. Kids who identify as trans, or lesbian or gay, they’re no different from anybody else. We didn’t want to place them into placements where that was going to be a conflict. It’s written into our contracts for anyone who works with us, that recipients of our social services should not be subject to discrimination because of their race, gender expression, political beliefs, religion, etc. We’re not going to go into a contract with an agency in those kinds of situations.

How often would you assume kids in foster care are GLBTQ?

National numbers tell us as many as 30 percent of the kids identify. It’s a very GLBTQ community. Other surveys that are bit more local suggest it’s 27 percent, 28 percent, so it’s similar numbers. We’re trying to collect demographic data. We need to do that, because we have the anecdotal stories. That’s part of the systems change we’re working on.

Why are those numbers so large?

It’s one of those things that are hard to hear. We end up with kids who are homeless, living on the street as teens. They may need to do sex work to get inside and out of the cold on a cold winter night. Kids who are homeless had conflict in their homes. They’re struggling with gender identity or gender expression, and their home situation is too much to bear. The streets might feel safer than what they have at home.

There’s times we may need to reach out to a grandma or an aunt to say, ‘Can you take this kid in?’ It’s a whole variety of factors. There’s other things that happen to kids, like bullying in school, that still make coming out a hard time for people. There’s a lot of public schools that are trying to have Gay/Straight Alliances, or alliances to acknowledge our non-binary kids. But there’s these individual factors that can make life hard, and make it difficult to live without fear. And all of that contributes to what we’re seeing — kids who are couch-hopping or living on the street.

We need to reach out to their kinship support groups. People shouldn’t be in child protection just because they’re GLBTQ. They shouldn’t be in a group home or institutional care. We need to work with families upfront in a welfare way and not in a child-protection way. Ultimately, we don’t want any kid in foster care, and that’s part of our overall mission as a county — only to use foster care when we need it. That’s part of why we show up at Pride, to say, ‘Have you thought about being a foster parent?’ We need people who reflect the community. We keep saying it, and sometimes you have to hear it 15 times to get someone to sign up: ‘We need you.’

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