Public Health Alerts: Sales of Unauthorized e-cigarettes in the United States

More than two-thirds of US sales of e-cigarettes are illicit, with most targeting young people, according to a Public Health Alerts report.

The report’s authors—scientists from the CDC Foundation—analyzed retail scanner data from Circana, a market research company that collects point-of-sale data, to estimate the proportion of unauthorized sales of e-cigarette products in US stores last December.

The report authors note that federal law requires a manufacturer to receive a marketing granted order (MGO) from the Food and Drug Administration (FDA) to legally market a new tobacco product in the United States.

A total of 146 products, accounting for 30.6% of e-cigarette sales, were matched to authorized products in December 2025. The remaining 69.4% of sales for 4,421 products were unauthorized.

The report notes that 7.0% of US adults, 24.8% of young adults (18 to 24 years old), 7.8% of high schoolers, and 3.5% of middle schoolers use e-cigarettes.

Disposable e-cigarettes in flavors that may appeal to young people comprised the majority of unauthorized sales.

The authors conclude, “Disposable e-cigarettes in flavors that may appeal to young people comprised the majority of unauthorized sales.”

Trump Admin Cuts Medicaid Funds for Youth Trans Care

The Trump administration on Tuesday finalized a plan to cut off federal Medicaid funding for hormone therapy, puberty blockers and surgeries for transgender youths.

The rule is the latest escalation in the administration's effort to limit transition-related care, which has tested the boundaries of executive powers and could undercut federal and state protections.

States may still use their own funds to cover gender-affirming care for youth in Medicaid or the Children's Health Insurance Program.

The Centers for Medicare and Medicaid Services rule doesn't cut off federal funding for psychotherapy related to gender dysphoria.

Beginning Oct. 13, states will not be able to claim federal Medicaid funding for gender-affirming health services, which the Trump administration refers to as "sex-rejecting procedures."

There will be a six-month period where states can continue to get funding for beneficiaries taking gender-affirming hormone therapies.

Seventeen states currently cover some degree of gender-affirming care for children under Medicaid and CHIP, according to the rule.

Building Resilience for Older Adults in a Changing Environment ECHO

Project ECHO is an innovative, solutions-based learning experience that connects professionals with specialized knowledge and situation-based learning to address complex community or organizational issues.

The sessions are designed to equip public and private sector professionals with actionable strategies to increase resilience for the growing number of older adults facing rapid environmental change. New research and community approaches provide innovations for adapting ongoing efforts and developing new partnerships. #AllTeachAllLearn

Register once and attend as many sessions in the series as your schedule allows. All sessions will be held on a Wednesday of the month from 12:00 p.m.— 1:00 p.m. EST

This series is intended for researchers and practitioners in health, gerontology, social work, social services, community development, emergency preparedness, planning, climate resilience, sustainability, hazard mitigation, and disaster risk management.

Each session is approved for (1) continuing education credit and it is offered FREE of charge.

The Building Resilience for Older Adults in a Changing Environment ECHO Series is produced by staff, faculty, and student teams at the Voinovich School of Leadership and Public Service. The applied research and practice insights featured in the series stem from an ongoing Grey Green Alliance collaboration with the Age-Friendly Innovation Center at the Ohio State College of Social Work. Invaluable input was also provided by colleagues at other partner organizations including the Coalition of Age-Friendly Communities of Ohio, Age-Friendly Athens County, Age-Friendly Cleveland, Population Reference Bureau, National Association of Development Organizations, AARP, Ohio Emergency Management Agency, Ohio Department of Aging, and the Ohio Governor’s Office on Appalachia. The Ohio University’s School of Public Service Project ECHO program is supported through funding from the Appalachian New Economic Partnership at the Voinovich School of Leadership and Public Service.

2026

• September 23rd - A Changing Landscape: Trends in Aging, Environment, and Community Well-Being
• October 28th - Finding Common Ground: Aligning Healthy Aging and Community Resilience
• November 18th - Beating the Heat: Protecting Older Adults from Heat and Extreme Weather

2027

• January 27th - Weathering the Storm: Building Resilience in the New Era of Flooding
• February 24th - Aging in Place in a Changing Environment: Housing, Livability, and Resilience
• March 24th - Powering Healthy Aging: Energy, Sustainability, and Resilience for Older Adults

Click here to view the flyer and click here to register!

CMS Moves to Codify Limits on Medicaid Provider Taxes

CMS is moving to restrict the taxes on providers and managed care companies that states use to fund Medicaid, proposing a rule to codify policies in the GOP’s tax and policy bill  (HR 1) passed last summer.

The rule released Tuesday would create new limits on the taxes based on provider and state, phase down allowable taxes in Medicaid expansion states and strengthen federal oversight of the arrangements. CMS actuaries estimate the changes will lower the federal government’s Medicaid spending by $246 billion over the next decade. Providers oppose stricter constraints on alternative Medicaid financing mechanisms, arguing they’re necessary to make up for insufficient Medicaid reimbursement. Curbing the taxes will also make it harder for states to raise money to cover their residents’ Medicaid coverage.