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Meddling in American democracy by outsiders — Russians and perhaps others — has triggered substantial public awareness and debate. But what if the damage was not only to elections? What if the bots, trolls and malicious hackers also undermined public health and well-being? That is the question raised by an important new study in the American Journal of Public Health reporting on the results of a research team led by David Broniatowsky of George Washington University. The researchers examined 1,793,690 tweets, collected from July 14, 2014, through Sept. 26, 2017, to explore how polarizing anti-vaccine messages were broadcast and amplified by bots and trolls. (8/28)

Sales of the nation’s most popular e-cigarette, Juul, have skyrocketed nearly 800% since last year. If trends continue, teenagers returning to school will be vaping sleek, easy-to-conceal devices in bathrooms, libraries and even in classrooms. And e-cigarettes, used by nearly 12% of high school students last year, have already surpassed the popularity of traditional cigarettes among teens. The craze has caught on so quickly among young people that  parents, school officials and public health advocates can hardly keep up. About the only thing moving slowly is the federal government’s effort to regulate the popular products. (8/28)

The number of teens who reported using tobacco products declined from 4.5 million to 3.6 million from 2011 to 2017, according to the Centers for Disease Control and Prevention. Last year, youth use of e-cigarettes fell from its peak in 2015. You might think that health activists and their allies in the press would be celebrating this reality. You would be wrong. Many activists have chosen to simply ignore the large declines in tobacco and e-cigarette use, pointing instead to the availability of flavored e-cigarette products and the rise of independent competitors to Big Tobacco like Juul. (Gregory Conley, 8/28)

Fifteen years ago, a Chinese pharmacist sparked a global innovation race to end smoking by inventing a safer, more appealing way for smokers to get the nicotine they desire without the smoke that may kill them–the modern day e-cigarette. Thousands of companies are now creating jobs and wealth competing to make quitting cigarettes easier, cheaper and more enjoyable. But smokers trying to switch to vaping face a host of obstacles. FDA regulation threatens to wipe out most e-cigarette businesses in a matter of years. Cities and states are imposing tax hikes, flavor bans, and extending smoke-free laws to cover vaping. Now there's another threat to add to the tally, with vapers set to join the seemingly endless list of consumers and businesses bracing themselves for the impact of the Trump administration's latest round of tariffs. (Guy Bentley, 8/28)

The Food and Drug Administration’s “black box” warnings and advisories give important safety information about drugs. But they can sometimes go too far and harm more people than they help. Take the FDA’s highly publicized warnings that taking antidepressants increases the risk of suicidality (defined as serious thoughts about taking one’s own life or planning or attempting suicide) among children, adolescents, and young adults. We have evidence, as do many others, that these warnings have decreased youths’ access to mental health care and increased suicide attempts. So far, the FDA has refused to accept this evidence. (Stephen Soumerai and Ross Koppel, 8/29)

It’s a fact: women experience pain differently than men. They also respond to opioids differently. These differences can seriously impact the likelihood that women become addicted to opioids. There are differences between women and men in all health conditions. Women are more likely to have certain conditions, such as arthritis, that can cause pain. They are more likely to suffer injuries, including injuries sustained during a domestic incident. As a result, women deal with pain — episodic, acute, and chronic — more frequently than men. Research also tells us that women tend to experience pain more intensely than men. (Connie Newman and Kim Templeton, 8/28)

When I was in medical school in the 1990s, it was rare to hear abortion mentioned as an option for pregnant women at all — let alone for there to be in-depth training on how to counsel patients on a full range of pregnancy options, including termination. My generation of physicians simply wasn’t prepared to provide basic, comprehensive reproductive health care. Even though it had been 20 years since Roe v. Wade legalized abortion nationwide, only 12 percent of obstetrics and gynecology residency programs at the time included abortion training. Twenty-five years later, the training situation has, fortunately, improved. (Jody Steinauer, 8/29)

A rise in sexually transmitted diseases has been reported by the Centers for Disease Control and Prevention for the fourth straight year. The CDC reports that the spike — close to a whopping 10 percent in 2017 — is fueled by a lack of awareness and changing sexual behavior. I can attest to that. As a young doctor, I became obsessed with exploring epidemics and public health crises. (Kristen Ries, 8/29)

The NYU decision marks an unprecedented move to eliminate the large educational debt that most medical students face. Three-quarters of medical students graduate with debt. In 2016, the four-year cost of attending medical school was nearly $250,000, and the median debt of graduating medical students was $190,000. These costs don’t include college debt or living expenses. Medical education debt for private universities is also considerably higher. What are the hoped-for results? (Anupam B. Jena, 8/28)

Not long before Mihir Shah was to be married in 2007, his soon-to-be mother-in-law got a diagnosis of breast cancer. She underwent chemotherapy and survived, wearing a wig to the wedding. But while the women in Mr. Shah’s family — in both India and the United States — were able to get breast cancer screening, it made him think of the millions who weren’t as fortunate. (Sophie Cousins, 8/28)

After ripping thousands of children from their parents, unprecedented public outrage forced President Donald Trump to sign an executive order purporting to end family separation in June. He proclaimed the problem solved. But the family separation crisis is far from over. Just this month, the Inter-American Commission on Human Rights ordered the adoption of new precautionary measures to protect immigrant families from the United States’ callous actions. The government is failing to resolve a crisis it manufactured, and the chaos at the border is emblematic of the Trump administration’s heartless, often slapdash approach to immigration. (Efrén Olivares, 8/28)