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TED: COMING UP NEXT ON "ARIZONA HORIZON," SECRETARY OF STATE ADRIAN FONTES JOINS US TO DISCUSS THE RECENT CYBERATTACK THAT BREACHED HIS OFFICE'S WEBSITE.

>>> WE'LL HEAR ABOUT MAYO CLINIC ARIZONA'S NEW LUNG TRANSPLANT PROGRAM.

>>> AND A CLOSER LOOK AT AN FDA DECISION REGARDING THE SELLING OF E-CIGARETTES BY JUUL LABS.

THOSE STORIES AND MORE NEXT ON "ARIZONA HORIZON."

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TED: GOOD EVENING, AND WELCOME TO "ARIZONA HORIZON," I'M TED SIMONS.

MARICOPA COUNTY SUPERVISOR STEVE GALLARDO WANTS JUSTIN HEAP INVESTIGATED FOR PUBLIC CORRUPTION, HEAP SEEN HERE ACCLAIMS THAT GALLARDO AGREED TO DIVIDE UP ELECTION DUTIES AFTER HEAP'S, QUOTE, BACKCHANNELING AND ARM-TWISTING BOUGHT GALLARDO'S SUPPORT.

GALLARDO DENIES THE CLAIM, CALLS IT A LIE AND SUGGESTING THAT HEAP, QUOTE, BETTER KEEP MY NAME OUT OF HIS LYING MOUTH.

GALLARDO ALSO CALLED ON THE ATTORNEY GENERAL TO INVESTIGATE.

>>> THE DRAGON BRAVO FIRE NORTH OF THE GRAND CANYON IS THE LARGEST ACTIVE WILDFIRE IN THE U.S.

THE FIRE BURNED MORE THAN 105,000 ACRES AND ONLY 9% CONTAINED AS HIGH WINDS AND LOW HUMIDITY CONTINUE TO FUEL THE FLAMES.

MORE THAN 1100 FIREFIGHTING PERSONNEL ARE ON THE GROUND WORKING THE FIRE NOW THE TENTH LARGEST IN ARIZONA HISTORY.

>>> PRESIDENT TRUMP'S TRADE DEAL DEADLINE IS TOMORROW.

THE PRESIDENT GAVE UP COUNTRIES UNTIL TOMORROW TO COME UP WITH NEW AGREEMENTS OR BE SUBJECT UP TO 50%.

PRESIDENT TRUMP ANNOUNCED A 90-DAY EXTENSION FOR MEXICO IN ORDER FOR THE COUNTRIES TO TALK ABOUT A POTENTIAL TRADE DEAL.

THE EXTENSION LEAVES 25% TARIFFS IN PLACE WITH AMERICA'S LARGEST TRADING PARTNER, BUT NO DEAL WITH CANADA, THE SECOND LARGEST TRADING PARTNER.

PRESIDENT TRUMP SAID IT WOULD BE, QUOTE, VERY UNLIKELY THAT A DEAL COULD BE REACHED AFTER CANADA'S PRIME MINISTER SAID HE PLANNED TO SUPPORT PALESTINIAN STATEHOOD.

>>> A FEDERAL APPEALS COURT HEARD ARGUMENTS IN A CASE ALLEGING THAT THE PRESIDENT OVERSTEPPED AUTHORITY IN IMPOSING TARIFFS.

A COALITION OF SMALL BUSINESSES IN STATES CLAIMS THE PRESIDENT IS MISUSING EMERGENCY ECONOMIC LAW TO ENACT TARIFFS.

IT COULD RESHAPE THE PRESIDENT'S TRADE STRATEGY AND TAKE MONTHS FOR COURT DECISION, AND EVEN THEN AN APPEAL WOULD LIKELY END UP IN THE SUPREME COURT.

>>> AN INFORMATIONAL WEBSITE HOSTED BY THE ARIZONA SECRETARY OF STATE'S OFFICE WAS RECENTLY DEFACED BY HACKERS WITH ASHES PARENT TIES TO IRAN.

THE ATTACKS RAISED QUESTIONS TO WHAT WAS TARGETED, HOW MUCH WAS INFILTRATED AND WHAT'S DONE TO KEEP IT FROM HAPPENING AGAIN?

JOINING US IS ARIZONA SECRETARY OF STATE ADRIAN FONTES, GOOD TO SEE YOU AGAIN, THANK YOU FOR JOINING US.

>> GOOD TO BE BACK, THANKS FOR HAVING ME.

TED: JUNE 23, WHAT HAPPENED TO THE SECRETARY OF STATE WEBSITE?

>> ON JUNE 23, WE DETECTED INFILTRATION INTO ONE OF OUR SYSTEMS ORIGINALLY BUILT MANY, MANY, MANY YEARS AGO FOR ACCESS BUT DIDN'T HAVE SECURITY IN MIND, A MALICIOUS PACKAGE OF SOFTWARE WAS PLACED AND WE DETECTED IT, SEQUESTERED IT, BUT IT WORKED THROUGH TO DEFACING THE CANDIDATE PAGE THAT SHOWS RESULTS, THE ONE WITH THE BLUE AND RED LINES, THE PICTURE OF THE AYATOLLAH POPPED UP OVER EVERYBODY'S FACE RUNNING FOR OFFICE SINCE 2016.

WE DID, AS I SAID, WE DETECTED IT, STOPPED ALL THAT STUFF FROM HAPPENING.

ENDED UP RECOVERING THE SERVER AND BEEN GOING THROUGH AN INVESTIGATION ON THAT, TO MAKE SURE THAT NOTHING ELSE WAS IMPACTED, BUT I WANT TO MAKE SURE THAT YOU AND YOUR VIEWERS KNOW REALLY WELL, THIS WAS NOT THE VOTER REGISTRATION SYSTEM WITH PERSONALLY IDENTIFYING INFORMATION, THAT IS HOUSED IN THE CLOUD, IT'S NOT AN ON-SITE SERVER.

IT DIDN'T HIT THE ADDRESS CONFIDENTIALITY PROGRAM WHICH HOUSES INFORMATION ON VICTIMS OF VIOLENCE AND STALKING THAT WE KEEP THEIR ADDRESSES CONFIDENTIAL.

SO NOWHERE WAS THERE SIGNIFICANT AMOUNT OF IDENTIFYING INFORMATION WAS ATTACKED.

TED: WHAT ABOUT ELECTION RESULTS?

THAT PART OF THE SYSTEM?

>> THE ELECTION RESULTS PAGE, THE ONE WE DISPLAY THAT ON WAS IMPACTED BUT THE ELECTION RESULT SEGMENT WHERE IT IS UPLOADED WAS NOT.

WE DIDN'T HAVE ELECTION AT THE TIME, SO WE'RE IN GOOD SHAPE WHEN IT COMES TO THAT.

TED: ANY OTHER SYSTEMS?

ANY OTHER DATA ACCESSED?

>> NO OTHER SYSTEMS OR DATA ACCESSED.

WE'RE NARROWING THE INVESTIGATION DOWN, SO IT DOESN'T LOOK LIKE IT WAS ANYTHING ELSE.

THE BIG PROBLEM WE HAVE WITH THE LEGACY SYSTEMS, TED, WRITTEN IN LANGUAGES THAT NO ENGINEERS KNOW HOW TO USE ANYMORE.

WHEN WE GO IN AND TRY TO FIX ONE OF THE SYSTEMS WE'RE GOING TO BREAK SOMETHING, AND THAT'S WHY FOR A LONG TIME PEOPLE SHIED AWAY FROM IT BECAUSE WE'VE GOT TO BASICALLY REPLACE THE ENTIRE SYSTEM, CAN'T FIX IT.

AS A MATTER OF FACT, THE ONES WE DID FIX ENDED UP BREAKING OR SIGNIFICANTLY SLOWING DOWN THE ACTIVITY THAT GOES ON THERE.

SO THE LEGACY SYSTEMS HAVE TO BE REPLACED.

WE CAN'T JUST FIX THEM BECAUSE MANY OF THE SOFTWARE COMPANIES THAT USED TO SUPPORT THEM DON'T EXIST ANYMORE.

THERE'S THOSE ISSUES WE HAVE TO DEAL WITH.

TED: IF THE LEGACY SYSTEMS CAN BE HACKED AND ARE THAT VULNERABLE, DOES THAT MEAN OTHER ASPECTS OF THE SECRETARY OF STATE'S WEBSITE,TH ACCESS OF DATA RANGING ACROSS THE BOARD, IS THAT BY ITS NATURE MORE VULNERABLE?

>> ABSOLUTELY.

NO QUESTION WE HAVE VULNERABILITY STILL, AND THIS IS WHY SINCE I GOT ELECTED WE'VE BEEN ASKING FOR MONEY TO SHORE UP THE SYSTEMS.

WE CAME IN JANUARY OF 2023 AND MADE ADJUSTMENTS IN THE I.T.

DEPARTMENT.

MY EXPERIENCE IN THE PAST TOLD ME THIS IS SOMETHING WE HAD TO PAY ATTENTION TO.

LO AND BEHOLD WE DISCOVERED THIS.

NOT ONLY DID WE MAKESHIFTS BUT ASKED FOR SPECIFIC MONEY TO SHORE UP THE SYSTEM IN 23.

WE ASKED FOR MONEY FOR THIS SYSTEM IN 24, WE ASKED FOR IT ALSO FOR 25.

NONE OF THE REQUESTS BY FOLKS DOING THE BUDGETING STUFF WERE GRANTED, AND SO WE'VE ASKED FOR OVER $17 MILLION OVER THOSE THREE CYCLES TO GET THESE SPECIFIC SYSTEMS UPGRADED AND THAT'S BEEN DENIED.

SO UNFORTUNATELY WE ARE WHERE WE ARE NOW, AND SO NOW FOLKS ARE PAYING ATTENTION, AND NOW WE'RE STARTING TO WORK WITH SOME ALACRITY TO SHORE UP THE SYSTEMS.

>> YOU WANT THEM SHORED UP AND UPDATED.

NOW THEY NEED TO BE FIXED, DO YOU HAVE THE FUNDS TO FIX THEM?

>> NOT EVEN FIX, WE FIXED SOME OF THE OLD THINGS AND WE KNOW THEY'RE GOING TO BREAK.

THAT'S ONE OF THE REASONS WE NEED TO REPLACE THEM.

IF WE'RE GOING TO DO WHAT WE NEED TO DO, WE NEED $10 MILLION RIGHT NOW AND $3.5 MILLION ONGOING.

HERE'S WHY.

GOVERNMENT USED TO BUY COMPUTER SYSTEMS AND YOU HAVE THE SERVER, YOU SET IT UP AND THAT WOULD LAST A COUPLE YEARS WITH MINOR UPDATES.

THAT'S NOT THE MODEL ANYMORE AND HASN'T BEEN FOR A LONG TIME.

YOU BUY SYSTEMS THAT ARE LEASED, UPGRADED CONSTANTLY.

YOU DON'T PUT A BUNCH OF MONEY UP-FRONT, YOU CONTINUOUSLY PAY AS YOU MOVE FORWARD.

WE HAVE TO MOVE FROM THE OLD PROCUREMENT MODEL AND HAVE TO REPLACE THE UNDERLYING ARCHITECTURE, THAT TAKES MONEY.

TED: BACK TO THE HACK HERE.

WHO DID YOU CONTACT AFTER THIS WAS DISCOVERED?

>> FIRST AND FOREMOST, CONTACTED ARIZONA DEPARTMENT OF HOMELAND SECURITY, THE CHIEF INFORMATION SECURITY OFFICER, ARIZONA'S CISO, RYAN MURRAY IS A PHENOMENAL GUY.

WE WORK DIRECTLY WITH THE NATIONAL GUARD, A PHENOMENAL PARTNER AND WE WERE UNDERGOING ACTIVE PENETRATION TESTING AT THE TIME.

WE HAD THE CONTRACTOR ON-SITE AND LOCKED THIS DOWN QUICKLY, MUCH LIKE THE CROWD STRIKE ISSUE THAT HAPPENED MANY MONTHS AGO.

THAT WAS A GLOBAL PROBLEM.

OUR DEPARTMENT, DEPARTMENT OF STATE WAS THE FIRST ONE IN ARIZONA TO IDENTIFY THAT ISSUE.

WE WERE UP AND RUNNING BY 11:00 THE NEXT MORNING.

A LOT OF OTHER FOLKS WERE SLOWER ON THE UPTICK.

WE'VE GOT A GREAT TEAM AND THEY DO AMAZING WORK WITH THE RESOURCES THEY HAVE, BUT, AGAIN, WE HAVE THE OLD ISSUES WE HAVE TO DEAL WITH.

TED: DID LAW ENFORCEMENT AGENCIES, WHEN YOU CONTACTED THEM, DID THEY TELL YOU WHAT HAPPENED?

DID THEY GIVE YOU ADVICE WHAT TO DO NEXT?

>> THE AGENCY WORKED WITH US TO DISCOVER THAT.

I'VE GOT AN AMAZING TEAM THAT WE BUILT VERY, VERY CAREFULLY OVER THE LAST SEVERAL YEARS BECAUSE WE UNDERSTOOD WE COULDN'T GET REPLACEMENTS ON THE SYSTEM BECAUSE THE MONEY WASN'T COMING IN, WE GOT PEOPLE TO HELP BUILD THIS DOUGHNUT AROUND THOSE WEAK SYSTEMS IN THE MIDDLE.

IF YOU GET TO THE INSIDE OF THE DOUGHNUT, IT'S OPEN AND THAT'S PROBLEMATIC.

WE DEALT WITH THE FOLKS THAT WE NEEDED TO, I WISH WE HAD BETTER PARTNERS AT THE FEDERAL LEVEL AT THIS TIME, WHERE WE USED TO BE ABLE TO DEPEND ON THEM.

WE CAN'T EVEN TALK TO MANY OF THEM BECAUSE OF THE WAY THE NEW ADMINISTRATION IS OPERATING.

WE GOT TO MAKE DO WITH WHAT WE GOT IN ARIZONA.

TED: HOW ARE THEY OPERATING SO THEY WON'T SPEAK TO YOU?

WHAT'S GOING ON THERE.

>> AFTER JANUARY OF 2025, THE CYBERSECURITY INFRASTRUCTURE SECURITY AGENCY, CISA, STOPPED TALKING TO US.

THEY GOT RID OF THE PHYSICAL AGENT IN ARIZONA, THE CYBERSECURITY AGENT, THEY HELPED US TRAIN TO DO THE STUFF IN 2024.

THEY DON'T EXIST ANYMORE.

I HAVE WRITTEN LETTERS TO SECRETARY NOEM AND THE CONGRESSIONAL DISTRICT, LOOK, I DON'T CARE IF YOU ARE REORGANIZING, PUT THIS OVER THERE, PUT THAT OVER THERE, BUT THE REARRANGEMENT OF THE DECK CHAIRS MEANS THEY TOOK ALL THE DECK CHAIRS OFF THE DECK.

WE DON'T HAVE THE SUPPORT SERVICES THAT CISA AND THE DEPARTMENT OF HOMELAND SECURITY USED TO PROVIDE FOR US AND WE CAN'T TALK TO THEM.

THE NEW ADMINISTRATION WILL NOT SUPPORT ELECTION SECURITY ANYMORE, AND THAT'S PROBLEMATIC AND ONE OF THE REASONS WHY THIS ISSUE IS REALLY SCARY.

TED: DID OTHER STATES EXPERIENCE SOMETHING SIMILAR, AND IF SO, IS THE ADMINISTRATION, THE FEDERAL GOVERNMENT, ARE THEY NOTICING THIS AND CHANGING THEIR TUNE?

>> THEY'RE NOT CHANGING THEIR TUNE AND OTHER STATES ARE IMPACTED BY THIS.

THANK GOD OTHER STATES HAVEN'T BEEN HACKED THAT WE'RE AWARE OF.

THAT AGENCY USED TO HELP SHARE INFORMATION AMONG ONE ANOTHER.

SOMETHING HAPPENED IN STATE A.

STATE B WOULD FIND OUT ABOUT IT THROUGH THE FEDERAL CHANNELS THAT DON'T EXIST ANYMORE AND FIX IT BEFORE IT HAPPENED OR THE SYSTEM COULD GET LOOKED AT.

WE'RE FIGHTING WITH ONE HAND TIED BEHIND OUR BACK AS IT PERTAINS TO FOREIGN ADVERSARIES BECAUSE THE ADMINISTRATION, WHETHER THEY SAY SO OR NOT, ABANDONED ELECTION SECURITY AND WE'RE TRYING TO GET THEM TO CHANGE THEIR TUNE.

TED: LAST QUESTION, WHAT WAS LEARNED FROM THIS HACK AND WHERE DO YOU GO FROM HERE?

WHAT CHANGES BECAUSE OF THIS INCIDENT?

>> WELL, WE'VE GOT A LOT OF OPEN EARS.

THERE'S A LOT OF FOLKS ON BOTH SIDES OF THE AISLE WHO UNDERSTOOD THIS ISN'T SOMETHING YOU POLITICIZE.

WE'VE GOT TO MAKE SURE SYSTEMS ARE SECURE BECAUSE IT PERTAINS TO NOT JUST ELECTIONS OR ELECTIONS RESULTS PAGE, WE'RE TALKING ABOUT ALL THE STATE SYSTEMS, HEALTH CARE SYSTEMS, UNEMPLOYMENT SYSTEMS, ALL OF THE THINGS THAT TAKE CARE OF TAXATION.

WE HAVE OLD LEGACY SYSTEMS ACROSS THE STATE.

WE NEED TO PAY ATTENTION TO WHAT IS WEAK, SHORE IT UP IMMEDIATELY AND INVEST IN THE FUTURE OF THE SECURITY OF OUR INFORMATION SYSTEMS WHICH IS SOMETHING I'VE BEEN ADVOCATING FOR YEARS.

NOW WE'VE GOT PEOPLE'S ATTENTION.

SADLY HAD TO COME AT THE BEHEST OF WE THINK THE ISLAMIC REPUBLIC OF IRAN.

TED: AS YOU MENTIONED, INVESTIGATION CONTINUES INTO WHAT HAPPENED?

YOU'RE STILL LOOKING AT THIS?

>> WE'RE STILL LOOKING AND HOPEFULLY THE NEXT COUPLE WEEKS HAVE A FULL PICTURE OF EXACTLY WHAT HAPPENED AND HOW WELL WE DID IN TAKING CARE OF IT, WHICH I THINK IS GOOD SO FAR.

TED: SECRETARY OF STATE ADRIAN FONTES, THANK YOU FOR JOINING US.

>> THANK YOU.

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TED: MAYO CLINIC ARIZONA ANNOUNCED A NEW LUNG TRANSPLANT PROGRAM.

THE GOAL IS TO HELP PATIENTS BATTLING END-STAGE LUNG DISEASE AND IN NEED OF A TRANSPLANT TO SURVIVE.

WE WELCOME DR. JONATHAN D'CUNHA, SURGICAL DIRECTOR OF MAYO'S LUNG TRANSPLANT PROGRAM.

WELCOME TO "ARIZONA HORIZON," GOOD TO HAVE YOU HERE.

>> YOU BETCHA.

TED: THIS IS A NEW PROGRAM, CORRECT?

>> YES.

TED: HOW NOW?

>> WE JUST OPENED THE PROGRAM LAST YEAR FOR EVALUATIONS OF PATIENTS, EVALUATING PATIENTS AND DID OUR FIRST TRANSPLANT ON MAY 30.

TED: I WANT TO TALK ABOUT THE FIRST TRANSPLANT IN A SECOND.

THIS TARGETS, AS I MENTIONED, CRITICALLY ILL PATIENTS?

THESE FOLKS, IT'S LUNG TRANSPLANT OR BUST, TRUE?

>> YES, ABSOLUTELY.

IT'S PATIENTS WITH SPECIFIC LUNG DISEASE, WHERE THEY HAVE NO HOPE AND TRANSPLANT IS THE ONLY OPTION, ALL MEDICAL THERAPIES FAILED.

TED: END-STAGE LUNG DISEASE MEANS IT'S NOT GOING, IT'S NOT GOING TO TURN AROUND.

THERE'S NOTHING ELSE LEFT?

>> CORRECT.

A NUMBER OF INDICATIONS FOR LUNG TRANSPLANT SUCH AS COPD, APATHIC PULMONARY FIBROSIS, PULMONARY HYPERTENSION.

TED: WE HEAR ABOUT COPD, WHAT IS THAT?

>> END-STAGE LUNG DISEASE WHERE THE SACKS IN THE LUNG ARE DESTROYED, AND YOU CAN'T EXCHANGE OXYGEN AND YOU ARE RUNNING OUT OF OPTIONS.

TED: HERE WE GO WITH THE LUNG TRANSPLANT IDEA, THIS INVOLVES A MULTIDISCIPLINARY TEAM, CORRECT?

>> HUGE TEAM.

TOUCHES ALL PARTS OF THE INSTITUTION, MUCH LIKE ANYTHING IN TRANSPLANT.

TED: AND IT'S RESEARCH DRIVEN?

>> ABSOLUTELY.

TED: TALK ABOUT HOW DIFFERENT TEAMS WOULD WORK TOGETHER IN SOMETHING LIKE THIS?

>> STARTS WITH THE EVALUATION OF THE PATIENT TO BECOME A CANDIDATE.

DONOR LUNGS ARE IN SCARCE SUPPLY, WE WANT TO MAKE SURE WE'RE PICKING THE RIGHT RECIPIENT.

DURING THE EVALUATION PIECE, THEY MEET PEOPLE FROM INFECTIOUS DISEASE, PULMONOLOGISTS, SURGEONS, SOCIAL WORKERS, CARDIOLOGISTS, ALL THOSE FOLKS, AND OTHER CONSULTATIVE PARTS OF THE PRACTICE AS NEEDED.

TED: ALL HANDS ON DECK, IN OTHER WORDS.

>> YES, SIR.

TED: RAMPING UP TO THE PROGRAM BEING GETTING THE FIRST PATIENT, I'M GOING TO GET TO HIM, I SWEAR I AM.

WAS THERE AN ADVANCEMENT, WAS THERE AN AH-HAH MOMENT, ALL RIGHT, WE'RE DOING THIS?

>> I THINK IT WAS SIX YEARS AGO WHEN I GOT HERE.

TED: AH.

>> I WAS WALKING ON MAYO CLINIC CAMPUS THINKING ABOUT THE FUTURE ON THAT CAMPUS, WALKING AROUND LOOKING AT THE POTENTIAL FOR THE INNOVATION THAT GOES ON, AND LOOKED UP IN THE SKY, IT WAS JANUARY, I'M FROM THE MIDWEST, THE WEATHER WAS PERFECT, AND SAID THIS IS THE PLACE.

TED: YEAH, WELL, THIS IS THE PLACE.

SO THE PLACE GETS THIS FIRST TRANSPLANT PATIENT.

I THINK HE HAD SURGERY MAY 30.

TALK TO US ABOUT HIM, HIS CONDITION AND HOW IT TURNED OUT?

>> HE'S A 67-YEAR-OLD PATIENT WITH COPD, RUNNING OUT OF OPTIONS HERE, COPD DIAGNOSED SEVEN YEARS PREVIOUS, BUT LIKE MANY WITH THE DISEASE, THEY DECLINE AND BECOME -- IT AFFECTS THEIR DAILY LIVES.

SO MUCH SO THEY HAVE TO CHOOSE BETWEEN TALKING AND BREATHING.

IT'S THAT SIGNIFICANT.

HE WAS A GREAT CANDIDATE FOR TRANSPLANTATION.

HE WENT THROUGH AN EXTENSIVE PROCESS, AND THEN DONOR LUNGS BECAME AVAILABLE FOR HIM.

TED: HE WAS A GREAT CANDIDATE BECAUSE?

>> BECAUSE THERE'S A LOT OF COMPONENTS THAT GO INTO IT.

HE REALLY JUST HAD LUNG DISEASE AS HIS MAIN THING.

HIS HEART WAS GOOD, OTHER ORGAN SYSTEMS WERE GOOD, AND ALSO THERE'S A LOT OF OTHER THINGS THAT GO INTO PICKING APPROPRIATE RECIPIENT INCLUDING FAMILY SUPPORT AND SUPPORT AROUND HIM.

IT DOES TAKE A VILLAGE WITH THESE PATIENTS.

TED: CURRENTLY TAKES A GONG, TOO.

WE SAW HIM HITTING A GONG.

SOUNDS LIKE EVERYTHING WENT WELL?

>> IT WENT GREAT.

I HAVE THIS PHILOSOPHY WITH LUNG TRANSPLANT CALLED M+ 1.

WHEN YOU FIND A RECIPIENT AND YOU WANT THE RECIPIENT WHO IS GOING TO GO THE EXTRA STEP, WITH CRAIG, OUR FIRST RECIPIENT, WHEN I ASKED HIM TO WALK THREE TIMES AFTER SURGERY, HE WAS WALKING FOUR.

THAT'S WHAT YOU NEED TO BE SUCCESSFUL WITH SUCH A COMPLEX OPERATION.

TED: HOW'S HE DOING NOW?

>> DOING GREAT.

JUST CELEBRATED TWO-MONTH ANNIVERSARY.

NO REJECTION.

HE HAS A NEW LEASE ON LIFE, AND HIS LUNG FUNCTION IS OUTSTANDING.

IT'S 102% PREDICTED FOR HIS SIZE AND AGE.

TED: WOW, AND HE CAN GET AROUND AND DO WHAT HE WANTS TO DO, I IMAGINE?

>> IT IS, NOT USING OXYGEN AT ALL.

THE TRADE-OFF IS YOU SEE DOCTORS, YOU TAKE MEDICINE TO KEEP IMMUNE SYSTEM FROM FIGHTING OFF THE TRANSPLANT.

WAY HE APPROACHES THINGS, I TALK TO HE AND HIS WIFE FREQUENTLY, THEY HAVE A WHOLE NEW OUTLOOK ON LIFE.

THAT'S THE HOPE TRANSPLANT PROVIDES PATIENTS.

TED: LAST QUESTION HERE, THIS TYPE OF TRANSPLANT, LUNG TRANSPLANT, CAN THE TECHNIQUES, MULTIDISCIPLINARY APPROACH, CAN THEY BE APPLIED TO DIFFERENT ORGAN TRANSPLANTS?

>> ABSOLUTELY.

AND AS A MATTER OF FACT, TRANSPLANT CENTER IS ONE OF THE BUSIEST IN THE COUNTRY, IF NOT THE WORLD, AND THAT'S THE INFRASTRUCTURE YOU NEED AND THAT MULTIDISCIPLINARY APPROACH IS STANDARD ACROSS ALL ORGANS.

TED: HOW MANY PATIENTS DO YOU THINK ARE EXPECTED TO BENEFIT FROM THIS?

FROM THE TRANSPLANT IN PARTICULAR?

>> TARGETING IN THE RANGE OF 30 PATIENTS A YEAR TO GET TRANSPLANTED.

THOSE ARE THE PATIENTS WE SEE ON AN ANNUAL BASIS WE WOULD LIKE TO OFFER THIS AS AN OPTION FOR THEM.

TED: SOUNDS ENCOURAGING AND CONGRATULATIONS ON YOUR AND YOUR PATIENT'S SUCCESS, AND WE'LL KEEP AN EYE ON IT.

GOOD STORY.

GOOD TO HAVE YOU HERE.

>> APPRECIATE THE OPPORTUNITY.

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TED: THE FDA RECENTLY APPROVED CONTINUED SELLING OF E-CIGARETTES BY JUUL LABS AFTER THE COMPANY MET THE LEGAL STANDARDS FOR MARKETING TOBACCO PRODUCT.

WE'RE JOINED BY LOCAL PEDIATRICIAN DR. GARY KIRKILAS.

GOOD TO HAVE YOU HERE.

>> THANK YOU.

TED: E-CIGARETTES, WHAT ARE THEY?

>> IN 2015, JUUL CAME OUT WITH E-CIGARETTES.

IF YOU WANTED TO HAVE AEROSOLIZED NICOTINE, YOU COULD DO THAT THROUGH ELECTRONIC CIGARETTE.

PRIOR TO THAT, PEOPLE WOULD HAVE TO USE NICOTINE GUM OR PATCH.

TED: HOW DOES IT WORK?

I'VE NEVER DONE THIS KIND OF THING AS FAR AS E-CIGARETTE IS CONCERNED.

>> GOOD FOR YOU.

TED: YEAH, THANKS.

HOW DOES IT WORK?

>> WHAT HAPPENS IS THEY HAVE A LITTLE CONTAINER THAT HAS PROPYLENE GLYCOL, GLYCERIN, FLAVORINGS AND LIQUID AND NICOTINE AND A HEATING COIL THAT AEROSOLIZED ALL THESE CHEMICALS SO THAT YOU CAN INHALE AEROSOLIZED NICOTINE WITHOUT HAVING THE BURNED TOBACCO LEAVES.

TED: YOU'VE GOT THE NICOTINE BUT DON'T HAVE TOBACCO DOES, THAT MEAN IT'S ADDICTIVE?

>> VERY MUCH SO.

YOU HAVE THE SAME ADDICTIVE PROPERTIES OF NICOTINE IN A TRADITIONAL CIGARETTE THAT IS IN THE LIQUID AEROSOLIZED NICOTINE.

TED: IT'S SLIGHTLY LESS, ISN'T THAT THE DEAL?

>> NO, SO AVERAGE CARTRIDGE, YOU HAVE ENOUGH NICOTINE THAT WOULD BE EQUIVALENT TO A PACK OF CIGARETTES.

ONE CARTRIDGE EQUALING ONE PACK OF CIGARETTES.

TED: WOW.

AND JUUL LABS WERE INVESTIGATED BY THE FDA FOR MARKETING CARTOON FIGURES AND THAT SORT OF THING, CORRECT?

>> YEAH.

WHEN THEY CAME OUT, THEY SAID THIS IS GREAT WAY FOR PEOPLE USING TRADITIONAL CIGARETTES TO GET OFF OF THEM, BUT WHAT HAPPENED IN 2015 IS YOU LOOK AT THE MARKETING THEY DID AND IT WAS DEFINITELY TARGETING YOUNG ADULTS.

ALL THE MODELS IN THE ADVERTISEMENTS WERE 21, 22-YEAR-OLDS, NOT PEOPLE WHO POSSIBLY USED TOBACCO, SO THEY'RE CREATING NEW CUSTOMERS.

THEY HAD A BIG SOCIAL MEDIA PRESENCE AS WELL.

TED: HAS THAT CHANGED?

>> YES.

THEY HAD TO PULL THE ADS AND PAID $1.9 BILLION IN SETTLEMENT FEES DUE TO THEIR TARGETING YOUTH.

TED: HOLY SMOKES, OBVIOUSLY SOMETHING IS WRONG THERE.

NOW THE FDA BASICALLY SAID, OKAY, YOU'RE DOING WELL AS FAR AS THE TOBACCO PRODUCT IS CONCERNED.

WHAT DID THE FDA REALLY SAY HERE?

>> THE DECISION IS THEY'RE A NET BENEFIT.

THE ADULTS USING TRADITIONAL CIGARETTES HAVING JUUL AVAILABLE TO THEM PRODUCING ENOUGH OF A PUBLIC HEALTH BENEFIT TO OVERSEE ALL THE YOUTH USING ELECTRONIC CIGARETTES, AND AS A PEDIATRICIAN, WE'RE DOING A GREAT JOB GETTING KIDS OFF OF TRADITIONAL CIGARETTES BUT DEFINITELY USING ELECTRONIC CIGARETTES.

TED: THE FDA SAID JUUL WAS APPROPRIATE FOR THE PROTECTION OF PUBLIC HEALTH.

E-CIGARETTES ARE APPROPRIATE FOR THE PROTECTION OF PUBLIC HEALTH.

HOW DO E-CIGARETTES PROTECT PUBLIC HEALTH?

>> THE IDEA IS WE HAVE A LARGE CONTINGENT OF SMOKING TRADITIONAL CIGARETTES, IF WE HAVE JUUL AVAILABLE TO THEM, THEY WOULD GET OFF THEM AND USE ELECTRONIC CIGARETTES.

TED: IT'S APPROPRIATE TO HAVE A REGULATED CONSISTENT MARKET SO THAT STUFF IS THERE, SO PEOPLE CAN'T GO BACK TO CIGARETTES BECAUSE THEY CAN'T FIND IT.

>> CORRECT.

TED: THAT'S WHAT THE FDA IS SAYING?

>> THEY HAVE A NET BENEFIT.

THEY KNOW THE YOUTH ARE GETTING THEIR HANDS ON THIS.

TED: WHAT DO THEY THINK OF THAT?

>> JUUL HAS A HISTORY FROM SOCIAL MEDIA PRESENCE, THAT THEY WENT AFTER YOUTH, I'M HOLDING MY BREATH TO SEE IF THEY ARE GENUINE AND NOT GO AFTER YOUTH AGAIN.

TED: YOU SAID THAT CIGARETTE SMOKING AMONG KIDS IS DOWN, CORRECT?

>> ABSOLUTELY.

TED: E-CIGARETTE USE, IS THAT DOWN AMONG TEENAGERS?

>> FORTUNATELY, IT IS TRENDING DOWN.

WHEN WE LOOKED AT STUDIES, TWELFTH GRADERS, 35% WERE USING ELECTRONIC CIGARETTES IN 2010.

2020, WE'RE GOING BACK DOWN, DOWN TO 21%.

IT'S GOING DOWN BUT STILL 21% OF HIGH SCHOOLERS ARE USING THIS.

>> THE IMPACT OF THIS DECISION, DO YOU THINK ON THE DECLINING RATES, WILL THERE BE IMPACT?

>> I FEEL THERE WILL BE.

THE MORE PRODUCT AVAILABLE, AND JUUL IS A LARGE CORPORATION, THEY HAVE A BIG IMPACT.

TED: FROM WHERE YOU SIT, ARE E-CIGARETTES SAFE?

>> NO.

TED: WHY?

>> WHILE IT'S TRUE A TRADITIONAL CIGARETTE HAS TAR AND CARBON MONOXIDE BECAUSE IT'S COMBUSTIBLE, ELECTRONIC CIGARETTES AREN'T SAFE.

THEY MIGHT BE USED, SAFER CAN BE IMPLIED BUT THEY ARE NOT SAFE.

WHEN YOU AEROSOLLIZE PROPYLENE GLYCOL AND GLYCERIN AND NICOTINE SOME OF THOSE PERFORM NONORGANIC COMPOUNDS, THE SPRING IS MADE OF METAL AND WE GET LEAD AND NICKEL LEECHED OUT OF THEM.

TED: SOME OF THE CHEMICALS GET INTO THE SYSTEM?

>> YES.

TED: SERIOUSLY SO?

>> WE DON'T KNOW YET.

IN THE STUDIES ON KIDS, THEY WILL TAKE URINE SAMPLES ON A TEENAGER HALF HOUR BEFORE USED ELECTRONIC CIGARETTES AND WE CAN DETECT THE CHEMICALS.

WE DON'T KNOW WHAT THE SIGNIFICANCE IS BUT WE'LL FIND OUT.

TED: IN YOUR MIND, DO YOU THINK THERE IS ENOUGH REGULATION OF E-CIGARETTES?

>> HARD TO SAY, YOU HAVE ADULTS GETTING OFF TRADITIONAL CIGARETTES WHICH WE WANT, BUT WE DON'T KNOW THE SIGNIFICANCE.

YOU'RE NOT GOING TO GET LUNG CANCER OR COPD UNTIL YOU'RE IN YOUR 50s.

WE DON'T KNOW WHAT'S GOING TO HAPPEN WITH VAPING.

TED: LAST QUESTION, VAPING, E-CIGARETTES COMPARE THAT TO THE NICOTINE GUN AND OTHER EFFORTS TO GET OFF CIGARETTES.

BETTER?

WORSE?

>> WE RECOMMEND GUM AND THE PATCHES, BECAUSE YOU ARE GETTING DIRECTLY NICOTINE, LUNGS ARE NOT SUPPOSED TO BE INHALING THOSE THINGS.

I OPT FOR THOSE MODALITIES.

TED: INHALING STUFF IS NEVER GOOD.

>> EXACTLY.

TED: DR. GARY KIRKILAS, THANK YOU FOR EXPLAINING THE DECISION BY THE FDA AND JUUL LABS, THANK YOU.

>> THANK YOU.

TED: THAT IS IT FOR NOW, I'M TED SIMONS.

THANK YOU FOR JOINING US.

YOU HAVE A GREAT EVENING.