Recent weeks have been deeply troubling from a public health perspective.
Most people are by now at least somewhat familiar with the wave of lung injury cases being reported across the country as part of a still-mysterious outbreak tied to the use of e-cigarettes and other vaping products.
The situation has resulted in Massachusetts Gov. Charlie Baker instituting a four-month ban on the sale of all vaping products, while Rhode Island Gov. Gina Raimondo, in her own executive order, has authorized health officials to prohibit the sale of flavored e-cigarette products that she says are targeted at young people.
The numbers are staggering and impossible to ignore. According to the Centers for Disease Control and Prevention, more than 800 incidents of lung injury associated with the use of vaping products or e-cigarettes had been reported across 46 states and the U.S. Virgin Islands as part of the outbreak. Rhode Island is not among the states on that list, although Connecticut and Massachusetts are included.
Twelve deaths associated with the outbreak have been confirmed, with those occurring in California, Florida, Georgia, Illinois, Indiana, Kansas, Minnesota, Mississippi, Missouri and Oregon.
According to the CDC, data from 771 of the patients involved in the outbreak show that 69 percent are male, 62 percent are between the ages of 18 and 34 and 22 percent are between the ages of 18 and 21. Sixteen percent of the patients are under 18.
While no single product or substance has been linked to all of the outbreak cases, the CDC reports that all of the patients involved “have a reported history of e-cigarette product use, or vaping.” The CDC states that “no consistent evidence of an infectious cause has been discovered,” and as a result it is believed a “chemical exposure” is responsible for the lung injuries.
“The latest findings from the investigation into lung injuries associated with e-cigarette use, or vaping, suggest products containing THC play a role in the outbreak,” the CDC’s update reads. “Most of the patients reported using THC-containing products or both THC-containing products and nicotine-containing products. Some of the patients reported using only nicotine-containing products.”
Specifically, according to CDC data for 514 of the patients, 77 percent used THC-containing products in the 30 days before the onset of their symptoms. Thirty-six percent reported using THC-containing products exclusively. Fifty-seven percent reported using nicotine-containing products within the same window, although only 16 percent reported using only nicotine-containing products.
In announcing her executive order last week, Raimondo notes that beyond the current outbreak, youth vaping has been declared a national epidemic by the CDC, FDA and surgeon general’s office.
While noting that Rhode Island has one of the nation’s lowest cigarette smoking rates for teenagers, Raimondo said she views electronic nicotine delivery systems – many coming in colorful packages and with flavors such as cotton candy, strawberry, grape, cherry and mint – are unmistakably and “aggressively” marketed toward children.
Aside from the potential health risks of vaping, she added, young people who use e-cigarettes are four times more likely to become cigarette smokers.
“Companies are specifically targeting teens with colorful packaging and flavors. But recent reported injuries and deaths make clear that we do not have a full understanding of the associated risks. It's critical that we act now to protect our kids,” she said.
Raimondo’s executive order calls for additional steps, including the creation of a Vaping Advisory Group to monitor the issue and strengthening the regulatory framework around vaping products.
We wholly agree with the governor’s action, which we see as rightly focused on protecting children while continuing to monitor national trends and developments related to vaping. With so much unknown at this time, we believe this strong but balanced approach will allow Rhode Island to best protect its citizens.
We feel it would be imprudent, at this point, to act against all vaping products, some of which are used for medicinal marijuana consumption or as smoking cessation tools. While the jury is still very much out on vaping’s long-term health implications or effectiveness as a means to quit cigarettes, we believe the governor is right at this point to focus the state’s attention on the products most likely to be used by young people.
More answers, we hope, will come soon. Until then, let us all – parents, guardians, educators, mentors, friends and neighbors – continue to do what we can to discourage our children from engaging in vaping or any form of substance abuse. Their future, after all, is our future as well.