CENTERS FOR DISEASE CONTROL AND PREVENTION LINK MAJORITY OF VAPING-RELATED HOSPITALIZATIONS TO THC PRODUCTS

September 30, 2019

The Centers for Disease Control and Prevention’s (CDC) latest Morbidity and Mortality Weekly Report examines the recent outbreak of vaping-related hospitalizations. According to CDC’s findings, more than 70 percent of hospitalizations have been linked to vaping tetrahydrocannabinol (THC).

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As of September 24, CDC has identified 805 reported cases of vaping-related hospitalizations in 46 states and one U.S. territory. Of these, 69 percent of patients were males. The median age was 23 years, with a range from 13 to 72 years. There have been 12 deaths reported in 10 states, including California (two deaths), Florida, Georgia, Illinois, Indiana, Kansas, Minnesota, Missouri, Mississippi, and Oregon (two deaths).

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Of the 805 cases, information on the substances vaped was available for 514 patients, about 64 percent of the reported cases. Of the 514 patients self-reporting, 395, 77 percent, “reported using THC-containing products.” Further, 210 patients, 41 percent, “reporting using both THC-containing and nicotine-containing products.” Only 82 of the 514 patients,16 percent, “reported exclusive use of nicotine-containing products.” At this time, the CDC still does not know the “specific chemical exposure(s) causing this outbreak.”

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These findings mimic state health department records. On September 16, the Utah Department of Health linked the state’s hospitalizations to THC products, with 60 percent of individuals “self-reported vaping nicotine” and 90 percent “self-reported vaping THC.”

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On September 19, the Connecticut Department of Public Health had “interviewed 9 of the 13 patients with vaping-related injury.” All nine patients reported using THC products.

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On September, 26, the Oregon Health Authority (OHA) reported the state’s second vaping-related death, finding the patient “had been hospitalized with respiratory symptoms after vaping cannabis products.” Earlier, on September 3, OHA announced the first vaping-related death, which was a patient who “had recently used an e-cigarette or vaping device containing cannabis purchased from a cannabis dispensary.”

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On September 23, the Texas Department of State Health Services reported a total of 89 cases under investigation, with 34 “classified as confirmed cases,” and 20 “classified as probable cases.” Of these, 76 percent “reporting vaping products containing [THC].”

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Of all cases reported by state health departments and the CDC, no single vaping product has been identified as a culprit in vaping-related hospitalizations. Health departments and the CDC have urged consumers to avoid using black market products and to refrain from manipulating products.

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Despite findings linking hospitalizations to illicit products, in recent weeks several states have moved to further restrict adult access to electronic cigarettes and vaping devices. Michigan, New York, and Rhode Island have all banned the sales of flavored e-cigarettes. Massachusetts has banned the sale of all e-cigarette products for four months. On September 27, Gov. Jay Inslee (D-WA), directed the Washington Department of Health to issue an executive rule to regulate e-cigarettes, including adoption of “emergency rules to ban all flavored vaping products, including flavored THC products.”

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Legislation banning flavored e-cigarette products has been introduced in Illinois and Ohio. Lawmakers in Connecticut, Delaware, Maine, Oregon, and South Carolina, have hinted at possible flavor ban legislation. Vermont’s governor is also “considering” a ban on flavored e-cigarettes.

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Many lawmakers believe flavor bans are necessary to reduce youth e-cigarette use. However, The Heartland Institute analyzed results from the 2017-18 California Youth Tobacco Survey (CYTS) and found that despite flavor

restrictions in some localities, youth use of e-cigarettes in those areas increased after the bans went into place.

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Santa Clara County, California, banned flavored tobacco product sales to age-restricted stores in 2014. Despite this, youth e-cigarette use increased while the ban was in effect. For example, in the 2015-16 CYTS, 7.5 percent of Santa Clara high school students reported current use of e-cigarettes. In the 2017-18 CYTS, this increased to 10.7 percent.

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Further, flavors are essential in helping adult smokers quit combustible cigarettes. A survey of more than 70,000 American adult vapers found flavors play an important role in e-cigarettes, with 83.2 and 72.3 percent of survey respondents reporting vaping fruit and dessert flavors, respectively. Only 20 percent of survey respondents reported using tobacco flavors at the point of e-cigarette initiation.

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Lawmakers should refrain from enacting legislation that would further restrict adult access to electronic cigarettes and vaping devices. Numerous public health groups, including Public Health England, the Royal College of Physicians, and the American Cancer Society have found e-cigarettes to be significantly less harmful than combustible cigarettes. Further, an estimated three million American adults have used these devices to quit smoking.

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It is imperative that policymakers understand the recent vaping-related hospitalizations are overwhelmingly linked to unregulated vaping products. Lawmakers (and the media) should not confuse these cases with legal e-cigarettes, which are regulated by the U.S. Food and Drug Administration. Rather than enacting unnecessary, counterproductive legislation and misguided bans, lawmakers should address youth use by utilizing existing tobacco moneys and working with local businesses, schools, and public health departments to develop better solutions to address and reduce youth vaping use.

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Nothing in this Research & Commentary is intended to influence the passage of legislation, and it does not necessarily represent the views of The Heartland Institute or Tobacco Harm Reduction 101.