Missouri regulators have raised the allowable limit for vitamin E acetate in regulated marijuana products from 0.2 parts per million to 5 parts per million, sparking concern from stakeholders, including the state’s chapter of the National Organization for the Reform of Marijuana Laws (NORML).
Previous regulations required vitamin E acetate testing for cannabis concentrates and inhalables, but the updated rule applies to concentrates, infused plant material, pre-rolls and vapes, according to media reports.
Vaping industry operators might remember vitamin E acetate as having caused the EVALI (e-cigarette or vaping use-associated lung injury) crisis of 2019-20, when nearly 70 people died and more than 2,500 vape consumers were hospitalized for a mystery lung illness eventually tied to the chemical, which some product manufacturers used as a thickening agent for vape oil.
After medical professionals sounded the alarm in 2019 about patients becoming gravely ill from vaping, it took months before scientists were able to identify the culprit.
According to Kansas City TV station KCTV, the Missouri Department of Health and Senior Services’ rules for licensed marijuana operators took effect March 1 and allow 25 times more vitamin E acetate in finished marijuana products, including vapes.
Missouri NORML Coordinator Dan Viets told KCTV that “there appears to be no rational explanation for why the state of Missouri would dramatically increase the amount of a very toxic substance in legal cannabis products when none of it whatsoever should be present in them.”
The health agency wrote in a letter to state marijuana business license holders that the Missouri Division of Cannabis Regulation “determined the good cause for granting this variance is that it provides accurate standardization of the method reference material for testing licensees, reduces the risks for false failures, and to ensure Vitamin E Acetate is not added to marijuana product.”
Pennsylvania regulators recalled hundreds of medical marijuana vape products because the state says they contain ingredients unapproved for inhalation. The state health department released a list of more than 500 cannabis vape products with ingredients not approved by the U.S. Food and Drug Administration.
“Although some of these added ingredients may be considered safe in other non-inhaled products, patient safety is the top priority of the Medical Marijuana Program,” the state wrote in an email announcing the recall, according to the Pittsburgh City Paper (PCP), as reported by MJBiz Daily.
Credit: Promesa Art Studio
The PCP stated that the agency did not respond to a request for more information. The FDA has not approved any cannabis product for marketing. The agency does not have the authority to approve the marketing for or the regulation of any cannabis products, unless a company makes health claims.
The recall comes after a months-long process in which Pennsylvania officials reviewed medical marijuana vaping products. In November, state regulators gave licensed grower/processors two weeks to resubmit vaporized cannabis products that contain additives, including flavors or terpenes, for approval.
The Philippines is set to approve the most progressive and risk-proportionate vaping legislation in Asia-Pacific.
By VV Staff
There are an estimated 17 million smokers in the Philippines. An estimated 117,000 of them die every year from smoking-related diseases, according to Quit for Good, a nonprofit organization that advocates “real, practical and tangible” solutions to smoking cigarettes. However, next-generation tobacco products, like electronic nicotine-delivery systems (ENDS), which studies have shown can be up to 95 percent safer than combustible cigarettes, have had a challenging path to market in the country.
In November 2019, Philippines President Rodrigo Duterte announced a ban on the use and sale of e-cigarettes. It was a sudden and unexpected decision that was made in part due to the rising number of cases of e-cigarette or vaping use-associated lung injury (EVALI) impacting the U.S.. A 16-year-old Filipino girl was also diagnosed with EVALI after using e-cigarettes for six months, prompting the country’s Department of Health to raise concerns.
“I will ban it,” Duterte declared at the time. “The use and importation. You know why? Because it is toxic, and government has the power to issue measures to protect public health and public interest.”
In February of 2020, Duterte signed an executive order that prohibited the use, sale or purchase of cigarettes or other tobacco products by anyone under the age of 18 or ENDS or their components by a person below 21 years old. Then there were proposals to raise the purchase age to 25 for ENDS and ban all vape flavors other than menthol and tobacco.
The U.S. Centers Disease for Disease Control and Prevention (CDC) then finally admitted publicly that EVALI was caused by black market marijuana vaping products rather than nicotine products. As the news spread, the Philippines began to reconsider its position of less-risky alternatives to cigarettes like vapor and heated-tobacco products (HTPs).
Consumer advocates in the Philippines began to promote the regulation of e-cigarettes as a consumer product. They pointed out that the age one can purchase tobacco, alcohol and get married in the Philippines is 18, so the 21-years-of-age requirement to purchase vaping products was nonsensical. At the same time, they argued that adult smokers keen to quit tobacco need reasonable access to safer alternatives, and restricted advertising should be permitted. Product safety standards were also critically important to the consumer advocates.
Earlier this year, the Philippine House of Representatives proposed the Noncombustible Nicotine-Delivery Systems Regulation Act (House Bill 9007). The bill is a massive legislative achievement for tobacco harm reduction advocates in the Philippines, according to Nancy Loucas, executive coordinator of the Coalition of Asia-Pacific Tobacco Harm Reduction Advocates (CAPHRA), a regional alliance of consumer tobacco harm reduction advocacy organizations.
If the measure becomes law, it will authorize the country’s Department of Trade and Industry, in consultation with its Food and Drug Administration, to set rules, regulations and standards on packaging, ingredients and graphic health warnings on ENDS products. The bill also includes the following provisions:
Only retailers can sell ENDS, electronic non-nicotine-delivery systems (ENNDS) or HTPs. Selling to minors is prohibited. Retailers will have to ask buyers for a valid government-issued ID.
Manufacturers, importers and distributors must comply with certain packaging and health warning requirements.
The use of alternative products will be prohibited in all enclosed public places except in designated vaping areas. Indoor use of the products is prohibited in schools, hospitals, government offices and facilities intended for minors.
The sale or distribution of these products within 100 meters from any point of the perimeter of a school, playground or other facility frequented by minors is prohibited.
Manufacturers are prohibited from sponsoring any sport, concert or cultural or art event.
In May, House Bill 9007 passed the House with 192 of its 300 representatives in favor—with only 34 voting against it and four abstaining. The Senate bill is expected to be voted on in September, although as of Aug. 2, it was still in the Philippines’ Senate trade subcommittee, which is deliberating four separate bills seeking the regulation of vaping products.
Several of the country’s health experts and advocates have asked senators to keep the current law with a purchase age of 21 or raise the age to 25 to purchase or use vape, e-cigarettes and vapor products in order “to curb its harmful effects on minors.”
In a press release, Philippine College of Physicians Executive Director Encarnita Blanco-Limpin stated that under the Republic Act No 11467 (a bill based on Duterte’s executive order), the age of purchase for vaporized nicotine products and heated-tobacco products is 21 years old and that should not change. She added that lowering the access of e-cigarettes from those 21 years old to those 18 years old is a retrospective act.
Clarisse Virgino and Peter Dator – Credit: CAPHRA
“Scientific studies have shown the age of maturation actually occurs at the age of 25 years. Now, if we are thinking of changing the minimum age of purchase, maybe what we should do is even increase it to 25 years,” she said. “To be consistent, since all of these [are] addictive substances, maybe it is wise to consider that we put the minimum age of purchase for all the vaporized products, heated-tobacco products, all the regular tobacco products and even alcohol at the age of 21, or even perhaps at the age of 25, so that we will be able to prevent our young from taking up [this] addiction at an earlier age.”
Peter Dator, president of consumer group Vapers PH and a CAPHRA member, hopes the Senate will pass the legislation, and he is confident a clear majority of senators realize just how much is at stake.
“This needs to get passed to ensure millions of Filipino smokers continue to have access to safer nicotine products. At the same time, existing vapers must maintain access to their product of choice to keep them from going back to cigarettes,” he says. “We would like to thank our congressmen for looking at scientific evidence in coming up with a bill that would provide Filipino adult smokers a choice to switch to less harmful alternatives to combustible cigarettes.”
The Philippine representative of CAPHRA, Clarisse Virgino, is also hopeful the Senate will give its approval, which is required to enact the legislation. She says the legislation will legitimize the fact that tobacco harm reduction is “a real thing backed by science,” adding that international evidence continues to put vaping at 95 percent less harmful than smoking.
“It’s vital this legislation gets Senate approval. It will give consumers better protection, enabling them to choose genuine THR products at a reasonable price. Fair regulation will also eradicate any black markets or any sellers who are not authorized to sell THR products, prioritizing the safety of consumers,” she says. “I am confident that like our House representatives, our senators have listened. Without doubt, vaping has proved to be [the] world’s most effective smoking cessation tool. Legitimizing it will go a long way to helping many more Filipino smokers quit cigarettes and protect the rights of consumers to access safer alternatives.”
Loucas says the Philippines’ goal of adopting best practice tobacco harm reduction policies will hopefully be emulated by other Asia-Pacific governments. She says that many of the region’s territories suffer from desperately high smoking rates, and in some countries, such as Thailand, vaping remains illegal.
“This move will only strengthen the Philippines’ independence as it shakes off any remaining vestiges of foreign influence on its public health policies. In recent years, we’ve seen American billionaires and their so-called philanthropic foundations fueling anti-vaping sentiment around the world. It’s well established that the Philippines has been a target,” she said. “As this landmark legislation nears its final hurdle, outside pressure will again pile on, but senators can be confident their positive action will undoubtedly save thousands of Filipino lives.”
According to 6W Research, vaping products are growing in popularity in the Philippines and are “anticipated to witness profound market growth” throughout the forecast period of 2020–2026. The group is predicting a compound annual growth rate of 26 percent.
In April of this year, YOOZ, a major Chinese e-cigarette brand, opened its first store in the Philippines. There are now 31 YOOZ stores nationwide. Willy Lim, a YOOZ franchise owner in Manila, said YOOZ stores in the Philippines have seen a surge in sales, according to a press release. “I am very happy to have made the right decision to join YOOZ,” Lim said. “With such a trustworthy partner, I am very confident in the future of this industry.”
Some victims of the mysterious vaping-related lung disease that swept through all 50 U.S. states in 2019 were actually Covid-19 patients, according to a group of Chinese scientists and radiologists. After reviewing some 250 chest CT scans from published papers, the group says they are confident in the conclusion that some patients were wrongly diagnosed with e-cigarette or vaping use-associated lung injury (EVALI).
Credit: Kawee
The scientists are now urging U.S. officials to start screening for Covid-19 in patients who in 2019 were diagnosed with EVALI. . According to the Global Times, sources close to the matter said that after studying 250 chest CT scans of 142 EVALI patients selected from some 60 related studies that have been published, the scientists found that 16 EVALI patients were involved in viral infections, which indicates that they could have had Covid-19. Five of the cases were determined as “moderately suspicious.”
The 16 EVALI patients were all from the U.S., and in 12 patients symptoms started before 2020. Researchers concluded that there were viral infection cases among EVALI infections reported in the U.S. in 2019, and the possibility of Covid-19 in the vaping-related lung disease in the U.S. cannot be ruled out, sources said.
Yang Zhanqiu, a virologist at Wuhan University, said that due to the similarity of symptoms between EVALI and Covid-19 patients and since no nucleic acid detection kits were available at the time, it’s highly likely that some Covid-19 patients were actually misdiagnosed as EVALI patients in 2019.
The additive that has been found as the source of THC vaping-related lung injuries and death would be formally banned in Michigan under legislation passed in the Michigan House this week. House lawmakers on Thursday approved a package of bills aimed at prohibiting the sale of tobacco and marijuana vaping products containing vitamin E acetate or other additives not approved by the Food and Drug Administration (FDA).
A processor or provisioning center found in violation of the ban would face a misdemeanor punishable by a fine of up to $10,000, according to M Live.
House Bills 4249 and 4250 passed the chamber with wide bipartisan support. The package now heads to the Senate for further review. The legislation is similar to bills introduced last session that also passed the House, but were never taken up for a vote in the Senate.
During a March 16 Regulatory Reform Committee hearing, one lawmaker said the harmful effects of vitamin E acetate were discovered in 2019 amid an “emergency when young people were dying after vaping.”
“This chemical is actually inserted in the vaping process and the manufacturing process, and there it was discovered that it was extremely dangerous to be inhaled,” they said at the time
The Marijuana Regulatory Agency in November 2019 created testing requirements banning the presence of vitamin E acetate in all marijuana vaping products and halted marijuana vaping sales until they could be tested for the presence of vitamin E acetate. In December 2019, the state recalled thousands of marijuana vaping products that tested positive for the additive.
Vitamin E acetate is safely consumed in food and applied to the skin in cosmetic products. When it comes to vaping, Vitamin E acetate can be used as a filler added to THC vaping cartridges – it’s a cheaper substance that dilutes potency.
The Centers for Disease Control and Prevention pointed to vitamin E acetate as a factor in many of the vaping-related deaths around the country, noting it “may interfere with normal lung functioning” when inhaled through a vaping product.
Misinformation continues to be a challenge for the vaping industry. After the U.S. Centers for Disease Control and Prevention (CDC) announced that vitamin E acetate in black market marijuana vaping products was the cause e-cigarette or vaping product use-associated lung injury (EVALI) more than a year ago, many media outlets continue to falsely blame nicotine vaping products for the lung illness that was first identified in 2019.
Credit: drphil.com
On his Friday episode of the show Dr. Phil, American TV personality Phillip Calvin McGraw, also known as Dr. Phil, wrongly blamed the EVALI lung illness outbreak on vaping nicotine products. Speaking to a guest who stated she only used nicotine vaping products, McGraw said he “was puzzled” by the guest’s understanding that vaping, while not entirely safe, is safer than smoking combustible cigarettes.
“Ventilators, hospitals, deaths … there is lots of news out there on this,” McGraw said. “This isn’t a matter of opinion, it’s a matter of science.” The host then went on to use several news reports wrongly blaming nicotine for EVALI to support his statements. According to Nielsen data, the average daily audience of the Dr. Phil Show is 2.9 million viewers.
Reports of serious illnesses and deaths related to vaping began mounting in summer 2019. By mid-February 2020, the CDC reported more than 2,800 cases of lung injuries requiring hospitalization across all 50 states, and 68 deaths. After nearly six months of falsely claiming nicotine vaping products were the cause of the outbreak, the CDC finally admitted that the cause was illicit THC vaping products and not nicotine vaping products.
By July of 2020, the CDC said that states no longer needed to track lung-related injuries caused by marijuana-based vapor products, partly because cases have dropped. The CDC said it stopped requiring states to report the numbers in February of 2020 after it pinpointed vitamin E acetate as the culprit in THC vaping products that were making people sick, but didn’t make the public announcement until nearly five months later.
McGraw holds a doctorate in clinical psychology, though he ceased renewing his license to practice psychology in 2006, according to Wikipedia. The CDC and U.S. Food and Drug Administration (FDA) now strongly recommend that people avoid use of “e-cigarettes or vaping products containing THC, especially from the illicit market.”
The UK and EU have a different view on e-cigarettes and whether or not combustible tobacco smokers should make the switch. More and more smokers began transitioning over to vapor products after the Public Health England stated that vaping is 95 percent safer than smoking cigarettes. Experts have pointed out that EVALI cases are almost exclusive to the United States and haven’t made a blip on the radar globally. In the UK, there are approx. 3.6 million e-cigarette users with virtually no EVALI cases reported during the media coverage period in 2019 and early 2020.
There were also little to no cases of EVALI in Canada and Mexico, the closest foreign neighbors to the US. “EVALI was largely the result of an unregulated illicit THC vape market in the United States which didn’t follow safe production standards” says Allan Rewak, executive director of Canada-based Vaping Industry Trade Association (VITA) in Nov. of 2020. “Canada’s nicotine vape market was on the final path toward federal regulation at the time, which prevented EVALI from occurring in any significant way north of the border.”
The use of EVALI to spread fear on nicotine vaping in Mexico and in Latin America was particularly crude, dishonest and more intense than in other places, according to Roberto Sussman, senior researcher and lecturer at the National University of Mexico and founder and director of Pro-Vapeo. .
“Up to this day, all officials of the health ministry in Mexico are still blam[ing] nicotine vaping,” says Sussman. “And when you try to engage them, they say, ‘No, no, no. That’s it. Full stop. End of discussion.’ That’s it.” Since EVALI has now been found to be caused by illegal THC vape pens, not nicotine-based e-cigarettes, Sussman says “no one has told Latin America.”
In late 2020, Mexico’s president signed legislation prohibiting the importation, manufacture and distribution of all noncombustible products tobacco (vaping) products, including heat-not-burn products. “Their justification was that we need to protect Mexican youth from EVALI. Given the proximity of the U.S., this epidemic can come to Mexico any time,” says Sussman. “Pure fear-mongering and they’ve refused all debate.”
Brad Jemmett, a former long-time smoker and now general manager for SnowPlus – an innovation based vape company – suggests that the core of what drove the negative media was a localized, US issue.
“Globally, we don’t really see EVALI cases like there were in the US, because EVALI was linked to illicit marijuana vapes, and most specifically the addition of Vitamin E acetate as a thickening agent. Our products on the other hand, are developed and tested to the highest degree, and designed specifically for adult smokers looking to transition out of smoking,” he said. “At SnowPlus, we never have and never will use Vitamin E acetate in any of our products. Through innovation, we’ve aimed to simulate the smoking ritual with vape technology, to provide a less harmful alternative compared to smoking cigarettes.”
Eight Missouri medical marijuana dispensaries, including three in the Kansas City area, started selling THC vape pens and cartridges for the first time last week. Store owners say customers have clamored for them for some time, despite varying opinions on their safety.
Credit: Clear Cannabis
The potential dangers of vaping nicotine and black market THC have been studied. The U.S. Centers for Disease Control and Prevention (CDC) hasn’t updated reports on a lung injury associated with black market THC vaping products since the start of the Covid-19 pandemic, but in February 2020 it reported 2,800 hospitalized cases of EVALI and 68 deaths since August of 2019. The CDC has stated that vitamin E acetate in illegal THC vape pens was to blame for the lung disease.
“Vaping products are “by far our No. 1 request,” Greenlight CEO John Mueller said, according to an article in Newsbreak.
Last week, medical marijuana vape pens were delivered to Greenlight’s dispensaries in Kansas City, Independence and Harrisonville. It’s the first time the products have been available in the state because it took time for cultivators to extract trim material down to a distillate form that could be vaporized.
“It’s an exciting day for the industry,” Mueller said, opening the first box.
A new study shows that teens who vape pot are more likely to wheeze and cough than those who smoke cigarettes or vape nicotine. Appearing in the March 3 Journal of Adolescent Health, the study found that U.S. youth aged 12 to 17 show they have a higher risk of wheezing, suffering from a dry cough and having their sleep, speech or exercise impeded by wheezing if they vape marijuana products.
Credit: Clear Cannabis
The results are from the U.S. federally funded Population Assessment of Tobacco and Health Study. It states that all symptoms are strongly related to lung injury, and it’s unclear how long they will last, said lead researcher Carol Boyd, co-director of the University of Michigan’s Center for the Study of Drugs, Alcohol, Smoking and Health.
“We found, and it was something that surprised us a bit, that it was the lifetime vaping cannabis that was associated with a far greater number of symptoms and a higher likelihood of having each of these symptoms than using either e-cigarettes or cigarettes,” Boyd said. “Lifetime” referred to any past use.
Survey responses from nearly 15,000 teens showed that vaping pot increased their risk of wheezing or whistling in the chest by 81 percent compared with a 15 percent increased risk from cigarettes and a 9 percent increased risk from nicotine e-cigarettes.
Vaping pot also increased teens’ risk of:
Sleep disturbed by wheezing by 71 percent;
Speech limited due to wheezing by 96 percent;
Wheezing during or after exercise by 33 percent; and
Dry coughing at night by 26 percent.
Smoking and nicotine e-cigarette use also increased risks for these indications of lung injury, just not by as much, Boyd said, according to an article on usnews.com.
“I think that industry would probably like to show that vaping e-cigarettes is healthier, that it’s the cannabis vaping causing these respiratory symptoms not the e-cigarettes. This is not true. E-cigarette vaping also causes symptoms among youth,” Boyd said. “However, in our study, and when we took into account their e-cigarette use, we found higher odds of having these respiratory symptoms among youth who had vaped cannabis.”
The survey was taken between December 2016 and January 2018—prior to the wave of lung injuries among young people that occurred in 2019. It was given the name EVALI, or e-cigarette or vaping use-associated lung injury.
Boyd thinks some of these lung problems reported in the survey were probably due to EVALI, which has been linked to pot-laced e-liquids and particularly those containing vitamin E acetate. According to the U.S. Centers for Disease Control and Prevention (CDC), four out of five patients with EVALI had vaped cannabis versus only about 16 percent who said they only vaped nicotine.
The CDC has stated that vitamin E acetate was found in the lung fluid of all patients with EVALI.
Maybe no one specifically asked for it, but when the first e-cigarette hit the shelves of bodegas and corner stores in 2010, this innovative nicotine delivery tool started making waves in smoker groups in urban centres in the US and Asia. For the better part of the following decade, smokers began to open up to this new tech as a possible replacement or pathway to quitting smoking and continued to convert smokers across the globe.
Credit: Elsa Olofsson
That all abruptly changed in August of 2019, when an Illinois man succumbed in hospital to a mysterious lung disease caused by a vaping product — 2,807 more Americans are hospitalized for vape related illnesses following. At the same time, certain industry players drew public ire for using unscrupulous marketing tactics seen as targeting underage users.
Yet instead of covering these two parallel stories in a way that’s in the best interest of public health, it quickly turned into a media firestorm combining both instances into one, spurring a race for headlines often spreading misinformation. Even President Donald Trump rode the media wave saying he would take ‘very, very strong action’ in September of 2019, then backpedaled a few months later.
In the height of the media frenzy, the CDC swiftly mobilized and better understood the lung illness, later named ‘e-cigarette, or vaping product use lung injury’ or EVALI for short. The findings found that vitamin-E acetate, a thickener in THC vape products (which are illegal for sale in the US, by the way) was the culprit. The research led to the potential source of these products, weeding them out to ensure less people get exposed to these black-market products.
Yet the general public was only hearing a generalized perspective of: “vape is bad.”
While governments reactively regulated, credible vape companies already aligned to FDA and EU specifications continued to offer the millions of smokers around the world an alternative to smoking tobacco. Still, the media narrative abandoned the smoker looking for an alternative and focused only on the convoluted story of ‘vape is bad!’
This position though, was not shared globally. The UK and EU experienced steady adoption in the vape category, with more and more smokers transitioning over to what UK Public Health says is 95% safer than smoking. In countries like Germany with more fully-fledged regulatory policies, youth vaping hasn’t appeared to be a problem.
Experts have pointed out that EVALI cases are almost exclusive to the United States and haven’t made a blip on the radar globally. In the UK, there are approx. 3.6 million e-cigarette users with virtually no EVALI cases reported during the media coverage period in 2019.
The EU experience was somewhat similar to what we saw here at home during that period. “EVALI was largely the result of an unregulated illicit THC vape market in the United States which didn’t follow safe production standards” says Allan Rewak, Executive Director of VITA. “Canada’s nicotine vape market was on the final path toward federal regulation at the time, which prevented EVALI from occurring in any significant way north of the border.”
Brad Jemmett, a former long-time smoker and now General Manager for SnowPlus – an innovation based vape company – suggests that the core of what drove the negative media was a localized, US issue. “Globally, we don’t really see EVALI cases like there were in the US, because EVALI was linked to illicit marijuana vapes, and most specifically the addition of Vitamin E acetate as a thickening agent. Our products on the other hand, are developed and tested to the highest degree, and designed specifically for adult smokers looking to transition out of smoking. At SnowPlus, we never have and never will use Vitamin E acetate in any of our products. Through innovation, we’ve aimed to simulate the smoking ritual with vape technology, to provide a less harmful alternative compared to smoking cigarettes”.
Brad, like many of the former smokers out there that have successfully transitioned from smoking to vaping, hope that those who are looking for an alternative to smoking can see a clearer picture now that the dust has settled, and the fake click-bait news headlines about vaping have passed. It may be time for smokers who want to butt out of the habit to reopen the conversation about alternatives that have a track record of working.
A recent study by Yale School of Public Health, “Rates of E-cigarette and Marijuana Use Not Associated With Larger Outbreaks of Vaping-Related Lung Injuries,” found that higher levels of e-cigarette and marijuana use did not result in more cases of e-cigarette or vaping related injuries (EVALI).
In a press release, the Canadian Vaping Association (CVA) stated it agreed with researchers that the study should serve as a warning to anti-vape proponents that restrictive vape regulation such as flavor bans are a danger to public health.
The study found that higher rates of e-cigarette and marijuana use resulted in fewer EVALI cases per capita, whereas areas with restricted access had a greater number of cases. Further demonstrating that as the CVA has expressed a numerous occasions, prohibition does not work.
“If e-cigarette or marijuana use per se drove this outbreak, areas with more engagement in those behaviors should show a higher EVALI prevalence,” said assistant professor Abigail Friedman, the study’s author. “This study finds the opposite result. Alongside geographic clusters of high EVALI prevalence states, these findings are more consistent with locally available e-liquids or additives driving the EVALI outbreak than a widely used, nationally-available product.”
“From the onset of the EVALI outbreak, the CVA was clear that the sudden onset of illness could not be related to regulated e-liquid products. Millions of people globally use vaping to reduce their harm from smoking and yet the cases were sudden and isolated to specific regions.,”said Darryl Tempest, executive director of the CVA. “Once the CDC confirmed the outbreak was caused by vitamin E acetate used in illicit THC products, our organization was explicit with regulators that this must serve as a warning of the dangers of the black-market. Now that research is supporting our position, we encourage regulators to review the data and regulate in the best interest of public health.”
In the release, the CVA states that regulators “must take note – flavor bans and excessive taxation create a breeding ground for unregulated products. These products adhere to no quality control standards or ingredient regulations. Moreover, their sales are not subject to inspection by tobacco enforcement or age restriction. Restrictive legislation not only harms ex-smokers by forcing them back to traditional tobacco, it often props up the black market creating public health hazards.”
