Even as investigations deepened into the harms caused by vaping and e-cigarettes, the Trump Administration confounded those concerned with public health and the environment with rollbacks of legal ways to get vehicles to be cleaner and less polluting and of measures to ensure food safety, notably via changes in inspections of long problematic pork producers.

Voters in the 2020 elections may wish to take note of these and other mounting issues — including proliferating “skimpy” health insurance plans — in which the administration zigs and zags on policies that it promises are intended for the public good, despite considerable evidence to the contrary.

President Trump made public his administration’s decision to revoke federal approval of California setting industry-leading vehicle emission standard even as he fund-raised in the Golden State.

As part of the GOP vision of reducing business regulation, administration officials argued that California has exceeded the exemption it long held to clean up, for example, what once was the legendary and horrific Los Angeles smog. Instead, Trump officials argued that California and the states that supported and adopted its vehicle emission standards had gone too far. By seeking rigorous vehicle efficiency to reduce pollution, the states allegedly were choking the auto industry and making cars and trucks unaffordable. It would be better, the argument goes, to relax standards, see vehicle prices come down — and make it more alluring for consumers to trade in older, more polluting models for new ones.

That view, critics noted, is unsupported by evidence. They noted that the measures led by California had made huge strides in reducing particulate, ozone, and other air pollutants — chiefly emitted by vehicles. This has improved Americans’ health and well-being, and the environment, including by reducing pollutants’ contribution to climate change.

And even as tens of thousands took to the streets in a global, youth-led protest against government inaction around the world on climate change, almost two dozen states and other governments — including the District of Columbia and the cities of Los Angeles and New York — sued the Trump Transportation Department and the Environmental Protection Agency to prevent the rollback of the tough vehicle emission and efficiency standards.

Air pollution, research has shown, is an inarguable contributor to lung, heart, and other health harms. The federal Centers for Disease Control and Prevention (CDC) says that conditions, including emphysema, chronic obstructive pulmonary disease, bronchitis, and asthma, have made lung disorders the No. 4 leading cause of Americans’ deaths each year. By itself, lung cancer is the leading cause of cancer deaths among men and women in this country. The World Health Organization reports that:

“An estimated 4.2 million premature deaths globally are linked to [outdoor] air pollution, mainly from heart disease, stroke, chronic obstructive pulmonary disease, lung cancer, and acute respiratory infections in children. Worldwide [such] air pollution accounts for: 29% of all deaths and disease from lung cancer; 17% of all deaths and disease from acute lower respiratory infection; 24% of all deaths from stroke; 25% of all deaths and disease from ischemic heart disease; [and] 43% of all deaths and disease from chronic obstructive pulmonary disease.”

The area around the nation’s capital, especially as traffic has become nightmarish, battles significant air pollution problems, especially with ozone and particulates.

The vaping mess

With all that is known about respiratory disorders, however, the investigation into the lung harms of vaping and e-cigarettes pressed on, with still no single cause identified for significant damage to the health of more than 500 patients and the deaths now of at least seven users.

The New York Times reported this profile from the CDC of those afflicted: Nearly three-quarters are male, two-thirds between 18 and 34. 16% are 18 or younger. More than half of cases are younger than 25.

Investigators haven’t zeroed in on any single product or substance in the outbreak of lung injuries, with officials finding that those harmed were inhaling both flavors, high amounts of addictive nicotine, and THC, tetrahydrocannabinol, the substance that gives marijuana its high. Suspicion has focused on additives or tainted e-cigarette cartridges that may have contained not only liquids catalyzed or vaped but also injurious to breathe substances like a Vitamin E extract that can be like inhaling grease.

Bootleg and street wares

While the federal Food and Drug Administration has slapped hard at major vaping device vendors, like the industry trend-setter Juul, new attention has focused on street and bootleg products. They abound, with users also getting easy online access. The quality and safety of their wares also is more suspect, with further confusion occurring with vaping of marijuana-related products and whether they are legal and inspected or bootleg. The Associated Press tested several dozen samples of vaping products that purported to provide CBD, a supposedly nonintoxicating and often hemp-derived substance. The AP, instead, found that, “Ten of the 30 [tested samples] contained types of synthetic marijuana — drugs commonly known as K2 or spice that have no known medical benefits — while others had no CBD at all.”

While the Trump administration has said it soon will issue regulations banning vaping’s candy and other flavorings, California, Michigan, and New York have banned or acted against e-cigarettes and vaping flavors. Wal-Mart announced it would sell its existing stocks of e-cigarettes and vaping materials, then would no longer carry the goods. (That’s good, Wal-Mart, but how about those cigarettes and cigars, too?)  Broadcast ads for them will no longer be carried on CNN, CBS, Warner Media (TNT and TBS), and Viacom (MTV, Nickelodeon, and BET).

Still, Kaiser Health News Service reported that vaping persists in its youthful popularity, including with products that let young people camouflage their use with specially designed hoodies, phone cases, backpacks, USB drives, and computer mice. And studies show that vaping and e-cigarette use and abuse by the young continues to spike.

This is not good. In my practice, I see not only the harms that patients suffer while seeking medical services, but also the havoc that can be wreaked on consumers by dangerous and defective products — including, frankly, vaping devices and vehicles that can’t be clean and efficient enough, so they don’t pollute the environment to excess and help to kill us.

Experience shows that an important way to protect the public is to prevent bad treatments, drugs, and products from getting to markets in the first place. This occurs with rigorous oversight, not coddling of big, profit-seeking businesses at the expense of the safety and well-being of patients and consumers.

It’s why it is so concerning that the current administration seems to rely more on industry lobbyists (including as agency heads) rather than evidence, science, and research as a basis for policy. A different, fact-based approach would have led officials against allowing vaping to burgeon as it has. It would back every effort to clean up and keep as pristine as possible our air, water, and other parts of the environment.

It also would ask why the pork industry, whose problems and corner-cutting have been infamous since even before the days of muckraking author Upton Sinclair, should get a worrisome wave on rigorous inspections designed to safeguard public health?

We’ve got a lot to do to protect ourselves and the world around us, and this will include staying as informed as possible and exercising our democratic rights in upcoming elections. They may be among the most important votes in a long time.