The Trump Administration kicked off the new year with a whimper not a bang with yet another of its attempts to corral the health nightmare of e-cigarettes and vaping by the nation’s young, while not upsetting the industry too much.
Starting Feb. 1, the federal government announced it will forbid the sale of most flavored cartridges for e-cigarette use, notably those with popular tastes like candy, fruits, and mint.
At the same time, though, vendors still can sell menthol and tobacco flavorings. And they can peddle flavored vaping liquids if they are used in the open tank systems that most often are so big, they are limited to shops or stores.
Critics ripped this half-a-loaf compromise by the president and his minions. That’s because administration officials had talked for months about cracking down on e-cigarettes and their flavorings, particularly after the nation experienced a rash of vaping-related deaths and serious cases of lung damage.
Between June and the year’s end, the federal Centers for Disease Control and Prevention recorded 55 such deaths and 2,562 confirmed lung damage cases serious enough to require hospitalization. They also have found that those with vaping-related lung injuries may require long-term, careful treatment, especially because these patients may be especially subject to relapses.
CDC officials have said they have narrowed their suspicion as to the cause of the vaping harms, blaming Vitamin E acetate — a taint or additive — as a key factor in an increasing number of cases. Experts have said that inhaling the substance is akin to spraying grease on to sensitive lung tissues. Many of the suspect cases have not only involved Vitamin E acetate but also users vaping street or illicit products with tetrahydrocannabinol or THC, the substance that produces marijuana’s high.
The outbreak of vaping deaths and injuries also has occurred while reports have piled up about skyrocketing use of e-cigarettes and vaping by teenagers and young people. This has led to a public scurry to crack down on vaping and device makers, including a ban on sales of tobacco products to those younger than 21.
Experts have targeted flavorings because research suggests they are key to vaping’s popularity with younger users, a generation of whom officials worry have become hooked to highly addictive nicotine by e-cigarettes. Studies also suggest this leads to dual use (both vaping and smoking burning tobacco products), as well as providing a gateway to cigarette abuse.
Tobacco abuse, the target of decades of public health campaigning, has declined, particularly among the young. But smoking cigarettes with burning tobacco, according to rigorous research that cannot be refuted, is implicated in the deaths “each year [of] more than 480,000 people in the United States,” the American Cancer Society reports, adding, “This means each year smoking causes about 1 out of 5 deaths in the U.S. Smoking cigarettes kills more Americans than alcohol, car accidents, HIV, guns, and illegal drugs combined. Cigarette smokers die younger than non-smokers. Smoking shortens male smokers’ lives by about 12 years and female smokers’ lives by about 11 years. Smoking not only causes cancer. It can damage nearly every organ in the body, including the lungs, heart, blood vessels, reproductive organs, mouth, skin, eyes, and bones.”
Menthol cigarettes long have been a target of anti-smoking advocates because they are popular in and cause increased health damage in minority communities. But Big Tobacco long has fought off moves to eliminate flavored cigarettes — and similar power political plays apparently have derailed efforts to ban vaping flavors.
Indeed, a big takeaway in the news reporting on the administration’s latest vaping actions focused on not just health but political concerns: Since the president, apparently with prodding from the First Lady, began to talk about crackdowns on tobacco and vaping, he has been besieged by lobbyists and business people seeking to change his mind.
The president’s aides told him that the clamor had grown so loud that it could affect votes in his reelection, leading Trump to push for a compromise. The devil’s bargain he struck aims to keep vape makers and vendors happy, while also demonstrating administration concerns about kids to try to win votes from suburban women alienated by the president’s coarse behavior and bellicose talk.
Really? In my practice, I see not only the harms that patients suffer while seeking medical services, but also the significant injury that can be inflicted on them and their loved ones by defective and dangerous products, as e-cigarettes arguably have turned out to be. As I’ve said before, it’s an unacceptable argument to me for vaping and e-cigarettes that they are less harmful than burning tobacco products. A chemical, nuclear, or biological “dirty” bomb might kill more people than, say, an assault rifle in the hands of a madman. As a society, we do everything we can to stop both — without talking about “harm reduction.” And we don’t kid ourselves about devices’ dangers: What experts want to step forward and endorse vaping as beneficial to the lungs or users’ health? Don’t hold your breath waiting.
The escalating health menace posed by e-cigarettes and vaping, of course, flowed from bad choices by this administration, with its appointed FDA commissioner (Scott Gottlieb) postponing tough regulation of these problematic devices and practices. Instead, in a nod to Big Tobacco, Gottlieb called for more study of e-cigarettes and the already known harms of nicotine, particularly its addictive powers. As regulators dawdled, Juul rose, exploiting social media and other marketing and advertising options to target the young and to which FDA officials seemed all but blind.
To be fair, the FDA has played endless catch up, cracking down on makers, who, in attempts at self-preservation, have tried to stay ahead of regulators. The maker and vendors have decided themselves to restrict youth sales, to curtail flavors, and other moves.
But, in health terms, Pandora’s box already had been flung open. And it is unclear how officials now can get young people off the vaping craze. To get a sense of how much it has advanced and how it keeps morphing, by the way, do an online search of “tank vaping systems” to see the extensive technology that is part of this practice — and how hard it will be to contain. This will be a persistent problem, of course, if the administration keeps compromising with Big Tobacco and other businesses about Americans’ health. This is yet another significant issue that voters should keep in mind as they go to the polls in November.
