September 16, 2019

The 3 biggest vaping myths we saw last week, busted

Daily Briefing

    Editor's note: This story was updated on Sept. 16.

    News about e-cigarettes and vaping dominated headlines last week.

    Cheat sheets: Evidence-based practice 101

    But as I was scrolling through my Facebook and Twitter feeds over the past few days, I was particularly struck by the amount of misleading and flat-out false information I came across. Many of my virtual friends—mostly those who use e-cigarettes—shared pro-vaping posts containing misinformation about recent cases of a vaping-linked illness and deaths, e-cigarette devices' safety, and the Trump administration's recent move to ban flavored e-cigarettes.

    Let's take a closer look at those claims—and set the record straight.

    Myth #1: Only illicit THC products have been linked to vaping-related illness cases and deaths

    The misinformation that caught my eye most frequently over the past few days came from posts claiming that only illicit tetrahydrocannabinol (THC) has been linked to vaping-related illness cases and deaths. Those same posts inferred that traditional e-cigarette products purchased from vape shops don't carry the risk of developed the illness.

    For instance, one poster shared an article from the Competitive Enterprise Institute with a headline stating, "Lung Disease Outbreak Caused by Black Market, not Vaping." Another article I came across stated, "Nearly all the deaths and lung illnesses reportedly 'linked to vaping' involved people vaping contaminated black-market cannabis (THC) oil purchased from street vendors. No cases have been linked to nicotine vaping."

    Those posts do have some truth to them, but they're also very misleading.

    For one, only one of the six patient deaths (the Minnesota patient) has officially been connected to illicit THC. Oregon health investigators said a patient who died in their state after vaping bought THC oil at two legal marijuana stores, and California officials have not stated whether the THC vaping product used by the deceased patient in their state was legally purchased. In Illinois, Indiana, and Kansas, officials have yet to confirm what type of vaping product—THC, nicotine, or something else—the deceased patients had used.

    It's also important to note that, while most of the 380 patients with confirmed or probable cases of the vaping-linked lung illness have reported using e-cigarettes to vape THC, some patients with the illness have reported vaping only nicotine, according to FDA.

    FDA, which currently is testing samples of products that patients with the illness have used, did find vitamin E acetate in 10 of the 18 THC products it tested. But FDA spokesperson Michael Felberbaum has stressed that "[n]o one substance … has been identified in all of the samples tested," and it still is unclear what could be causing the illness and associated deaths.

    As Boston Magazine's Tessa Tannone writes, "Anyone who uses, or has used, e-cigarettes or vaping devices" is at risk of developing the illness, even if they're vaping only nicotine or legally purchased THC.

    Myth #2: Trump is moving to ban flavored e-cigarettes because of the vaping illness and deaths

    Another myth I've seen come from posts criticizing the Trump administration for its recent announcement that FDA will move to ban most flavored e-cigarettes from the U.S. market. The posts imply that the administration made the announcement as a direct result of rising cases of and deaths from the vaping-linked illness. For example, one twitter user wrote, "#DonaldTrump is going to ban the sale of flavored e-cigarettes after 6 deaths. Smoking cigarettes cause 480K deaths per year, why aren't they being banned??"

    In reality, FDA and the Trump administration for years has been moving to enforce stricter regulations on e-cigarettes and to restrict sales of flavored e-cigarette. This latest announcement is an extension of those efforts, and it doesn't stem from reports of the vaping illness or deaths; it comes from growing concerns about spiking e-cigarette use among U.S. youth.

    Both President Trump and federal officials on Wednesday said the new restrictions are intended to target growing e-cigarette use among youth, which Trump's Surgeon General has called an "epidemic." HHS said the policy announcement comes as preliminary numbers from the National Youth Tobacco Survey show a continued increase in the number of children using e-cigarettes, including more than a quarter of high school students. HHS said the survey data shows that the majority of youth e-cigarettes users said they preferred fruit, menthol, or mint flavors of e-cigarettes.

    Acting FDA Commissioner Ned Sharpless said the new policy "will serve as a powerful tool that the FDA can use to combat the troubling trend of youth e-cigarette use. We must act swiftly against flavored e-cigarette products that are especially attractive to children."

    Myth #3: Federal officials only are targeting e-cigarettes and only flavored products

    The last misperception I've seen related to vaping over the past few days is that federal officials are targeting only e-cigarettes, and particularly flavored e-cigarettes.

    In fact, federal officials late last year announced plans to ban sales of menthol-flavored traditional cigarettes and cigars in the United States. Former FDA Commissioner Scott Gottlieb at the time said, "[M]enthol serves to mask some of the unattractive features of smoking that might otherwise discourage a child from smoking," adding that menthol products "exacerbate troubling disparities in health related to race and socioeconomic status."

    FDA also said it plans to order tobacco companies to remove certain flavored cigars from the market, and separately is developing regulations to completely ban the sales of flavored cigars in the United States.

    Further, Sharpless on Wednesday noted that the agency also could take action to ban tobacco-flavored products if data show continued youth use of such products once flavored tobacco products are taken off the market. "Moreover, if we see a migration to tobacco-flavored products by kids, we will take additional steps to address youth use of these products," he said.

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