Editorial: State, federal responsibility clearer on vaping

By The Herald Editorial Board

There’s more certainty now about what caused an outbreak of pneumonia-like illness for those using e-cigarette and vaping products earlier this year, which sickened more than 2,000 and killed 40 people across the country.

The Centers for Disease Control and Prevention identified vitamin E acetate — a sticky oil-like substance used primarily in cannabis vaping products — as a “very strong culprit” in the health scare, The New York Times reported last week.

The CDC based the report on samples taken from 29 patients from 10 states across the country in which the vitamin additive was found. Vitamin E acetate has been added to vaping solutions used in e-cigarettes to adjust the level of THC, the psychoactive compound in marijuana, and sold legally in states that allow the sale of cannabis products and illegally elsewhere.

Vitamin E, when used as a vitamin supplement or an ingredient in skin lotions is safe, but the acetate, when vaporized and inhaled, clings to lung tissue and can cause extensive damage to lungs, the CDC said.

Because some uncertainty remains about the illness outbreak, the CDC is continuing to urge people to avoid vaping altogether.

During the scare — and before there was a clearer understanding of the cause of the illnesses — temporary bans were enacted federally and by several states, including Washington state, on the use of flavors in vaping products. But even with the CDC’s announcement, vaping enthusiasts likely won’t see those flavor bans lifted anytime soon.

Also last week, a judge in Thurston County ruled against a temporary restraining order that sought to lift the ban on flavored vaping products that had been put in place in October by the state Board of Health, following an executive order by Gov. Jay Inslee. The 120-day ban, which can be renewed, is intended to give the state Legislature time to consider legislation regarding regulation of e-cigarettes and flavored and other vaping products.

As we’ve stated earlier, even though flavored vaping products’ connection to the illnesses was uncertain at the time, there were other health-related reasons to seek at least a temporary ban on those products; specifically how they had been directly marketed to teens and younger children and the alarming increase in vaping among youths that resulted.

Those concerns remain, and the flavor ban in Washington state should remain in place until the Legislature has fully addressed all concerns.

Tighter regulation is needed at state and federal levels regarding identification and review of the ingredients of all vaping products. And because Washington is one of the states that has made cannabis legal for recreational use, the state has the additional responsibility to ensure the safety of vaping products containing THC that are sold in licensed retail cannabis shops.

That’s a responsibility left solely to this state and others because the U.S. Food and Drug Administration is unlikely to take action to regulate what remains — as far as the federal government is concerned — an illegal drug.

Getting the cooperation of e-cigarette and vaping product manufacturers and retailers could be difficult for state and national lawmakers to win, but a recent Bloomberg Opinion commentary — published in Sunday’s Herald — might provide some leverage.

David Kessler, FDA commissioner during the Bush and Clinton administrations, suggests e-cigarettes and vaping products could be more effectively kept out of the hands of underage users by restricting their sales to pharmacies only, similar to how the popular decongestant Sudafed is now handled. After Sudafed’s illicit use to manufacture methamphetamine arose, federal law was changed to keep it as a nonprescription medication but put it behind pharmacists’ counters to limit access.

The same can be done, Kessler said, with vaping products, allowing better control of who vaping products are sold to and still providing e-cigarettes to the adults who use them as an alternative to smoking.

In their early years of availability, e-cigarettes and vaping products were touted as a “safer” alternative to smoking that didn’t carry with it cigarettes’ threats of cancer, emphysema and other heart and lung diseases.

That perception of safety — partnered with the marketing to youths by using fruit and candy flavors — provided vaping the cover it needed to reach epidemic numbers among youths.

If e-cigarettes are going to remain as a legitimate alternative to smoking or an option for smoking cessation, state and federal regulators and lawmakers need to do more to assure that “safety” and require it from manufacturers, distributors and retailers.