Public Health Recommendations in Light of Severe Lung Illness Linked to Vaping

COLORADO REGULATORS DRAFT BAN ON ADDITIVES IN CANNABIS VAPE PRODUCTS

Since early August a multistate outbreak of lung illness associated with e-cigarette products that, as of October 22, 2019, has sickened 1,479 people and resulted in 33 deaths. The Centers for Disease Control and Prevention (CDC), the U.S. Food and Drug Administration (FDA), state and local public health agencies, and other health partners have been investigating the cause of this illness.

E-cigarettes, also called vapes, vape pens, electronic nicotine delivery systems, and vaping, work by heating liquid to produce an aerosol that users inhale into their lungs. The liquid can contain many substances including nicotine, tetrahydrocannabinol (THC), cannabinoid (CBD) oils, and other additives.

Regulators with the Marijuana Enforcement Division (MED), a division of the Colorado Department of Revenue, are finalizing a ban on certain additives in cannabis vape products. In its natural form, THC oil is too thick to be vaporized, the ban would include three ingredients commonly used in products intended for inhalation including:

  • Polyethylene glycol (PEG);
  • Vitamin E Acetate; and
  • Medium Chain Triglycerides (MCT Oil).

The proposed rule change would also include additional labeling requirements for concentrates or products intended to be inhaled through a vaporizer or metered-dose inhaler, including a requirement that the product has a label that states, “Not approved by the FDA”.

The rules have been proposed, the state licensing authority will ultimately decide if the measure moves forward. If approved, the ban could be in effect as early as January 1, 2020.

What We Know

  • According to the Centers for Disease Control and Prevention (CDC), the substances being used in the vape products vary:
    • Most patients have reported using e-cigarette products containing THC, this is the psychoactive element of cannabis.
    • Many have reported using THC and nicotine.
    • Some have reported vaping with products only containing nicotine.
  • In Colorado, there are nine outbreak-associated cases, all in front range communities. Seven of those individuals were hospitalized*.
  • Colorado has the highest vaping rates in the nation among teens.
  • A special report from Mesa County Public Health revealed nearly half (48.7%) of high school students in Mesa County say they have tried a nicotine-containing vape product.

What We Don’t Know

  • The specific chemical exposure(s) causing the lung injuries associated with vaping is still unknown.
  • No specific e-cigarette or vaping product (pod, refill, device, or cartridge) linked to all cases has been identified.
  • The long-term health effects of vaping are still unknown, however, we do know that vaping products contain more than just harmless water vapor.

Public Health Recommendations

  • Use FDA-approved cessation products to quit all tobacco use, including vaping.
  • Be a trusted adult for a teen or young person in your life–have conversations with them about vaping and the dangers of tobacco and other substance use.
  • Share cessation resources with youth and adults currently using e-cigarettes.
  • Do not buy vape products off the street and do not use them in any way not intended by the manufacturer, including modification of any kind.

*Data from Colorado Department of Public Health and Envoirnment as of 10/22/1019

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