E-cigarette users urged to quit amid deadly illness rise
Juul marketing questioned
Alarm over the potentially harmful effects of e-cigarettes grew Tuesday as Kansas reported its first vaping-related death and Alabama and Delaware reported a total of eight new cases of vaping-related respiratory illnesses.
The number is ticking up as the Food and Drug Administration accuses Juul, a leading e-cigarette maker, of illegally marketing its merchandise as “unauthorized modified risk tobacco products.” The FDA also is requesting information about the company’s marketing practices, particularly those targeting students, tribes, health insurers and employers.
A Juul Labs spokesman told The Washington Times on Tuesday that the company is reviewing the FDA’s warning
letters and will fully cooperate. The Federal Trade Commission also is reportedly investigating the e-cigarette maker’s marketing practices.
Meanwhile, public health officials across the country are urging people to stop vaping, and Michigan has become the first state to ban the sale of flavored e-cigarette products.
Kansas health officials on Tuesday confirmed the state’s first death linked to a vaping-related lung illness. Similar deaths have been reported in Minnesota, Indiana, Oregon, Illinois and Los Angeles.
In addition, Delaware reported three new cases and Alabama five. They joined the increasing number of states with instances of severe lung injuries linked to e-cigarettes, with more than 450 suspected cases nationwide.
Amid the rapid increase in vapingrelated lung injuries, health officials are investigating what is causing the illnesses. New York health officials are turning their attention to vitamin E acetate, a common additive for skin creams and dietary supplements that has been found in cannabis-containing products.
Federal health agencies say they have not pinpointed a cause and are looking into a variety of substances including nicotine, cannabinoids such as THC, opioids, pesticides and poisons.
More state officials are taking action against flavored e-cigarettes. New York Gov. Andrew Cuomo said Monday that he was advancing legislation to ban flavored e-cigarettes, following Michigan’s move last week.
“Common sense says if you do not know what you are smoking, don’t smoke it, and right now we don’t know what you are smoking in a lot of these vaping substances,” said Mr. Cuomo, a Democrat.
Mr. Cuomo said he has ordered the state health department to issue emergency regulations mandating that vape and tobacco shops post warning signs to address the increasing number of respiratory illnesses and the e-cigarette youth epidemic.
Vince Willmore, a spokesman for the Campaign for Tobacco-Free Kids, said Juul helped hook youths on e-cigarettes by combining high-tech designs and sweet flavors such as mint and mango with a nicotine-salt formulation or saltbased nicotine e-liquids.
Last year, 3.6 million middle and high school students across the country used e-cigarettes, up 1.5 million from the previous year, the FDA reported.
Tony Abboud, executive director of the Vapor Technology Association, has said science demonstrates that flavors are not the reason youths illegally use vaping products but shows that flavors play a “critical role” in helping adult smokers quit traditional cigarettes.
E-cigarettes entered the Chinese marketplace in 2003 and were patented internationally in 2007, according to the American Heart Association.
The U.S. began importing the products in 2008, said Erika Sward, national vice president for advocacy for the American Lung Association.
The first vaping product to enter the U.S. market was a Ruyan e-cigarette imported by Mark Weiss, founder of ecigarette company NJOY.
The product received little attention until the FDA tried to ban its importation in 2009, said Gregory Conley, president of the American Vaping Association.
That year, the FDA denied the import of electronic cigarettes into the U.S. from a couple of manufacturers because the products were not approved as drug delivery devices intended to help treat withdrawal symptoms of nicotine addiction, according to the Public Health Law Center.
The manufacturers, Smoking Everywhere and NJOY, filed a federal lawsuit stating that e-cigarettes are not intended to treat withdrawal symptoms of nicotine addiction but for smoking enjoyment similar to traditional cigarettes. The two companies sought an injunction to stop the FDA from blocking imports of the products until a court ruled on the case.
The court granted a motion for a preliminary injunction in 2010 and found that e-cigarettes are intended to encourage rather than prevent or mitigate nicotine use. Under the court ruling, e-cigarettes could be regulated as tobacco products and not as drug delivery devices unless they are marketed with a therapeutic purpose such as cessation.
E-cigarettes have been under the Tobacco Control Act since August 2016, the FDA said.
No authorized e-cigarette products are on the market.
The American Vaping Association estimates that more than 500 manufacturers or importers are registered with the FDA but believes 8,000 to 10,000 vaping or tobacco shops feature e-cigarette products.
Under the Tobacco Control Act, ecigarette makers are supposed to submit product applications to the FDA for approval to stay on the market. However, the FDA tried to delay the review process until 2021 and 2022, prompting outcry from advocacy groups such as the American Lung Association and the Campaign for Tobacco-Free Kids.
Ms. Sward of the American Lung Association said inhaling chemicals is not safe. She said it is troubling that the products have gone unregulated for so long and that the FDA’s delay of the review process has partially contributed to the youth epidemic.
E-cigarette makers now have to submit premarket product applications to the FDA by May 2020, the result of a federal lawsuit filed by advocacy groups against the federal agency last year.
The vaping industry is fighting back and suing the FDA for its “grossly accelerated” timeline for e-cigarette makers to submit premarket product applications.
E-cigarettes are battery-powered devices that have cartridges or refillable tanks containing liquid mixtures that may contain nicotine in combination with propylene glycol, vegetable glycerin, flavoring and other chemicals such as acetaldehyde, which is also found in cigarette smoke.
E-cigarettes have been linked to severe lung injuries, some resulting in death. Public health officials across the country are investigating and urging people to stop vaping. Michigan has become the first state to ban the sale of flavored e-cigarette products.