Wednesday, September 11, 2019


Recently, there have been a number of severe respiratory illnesses that have been linked to e-cigarette use; some 450 cases thus far with 6 reported deaths. On the heels of this, even the President is acting, having announced a planned nationwide ban on the devices. When i first heard of the illnesses, I was curious. Vaping isn't new; the devices have been around for a decade and a half now, and it seems odd that if the practice itself were that dangerous, that we'd just now be seeing serious health impacts.

When I was listening to the radio yesterday, the story came up; the question being if Washington should follow Michigan's lead in instituting it's own ban on flavored e-cigarettes. (Of course, the nationwide ban proposed by the Food and Drug Administration would preempt this.) During the story, vitamin E acetate and THC additives were brought up; according to Washington Department of Health office Kathy Lofy, "only a small minority of these patients have reported using nicotine-only products" and that this "suggests that the THC products may be causing this illness." "But," she continued, "I think it's really too early to draw any conclusive, to make any conclusive statements."

USA Today makes a similar point, noting "Some state health department and news reports suggest many of the cases of lung problems involve tetrahydrocannabinol, known as THC, the chemical in marijuana that causes psychological effects." They then go on to state that "Boston University public health professor Michael Siegel said the Centers for Disease Control and Prevention is being 'unnecessarily vague' about describing the injuries as simply vaping-related when many people might have been injured by vaping THC oil." Indeed the title of the article is "People are vaping THC. Lung injuries being reported nationwide. Why is the CDC staying quiet?"

I don't smoke or use e-cigarettes myself, so I don't really have a dog in this fight, but it does seem to me that the general disagreement with e-cigarette use in the overall public-health community is at work here. It strikes me as unusual that the CDC would make a broad statement, when the evidence appears to point to a narrower cause. I think I understand, however. I suspect that if certain people in the public-health field had their way, nicotine would simply be banned outright, and the overall problems with maintaining these sorts of prohibitions be damned. And a ban would at least be more honest and straightforward than the maze of regulations and restrictions that governments seem fond of erecting to drive people away from the practice of smoking.

To the degree that implying that e-cigarette use broadly is dangerous comes across is deceptive, it weakens people's trust in these sorts of institutions. Granted, state health officer Lofy was fairly straightforward about the THC link when asked about it. But this sort of paternalism in the public-health community generally creates suspicions like those that my father expressed to me when I was younger; that the truth can't be allowed to stand in the way of a useful call to action. Now, as then, I believe that part of the problem is with the public, which is has proven disinclined to mobilize against e-cigarettes in the way they have against conventional tobacco smoking. But is that really a problem? I'm not sure that it is, and if it isn't, attempting to convince the public that there's a crisis afoot may not be called for, and public health officials risk their credibility when perhaps they shouldn't.

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