Gov. Jay Inslee announced a new executive order today that asks the Department of Health (DOH) to ban all flavored vaporizers in the state after a rash of vape-related illnesses have spread across the country.
"[The executive order] will ask the state board of health to adopt emergency rules to ban all flavored vapor products, including flavored THC products," Inslee said. "We expect the board to take up this request at their next meeting on Oct. 9."
John Weissman, the secretary of DOH, said they did not yet have a definition for what would be included in "flavorings."
Electronic cigarette shop owners said the new rule would be disastrous to their businesses.
Inslee’s executive order comes as a vape-related health crisis spreads across the country with 805 confirmed cases and 13 deaths connected to vaping, according to the Centers for Disease Control (CDC). The Washington Department of Health (DOH) has confirmed seven cases but no deaths in Washington state.
The CDC, the Food and Drug Administration (FDA), and numerous state health departments are mounting a massive effort to find out what is causing the mysterious lung illnesses, which has symptoms including shortness of breath and nausea. No single product or additive has been connected to the illnesses, but health experts are confident that vaping is the cause.
Inlsee was joined by nearly a dozen other state and local officials at the press conference, including King County Executive Dow Constantine and Attorney General Bob Ferguson. Constantine said youth vaping use in the county was at "epidemic levels" and that the two local illnesses may be "just the tip of the iceberg" with more local injuries to come.
The spread of the mysterious lung illness has brought new urgency for health officials to confront the rise of teen vaping, which has been a known problem across the country for at least five years. However ending teen use isn't necessarily connected to ending the mysterious lung illness. Health experts are also grappling with what the long-term effects of vaping are, which are currently unknown.
Inslee is following the lead of multiple of other state and local governments who have either banned flavorings or outright banned the vaporizers. San Francisco banned all e-cigarette sales in June. Massachusetts announced a four-month ban on all e-cigarettes this week. And Michigan announced a ban on all flavored e-cigarettes starting in October.
These bans come as more evidence comes out that black market pot vaporizers are causing many of the lung illnesses and no apparent connection between illnesses and flavorings has been established. Inslee admitted during today's press conference that there is no known connection between flavoring agents and the illnesses, but he said banning flavoring agents would still "save lives."
"We don’t have evidence at the moment that the flavoring chemistry itself is the reason for the disease. But it is the reason for the disease in the first place because it is hooking our kids on the product in the first place," Inslee said.
Teen use and the mysterious vape illness both appear to be public heath crises created in some part by past government inaction. Federal authorities have known about electronic cigarettes for over 12 years, yet authorities took a hands-off approach instead of regulating what goes into the products and how they are marketed. That isn't the case in the United Kingdom, where e-cigarettes are tightly regulated, nicotine limits are put in place, and e-cigarette advertising is limited. The U.K. has not yet reported any vaping-related illnesses.
Vape business are not happy
Inslee was interrupted multiple times during Friday’s press conference by angry vape shop owners who say his flavored ban will all but destroy their livelihoods. Justin Edwards, who owns a vape shop in Puyallup, said after the press conference that without being able to sell flavored vape juice he won’t have many customers left.
“It’s going to end my business,” Edwards told The Stranger. “If they ban the flavors, realistically, there’s nothing more. It’s crazy.”
Edwards said he sells only about “one or two” bottles of tobacco-flavored e-juices a month but sells “hundreds” of their flavored counterparts. His business sells bottles of the vape fluid which customers then load into their own personal vaporizing batteries. The popular Juul e-cigarette devices are instead self-contained cartridges that are pre-filled with the e-juice.
Edwards said the flavored juices are very popular with adults, including his own family.
“My mother is all about the different berry flavors,” Edwards said. “My aunt, who quit smoking after 15 years, she’s all on the berry flavors.”
Edwards said all of his products include warning labels that list all ingredients in the vape juice. He said he did not sell any products with diacetyl or vitamin e acetate, two additives that have been considered possible culprits for the mysterious vape-related lung illness.
Edwards said that despite the ban, he has no plans to shut down his store.
“I’m not going to shut down until I can’t possibly do anything else,” Edwards said. “I’m not shutting down till they make me shut down.”
"Extremely frustrated" with the investigation’s pace
Inslee’s executive order may seem decisive but Friday’s press conference did not bring any more clarity to what it is getting people sick. Anne Schuchat, the principal deputy director of the CDC, made it clear in congressional testimony this week that she is troubled by the federal government’s inability to find a specific culprit for the disease.
“I would just say I am extremely frustrated with the pace of our investigation. I wish we had answers already," Schuchat said on Wednesday. “I think there may be a very complex set of root causes here that may be difficult for us to address as a nation.”
Schuchat said the CDC has more than 100 people working on the investigation, in addition to personnel at the FDA and numerous state agencies investigating the outbreak. Norman Sharpless, the acting commissioner of the FDA, said in the same congressional testimony that the FDA has received over 300 vape samples believed to have caused the illness and have completed tests on half of them.
Sharpless said a significant portion of the vaporizers contain THC and many of those tested positive for vitamin E acetate, a skin product he described as an “oily goo” that may be harmful if inhaled.
“A significant fraction of the THC products, like maybe half of them are contaminated with vitamin E acetate... which is a skin oil that has no business being in a pulmonary product and we believe is added as a cutting agent,” Sharpless said.
The pot news site Leafly has thoroughly documented the rise of vitamin E acetate in pot vaporizers. NBC news paid for tests on 18 THC vape cartridges this week and found troubling results. The three legally-purchased vaporizer cartridges did not have any heavy metals, pesticides, or vitamin E while 13 out of the 15 black market cartridges contained vitamin E. NBC paid for pesticide tests on ten of the black market cartridges and all ten tested positive for pesticides.
Sharpless clarified that while vitamin E acetate has been found in many vaporizers, it has not been documented in every single vaporizer believed to have gotten people sick.
“I should be clear that [vitamin E acetate] is only present in half of the THC products,” Sharpless said. “We have a lot of cases that are not associated with vitamin E acetate. We don’t know if it causes something or if it is just a marker for adulteration. Or a marker for a bad product.”
Schuchat said the black market nature of many of the products is making it extremely difficult to identify the exact cause of the illness.
“I think if there’s a set of supply chains that are completely underground that are adultering products in ways that are just experimental,” Schuchat said.
At one point during Friday’s press conference security was called for some unruly vape shop owners and Inslee had to raise his voice over angry shouts from the crowd.
“How will you stop the black market dealers from selling flavorings?” one person yelled.