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Governor Kate Brown today received recommendations from the Vaping Public Health Work Group to address the epidemic of vaping-related illness and youth vaping in Oregon. According to the Oregon Health Authority, youth e-cigarette use jumped 80 percent between 2017 and 2019.
The work group’s membership includes doctors and experts in pulmonology, pediatrics, and public health, as well as state legislators and state agency representatives. Over the course of the last 8 months, they met to discuss the health risks of vaping and public policy recommendations for long-term solutions.
“In the middle of a worldwide pandemic, it might be easy to forget that less than a year ago, we faced a nationwide epidemic of vaping-related illness,” said Governor Brown. “Now, though, as we are facing the spread of a disease that attacks the respiratory system, it’s even more important that we take steps to protect the health and safety of Oregon’s youth, who have been using vaping products at increasingly high rates.”
“I would like to thank the members of this work group for continuing this important work even as many of them were also on the front lines responding to the COVID-19 pandemic. Based on these recommendations, we can take long-term steps to ensure that we do not see another outbreak of vaping-related illnesses and deaths, as we did last summer.”
Among the health experts on the Vaping Public Health Work Group is Dr. Brian Druker of the OHSU Knight Cancer Institute, a pioneer in the field of precision medicine whose research has helped to revolutionize cancer treatment. Dr. Mary McKenzie, the Director of Pulmonology at Legacy Health, also brought her direct experience working with patients with vaping-related lung injuries to the panel.
The recommendations of the Vaping Public Health Work Group include:
Banning the use of flavored e-cigarettes and other flavored vaping tobacco products
Flavored products disproportionately target Oregon youth, young adults, and communities of color. Banning these products is an evidenced-based approach to prevent Oregonians from becoming addicted at a young age. Flavored products are market-entry products, with 75% of Oregon youth choosing flavored products, compared to only 18% of adults over the age of 25. For decades, the tobacco industry has also targeted people with low incomes and Black, Indigenous, and People of Color (BIPOC) communities with marketing campaigns, leading to harmful health impacts for those communities.
Banning harmful additives, requiring ingredient disclosure for cannabis vaping products, and establishing standards for documentation and verification
Because cannabis is a new industry, additional regulations are needed to ban harmful additives, such as vitamin E acetate, which were strongly linked to the outbreak of vaping-related illness last summer. Many illnesses were linked to products purchased at licensed retailers. Other additives may also be harmful. Ingredient disclosure will help consumers and regulators verify what additives are in cannabis vaping products. In addition, there are not yet established federal or state safety standards for the safety of additives when combusted or vaporized.
Increasing the price of tobacco and nicotine products, including e-cigarettes, through tax and non-tax approaches
As youth have less spending money than adults, they are generally price-sensitive consumers. Raising the price of tobacco products has shown to be the most effective way to reduce youth use, reducing overall tobacco-related health care costs and deaths. In general, for every 10% increase in the price of e-cigarettes, use can drop by as much as 20%, depending on the type of e-cigarette. E-cigarettes and other inhalant delivery systems are not currently taxed in Oregon.
Banning online and phone sales of e-cigarettes and other vaping products
Requiring in-person sales of vaping products will help prevent the sale of vaping products to underage Oregonians. While state and federal law prevent the online sale of cigarettes, there is no federal law prohibiting the sale of e-cigarettes and other inhalant delivery systems.
Tobacco retail licensing
Only eight states, including Oregon, do not have a tobacco retail licensing system. Licensure would create a mechanism to help ensure that tobacco laws can be enforced effectively, including laws prohibiting the sale of vaping products to underage Oregonians. Licensure fees would help to cover the costs of vaping-awareness education and enforcement.
CBD device regulations
The CBD market is one of the fastest-growing sectors of the cannabis industry. Because they do not contain THC, CBD vaping products are not subject to the same regulations as other cannabis vaping products. As such, no regulations currently prevent youth access to these products.
Audit testing of cannabis products
A state lab to conduct audit testing of marijuana products would help to prevent the sale of prohibited substances and verify ingredients and additives. Recognizing that a state lab would be a significant expenditure, the work group recommends that the state utilize private, licensed labs to conduct audit testing in the near term.
Nicotine is a powerfully-addictive drug, and making cessation supports like medications and counseling available through health care providers and insurers, as well as non-clinical, culturally-responsive supports, would remove barriers to patients receiving the help and support they need to quit. Availability of a variety of approaches focused on the needs of the patient provides the best chance of cessation success.
Public relations campaign
Public education efforts have helped to decrease youth smoking and smoking rates generally in the United States, and would also be effective in decreasing youth vaping rates. This would save future health care costs over the long term.