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US to ban flavoured vaping products as lung disease cases surge

US to ban flavoured vaping products as lung disease cases surge

UNITED STATES: US President Donald Trump's administration announced Wednesday (Sept 11) it would soon ban flavored e-cigarette products to stem a rising tide of youth users, following a spike in vaping-linked deaths.


By AFP

Thursday 12 September 2019, 09:36AM


The move could later be extended to an outright prohibition of vaping if adolescents migrate to tobacco flavors, seen as more legitimate products that help smokers quit their habit.

Addressing reporters at the White House, the president said that both he and First Lady Melania Trump were worried as parents of a teenage son about an outbreak of severe lung disease that has killed six people and sickened hundreds.

“We are both reading it,” he said. “A lot of people are reading, people are dying of vaping,” he added, vowing to act.

Trump was accompanied by Ned Sharpless, the acting head of the Food and Drug Administration (FDA) that regulates e-cigarettes and by Health and Human Services Secretary Alex Azar, who responded to a question about the proposed timeline by saying his agency would issue rules in the coming weeks.

Following the release of new guidance, “there will likely be about a 30-day delayed effective date,” said Azar.

“At that point, all flavored e-cigarettes other than tobacco flavor would have to be removed from the market.”

The agency said in a release that non-tobacco flavors were being targeted for their youth appeal, with preliminary data for 2019 showing that more than a quarter of high school students had used e-cigarettes in the past 30 days.

The overwhelming majority reported using fruit, menthol or mint flavors.

While tobacco flavors will initially be exempt, manufacturers will still need to apply for FDA approval by May 2020 to continue to sell their products.

But Azar also tweeted: "If data show kids migrating to tobacco-flavored products, we will do what's necessary to tackle continued youth use of these products."

The news was a major blow to the burgeoning vaping industry, worth $10.2 billion globally in 2018, according to Grand View Research.

Mystery illness

It comes amid growing concern over how more than 450 people who reported recent use of e-cigarettes have fallen ill, with initial symptoms including breathing difficulty and chest pain before some were hospitalised and placed on ventilators.

Several teens across the country have been placed in medically-induced comas, including one whose doctors said he may require a lung transplant if he recovers.

The Centers for Disease Control and Prevention has urged people to cease vaping while a nationwide investigation is underway.

Federal authorities have yet to identify a single substance common to all cases, but New York’s health department is focusing its probe on counterfeit cannabis cartridges containing vitamin E oil, which is harmful when inhaled.

North Carolina medics have reported that patients developed acute lipoid pneumonia, a non-infectious form of the respiratory illness that occurs when oils or fat-containing substances enter the lungs.

‘Illegal’advertising

E-cigarettes have been available in the US since 2006 and were widely considered a safer alternative to traditional smoking, even though experts had warned even before the current wave of illnesses that it may take decades to learn about vaping’s long-term effects.

While e-cigarettes do not contain the estimated 7,000 chemical constituents present in traditional cigarettes, a number of substances have been identified as potentially harmful and the vapor could contain traces of metal, according to a 2018 study prepared for Congress.

It’s also not clear why the US is so far alone in reporting such cases, and whether they are even new, or only being recognised now by doctors after earlier misdiagnoses.

Whatever the case, wider public and political opinion appears to be hardening.

Trump’s announcement received bipartisan support, including from his longtime Republican critic and former presidential candidate Mitt Romney, and several Democrats including Senate whip Dick Durbin, who commended the FDA for “doing its job”.

Billionaire and former New York mayor Michael Bloomberg, who on Tuesday announced a $160 million campaign to ban vaping, said the flavor ban was overdue and should come into effect immediately.

The FDA has become increasingly assertive against the sector over misleading advertising and on Monday accused market-leading e-cigarette maker JUUL of breaking the law, warning it to cease presenting itself as less harmful than smoking.

But shares in Altria, which holds a one-third stake in JUUL, were stable by 4:00 pm (2000 GMT), following the announcement.

FOUR THINGS TO KNOW ABOUT VAPING

The Trump administration has announced it will soon ban flavored e-cigarette products to deter an ever growing number of young users.

It comes amid an outbreak of vaping-linked severe pulmonary disease that has killed six people and sickened hundreds.

Thai Residential

Here are four things to know about vaping.

 

Is it safer than smoking?

The truth is, we don't know.

Unlike tobacco cigarettes, e-cigarettes don't “burn”. The devices, available in the United States since 2006, work instead by heating a liquid that turns into vapor and is inhaled.

Therefore e-cigarette smokers are not exposed to the estimated 7,000 chemical compounds in regular cigarettes, and there is no known link between vaping and cancer.

The liquids however contain highly addictive nicotine.

There are also a variety other compounds classed as “potentially harmful” according to a 2018 study compiled by the US National Academy of Sciences.

And there is “substantial evidence” that the vapor contains traces of metals, either from the coil used to heat the liquid or from other parts of the device. Some flavorings also contain diacetyl, a chemical linked to a serious but relatively rare lung disease.

While most of existing scientific literature holds that vaping is less toxic than smoking, “the implications for long-term effects on morbidity and mortality are not yet clear” and would require decades of more data and studies to know for certain, said the NAS report.

But the bulk of this research was carried out before the current outbreak of severe lung disease in the United States, with more than 450 cases currently under investigation.

The US investigation

The patients’ initial symptoms included breathing difficulty and chest pain before some were hospitalised and placed on ventilators.

Several teens were placed in medically-induced comas, including one who may need a lung transplant if he recovers, according to his doctors.

New York’s health department is focusing its probe on counterfeit cannabis cartridges containing vitamin E oil, which is harmful when inhaled. Federal authorities however have yet to identify a single substance common to all cases.

Some medics have reported seeing patients developed acute lipoid pneumonia, a non-infectious form of respiratory ailment that occurs when oils or fat-containing substances enter the lungs, a potential clue for what is driving the illness.

That said, it’s unclear why these cases have only been reported in the United States, and whether they are even new, or only being recognized after earlier misdiagnoses.

Local authorities acting

In June, San Francisco became the first US city to ban the sale and manufacture of electronic cigarettes, and has since been followed by Richmond, Virginia.

Market leading maker JUUL’s response to the San Francisco ban was that it would “drive former adult smokers who successfully switched to vapor products back to deadly cigarettes”.

That claim is true, according to a study in the New England Journal of Medicine on 886 patients in Britain’s National Health Service published in February.

The one-year abstinence rate among e-cigarette users was 18%, compared to 9.9% among a group who used other nicotine replacement products like gum or patches.

But the conversions are not all in one direction.

Recent studies have found that, among adolescents, e-cigarettes provide a gateway toward full-fledged smoking.

Regulation or prohibition?

The vaping industry is adamant that it doesn't want underage people using its products, and says that more must be done to prevent their sale. E-cigarettes are already illegal to sell in the US to people under 18 or 21, depending on the state.

But bans also deprive adults addicted to smoking of a valuable tool to quit, the industry says.

“To deprive those smokers from access to e-cigarettes, which we know are substantially less harmful, I think is a terrible decision,” Neil McKeganey, of the UK-based Center for Substance Use Research – which is partly funded by the industry – told AFP.

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