UPDATED: What you need to know about vaping

UPDATE: On November 27, 2019, Governor Baker signed legislation titled “An Act Modernizing Tobacco Control.” This legislation is not designed to be a total ban of all products but will only allow the sale of flavored vaping products “to licensed smoking bars where they may only be smoked on-site." This includes menthol flavors and smokeless tobacco. The law will also add a 75% excise tax on all e-cigarette products in an attempt to make them less affordable for young people. In light of this new legislation, Governor Baker decided that the temporary ban will end on December 11, 2019. This new legislation is set to begin June 1, 2020.

In addition, the FDA has come up with some recommendations listed below:

• Do not use vaping and e-cigarette products containing THC.
• Since the investigation is ongoing the FDA asks that everyone refrain form vaping and e-cigarette use until the investigation is concluded.
• Do not return to using combustible tobacco use. No tobacco product is safe.
  

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Gov. Charlie Baker of Massachusetts imposed a temporary ban on the sale of all vaping products in September of this year following several nationwide cases of lung illness — and 42 deaths — related to  vaping. Massachusetts was the first state to halt sales of vaping products of all kinds. While the ban is slated to end on January 25, a bill to impose a new 75% excise tax on nicotine vaping products and ban the sale of all flavored tobacco products is making its way through the Massachusetts legislature. The House and Senate just approved this bill, and there only remains the approval of a joint House and Senate session and a signature by Gov. Baker to make the bill a law. Gov. Baker has a history of approving anti-smoking and anti-vaping legislation, so the likelihood of this bill becoming law is high.

Vaping is a fairly new phenomenon, quickly becoming a hot-button issue over the past few years. You and your patients may be asking: Why is vaping such a pressing issue, and how does it really affect one’s health?

Health risks of vaping

When vaping first became popular, there was limited information about the harm it could cause. But recently many organizations are beginning to speak out about the dangers of vaping, especially to the lungs. In fact, the CDC considers the U.S. to be in the midst of an outbreak of lung injury associated with vaping and e-cigarettes. The main concern appears to be vitamin E acetate, a chemical likely used as a thickening agent in THC-containing vaping products. The CDC tested fluid from the lungs of 29 individuals with e-cigarette or vaping-associated lung injury from 10 states. All 29 samples were found to contain vitamin E acetate, as opposed to 82% of samples containing THC and 62% containing nicotine. Although vitamin E acetate is not dangerous when ingested or used on the skin, there is evidence that inhaling the chemical can interfere with normal lung function. The CDC recommends that people completely avoid e-cigarettes and vaping products.

Another cause for concern is the chemical diacetyl, a flavoring compound used in 75% of flavored e-cigarettes and refill liquids. Formerly used to flavor microwave popcorn, diacetyl is proven to cause bronchiolitis obliterans. This disease, nicknamed "popcorn lung," causes scarring of the lung’s alveoli, which results in dry cough and shortness of breath, and, in some cases, a flu-like illness. Although treatment is available to address the symptoms and slow the progression of the disease, damage from popcorn lung cannot be reversed. If untreated, it can even be fatal.

So far, vaping has been attributed to 37 deaths and over 2,000 cases of lung injury across the country, including three deaths in Massachusetts.

Can vaping help people quit smoking?

Supporters of vaping often make the claim that vaping can help people quit smoking. However, there is limited evidence of this, and it’s unclear how vaping compares to nicotine patches or other quit methods. The FDA does not approve of vaping as a smoking cessation method, and the CDC reports that smokers who vape tend to use both cigarettes and e-cigarettes. “There is no safe tobacco product,” the CDC states. “All tobacco products, including e-cigarettes, carry a risk.”

If you have patients who are trying to quit smoking, AllWays Health Partners offers the Quit for Life Tobacco Cessation Program. As part of the program, a Certified Tobacco Treatment Specialist (CTTS) can help your patient create a quit plan, discuss treatment options, choose a quit day, deal with cravings, and live with other tobacco users who are not ready to quit. AllWays Health Partners’ pharmacy benefit covers certain over the counter and prescription cessation medications at $0 cost with a prescription.