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Op-Ed: Yale study on lung disease forecasts dire consequences for flavor bans

A new study from Yale School of Public Health should serve as a warning to e-cigarette opponents and public health officials pushing e-cigarette flavor bans and restrictions around the country. The Yale research revealed that higher levels of e-cigarette and marijuana use did not result in higher rates of e-cigarette or vaping-related lung injuries (EVALI). EVALI made headlines during 2019 and was responsible for at least 2,800 hospitalizations and 68 deaths.

In fact, the study found that more vaping and marijuana use are associated with few cases of EVALI per capita. Restrictions on e-cigarette products and consequently less use led to higher incidence of lung illness.

“If e-cigarette or marijuana use per se drove this outbreak, areas with more engagement in those behaviors should show a higher EVALI prevalence,” said Assistant Professor Abigail Friedman, the study’s author. “This study finds the opposite result. Alongside geographic clusters of high EVALI prevalence states, these findings are more consistent with locally available e-liquids or additives driving the EVALI outbreak than a widely used, nationally-available product.”

Following sensational news reports of the once mysterious respiratory affliction, e-cigarette use and vaping were demonized and blamed. Anti-vape advocates and politicians began a national crusade to ban flavors and restrict e-cigarette sales claiming regulation and prohibition would limit the risk of lung illness.

The Truth Initiative, an organization that claims to “inspire tobacco-free lives” brags that “By the end of 2019, 274 localities placed restrictions on flavored tobacco products, and, of those, 88 have comprehensive bans on menthol products, which are sometimes exempted from flavor policies.”

However, Friedman writes, “the study suggests that those policies may have targeted the wrong behavior.”

Areas that forced consumers into the black market either because the products were restricted or simply illegal saw greater incidence of EVALI almost certainly because black market products have no traditional methods of quality control.

I recently explained, “Black market items undergo no quality control and they are created with an intent to maximize profit by using cheap, readily available ingredients obtained from unknown sources. They are created in conditions that do not meet standard sanitary lab conditions, increasing the likelihood their product will be contaminated. Flavor users will have no idea what is in these black-market products and we could very well see another wave of lung injury and deaths as people turn to the streets to buy their flavored e-cigarette cartridges.”

And this is precisely what the CDC and FDA found when they investigated the lung illness outbreaks. “Laboratory data show that vitamin E acetate, an additive in some THC-containing e-cigarette, or vaping, products, is strongly linked to the EVALI outbreak,” states the CDC on it’s website. Vitamin E acetate is not found in legal e-cigarette products, it’s a cheap way to cut the contents of illegal vape cartridges to increase profit margins.

The recent Yale findings are consistent with the CDC research: locally brewed, unregulated products increase the risk of EVALI. This does not bode well for the e-cigarettes and flavor ban crusaders. By pushing people into the black market for flavored products, they are increasing the risk that we will see another wave of consumers sickened by unregulated, illegal goods. Many of these folks are simply trying to stay away from toxic combustible tobacco products but public health advocacy groups, anti-vape advocates and nanny state politicians are pushing them in a dangerous direction.

By Elizabeth Sheld
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Reposted with permission

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