Wednesday, January 15, 2020

Vaping (Marijuana) and Lung Disease: Tale of Two State Health Departments


A few days ago, vaping-related deaths in two states were publicized by their respective state health agencies.  The announcements reflect a stark difference in tone and accuracy.


MICHIGAN


“The Michigan Department of Health and Human Services (MDHHS) [announced] the third death associated with the outbreak of vaping-related lung injuries in the state” on January 10.  Dr. Joneigh Khaldun, MDHHS Chief Medical Executive and Chief Deputy for Health, said “We extend our deepest condolences to the family. I urge people not to use THC-containing e-cigarettes or vaping products until the specific cause of these vaping-related severe lung injuries being reported nationwide has been identified.”  (emphasis added)

MDHHS recommendations start with the following: “People should not use THC-containing e-cigarette or vaping products, particularly from informal sources such as friends, family or in-person or online sellers.” (emphasis added)  The agency says people should avoid vitamin E acetate and “should not add any other substances not intended by the manufacturer to products… Adults using e-cigarettes or vaping products as an alternative to cigarettes should not go back to smoking.”

This is an example of a public health agency providing useful information to marijuana and tobacco users: Don’t vape THC products that are not from legitimate retailers.  Don’t stop vaping legitimate nicotine products and return to smoking.

 


KENTUCKY



On the same day, the Kentucky Department for Public Health “announced the state’s first probable fatality related to vaping.”  Eric Friedlander, acting Secretary of the Cabinet of Health and Family Services, said, “To protect public health, we urge Kentuckians – especially young people -- to stop using all vaping products.” (emphasis added)  Public Health Commissioner Dr. Angela Dearinger added, “health experts can’t guarantee the safety of any e-cigarette or vaping product.”



In its three-page press release, Kentucky never identified THC liquids as the probable cause of the lung injuries, and failed to inform marijuana users about the dangers of unregulated THC products. Officials urged the public “to stop using all vaping products,” which is likely to send those former smokers who had successfully switched to e-cigarettes back to smoking.   



The Kentucky Health Cabinet boasts that it “is one of the largest agencies in state government, with nearly 8,000 full- and part-time employees located across the Commonwealth focused on improving the lives and health of Kentuckians.”  It is regrettable that with all these resources, public health officials are distributing misleading information that may contribute to higher smoking rates.



Australian tobacco researchers, led by Coral Gartner at the University of Queensland, have published a scathing analysis of how THC-related lung injuries and deaths in the U.S. were – and still are – exploited by American health officials and media to fuel a crusade against e-cigarettes and nicotine vaping products.  The Australians itemize the key flaws in this misguided campaign:



[M]ost [lung injury] cases developed suddenly within a short period, mostly in young males, in only one country. Over 40 million people have vaped nicotine in the UK, USA and Europe, and vaping has been around for nearly a decade without any similar clusters of serious acute cases of lung injury.  If vaping nicotine were the cause of these lung injuries, many more cases should have been reported in these countries…”



[C]annabis oils, like nicotine‐based vaporisers, have also been used since around 2014 with almost no reports of lung injury. What recently changed is the proliferation of black market cannabis vaping products, some of which are sold in the same packaging as legal cannabis vaping products.”



“In October, the CDC concluded that vaping contaminated THC products was the likely cause of the lung damage.” 



While the CDC was slow to blame unregulated THC products, it is inexcusable that state health departments continue to release inaccurate information about dangerous products.