With the L.A. County Board of Supervisors’ recent move to ban flavored tobacco, some are wondering if the nationwide crisis that also includes THC vapes could put cannabis in the crosshairs. 

So far, the county’s actions have focused on tobacco alternatives, but last week the L.A. Department of Public Health said all but one of the 16 reports of serious vaping-associated pulmonary injury (VAPI) and one death reported using both an e-cigarette and a cannabis-type product. The outlier reported using flavored liquids exclusively. 

On Thursday, DPH announced five new cases this week, bringing the number of those impacted locally to 21. 

As of October 1, 2019, the Centers for Disease Control reported 1,080 lung injury cases associated with vaping in 48 states; the figure represents an increase of 275 cases since last week. During a Thursday night telebriefing, the CDC said the new cases were a combination of new patients becoming ill in the past two weeks and recent reporting of previously-identified patients. The CDC said out of the 1,080 cases, approximately 70 percent of patients are male, 80 percent of patients are under 35 years old, and 37 percent are under 21 years old.

The official death count has now risen to 18, with more under investigation. 

The CDC were asked what they would say to people on the internet claiming buying from a regulated dispensary was fine, and if this was generally a black market issue. The CDC’s principal deputy director, Dr. Anne Schuchat, responded that the black market was certainly a major concern but they weren’t ruling anything out. 

“But at this stage in the investigation, we really need to keep an open mind and recognize that sources in one part of the country may not be the same as elsewhere,” Schuchat told reporters, “There is a lot we do not know about what’s in various e-cigarette or vaping products and what harms they can have. But I think this black market concern is a high one for us.”

Schuchat later noted federal officials have declined to interfere in any state regulations around the crisis. “Obviously, individuals will make choices about their own health and their own behaviors and individual stats that have licensed dispensaries are taking steps to assure that what they regulate is safe. So, we’re not interfering with state regulation,” she said, “We’re just saying that right now, it’s very difficult for a consumer to know what they have.

With the body count rising, some have been quick to call for a full ban on all vape products. Despite this week’s new five reported local cases, would an all-out ban make the situation even worse and send even more people to the hospital?

The first place to make waves nationally by prohibiting all vape products was Massachusetts, when anti-pot Gov. Charlie Baker banned all forms of vaping in the Bay State. regardless of whether they were tobacco alternatives or THC.

While most of her fellow officials have stayed silent or backed the governor, Massachusetts Cannabis Control Commission member Shaleen Title has warned of the impact the all-out ban could have.  

“This is a terrible decision. Purposely pushing people into the illicit market — precisely where the dangerous products are — goes against every principle of public health and harm reduction,” Title wrote in a tweet the day the ban was announced. “It is dangerous, short-sighted, and undermines the benefits of legal regulation.”

Title spoke with L.A. Weekly about a balanced approach focused around the importance of public safety but reminded how much regulation to maintaining that safety. 

“I think all state officials are in agreement that we have a serious problem here with these vaping illnesses, and we need to investigate, find out the source of the problem, make sure we have appropriate testing protocols and safety standards, and restrict any ingredients or additives that’s causing the problem,” Title told the Weekly. “But my concern is this is the time when regulation is most critically necessary, and by implementing a ban and taking away our ability to regulate, we are purposely pushing people to the illicit market when we don’t know the source of the unregulated and potentially dangerous product.”

We reached out to DPH on the eve of their announcement about the five new cases to talk about bans. 

DPH said said its director, Dr. Barbara Ferrer, and Dr. Tony Kuo had crafted a response to our question and a few others. Kuo leads the Division of Chronic Disease and Injury Prevention.

The pair quickly put the target on the tobacco industry, saying the current crisis was years in the making from a “tobacco industry that has prioritized profit over public health for decades.”

After addressing the recent ban in L.A. County, the pair next took aim at the news cycle and claims bans were dangerous saying, “While the numerous voices in recent news cycles suggesting that bans on vaping may have a detrimental effect on the public may be well intended, they might also be inadvertently obfuscating the issue.” They said their interest was in protecting the 10 million residents of L.A. County “we are sworn to serve (and the public in general), we feel compelled to weigh in by offering some context to three common misperceptions about tobacco control policy as it relates to the e-cigarette epidemic.”

The first misperception they pointed out was that the illness associated with vaping-associated pulmonary injuries are primarily associated with the use of black-market products containing THC.

“While there have been documented VAPI cases in which individuals used vape chemicals containing THC that were obtained outside of regulated dispensaries, there is absolutely no evidence that resultant lung injury was due exclusively to THC use or to any specific product, such as “Dank vapes.”

After noting the CDC still doesn’t have conclusive evidence of what’s happening, the statement emphasized that “In Los Angeles County, it is clear that some people who became seriously ill with this lung condition did not use vape chemicals containing THC.”

The second thing DPH has taken issue with is the idea vapes are effective for people who want to quit smoking and flavor bans restrict access to those looking to quit. They said apart from the potential of removing the carcinogens and chemicals in tobacco, we don’t actually know the long-term safety profile and health impact yet.  

“Contrary to many inaccuracies that are in print, flavor bans are intended to restrict flavors primarily marketed to youth and do not include products with regular tobacco flavor,” the leadership team said, “It is worth noting that many users of e-cigarettes report that they are vaping much more than they smoked, which means they are introducing significantly more addictive nicotine into their bodies, a fact that seems to contradict claims of aiding in kicking the habit.”

DPH’s final issue with the news cycle is the idea that states and cities are rushing to crack down on vaping products. They noted it was typically the responsibility of jurisdictions to set these policies but also ensure resources are available to people dealing with a nicotine addiction. 

The statement closed with, “The VAPI outbreak has only added to this urgency to take policy action to curb this highly preventable epidemic. Big tobacco and those whom they employ are actively trying to protect their interests. As public servants and medical professionals, we see it as imperative that we meet their efforts with an equal level of energy to protect the health of the public.”

The L.A. Department of Cannabis Regulation told L.A. Weekly they will not be providing comment at this time on whether bans are a threat to public safety. 

However, we did reach out to the Drug Policy Alliance, where L.A.’s chief regulatory officer Cat Packer previously served as DPA’s California Policy Coordinator. We asked DPA if the bans were dangerous?

“Yes, that is exactly our thoughts on the matter,” DPA’s media director Matt Sutton told L.A. Weekly in an email. 

Sutton said all the vape bans really accomplish is to stoke more fear and stigma around yet another substance. 

“What we are seeing play out right now is a real life drama of how various substances are criminalized without justified reasoning and reliable research to do so,” he said, “Taking this approach, we fail to consider the harm that may result from its removal from the marketplace, such as people turning to the black market or more harmful substances.”

For THC, DPA believes the issue is undoubtedly the lack of regulation, which cannot be put in place so long as it remains illegal at the federal level. “At this point, with these illnesses becoming a growing concern, it is incumbent on policymakers to legalize marijuana in the interest of public health,” Sutton said. 

California NORML has also joined the chorus coming out against bans. Proposition 215 co-author and long-time Cal NORML executive director Dale Gieringer said their opposition comes in light of the fact nothing has actually been linked to the state’s legal market.  

“The evidence indicates that products from the illicit market are to blame,” Gieringer told L.A. Weekly in an email. “Any ban would affect only the legally licensed manufacturers; the underground pirate producers would ignore them.    

Gieringer said bans would make vapor enthusiasts more dependent on dangerous black market products. 

“Studies have shown that vape pens that use pure THC oil are 5,000 to 250,000 less harmful to health than smoking. The best vape extracts use pure cannabis oil. The problem appears due to toxic additives,” Gieringer said citing the latest research just out in September.

As opposed to bans Cal NORML said they strongly urge the state to strengthen its oversight of cannabis vape products. “In particular all manufacturers should be required to clearly state any additives to cannabis extracts on the label. Any product found to cause lung disease should be tracked down and withdrawn from the market.”

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