Wednesday, November 20, 2019

Massachusetts State Senate Votes to Ban Almost All E-Cigarettes, But to Leave the Real Deadly Ones on the Shelves

In a move that defies public health logic, the Massachusetts Senate today voted for a bill that would ban the sale of virtually all e-cigarettes, but would allow non-mentholated real cigarette brands to remain on the shelves of all stores, including convenience stores and gas stations where youth have easy access to these products.

There is simply no public health justification for taking e-cigarettes off the market but allowing youth to continue to have unfettered access to real tobacco products. The average annual death toll of these products is starkly different:

Flavored e-cigarettes: 0
Real cigarettes: 480,000

Given the morbidity and mortality burden differential between these two products, how can the state Senate ban the former, but leave the latter free to addict and eventually kill the youth of the Commonwealth?

The Rest of the Story

I'm sorry, but there is simply no justification for banning the sale of most electronic cigarettes but allowing real cigarettes, which kill more than 400,000 Americans each year, to remain on the shelves, almost completely unregulated.

One of the major arguments that supporters of the bill offered to support their call for a ban on all flavored e-cigarettes is that when JUUL pulled its flavors other than mint and menthol from store shelves, youth simply switched to mint and menthol flavors. But if that's true, then shouldn't we be concerned that if flavored e-cigarettes are banned, youth will simply switch to tobacco-flavored e-cigarettes?

If the Senate is genuinely concerned about youth vaping, then there is no justification for it failing to call for a ban on all e-cigarettes. By its own logic, leaving tobacco-flavored e-cigarettes will simply result in youth switching to tobacco-flavored e-cigarettes.

OK, so you're thinking that kids are not going to switch from a candy- or fruit-flavored e-liquid to a tobacco-flavored one? Fine, but if that's the case, then it's even less logical to argue that kids are going to switch from fruit-flavored e-cigarettes to the harsh, tobacco-flavored real ones. You can't credibly make the argument that youth will avoid the tobacco flavor of e-cigarettes, but get hooked on the tobacco flavor of real cigarettes.

The truth, of course, is that kids are not getting hooked on flavored e-cigarettes and then progressing to tobacco-flavored real cigarettes. They are using flavored e-cigarettes specifically because they want to avoid the health consequences that they all know are associated with the tobacco-flavored real cigarettes.

So if youth are not going to switch from flavored e-liquids to tobacco-flavored e-liquids, what are they going to switch to?

The answer is THC e-liquids, many of which are packaged in kid-friendly brands like "Apple Jacks," "Banana OG," "Birthday Cake," "Black Berry Kush," "Blue Dream," "Blueberry Kush," "Bubble Gum," "Candy Land," "Cherry Pie," "Cotton Candy," "Fruity Pebbles," "Gelato," "Grape Ape," "Grape Stomper," "Green Crack," "Honey Berry," "Honey Dew," "Ice Blue Raspberry," "Key Lime Pie," "Lemon Berry," "Lemon Head," "Lemon Slushie," "LSD," "Mai Tai," "Mango Kush," "Maui Wowie," "Mimosa," "Mojito," "Orange Chai," "Orange Cookies," "Orange Daiquiri," "Peach," "Pineapple Express," "Pot of Gold," "Purple Punch," "Rose Gold," "Russian Cream," "Sour Apple," "Strawberry Shortcake," "Sweet Aromatic," "Tangie," "Vanilla Kush," "Water Melon," "Wedding Cake," and "Zskittlez."

These are precisely the black market products that have led to more than 2,000 cases of severe respiratory failure, most among young people, with 42 fatalities.

The Senate's proposal to ban all flavored e-cigarettes would result in a shift from flavored e-liquids to the increased use of flavored e-joints, and it would make the current respiratory disease outbreak much worse, potentially resulting in more deaths. Does the Senate really want those severe illnesses and deaths on its hands?

This is before we even get to talking about the effects that a flavored e-cigarette ban would have on adults, which include a mass return to cigarette smoking or entrance into a new black market for flavored e-liquids, which might eventually result in an even worse disease outbreak in the future, since the number of adults using these products and thus subject to any contaminant that may arise in these black market products will be immense.

The Senate has apparently written off adult smokers completely. This is a complete betrayal of the Commonwealth's stated objective of reducing tobacco use by increasing successful quit rates and reducing disparities in access to prevention and cessation services.

The rest of the story is that the state Senate has steered away from its mission to protect the health of the public, and this bill to ban flavored e-cigarettes would severely harm the health of both youth and adults across the Commonwealth.