As New Jersey vape shop owners decried lawmakers’ efforts to ban the sale of flavored e-liquid, they insisted that their products aren’t causing the mysterious lung illness associated with vaping. It turns out that they may be right.
According to a new a study by the Yale School of Public Health, higher rates of e-cigarette and marijuana use in U.S. states did not result in more e-cigarette or vaping-related lung injuries (EVALI).
Published in the journal Addiction, the study estimates the relationship between states’ total reported EVALI cases per capita as of January 2020, and pre-outbreak rates of adult vaping and marijuana use. Results show that higher rates of vaping and marijuana use are associated with fewer EVALI cases per capita.
“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 Abigail Friedman, the study’s author. “This study finds the opposite result.”
Friedman added: “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.”
The Centers for Disease Control and Prevention began a cross-state investigation into vaping-related lung injuries in August 2019, and has since confirmed over 2,800 cases and 68 deaths. In February 2020, the CDC concluded its national updates, and officially classified vitamin E acetate, an additive long linked to EVALI and most common in THC e-liquids that are informally-sourced—i.e., purchased off the street or home-mixed—as “a primary cause of EVALI.”
The EVALI outbreak has motivated a variety of state and federal legislation to restrict sales of nicotine e-cigarettes, including a temporary ban on all e-cigarette sales in Massachusetts in late 2019, and bans on flavored e-cigarette sales in several states and localities. However, if the goal was to reduce EVALI risks, the study suggests that those policies may have targeted the wrong behavior.
On June 4, New Jersey Senators Ronald Rice and Teresa Ruiz introduced legislation that would no longer treat the possession and distribution of up to a pound of marijuana as a crime. But it has not been scheduled for a hearing, which falls under the purview of Senate President Stephen Sweeney, and Judiciary Committee Chairman Nicholas Scutari.
Meanwhile, the States Act, which simply prevents the federal government from enforcing its marijuana ban in states with legal cannabis, has 19 GOP co-sponsors in the House and five in the Republican-controlled Senate. Republican members argue that the more narrowly focused States Act has a better chance of becoming law.