Rep. Jerry Miller announces his pre-filed vaping bills, aimed at rampant teen use of electronic cigarettes. (WLKY-TV image)
By Melissa Patrick
Kentucky Health News
A Louisville legislator has pre-filed two bills to combat the surge of youth use of electronic cigarettes in Kentucky, but some say they don’t go far enough.
Louisville Republican Rep. Jerry Miller’s most recently pre-filed bill would require all retailers or manufacturers of vapor/aerosol products that come with “enhanced cartridges” to register with the Department of Alcoholic Beverage Control and pay a $500 annual licensing fee per location annually.
It would also prohibit retailers and manufacturers from selling such products online, by catalog or by phone; prohibit home delivery by outside vendors; require real-time age verification for purchase through an electronic third-party source no later than Jan. 1, 2021; and call for fines on any person under the age of 18 who tries to purchase electronic cigarettes or related products.
WLKY-TV reports that representatives from the Foundation for a Healthy Kentucky and officials from the Jefferson County Public Schools and Greater Louisville Inc., the regional chamber of commerce, attended a press conference at Eastern High School in Louisville to support the bills.
But not all health advocates support the bill as written, largely because it doesn’t include language to prohibit flavored e-cigarettes, a proposal that is supported by President Donald Trump.
“Anything short of bold and immediate action by the state to prohibit the sale of all flavored tobacco products, including mint and menthol, fails to protect the health of Kentucky’s kids,” says a statement from the American Heart Association, American Lung Association, Campaign for Tobacco-Free Kids and Kentucky Voices for Health. “We urge Rep. Miller to amend his bill to adequately address flavored tobacco products and protect our youth.”
Juul Labs, which has the most popular brand of electronic cigarettes among teens, announced Oct. 17 that it would stop selling fruit-flavored e-cigarettes in the U.S., while continuing to sell mint and menthol products.
The Campaign for Tobacco Free-Kids said in a separate statement that Juul not taking its mint and menthol products off the market shows the company “isn’t serious about preventing youth use” of e-cigarettes since they are well aware that preliminary data from the 2019 National Youth Tobacco Survey shows that 64% of high school students who “vape” say that menthol and mint is their second most popular flavor behind fruit “and this number is growing all the time.”
According to the Kentucky Incentives for Prevention survey, 26.7% of the state’s high-school seniors reported they had vaped in the past 30 days in 2018, up from 12.2% in the 2016 survey. Use by sophomores, or 10th graders, increased to 23.2% from 11.3%; use by eighth graders jumped to 14.2% from 7.3%; and sixth-grader use increased to 4.2% from 2.3% over 2016.
Miller told Bailey Loosemore of the Louisville Courier Journal that he recognized the lure of the flavored products to teens and doesn’t oppose a ban on them, but said that such a ban needs to take place on a federal level.
“If Washington wants to ban it, fine, that’s their deal,” he said. “In terms of Kentucky, how we’re going to reduce teen vaping, I see it as more effective to regulate it.”
(“Vaping” is a term used by manufacturers, sellers and users of electronic cigarettes, but the devices do not produce a vapor, which is liquid particles suspended in the air. They produce an aerosol, which has liquid and/or solid particles suspended in a gaseous medium.)
Miller has also prefiled a bill that would impose a 27.5% excise tax on electronic cigarettes and related devices.
On top of the youth e-cigarette epidemic, the cause of related lung injuries is still unknown. And such injuries have disproportionately affected young people.
As of Oct. 15, 1,478 vaping-related lung injury cases have been reported to the Centers for Disease Control and Prevention, and 33 deaths have been confirmed in 24 states. The CDC reports that 15% of the cases were in patients younger than 18 years old, 21% of them were in patients between the ages of 18 and 21 and 18% were in patients between the ages of 21 and 24.
In Kentucky, 28 cases are under investigation, with six of them probable, two of them confirmed and four of them ruled out.
The CDC adds that while they haven’t found the exact cause of the lung injuries, “national and state data suggest that products containing THC, particularly those obtained off the street or from other informal sources are linked to most of the cases.” THC stands for tetrahydrocannabinol, the psychoactive ingredient in marijuana.
The CDC just released a report that analyzed 79 Utah patients who had suffered from what is now called EVALI, for “e-cigarette, or vaping, product use-associated lung injury.” The report found that almost all of the patients reported using THC-containing vaping cartridges and most of the THC-containing products contained vitamin E acetate.
The study showed evidence of vitamin E acetate in 17 of 20 THC-containing cartridges, which were provided by six of 53 interviewed patients. The report notes that national data suggests that vitamin E acetate is now a common dilution ingredient, or diluient, in THC cartridges.
“The potential role of vitamin E acetate in lung injury remains unknown; however, the identification of vitamin E acetate among products collected from patients in Utah and elsewhere indicates that the outbreak might be associated with cutting agents or adulterants,” says the report. “Ascertaining the potential contribution of diluents to the current outbreak will require data from multiple states and analysis at the national level.”
Among the 849 lung-injury patients with information on the substances they used in their electronic cigarettes, the CDC reports that about 78% of them used THC-containing product, with 31% of those only using THC. About 58% of them reported using nicotine-containing products, with 10% of those reporting that they only used nicotine.
The CDC recommends that at at this time, all persons should not use e-cigarettes or vaping products containing THC. And because the cause or causes of these lung injuries is still not known, “persons should consider refraining from use of all e-cigarette or vaping products.”