E-Cigarettes Must Be Banned

Prevent Further Harm from Vaping-Related Lung Disease

Credit: Pat Bagley, The Salt Lake Tribune, UT

As a pulmonary and critical care specialist, I am writing this open letter today, September 25, World Lung Day, to ask that the Board of Supervisors take immediate action to ban the sale of all e-cigarettes and vaping devices in Santa Barbara County. We are at the beginning stages of an alarming epidemic of both vaping-related lung disease and nicotine addiction in adolescents and young adults.

In national surveys, the rapid rise of vaping/e-cigarette use has been astounding, with more than 28 percent of high school students vaping on most days of the month in 2018. This represents a 78 percent increase between 2017 and 2018.

The recent outbreak of vaping related lung illness cases was first reported in August. Just in the past month the number of cases has more than doubled to well over 600 probable cases with hundreds more being reported every week. There have been nine deaths attributed to vaping-related lung disease so far. Unfortunately, this number will certainly rise. Cases have been in both adolescents and adults: 16 percent are under age 18, 67 percent between 18 and 35, and 17 percent over 35.  This week we had a possible case of a 19-year-old requiring mechanical ventilation in our own community. 

The cause of these severe lung illnesses related to vaping is unknown and still under investigation at the Centers for Disease Control and at public health departments throughout the country. While as many as 80 percent of cases reported vaping nicotine and THC or other cannabis-related products, approximately 20 percent reported only the use of nicotine products.

The dramatic rise in vaping among our youth has largely been attributed to flavored e-cigarettes, as well as direct marketing of these products to our children, adolescents, and young adults, by Juul and others. While Juul has just recently disavowed the sale of e-cigarettes to minors, they historically have targeted minors in their advertising efforts. At this point, they will say and do anything to prevent an existential threat to their business of addicting another generation to nicotine.

While e-cigarettes have been touted as a “safer” cigarette, this is now known to be untrue. Traditional tobacco products cause severe chronic lung disease, as well as cardiovascular disease, many types of cancer, and other serious illnesses with chronic use. E-cigarettes were thought not to contain harmful substances, other than nicotine. The current epidemic of vaping related lung disease proves this to be completely false — these devices are causing acute severe illness, often requiring hospitalization, and unfortunately leading to deaths. Even if the cause of these illnesses are identified, many of the devices themselves facilitate the use of re-fillable cartridges, which will allow users to vape any liquid substance that can be acquired legally or illegally, in stores or on the street. As these substances will be impossible to regulate, this will undoubtedly become an ongoing hazard to public health.

While the FDA is currently considering a proposal to ban flavored e-cigarette products, this would not prohibit the sale of e cigarette devices themselves, which could be used to vape other toxic and deadly substances. In addition, even unflavored e-cigarette use is designed to addict another generation, and future generations, to nicotine. Nicotine itself is likely harmful to the developing brains of children and adolescents, and has uncertain effects on adults. While some tobacco users have transitioned to e-cigarettes, they remain addicted to nicotine. Any benefit to these individuals is small, compared to the potential hazard to our youth now, and our society at large, in the future. Therefore, a complete ban on the sale of e-cigarettes in Santa Barbara County is warranted.

Los Angeles County, other counties, and municipalities in California are considering, or have passed, such ordinances.If enough contiguous counties ban these devices, access, while not impossible, will be much more difficult. There is no reason we have to wait for the federal government to take action.The paralysis of our national government will lead to more severe illnesses and deaths, which can be prevented if we ban the sale at the local level.

Therefore, I implore the Board of Supervisors to take action to protect our youth and our community and immediately ban the sale of e-cigarettes and vaping devices in Santa Barbara County.


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