As cases mount, NY health officials still can't identify cause of deadly vaping illness
State health department officials, testifying at a Senate hearing Monday, say they still don’t know the exact cause of the vaping-related respiratory illness that has sickened over 1,800 people across the nation, including 156 New Yorkers, and caused 38 deaths.
Deputy Health Commissioner Brad Hutton told Senators that despite weeks of testing 200 vaping cartridges used by people who became ill from vaping, and additional research, they still can’t find one link to all of the cases. He said some of the cartridges are from black market cannabis vaping products containing THC and two other additives, Vitamin E acetate oil, and castor oil, which are not considered safe to inhale. The nicotine vaping devices also contain substances that are commonly mixed in to facilitate vaping, including PEG or polyethylene glycol, and other chemical compounds.
"However, the most important thing, is that we don’t have one specific substance," said Hutton. "There continue to be many hypotheses for what could be causing these illnesses."
Hutton said theories range from thickeners used along with the THC and nicotine in the vaping products, to other contaminants that might be prevalent, or whether the vaping devices heat up to a temperature not tolerated in human lungs.
"Or a potentially an interaction of many of those factors," Hutton said. "And so the investigation continues."
Gov. Andrew Cuomo signed executive orders to ban the sale of flavored and menthol e-cigarettes, though the ban is currently on hold due to a court challenge by the vaping industry.
On November 13, the legal age to buy tobacco and electronic cigarettes will be raised from 18 to 21 in New York, although many counties already require the higher age limit. And on December 1, a new 20% tax will be imposed on the sale of e-cigarettes.
Those measures are in response to the dramatic increase in teen vaping. Hutton said health officials successfully reduced the use of combustible-cigarettes among teens in the past 20 years, but he said vaping has essentially replaced regular cigarettes among high school students.
"In a sad irony, the rate of e-cigarette use among New York State high school youth in 2018 was 27%," Hutton said. "The same as the-cigarette smoking prevalence back in 2000."
And he said the rate of teenagers using e-cigarettes has increased 160% in just the past five years, which the CDC has called an "epidemic." In 2014, only 10% of high-schoolers used e-cigarettes.
And Hutton said the tobacco companies that dominate the e-cigarette market are using similar strategies used for combustible tobacco products in the past to entice teens to vape, with a modern twist that includes endorsements by social media influencers that younger people can see on their smartphones.
Hutton’s testimony led Sen. Brad Hoylman to ask, why not ban all nicotine vaping products?
"It’s a dangerous product to begin with, that’s been not fully vetted by the FDA," Hoylman said. "Why should we be allowing its use at all in New York state?"
Hutton answered that because of the current outbreak the state health department is recommending that no one engage in any type of vaping. But he said he "looks forward to any discussions" about a broader ban.
Hoylman also asked if all menthol tobacco products, including combustible cigarettes should be outlawed. Hoylman is sponsoring a bill to do that.
Hutton answered that it’s harder to ban regular menthol cigarettes because federal law permits their sale.
Sen. Liz Krueger took it a step further, saying she believes all tobacco products should be outlawed.
Krueger is sponsoring the Senate’s bill to legalize the adult recreational use of marijuana, which could include the vaping of cannabis products. She asked Hutton whether the act of vaping itself can be considered a health hazard.
"We should be doing everything we can to make sure we are not creating a new health problem for New Yorkers through the vaping of products," said Krueger. "If we can’t guarantee that regulated correctly, with the right ingredients being vetted, can’t be made safe."
Hutton answered that the act of vaping nicotine products can be harmful. But he said there has not been enough research done on the vaping of cannabis.
Most of the Senators at the hearing were part of that chamber’s Democratic majority. The lone Republican who questioned the health department officials, Sen. Phil Boyle, said many adults say they use flavored nicotine vaping products to help them quit harmful combustible cigarettes, and he said he’s concerned those adults would go back to smoking regular cigarettes if e-cigarettes were banned.
"In the short term do you think it’s best to ban vaping immediately in New York state and deal with the consequences of long term health care with cigarette problems, or not (impose) a ban at all?" Boyle said.
Hutton said there are better products available for smoking cessation, including nicotine gum and patches, although many users of nicotine e-cigarettes dispute that.
The Senate has proposed a bill that would make Gov. Cuomo’s proposed emergency ban on flavored and menthol e-cigarettes permanent. It’s likely to be considered in the 2020 legislative session.