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Heads Up – News – Updates 12.13.2019

If you believe the security rule is affecting the normal operation of your website, contact your host support team and provide detailed instructions how to recreate this error.They will be able to assist you with rectifying the problem and adjusting the security configuration if needed.Original author: KNoll-Marsh
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“Dependence” and the danger of adopting the language of your oppressors

by Carl V Phillips

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Massachusetts DPH Destroys Its Own Justification for the Emergency E-Cigarette Ban

The Massachusetts Department of Public Health (DPH), via a vote by the Public Health Council, has rescinded its emergency ban on the sale of electronic cigarettes which was issued on September 25. When the ban was implemented in September, the Department's rationale was that since we don't know what is causing the outbreak, there may be e-cigarettes that could be involved. Therefore, to protect the public's health, we need to ban the sale of e-cigarettes.In rescinding the emergency order, DPH stated that the cause of the outbreak remains unknown. So by its own rationale which it invoked on September 25, there could still be e-cigarettes causing the outbreak and therefore we need to continue to ban the sale of e-cigarettes to protect the public's health.By rescinding the ban, DPH is acknowledging that it wasn't actually necessary to ban the sale of electronic cigarettes back on September 25th because according to the Department, we still don't know what is causing the outbreak so we're in exactly the same position on December 11th as we were on September 25th. So how could banning electronic cigarettes be justified on September 25th but no longer appropriate on December 11th?What changed between September 25th and December 11th?What changed was that the Massachusetts legislature enacted a ban on flavored electronic cigarettes. However, this ban does not include tobacco-flavored e-cigarettes. There is absolutely no evidence to suggest that the e-cigarettes that may be associated with the outbreak are only the flavored varieties and not the tobacco-flavored ones. Therefore, allowing the continued sale of e-cigarettes, by the DPH's own rationale, is putting the lives of Massachusetts residents at risk.In other words, the Massachusetts Department of Public Health has chosen to knowingly put the public at risk of developing a potentially fatal respiratory illness that, even when not fatal, is often life-threatening and requires mechanical ventilation for several days.The Rest of the StoryI find this alarming. Frankly, it scares me to think that a state health department would knowingly put the public at risk of great harm from a potentially dangerous (and possibly fatal) product. Because the sale of electronic cigarettes was not allowed on December 10th, to suddenly allow the sale of e-cigarettes on December 11th is actively imposing a known risk upon the public. This is unethical by any standard. It is the last thing that any public health agency should do. It certainly violates the medical and public health code of ethical conduct: "to do not harm."The only way that DPH could justify rescinding the ban and knowingly exposing the public to a known health hazard would be if the Department had discovered the cause of the outbreak and therefore could determine that electronic cigarettes no longer posed a risk of respiratory illness. However, the Department has made it clear, through multiple public statements--made as recently as December 11th--that the cause of the outbreak remains "unknown."This has three important implications.1. The Department of Public Health Has Admitted that Its Emergency Order was Not Necessary to Protect the Public's Health The first implication of the rescinding of the emergency order is that it absolutely destroys the DPH's own justification for imposing the emergency ban on electronic cigarettes in the first place. By rescinding the emergency order on December 11th, the Department is acknowledging that the emergency order is not necessary. But if it is not necessary on December 11th - when DPH doesn't know the cause of the outbreak - then it was also not necessary on September 25th when DPH didn't know the cause of the outbreak. And if it was not necessary on September 25th, then DPH abused its power under chapter 17, section 2A of the Massachusetts General Laws because that section allows the Department of Public Health only to take actions that are "necessary" to protect the public's health.If it is not necessary to ban all e-cigarette sales on December 11th, then it was not necessary to ban all e-cigarette sales on September 25.In his letter declaring that the emergency is now over, the governor states very clearly that what he purported to be the emergency back on September 25th is actually not over. The letter states that: "the underlying public health concerns associated with the use of vaping products and e-cigarettes and identified in my September 24, 2019 declaration remain...".So the governor is admitting that the public health concern that led to his declaration of an emergency still remains! But he then goes on to declare that because the legislature has enacted a flavor ban, the need for addressing these concerns has "abated." Since the flavor ban does not prohibit the sale of either tobacco-flavored electronic cigarettes or flavored e-cigarettes, which can still be sold in smoking bars, the governor is admitting that the respiratory disease outbreak was not the emergency in the first place. Instead, the governor is admitting that the emergency justifying the original order was the problem of youth vaping, since that's what the new law addresses, not the disease outbreak.But here's the nail in the coffin of the Department's justification: DPH has already testified in Superior Court that the problem of youth vaping, while serious, is not an emergency.So if the respiratory outbreak is not an emergency and the problem of youth vaping is not an emergency, then what was the emergency? By the governor's and DPH's own admission, there was no emergency. And therefore, there was no justification for its September 24th declaration of an emergency and its order that banned the sale of electronic cigarettes throughout the Commonwealth.This confirms that what really occurred in Massachusetts is that the state used the respiratory disease outbreak as an excuse to impose a flavor ban. Once the flavor ban was imposed, the emergency no longer existed and the ban on e-cigarettes sales could be rescinded. Obviously, this had nothing to do with the respiratory disease outbreak because that outbreak is still occurring and both the governor and DPH admit that the public health concerns that justified the emergency declaration on September 24th still exist.Thus, what the governor and DPH are now admitting is that the emergency order was essentially a political move, not a public health necessity. The goal was to ban flavored e-cigarettes, not to protect the public from an outbreak of severe, acute respiratory failure.2. The Department of Public Health Has Unnecessarily Put Hundreds of Massachusetts Residents Out of Work and Destroyed their LivelihoodsAs anyone who has heard me testify against Big Tobacco knows, I believe that we sometimes must be willing to put people out of business if it is absolutely necessary to protect the public's health. Health must come before business. However, only if it is absolutely necessary. What the state is now admitting is that it was completely unnecessary to put hundreds of small businesses out of business. It was unnecessary to destroy the livelihoods of so many people. It was unnecessary to force many ex-smokers to return to smoking. It was unnecessary to force many vapers to turn to the black market to obtain their products to keep them smoke-free. It was unnecessary for the state to force hundreds of business owners to sustain losses of tens of thousands of dollars by requiring them to destroy their entire inventories of vaping liquids.3. The Department of Public Health is Apparently Willing to Knowingly Put People's Lives at Risk to Achieve a Legislative GoalBy its own admission, the Department of Public Health is putting the lives of the public at risk. They rescinded the ban on electronic cigarette sales when the governor and DPH have both acknowledged that the public health concerns regarding the outbreak of potentially fatal respiratory disease still remain. The state has also admitted that the cause of the outbreak remains unknown and that electronic cigarettes may be causing a substantial proportion of the cases. In its latest update, DPH reports that 32% of the cases in the state used only nicotine-containing products. In this light, how could DPH possibly allow the introduction of the sale of electronic cigarettes in the Commonwealth? How can they justify knowingly putting the lives of Massachusetts residents at risk?It is scary to me to think that a state health department would be willing to knowingly risk the lives of the state's residents in order to advance a legislative goal. No matter how important that legislative goal may be, it does not justify putting people's lives at risk. While my opinion is that the legislation is actually going to cause substantial public health harm, even if we stipulate that this legislation is necessary to protect the health of youth in the state, it still does not justify the Department of Public Health knowingly putting those very lives at risk of severe health damage, or even death.Original author: Michael Siegel
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Heads Up – News – Updates 12.12.2019

If you believe the security rule is affecting the normal operation of your website, contact your host support team and provide detailed instructions how to recreate this error.They will be able to assist you with rectifying the problem and adjusting the security configuration if needed.Original author: KNoll-Marsh
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The Height of Irresponsibility: Massachusetts Department of Public Health Tells Public the Cause of Respiratory Disease Outbreak is Unknown

Yesterday, the Massachusetts Department of Public Health (DPH) proclaimed to residents of the Commonwealth that it has no idea what is causing the outbreak of respiratory illness that has affected more than 2,000 people and killed 47 throughout the country.The proclamation came on a day when the Public Health Council voted to rescind the emergency order that banned the sale of all e-cigarettes in the state.According to an article in Boston Magazine, the Department of Public Health told reporters: "We don’t understand what is causing these illnesses. From a public health point of view, we cannot recommend that anybody use vaping or e-cigarette products at this time."In a press release issued by DPH yesterday, it stated: "The cause of e-cigarette or vaping-associated lung injury (EVALI) remains unknown and under investigation at both the state and federal level. The Department of Public Health recommends that people not use e-cigarettes or vaping products."The Rest of the StoryThis is the height of irresponsibility. Many people - especially youth and young adults - continue to develop life-threatening respiratory failure, primarily from the consumption of black market THC products that contain vitamin E acetate oil as a thickening agent, yet the Massachusetts Department of Public Health claims that it has no idea what is causing these illnesses.Both the CDC and the FDA have concluded that vaping THC products that contain vitamin E acetate oil is causing the bulk of cases of the outbreak, yet DPH is telling Massachusetts residents that the cause remains unknown.The CDC found that 100% of case patients whose lung fluids were tested revealed the presence of vitamin E acetate, yet the Department of Public Health claims that we have no idea what is going on -- it remains entirely a mystery what is causing this outbreak.Who, or what, is the Massachusetts Department of Public Health trying to protect? The black market marijuana industry? It is certainly not protecting the public health. On the contrary, it is putting the health of residents of the Commonwealth, especially young people, at great risk. After all, the public needs to understand that black market THC vape carts are--at the very least--playing a major role in the outbreak and must absolutely be avoided. Telling the public to avoid all e-cigarette, or vaping products is so vague a warning that it is essentially meaningless. Kids need to know that they absolutely should not be vaping THC vape carts. They need to be explicitly told that use of THC vape carts could be life-threatening.Even if there is a chance that some small proportion of the cases are being caused by something else, there is no justification for hiding from the public the fact that the majority of cases are being cause by THC vape cartridges. There is no justification for hiding from the public the fact that vitamin E acetate oil, a thickening agent that is a viscous oil, has been identified in the lungs of every outbreak patient tested so far.Ironically, the absolute height of irresponsibility was the Department of Public Health's decision - adopted by the Public Health Council - to rescind the emergency ban on the sale of e-cigarettes. Let me explain exactly what I mean because as readers know, I opposed the emergency order in the first place as it pertains to the sale of e-cigarettes at retail stores.I do not believe that there is any evidence that e-cigarettes are causing the outbreak. However, based on the Department of Public Health's statement that the cause of the outbreak remains unknown, how can it possibly rescind the emergency order? How can it possibly allow the sale of e-cigarettes in the Commonwealth if it does not know what is causing the outbreak?The entire justification for the emergency ban on e-cigarettes in the first place was that since DPH doesn't know the cause, it has to err on the side of caution and ban the sale of all e-cigarettes. Now, without having identified the cause, the DPH is suddenly throwing caution to the wind and allowing the sale of e-cigarettes. I can't think of anything more irresponsible than knowingly putting the public at risk.My point is not that the public is actually being put at risk because there is not one iota of solid evidence that e-cigarettes are contributing to the outbreak. My point is that based on the position of DPH - that the cause of the outbreak is unknown - they are knowingly putting the health of the public at risk by allowing the sale of e-cigarettes.In this context, the flavor issue is moot. There is certainly no evidence that the flavorings are what is causing the outbreak. Based on the DPH's justification for its ban on e-cigarette sales, there is no rational basis for it now to rescind that emergency order and allow the sale of any e-cigarettes, whether flavored or not.The rest of the story is that the premature cancellation of the e-cigarette sales ban demonstrates that what is really going on in Massachusetts is that the Department of Public Health apparently has used the respiratory disease outbreak to push through its desired agenda of banning the sale of flavored e-cigarettes. By conflating the respiratory disease outbreak with the general problem of youth vaping, the Department has successfully fooled both the public and policy makers into believing that e-cigarettes are causing youth to suffer severe respiratory failure. And that hysteria is what convinced the legislature to enact the ban on flavored e-cigarettes.It is scary to think that the Department of Public Health, which is entrusted with protecting the public health, would knowingly put the health and lives of residents of the Commonwealth at risk. But that is exactly what they are essentially doing by rescinding the emergency order. If the emergency order was justified on September 25 because we didn't know the cause of the outbreak, then the order is certainly still justified on December 11, when--according to DPH--we still don't know the cause of the outbreak.That DPH and the Public Health Council are willing to knowingly put lives at risk to advance a legislative agenda should give all of us pause.Original author: Michael Siegel
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Heads Up – News – Updates 12.10.2019

If you believe the security rule is affecting the normal operation of your website, contact your host support team and provide detailed instructions how to recreate this error.They will be able to assist you with rectifying the problem and adjusting the security configuration if needed.Original author: KNoll-Marsh
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Outbreak of Salmonella Poisoning from Contaminated Vegetables in Massachusetts But DPH Refuses to Release Data on Which Products are Involved and Where They Were Purchased

Despite an outbreak of vegetable-associated Salmonella poisoning linked to products sold at Massachusetts restaurants that has affected 90 Massachusetts residents and resulted in three deaths, the Massachusetts Department of Public Health is refusing to release any information on the restaurants at which the patients ate or the exact products they consumed. The Department has revealed only that the outbreak is associated with "vegetable products" and that some of the patients reported having eaten vegetables at restaurants in the Commonwealth.The Department of Public Health is not even telling the restaurant owners themselves that their products may have been implicated in the outbreak. There have been 90 confirmed and probable cases of Salmonella poisoning. According to DPH, the only thing that links all the cases is that they all reported eating vegetables. However, DPH has not released information on how many of the patients reported eating vegetables at restaurants and how many purchased their vegetables off the unregulated black market, such as the many "farmers' markets" that are held weekly in cities across the Commonwealth.In response to the outbreak, the Department of Public Health issued emergency regulations that shut down all restaurants in Massachusetts for three months until the source of the outbreak could be identified. Of the 16 confirmed cases in which the patients were interviewed to determine what products they consumed, 14 of the 16 reported having purchased Romaine lettuce at farmers' markets. Only two of the patients denied having purchased vegetables from farmers' markets, although published studies have shown that patients in Massachusetts are reluctant to report that they frequent illicit farmers' markets because of the social stigma associated with that behavior.A recent study released by CDC found that 100% of the patients whose stool samples were tested were found to have consumed a strain of Romaine lettuce that is not sold at restaurants, but only at farmer's markets and black market produce stands. Nevertheless, it is possible that one or two restaurant chains may have cut corners and purchased this contaminated strain of Romaine lettuce from shady farmers. The Department of Public Health, however, will not release to the public any information on what restaurant chains were reported as having been frequented by case patients who denied buying from farmers' markets.Of the 16 confirmed cases, none were associated with the purchase of vegetables from restaurants. However, there are six probable cases who admitted to having purchased vegetables from restaurants; DPH has refused to release information on what restaurants those vegetables were purchased from or what the specific vegetables were.At a hearing last week, the Massachusetts Lettuce Commission, which is in charge of ensuring the safety of the lettuce supply at restaurants in the Commonwealth, complained about the lack of information being shared with it by DPH. Several commissioners told a DPH staff panel that the Department refused to provide them with any information on what vegetable products were reported being purchased at restaurants in the state and at which restaurants they were purchased.Fortunately, the Massachusetts Lettuce Commission was finally able to get DPH to enter into an agreement to release limited data on the vegetable products reported by case patients. However, the data will be released only to one person - the executive director of the Commission - and he will have to enter into a non-disclosure agreement, certifying that he will not share the information and under no circumstances will release it publicly, even if it becomes clear that a specific product at a specific restaurant is contaminated. In addition, the executive director of the Commission had to put up as collateral his David Ortiz, Bobby Orr, Tom Brady, and John Havlicek jerseys.Notably, DPH was not being asked to release any personally identifiable information or any information protected by patient confidentiality laws. The only data being sought was aggregated, de-identified product information, not linked to any particular patients but aggregated over the population of case patients.One piece of critical information that DPH refused to release was whether or not the six patients who reported consuming vegetables at restaurants had also eaten vegetables bought off the street. There is a suggestion that at least one of the patients who ate at a restaurant also ate vegetables that they purchased from an unnamed, makeshift corner farm stand, and it is possible that all six of the patients who reported having eaten vegetables at a restaurant also purchased from makeshift farm stands. Without that information, the Lettuce Commission is hard-pressed to figure out whether any of the products it regulates are involved and if so, where they are coming from and what specific lettuce strains are potentially contaminated.In what appears to be a possible step forward, DPH has posted the first information it shared in months on some of the products reported being consumed by case patients. Here are some of the data:First, although there were a total of 49 case patients interviewed, only 16 of these were confirmed cases and the other 33 were probably cases. Looking just at the confirmed cases, 14 of the 16 admitted to having eaten Romaine lettuce that was purchased at black market farm stands. There were only two patients who reported only eating vegetables from restaurants, but they purchased a non-lettuce product that is not regulated by the Commission. So none of the confirmed cases reported having purchased a lettuce product from a Massachusetts restaurant.Second, there were six of the probable cases who reported having consumed Romaine lettuce from a Massachusetts restaurant.Third, some of the products that were reported by patients included:Dank RomaineDr. BLTSweet LeafTossed SaladNaked SaladWettuceDespite the CDC's finding that a specific, contaminated strain of Romaine lettuce was detected in samples of 29 out of 29 case patients, the most recent communication from the DPH reports that the cause of the outbreak is "unknown." All that DPH is telling the public is that it is "vegetable-associated."Moreover, the product summary information sheet for providers states that the cause of the outbreak has not been determined. This despite the fact that both the FDA and CDC have concluded that contaminated black market Romaine lettuce is the predominant, if not only, cause of the outbreak. Due to an order by the Massachusetts Superior Court, all restaurants in Massachusetts will be allowed to re-open this Wednesday. However, on the same day, the Department of Public Health is expected to release regulations that will ban the sale of flavored Romaine lettuce as of next July. This is not expected to affected large chain restaurants because they sell a plethora of products. However, it is expected to put the state's specialized lettuce shops completely out of business.The Rest of the StoryCORRECTION: I apologize but I got the story slightly wrong. The numbers are all correct; however, the outbreak is not Salmonella poisoning but acute respiratory failure and the implicated product is not vegetables but e-cigarettes, or vaping products. The contaminant identified in 29 of 29 samples tested by CDC is vitamin E acetate oil, which is a thickening agent that is used only in black market THC vape cartridges and perhaps some shoddy CBD oil cartridges, as well as possibly a small number of legal THC vape cartridges sold by dispensaries, although it is not clear if any Massachusetts products are involved.It is inexplicable why the Massachusetts Department of Public Health has been so secretive about the products being used by outbreak cases, especially the confirmed cases. Not only does the Massachusetts Cannabis Commission need this information to determine whether any regulated THC vape products are involved, but the public needs this information to be able to make informed decisions about what products to avoid.For example, the fact that 14 of the 16 confirmed outbreak cases who provided information on the products used reported having vaped black market THC cartridges is game-changing. These data point strongly towards the recognized vitamin E acetate oil adulteration of black market THC vape cartridges as being the predominant, if not only, cause of the outbreak. This information is hidden on the web site, and not reported in summaries of the data that DPH is providing, which combine probable and confirmed cases, which is problematic because many probable cases will turn out not to be actual confirmed cases.This information casts serious doubt on the rationale behind the emergency order which closed down the state's vape shops, leading large numbers of former smokers to return to smoking. It also makes it inexcusable that the Department of Public Health is continuing to tell the public that it has no idea what is causing the outbreak and that DPH is doing absolutely nothing to try to curtail the outbreak by: (1) telling the public explicitly that black market THC vape cartridges should be avoided; and (2) identifying and shutting down the sources of black market THC vape carts being sold in the Commonwealth.The entire point of an outbreak investigation is to identify the cause of the outbreak so that this information can be communicated to the public in order to avoid further cases. Despite having shut down hundreds of small businesses, some permanently, DPH has done literally nothing to actually curtail the outbreak. If anything, its actions have resulted in more cases than would have occurred if DPH had shared, honestly, the information that it did have available rather than hide the truth from the public.In fact, it kind of has the appearance that the reason why DPH has been hiding this information is that it doesn't support its apparently pre-ordained conclusion that traditional e-cigarettes are causing respiratory disease.It is unconscionable that in order to obtain critical data to help ensure the safety of the THC vape product supply, the Massachusetts Cannabis Commission has to enter into a non-disclosure agreement with DPH.Original author: Michael Siegel
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Heads Up – News – Updates 12.05.2019

If you believe the security rule is affecting the normal operation of your website, contact your host support team and provide detailed instructions how to recreate this error.They will be able to assist you with rectifying the problem and adjusting the security configuration if needed.Original author: KNoll-Marsh
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American Lung Association's Lies About E-Cigarettes are Dangerous and Irresponsible

Earlier this week, I revealed that, ironically, in a campaign attacking e-cigarette companies for lying to the public, the American Heart Association was itself lying to the public by asserting that e-cigarettes cannot help smokers quit.Today I reveal that, not to be outdone, the American Lung Association is lying even more blatantly to the public and in a way that is not only irresponsible but dangerous for the public's health.In a press release issued yesterday, the American Lung Association made the following claims:Cigarette smoking is no more hazardous than using e-cigarettes.E-cigarettes cannot help smokers quit.If you have switched completely from smoking to using e-cigarettes, you have not quit smoking. The use of e-cigarettes has caused recent hospitalizations and deaths.Specifically, the American Lung Association stated:"While the e-cigarette industry tells smokers falsely that switching to their products is safer and can help them quit, the American Lung Association is urging the FDA to reject these false quit smoking claims, and is also urging smokers to "Quit, Don't Switch." "Switching to e-cigarettes does not mean quitting.""One of the biggest problems with e-cigarettes is that many people have switched to e-cigarettes believing it will help them quit tobacco products, which it doesn't.""E-cigarettes are tobacco products. No tobacco product is safe, and that includes e-cigarettes. Recent hospitalizations and deaths related to vaping underscore the fact that vaping is in fact harmful."  In a separate fact sheet, the American Lung Association reiterates its assertion that if someone quits smoking by switching to e-cigarettes, they have not quit smoking: "Despite what Juul and e-cigarette companies want you to believe, switching to vaping (e-cigarettes) is not quitting smoking."In the same fact sheet, the American Lung Association reiterates its claim that e-cigarette use is causing irreversible lung damage, as seen in the vaping-associated respiratory illness outbreak: "E-cigarettes still produce a number of dangerous chemicals including acetaldehyde, acrolein, and formaldehyde. As we’ve recently seen on the news, the inhalation of harmful chemicals can cause irreversible lung damage, lung diseases—and even death." On another web page, the American Lung Association asserts even more definitively that e-cigarettes can cause irreversible lung damage, as has been seen in the recent EVALI outbreak: "While much remains to be determined about the lasting health consequences of e-cigarettes, there’s evolving evidence about the health risks of e-cigarettes on the lungs—including irreversible lung damage and lung disease."The Rest of the Story Ironically, all four of the assertions made by the American Lung Association are false, even though they are made in the context of criticizing the e-cigarette industry for lying to the public.1. Cigarette smoking is no more hazardous than using e-cigarettes.There is abundant evidence that smoking is much more hazardous than using e-cigarettes. Smoking kills more than 400,000 people each year, while the use of e-cigarettes has not been confirmed to have caused any deaths to date. Tobacco smoke contains more than 10,000 chemicals, including at least 60 known human carcinogens, while e-cigarette aerosol has been shown to contain only a few chemicals of concern and biological monitoring has demonstrated that smokers who switch to e-cigarettes have lower levels of toxins in their body and experience improvement in both cardiovascular and respiratory health.2. E-cigarettes cannot help smokers quit.A randomized clinical trial published in the New England Journal of Medicine demonstrated not only that e-cigarettes can help smokers quit, but that e-cigarettes were actually more effective than nicotine replacement therapy, which is typically viewed as the gold standard. 3. If you have switched completely from smoking to using e-cigarettes, you have not quit smoking. This is such an absurd statement that it hardly requires refutation. It is essentially stating that: "If you have quit smoking (using e-cigarettes), you have not quit smoking." A person who switches completely from smoking to e-cigarettes has quit smoking. They are no longer smoking. It's not clear what is so difficult to understand about that fact. If you have completely stopped smoking, then you have quit smoking. 4. The use of e-cigarettes has caused recent hospitalizations and deaths.There is no solid evidence that e-cigarettes are responsible for any cases of the EVALI outbreak. The predominant cause is the vaping of THC and CBD cartridges that contain vitamin E acetate oil as a thickening agent. There is no evidence to support the assertion that traditional e-cigarettes, sold legally in retail stores, are responsible for the outbreak.These lies are so egregious that it is difficult for me to explain why the American Lung Association is going to such lengths to deceive the public. The only explanation that seems plausible to me is that the American Lung Association simply cannot tolerate the concept that a device which is used similar to a cigarette and which delivers nicotine could possibly be helping people to quit smoking. This is apparently such a difficult concept for the American Lung Association to accept that they have gone to the extreme and nonsensical assertion that if you quit smoking using e-cigarettes, you have not actually quit smoking.It appears that the American Lung Association is only prepared to acknowledge that a person has quit smoking if that person quits the way the ALA wants them to quit: using FDA-approved medications produced by Big Pharma companies with which the ALA has a financial relationship (and has had a long-term financial relationship, receiving hundreds of thousands of dollars). In the first two quarters of 2019 alone, the American Lung Association received $182,000 from Pfizer, the maker of Chantix, a smoking cessation drug that the American Lung Association is recommending that smokers use rather than e-cigarettes.The American Lung Association simply cannot tolerate the thought that someone could use a product in a way that "looks like" smoking to quit smoking, even though it is much safer than smoking and has been shown to be a much more effective of quitting smoking than using a nicotine patch or other nicotine replacement products. E-cigarettes are currently the most effective strategy for quitting smoking for anyone who is unable to quit cold turkey (which is the overwhelming majority of smokers).It's fascinating to me that the American Lung Association, whose goal is supposed to be to prevent lung disease, would be condemning vapers rather than congratulating them. This is rubbing vapers' noses in the ground and is extremely disrespectful to them. These are the very people whose stories the American Lung Association should be celebrating! These are the kind of successes that the American Lung Association should treasure.The rest of the story is that the American Lung Association is acting in a way suggesting that protecting the public's health is not their most critical value. Their primary value seems to be purity: that is, freedom from any tobacco product. This suggests that they are viewing tobacco use on moral terms, not health ones. If you use tobacco products, you are a bad person. It is a character flaw. It is a vice that cannot be tolerated or accepted. You have to cleanse yourself completely or you remain tainted. Even if switching to vaping has saved your life!This is not public health. It is some form of puritanism. But more importantly, it is a type of public health malpractice. Recommending that ex-smokers who are relying on vaping to keep them smoke-free stop vaping is tantamount to telling them to return to smoking, since that would be the practical effect if they actually took such advice. If a physician instructed a vaping patient to return to smoking, that would essentially be malpractice.Whatever the biases or political views that are motivating the American Lung Association, it is clear that this organization is not in any position to be giving medical advice. And it certainly not in any position to be criticizing the e-cigarette companies for lying to the public.Original author: Michael Siegel
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Heads Up – News – Updates 12.04.2019

If you believe the security rule is affecting the normal operation of your website, contact your host support team and provide detailed instructions how to recreate this error.They will be able to assist you with rectifying the problem and adjusting the security configuration if needed.Original author: KNoll-Marsh
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Vaping policy – rapid questions and answers


Vape shop in Manila, Philippines Vaping House Manila Play,Chill & VAPE

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Heads Up – News – Updates 12.03.2019

If you believe the security rule is affecting the normal operation of your website, contact your host support team and provide detailed instructions how to recreate this error.They will be able to assist you with rectifying the problem and adjusting the security configuration if needed.Original author: KNoll-Marsh
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Heads Up – News – Updates 12.02.2019

If you believe the security rule is affecting the normal operation of your website, contact your host support team and provide detailed instructions how to recreate this error.They will be able to assist you with rectifying the problem and adjusting the security configuration if needed.Original author: KNoll-Marsh
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Massachusetts State Health Department is Completely Irresponsible in Hiding the Cause of Vaping-Associated Respiratory Illness

The Department of Public Health's Silence is Putting the Lives of the State's Youth at RiskI was startled this morning to read what the Massachusetts Department of Public Health (DPH) is currently telling the public about the vaping-associated respiratory illness outbreak that has affected more than 2,000 people and resulted in 47 deaths. This information appears on the emergency web page that the Department has created , entitled "Vaping Public Health Emergency."There are three critical pieces of information provided regarding the outbreak. First, here is what DPH is currently saying about the cause of the outbreak:"The cause of e-cigarette or vaping product use associated lung injury (EVALI) remains unknown and under investigation at both the state and federal level"Second, here is the DPH recommendation for all members of the public:  "The Department of Public Health recommends that people do not use e-cigarettes or vaping products."Third, DPH advises readers to check back for updates: "Please check back for updates."The most recent information provided by the governor's office is a press release issued on November 27. In the release, the state health department reiterates its recommendation that: "people not use any e-cigarette or vaping products." In addition, here is what the press release tells the public about the cause of the respiratory disease outbreak:"The cause of e-cigarette- or vaping product use-associated lung injury (EVALI) remains unknown and is under investigation at both the state and federal level."The Rest of the StoryIn the face of a severe respiratory illness outbreak that is resulting in thousands of cases of severe, life-threatening respiratory failure, many requiring mechanical ventilation, it is unconscionable that the Massachusetts Department of Public Health and the Office of the Governor are telling people that the cause of the outbreak is "unknown."That is it!Nothing else!The only thing the state health department is telling people about the cause of this disease outbreak is that the cause is unknown.This is completely irresponsible and frankly, quite shocking to me. After all, we do know the cause of the overwhelming majority of these cases. The major cause is the vaping of THC vape carts that contain vitamin E acetate oil. There is no controversy about this. Both the FDA and the CDC state unequivocally that THC vaping cartridges that contain vitamin E acetate oil are playing a major role in the outbreak and are linked to the overwhelming majority of the cases. The CDC has reported that of 29 patients whose lung fluids were tested, all 29 (100%) contained vitamin E acetate, demonstrating that in all of these cases, a single product explains them: THC or CBD vape carts containing this viscous oil-based thickening agent.In light of this definitive evidence and the conclusions of both the FDA and CDC that THC vaping is the #1 cause of the outbreak, how could the Department of Public Health possibly hide this information from the public? Lives are at stake here. People need to know--and urgently--that if they vape black market THC oil (which is the only kind now available in Massachusetts), they are putting their lives at risk. It is critical that young people in particular be informed that the supply of THC vape carts in the state is extremely dangerous because it has been adulterated with vitamin E acetate oil, which can literally be deadly.But the Massachusetts Department of Public Health is not telling them! Instead, DPH continues to put out a general warning not to vape and all of its statements focus not on the risks of THC vaping, but on the risks of electronic cigarettes.Not only does hiding the truth from the public put young people's lives at risk, but the state's recommendation that everyone stop vaping puts at risk the health of adult e-cigarette users who are former smokers. If they follow the advice of DPH, then they may very well decide to stop vaping, which for most of them means returning to cigarette smoking. That would be the worst possible thing they could do for their health. As long as they are vaping legal e-cigarettes and not THC, they should absolutely continue to vape.I am struggling to come up with an explanation for why the state health department in Massachusetts would want to hide the main (if not only) cause of the respiratory disease outbreak from the public. Can the Department's venomous attitude about e-cigarettes be so strong that it is choosing to put the lives of the public at risk in order to avoid letting people in on its secret: that e-cigarettes are not the driving force behind the outbreak?The rest of the story is that this is precisely what the Department of Public Health is doing.Original author: Michael Siegel
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New York City: Where You Can Get Cigarettes at Every Corner Store But There's Not an E-Cigarette to Be Found



The New York City Council yesterday passed a law that bans the sale of all e-cigarettes, with the sole exception of tobacco-flavored ones, but allows cigarettes - including menthol-flavored brands - to continue to be sold at any gas station, convenience store, or other retail store in the city.On the heels of the New York City ban, the governor of Massachusetts today signed a law that bans the sale of all e-cigarettes in the state, with the sole exception of tobacco-flavored ones, but allows cigarettes to continue to be sold at any gas station, convenience store, or other retail store in the state.There is no public health justification for banning the sale of fake cigarettes but allowing the real ones to remain on the shelves, especially since the fake ones are much safer than the real ones.Moreover, these policies are going to have a severe, negative impact on the public's health, since they are going to result in many former smokers returning to smoking and many others turning to black market products.The Rest of the StoryAlthough these policies strike a severe blow to the protection of the public's health, they are not bad for everyone. They are a tremendous gift to Big Tobacco, especially the cigarette companies which stand to gain financially from the removal of what is currently the greatest threat to cigarette sales.This gift to Big Tobacco is reflected in the unanimous assessment by tobacco stock analysts: these e-cigarette bans are going to result in a substantial shift from flavored e-liquids to tobacco cigarettes. Because of the removal of competition and the increase in cigarette sales, these analysts are recommending that investors buy tobacco stocks.You can see how well Altria stock has done since several states implemented or announced emergency bans on e-cigarette sales: Original author: Michael Siegel
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More Evidence that Vitamin E Acetate Oil, Not E-Cigarettes, Is the Cause of the Respiratory Disease Outbreak

A new study published today by the Centers for Disease Control and Prevention (CDC) in the weekly MMWR (Morbidity and Mortality Weekly Report) bolsters the evidence that vitamin E acetate oil, rather than e-cigarettes, is causing the "vaping-associated" respiratory illness.The study reports the results of laboratory testing conducted in the state of Minnesota, where 96 confirmed cases occurred through October 31. Here are the critical findings:1. Of 58 patients interviewed, 53 (91%) reported the use of black market THC vape carts. A total of 14 reported using CBD products, of whom 11 stated that they used CBD products with illicit THC. Only 2 of the patients reported exclusive use of nicotine-containing products.2. Two patients reported using nicotine e-liquids exclusively, but were found to have THC in their lung fluids, confirming exposure to THC products.3. Every vape cartridge recovered from a drug seizure in 2018 did not contain vitamin E acetate oil, while every vape cartridge recovered from a drug seizure in 2019 did contain vitamin E acetate oil.4. Of the 12 patients from whom THC cartridges were obtained for testing, products used by 11 of them tested positive for vitamin E acetate. However, the 12th patient admitted to using Dank Vapes, but that was not included among the samples submitted for testing. In addition, every Dank Vapes cartridge tested contained vitamin E acetate oil.The Rest of the StoryThis study not only provides very strong evidence that vitamin E acetate oil, rather than e-cigarettes, is the cause of the outbreak, but it also helps to explain why approximately 10% of patients are not reporting the use of THC-containing products. For one, some of the patients are apparently using CBD products that may contain vitamin E acetate oil. Second, there is clearly substantial under-reporting occurring. Patients who reported using nicotine-containing liquids exclusively have nevertheless tested positive for THC and/or vitamin E acetate oil. Third, there is tremendous product multi-use occurring, so it is not clear that the reporting of nicotine-only product use is reliable.The hardest evidence we have is that every single patient whose lung fluids were tested were found to have vitamin E acetate in the lungs and that every patient who used THC vape carts and submitted samples was found to have at least one cart that contained vitamin E acetate oil.This is about the strongest imaginable evidence that one could possibly expect if the outbreak were due exclusively to vitamin E acetate oil.Moreover, the findings of this study help explain the timing of the outbreak. The findings provide evidence that vitamin E acetate oil was not present in the illicit THC vape cart supply in 2018, but appeared extensively in the supply this year.In addition, two-thirds of the case patients reported the use of a single common product - Dank Vapes - which was found to contain vitamin E acetate oil.Furthermore, none of the nicotine-containing e-liquids was found to contain vitamin E acetate oil or any other toxicant of concern.Based on these findings, the study recommends that people not use THC vape cartridges and not use black market vape cartridges, but does not provide a recommendation not to use legally purchased e-cigarettes.This study provides a strong justification for the Massachusetts Department of Public Health to rescind its emergency order banning the sale of nicotine-containing e-cigarettes at retail stores. It also confirms that there is no rational basis for the decision of several other states to issue emergency regulations banning the sale of traditional e-cigarettes at retail stores.Original author: Michael Siegel
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Heads Up – News – Updates 11.26.2019

If you believe the security rule is affecting the normal operation of your website, contact your host support team and provide detailed instructions how to recreate this error.They will be able to assist you with rectifying the problem and adjusting the security configuration if needed.Original author: KNoll-Marsh
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Why E-Cigarette Flavor Bans are Misguided: The Flavor's Not the Problem, It's the Nicotine Salts

The obsession of policy makers, politicians, and health groups on banning flavored e-cigarettes as a solution to the youth vaping epidemic is misguided and is detracting attention from the real issue: the use of nicotine salts that have greatly increased the addiction potential of e-cigarettes.Prior to the introduction of JUUL, three-fourths (74%) of nonsmoking youth e-cigarette users reported using e-cigarettes no more than about once a week and only 4% used them every day, a sure sign of addiction. But by 2018, 12% of nonsmoking youth vapers used e-cigarettes every day, a tripling of the percentage of youth e-cigarette users who were addicted, and less than half (42%) of non-smoking youth e-cigarette users only used them less than once a week. This change is what has created a public health crisis. So what explains this change?  Was it the introduction of flavors?Absolutely not. Back in 2015, there were just as many flavors on the market as there are now. There were plenty of sweet, fruity, candy flavors available. If anything, JUUL offered fewer flavors than most other e-cigarettes.  What changed is that JUUL discovered that if you use a nicotine salt to deliver the nicotine rather than freebase nicotine, it is absorbed into the bloodstream much more rapidly. The upshot of this is that the product delivers a nicotine hit or buzz, unlike virtually all other e-cigarettes on the market. So when products like JUUL, Suorin, SMOK, and Phix entered the market with their nicotine salts, they quickly became popular among teenagers. All of these brands use a different nicotine formulation from virtually all other e-cigarettes. They use a nicotine salt at very high concentrations, as much as 50 mg/mL, compared to most other e-cigarettes on the market, which do not use nicotine salts and generally have nicotine concentrations that are less than 25 mg/mL. The use of nicotine salts allows the nicotine to be absorbed into the bloodstream much more quickly, simulating the pattern you get with a real cigarette. This is why so many youth are now becoming addicted to vaping. It’s not the flavors. It’s the nicotine. And more specifically, it's the nicotine formulation and to some extent, the concentration.The combination of nicotine salts and high concentrations of nicotine is what changed youth e-cigarette use from a problem to a crisis. It's not the flavors that created this crisis, it's the nicotine absorption pattern of these new products. The reality is that prior to JUUL and its copycats, nicotine addiction was not a problem among youth e-cigarette users. Patterns of use were not habitual, but were almost exclusively social. There were plenty of cotton candy e-cigarette available. But e-cigarette use was not a crisis. There were plenty of gummy bear flavors around. But e-cigarette use was not a crisis. Kids weren't getting addicted to cherry, strawberry, or banana vapes. Nicotine salts--not the flavors--changed everything.And so now, policy makers are deceiving themselves if they think that banning e-cigarette flavors is the answer to this crisis. No - what's going to happen is that many youth are going to switch over to the e-liquids that remain easily accessible: THC vape carts. Yes, the ones that are causing the respiratory disease outbreak that has killed 49 people and sent more than 2,000 to the hospital with respiratory failure. It's even possible that many youth will switch over to the tobacco flavors. Not only will they continue to be addicted to nicotine, but then a transition to cigarette smoking will become a real risk, something that is not the case today because a youth is not going to transition from a sweet-flavored e-cigarette to a Marlboro. But switching from a tobacco-flavored JUUL to a Marlboro is probably much more realistic.So beyond the devastating effects of flavored e-cigarette bans on adult vapers - leading them to return to smoking or to a new, potentially dangerous black market - flavor bans are actually going to make things worse for youth as well, by driving them towards cigarette use or towards black market products that are even more acutely dangerous.The most effective solution is right before our eyes, but it's being hidden because of the obsessive and misguided focus on cotton candy, bubble gum, and gummy bear. What we need to do is not ban bubble gum flavor, but severely restrict and control the use of nicotine salts as well as limit the allowable nicotine concentrations in all products.The Rest of the StoryThe biggest myth out there is that there is such a thing as an unflavored e-cigarette. There is no such thing. Every e-cigarette (i.e., e-liquid) is flavored. It's just a question of what the flavor is.This is another reason why arguing that the flavors are the problem is a meaningless statement. Every e-cigarette is flavored, so how can you argue that the flavors are the problem. E-cigarette flavor bans, then, are not actually flavor bans. What they are is policy makers dictating to e-liquid manufacturers that they can only produce one flavor out of a list of thousands: tobacco-flavor. Even tobacco flavor is not a single flavor. There are many varieties of tobacco flavor on the market: classic tobacco, Virginia tobacco, regular tobacco, golden tobacco, and so on. Youth will find a way to make the tobacco flavors more palatable. Already, they are using mints to accomplish this. Soon they will be buying their own flavorings and adding it to the tobacco e-liquids. At least, youth are aren't exclusively vaping THC will be doing this.The only effective way to substantially reduce youth access to flavored e-cigarettes would be to ban them completely. Otherwise, there will always continue to be flavored e-cigarettes available. However, a complete ban on e-cigarettes would be even worse for adult smokers and vapers than banning non-tobacco-flavored e-cigarettes (although probably not much worse).Policy makers who are using the respiratory disease outbreak as a justification for banning e-cigarette flavors are perhaps the most irresponsible of all. If they truly believe that e-cigarettes present a risk of life-threatening respiratory disease, then how can they possibly allow tobacco-flavored e-cigarettes to remain on the market? There is simply no justification for that and by their own admission, they are knowingly putting the lives of youth at risk.In fact, every public health advocate who has used the respiratory disease outbreak as a justification for the need to ban e-cigarette flavors is acting irresponsibly because by allowing tobacco flavored e-cigarettes to remain, they are knowingly putting the lives of youth at risk for what is essentially political gain.The real question is really more basic: Do we allow e-cigarettes or do we not allow them? The good news is that we can choose the first option while at the same time putting an end to the youth vaping crisis. The sad truth is that the real objective is not to end the youth vaping crisis and to protect youth from the most important risks they face. Instead, it's to get flavors off the market in order to punish e-cigarette companies so that we can feel better about the fact that so many youth are Juuling.Original author: Michael Siegel
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Twitter Q&A: debunking tobacco harm reduction misconceptions


November 26th, 2019

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Heads Up – News – Updates 11.25.2019

If you believe the security rule is affecting the normal operation of your website, contact your host support team and provide detailed instructions how to recreate this error.They will be able to assist you with rectifying the problem and adjusting the security configuration if needed.Original author: KNoll-Marsh
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