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Mountain Vapor Blog

Welcome to the blog area of our site where we hope to keep you updated on the trends of the e-cigarette industry as well as product reviews.

CASAA – Heads Up Round Up – 09.22.19

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Results from National Survey Show that CDC's Communication about Respiratory Disease Outbreak Has Been a Public Health Disaster

A newly released, national public opinion survey conducted by Morning Consult reveals that twice as many U.S. adults believe that JUULs, as opposed to marijuana vape carts, are associated with the outbreak of deaths from respiratory disease. The survey also reveals that U.S. adults are no more likely to believe that marijuana vape carts are associated with the deaths as to think that marijuana vape carts are not associated with the deaths.Specifically, 58% of the adults surveyed attribute the outbreak deaths to the use of "e-cigarettes such as JUUL," while only 34% attribute these deaths to "marijuana or THC" vaping. And an almost equal proportion of adults believe that the deaths are not associated with marijuana or THC vaping (32%) as believe that the deaths are associated with marijuana or THC vaping.The truth is that of the five reported deaths in which the product being used has been revealed, all five (5/5, or 100%) are associated with the use of marijuana or THC vape carts while none are associated with the use of JUUL.It isn't even plausible that these deaths could be associated with JUUL because there are millions of JUUL users who have been using the products for several years without any reported problems. Moreover, we would be seeing a lot more cases among adults if JUUL was the culprit.In contrast, there are very strong reasons to believe that marijuana vape carts are the primary culprits. More than 80%, and probably closer to 90% of the cases involve patients who admitted to vaping THC. Of the remaining 10%, it is highly likely that many (if not all) of them are simply not reporting THC use because many youth would not want to admit to the use of illicit THC vape carts purchased off the black market from drug dealers. Furthermore, I am not aware of a single case in which a negative THC urine screen was obtained, meaning that we can't rule out the use of a THC cart in any of the cases. And finally, all five of the deaths for which products were reported involve patients who vaped cannabis.The Rest of the StoryThese results demonstrate how awful the CDC's risk communication has been around this outbreak. Despite the fact that close to 90% of the cases are associated with the use of THC oils, the public is much more likely to attribute the outbreak to the use of legally sold and rigorously lab-tested JUUL than to the use of illicit and completely untested and unregulated THC vape carts. This is truly a public health disaster!It is a disaster because it means that the CDC has failed to properly communicate the severe risks of vaping marijuana. Instead, the CDC has successfully scared the public into thinking that e-cigarettes like JUUL could almost instantly kill you. Undoubtedly, this means that many of the continuing cases that we now observe and will observe moving forward are being caused by the failed, if not fraudulent, CDC warning.People who otherwise might have been dissuaded from vaping marijuana if the CDC had been honest are likely continuing to do so and are at great risk of suffering respiratory failure or even death.The rest of the story is that the CDC has not been transparent, forthcoming, or honest in its communications regarding the outbreak of vaping-associated respiratory illness. It has gone out of its way to hide the fact that most of these cases were associated with the use not of legal electronic cigarettes, but of illicit THC vape carts. And sadly, the misinformation campaign is working. The public is completely misinformed about the outbreak and is not in a position to make informed, rational decisions to take action to avoid this life-threatening disease.In its apparent zeal to demonize electronic cigarettes, the CDC has put the lives of the public at risk.Original author: Michael Siegel
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Heads Up – News – Updates 9.20.2019

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Heads Up – News – Updates 9.19.2019

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As Another Person Dies from Using Illicit THC Vape Carts, Health Authorities Still Insist that We Have No Idea What is Causing the Problem

Yesterday we learned that a seventh person has died from the growing epidemic of "vaping-associated respiratory illness" that is sweeping the country. In the six previous deaths, authorities released information about the products used in three of them, each of which involved vaping marijuana, not electronic cigarettes.Although authorities did not release information about what caused this seventh death, family members apparently attribute it to the use of an illicit THC vape cart. It's not clear, however, whether the brand used - a Lucky Charms CUREpen - was real or whether it was a counterfeit product that was packaged in the same packaging. Cannabis insiders have been warning us since last January about the dangers of counterfeit THC vape carts that started to go into wide distribution around that time. How prescient they were!All in all, marijuana vaping has been associated with approximately 90% of the cases. Although about 10% of cases reported using only nicotine-based e-liquids, we know that there is significant under-reporting of THC use by youth. In addition, many youth may actually not know what is in their cartridges. Moreover, we know that there are many counterfeit cartridges on the market. Finally, the CDC has not recommended that case patients be tested for THC so its use cannot be ruled out. In fact, unless THC testing was conducted, the use of THC oils cannot be ruled out in any of the cases.Given these facts, you would think that health authorities would issue very clear warnings to youth to avoid vaping marijuana, especially illicit THC vape carts that are purchased off the street.The Rest of the StoryInstead, here is what one physician is telling the public in an article published by The Mighty:"The Mighty spoke to Meghan Cirulis, M.D., a physician and researcher at the University of Utah. She has led a number of studies on lung diseases and was recently involved in research for the New England Journal of Medicine identifying markers physicians could use to diagnose vaping-induced lung injury. Is there a safe way to vape? “At this stage, I would say no,” Dr. Cirulis said. “Until we figure this out, I think vaping puts people at immediate risk of health consequences that can be severe, even fatal.”"She added that while some vape products may seem safer than others, we can’t make reliable risk assessments until these products are studied more. Cirulis said that while a “higher proportion of cases” have been linked to e-cigarettes containing CBD and THC, she “wouldn’t consider any product higher or lower risk” until more information is available. “We have definitely seen cases in patients only using nicotine products,” she noted. A lot of discussion has centered on legal versus illegal e-cigarettes, but Cirulis said that at the moment, it’s not clear commercial vapes are safer than “street” vapes. “Some of the cases have reported use of only commercial e-liquids — so I wouldn’t say any product is ‘safe’ currently,” she told us.""This is in part because even legally sold vape products are subject to very little government oversight. “I have found it interesting that we still don’t really know exactly what is causing the issue,” said Cirulis. “I think [it] speaks to how poorly regulated the e-cigarette market really is — we have no idea what is in even the commercially sold e-liquids.”"So the main points this physician is making are:1. The vaping of any e-liquid, even if it is a product that has been on the market for ten years and has caused no problems, is dangerous and could be fatal.2. No e-liquids are any safer than any others. They are all equally risky. Vaping illicit THC carts purchased off the black market is no more dangerous than vaping a nicotine-containing e-cigarette purchased from a reputable retailer and made by a reputable company.3. It is no riskier to buy a vaping cartridge off the street where you have no idea what is in the e-liquid than to purchase an e-cigarette from a retail store made by a reputable manufacturer where you know exactly what is in the e-liquid.This is just crazy. And irresponsible.There is no way I would give the public advice that buying a THC vape cart from some drug dealer on the street is just as safe as buying an electronic cigarette from a reputable retailer. Or for that matter, that buying a THC vape cart from some drug dealer on the street is just as safe as buying a THC vaping liquid sold at a licensed dispensary.As inaccurate, uninformed, and irresponsible is this advice, I don't completely blame the physician. I think that physicians are relying on the CDC to do its job and they listen to what the CDC has to say. And so far, the CDC has essentially been saying the same thing. They have lumped all vaping together and have not clearly stated that using THC vape carts is more risky than using traditional e-cigarettes.I have never seen such a dismissal of the idea that there are gradations in risk. Apparently, I missed the memo that told us that from now on, everything is either dangerous or not. There is no middle ground and everything gets lumped together.Unfortunately, whoever sent that memo is endangering the lives of our nation's youth.Original author: Michael Siegel
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Despite Increasing Clarity in Role of Illicit THC Vape Carts in Lung Injury Outbreak, CDC Violating Its Own Principles to Blame E-Cigarettes

The role of illicit THC vape carts in the lung injury outbreak --which has now caused 7 deaths--continues to become clear. Yesterday, Dallas County reported 14 new cases ranging in age from 16 to 44 with a median age of 19, all of whom were hospitalized with severe respiratory distress. Although the news headline mentions only that these cases were associated with "vaping," if you read down to the 11th paragraph, you find out that "Ninety percent of the Dallas County cases reported vaping THC products."The CDC has continually downplayed the role of THC vape carts in the outbreak and even today, continues to blame it on electronic cigarettes generally. Most revealing is the fact that every time the CDC even mentions a potential role of THC, it immediately undermines it by emphasizing that "The investigation has not identified any specific e-cigarette or vaping product (devices, liquids, refill pods, and/or cartridges) or substance that is linked to all cases."The Rest of the StoryDon't let the CDC fool you. What they're not telling you is that in epidemiological outbreak investigations, we almost never identify a single exposure that ties together all of the cases. This is why we calculate odds ratios to estimate the strength of association between the exposure and the cases. If every single case was associated with a single exposure, then it wouldn't take an epidemiological analysis to identify the source of the outbreak.I defy you to find a single other CDC outbreak investigation in which the agency emphasized that "the investigation has not identified any specific exposure that is linked to all cases." The failure to find a 100% link between a single exposure and every single case is the norm in outbreak investigations and never precludes the CDC from concluding that a highly common exposure is a likely source. Except in this investigation.For example, consider the CDC's investigation of an outbreak of severe ocular and respiratory illness following exposure to a contaminated hotel swimming pool. The investigation identified 24 cases of disease. What percentage of the cases had gone swimming or entered the pool area?If you are thinking 100%, you are wrong. It was just 83%. But that didn't preclude the CDC from concluding that the swimming pool was implicated in the outbreak. They didn't issue a statement saying:"While 83% of the cases reported spending time in the pool area, 17% did not. The investigation has not identified any specific exposure that is linked to all cases."Consider the CDC's investigation of a Salmonella outbreak caused by contaminated beef sold in the U.S. Of the 73 cases who did not visit Mexico, what percentage reported eating beef?If you are thinking 100%, you are wrong. It was 93%. Again, that didn't cause CDC not to warn the public about the dangers of eating contaminated beef. They didn't issue a statement saying:"While 93% of the cases reported eating beef, 7% did not. The investigation has not identified any specific exposure that is linked to all cases."In the current outbreak investigation, there are many reasons why one would not expect to be able to tie every reported case to the use of THC vape carts:1. The primary affected demographic group is youth. About half of the cases are ages 19 and below. Thus, many of the cases are minors and would be expected to under-report their use of illicit marijuana vape cartridges that by definition were obtained from black market drug dealers.2. The CDC did not recommend that clinicians test patients for THC. In the absence of this testing, there is no way to validly conclude that a youth who doesn't report using THC products actually did not use those products.3. Not every youth may know exactly what is in the e-liquid cart they are using. It is entirely possible that some of the youths were vaping THC e-liquids but didn't know it.Frankly, given the consequences of admitting to illicit marijuana use for minors, it is quite remarkable that 90% the cases have admitted to using THC vape carts. Given these basic principles of outbreak investigation, why would the CDC violate its own principles in an effort to try to implicate legal electronic cigarettes and to take the focus off marijuana vaping?It is clear to me that the agency has a pre-existing bias against electronic cigarettes and really wants to be able to implicate these products.The CDC might attempt to defend itself by saying that they are simply trying to be extra cautious. But the truth is that if they wanted to be cautious, they would immediately issue a very clear and explicit warning to youth not to vape marijuana, period. That they have failed to do this indicates that they are playing with children's health and lives.The rest of the story is that the CDC is playing with children's health and lives in order to try to further demonize electronic cigarettes.Original author: Michael Siegel
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Heads Up – News – Updates 9.16.2019

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Under Michigan's New E-Cigarette Flavor Ban, a Youth Caught With a Juul Four-Pack Could Be Put in Prison for Six Months

Michigan's governor is prepared to issue an emergency executive order that would ban the sale of flavored electronic cigarettes effective immediately (once the order is filed). I have already explained why this law will be a public health disaster. It will have three major deleterious health effects:1. It will cause many ex-smokers to return to smoking as their vaping products are taken off the market.2. It will create a new black market for flavored e-liquids that does not exist today. As we are finding out, black market products can be extremely dangerous.3. It will cause many youths who are currently vaping e-liquids to switch to vaping marijuana e-joints that are purchased off the black market (and which are likely responsible for the current epidemic of severe respiratory disease).The law is also unjustified because it bans flavored e-cigarettes while leaving flavored real cigarettes on the shelves (in the name of menthol cigarettes). So while menthol fake cigarettes will be banned, selling menthol real cigarettes will be just fine. This will certainly harm menthol smokers who want to quit smoking by switching to menthol e-cigarettes.The Rest of the StoryOn top of all of the above, the law will criminalize the mere possession of four or more flavored e-cigarettes. Thus, a high school kid who is caught with a four-pack of flavored Juul pods will be guilty of a crime. An that crime is punishable by up to six months in state prison.The part of the law that criminalizes the possession of four or more flavored e-cigarettes reads as follows:"A person who possesses four or more flavored vapor products, or flavored alternative nicotine products is rebuttably presumed to possess said items with the intent to sell."The rest of the story is that Michigan's proposed flavored e-cigarette ban is terrible public policy that will have terrible public health consequences. It will also potentially criminalize any vaper who possesses four or more flavored e-liquid cartridges or pods. It has taken years to start the process of decriminalize the possession of small amounts of marijuana. Are we now going to have to do the same thing for the possession of life-saving e-liquids?Original author: Michael Siegel
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CASAA – Weekly Heads Up Round Up – 09.15.19

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Heads Up – News – Updates 9.13.2019

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Why ecig flavor bans are such a terrible policy

by Carl V Phillips

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E-Cigarettes are a Gateway to Smoking, so as Teen Vaping Dramatically Increased from 21% to 28%, Smoking Plummeted to Lowest Historical Level



Countering the claims of anti-nicotine groups that electronic cigarettes are a gateway to smoking, data released yesterday from the National Youth Tobacco Survey indicate that while the rates of teen vaping continued to increase dramatically (from 21% in 2018 to 28% in 2019 and from 12% to 28% from 2017-2019), the rate of decline in youth smoking accelerated in 2019, dropping to its lowest level in recorded history.If vaping was a gateway to smoking among youth, one would expect to see some sort of positive correlation between youth vaping rates and youth smoking rates. And in fact, there is a HUGE correlation between the rates of youth vaping and youth smoking during the period 2011-2019.The Rest of the StoryTo cut to the chase, the rest of the story is that there is indeed a huge correlation between the rates of youth vaping and the rates of youth smoking, which is at the very high level of 0.89. In fact, this is about as close to a perfect correlation as you can get with public health surveillance data.So, you say, this proves - beyond a doubt - that the anti-nicotine groups were right and that e-cigarettes are a gateway to youth smoking.There's just one thing I forgot to tell you ...... I forgot the minus sign.The correlation between the youth vaping and youth smoking rates during this decade is actually --0.89 (that's NEGATIVE 0.89).Here is the scatter plot (the smoking rate is the x-axis; the vaping rate is the y-axis):As you can see, there is a dramatic relationship here. The lower the vaping rate, the higher the smoking rate. And the higher the vaping rate, the lower the smoking rate.In other words, these data show that vaping is supplanting smoking, not supporting it. Vaping culture is not being transformed into smoking culture. It's exactly the opposite. Vaping culture is almost completely replacing smoking culture.Thus, the truth is that e-cigarettes are not leading to an increase in youth smoking. E-cigarettes are actually accelerating the trend of declining youth smoking.If you actually stop to talk to kids, they will tell you this. I do educational workshops with youths who are caught vaping or Juuling. And they repeatedly tell me - especially the Juulers - that they wouldn't even think about putting a cigarette in their mouths. They think it's disgusting. And that's a huge part of the appeal of the Juul - a cutting edge, modern, cool device that looks like a flash drive and allows you to emit a cool vapor cloud that dissipates almost instantly.The rest of the story is that vaping is not leading youth to smoking. Instead, what the data tell us is that a vaping culture is further decimating a smoking culture that is already on the decline.Original author: Michael Siegel
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Tobacco Financial Analysts: Flavored E-Cigarette Ban Will Substantially Boost Cigarette Sales

Due primarily to the CDC's hiding the fact that the overwhelming majority, if not all of the cases of "vaping-associated pulmonary illness (VAPI)" are most likely caused by vaping marijuana, not e-cigarettes, the Trump Administration and the FDA are poised to ban all flavored e-cigarettes.This obviously makes no sense at all.The logic is basically: Product X is causing a severe disease outbreak. Product Y is not. So we are going to immediately ban Product Y.The CDC has taken it a step further. They are essentially warning the public not to use "products," rather than telling them not use Product X.I have argued that a flavored e-cigarette ban would drive masses of ex-smokers from vaping back to smoking. This prediction now seems to be confirmed by a number of tobacco financial analysts, who are alerting investors that such a ban would substantially boost the sale of cigarettes while decimating the e-cigarette market, which has nearly doubled in the past year. It is predicted that nearly all of the declines in vaping will be translated into cigarette smoking.The Rest of the StoryThis may be the best evidence yet that the FDA's flavored e-cigarette ban will result in a substantial increase in smoking-related morbidity and mortality.There is no question that there is a direct link between the level of cigarette consumption in the U.S. and the number of smoking-related deaths. If cigarette consumption rises, then so does the number of deaths.The rest of the story is that the health groups calling for a ban on flavored e-cigarettes are also calling for a dramatic increase in smoking rates and in the number of smoking-related deaths.Original author: Michael Siegel
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Heads Up – News – Updates 9.11.2019

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Trump Administration’s Ban on Flavored E-Cigarettes Does More Harm

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Tobacco Companies’ Best Friends



Anti-tobacco activists portray themselves as enemies of “Big Tobacco,” so they naturally characterize the current panic about vaping among American teens as a new campaign by the industry.  This is fundamentally wrong, according to David Sweanor, a veteran anti-smoking advocate and chair of the advisory board for the Center for Health Law, Policy and Ethics at the University of Ottawa.  In the following guest blog, Sweanor suggests that the war against vaping is cigarette manufacturers’ best hope for a lucrative future. The presence of the tobacco industry plays a huge role in discussions on tobacco harm reduction and disruptive technology, but I have long found that those who think they are that industry’s greatest enemies are often among its biggest enablers. Yet understanding the fundamentals in play should not be so hard. We can start with what the financial markets appear to think of the state of these companies, which is seen in the 5-year stock price charts at left. In early 2017, the combined value of the FT500 tobacco companies (PMI, BAT/Reynolds, Altria, Japan Tobacco, Imperial and ITC) surpassed US$700 billion. That was a continuation of a longstanding skyward march of these companies as they benefitted from their ‘nicotine maintenance monopoly’ and raised prices in a cartel-like fashion. Recently the combined value was down to US$372 billion. In looking at their stock charts we can see clearly when disruption started to bite. This makes sense when we consider that those valuations are the present value of future anticipated earnings. So long as the companies can, as in the US, make cigarettes for 28 cents a pack and sell them, pre-taxes etc., for over $2.00, and keep raising their prices aggressively, and price elasticity is low, it is a licence to print money. Regulatory barriers thwarting competition keep them secure. But just as OPEC’s cartel invited alternative sources of energy and taxi cartels created an opportunity for Uber, the nicotine market has long been at risk of disruption, of true competition breaking out. The global cigarette market, at well over $US800 billion annually, huge profit margins, high tax burdens putting them at a price disadvantage, and unhappy customers, creates a tempting target. Regulations, public misinformation, actions by self-styled anti-tobacco groups, and technological challenges protect the cartel. But that protection is no longer assured and buying shares in Big Tobacco today starts to look a bit like buying into New York City taxi medallions just as Uber was getting launched. The idea that cigarette companies welcome this disruption flies in the face of their stock prices. Yet many in the tobacco control field seem convinced that whatever happens with new technology Big Tobacco will win because, well, they have long dominated the market. Leaving aside that the market apparently disagrees, this is worth thinking about. Disruption has hit a great many businesses over a very long time. Would anyone care to list all the market-dominating companies that did well from such disruption? They typically get blown away, and for very good reasons. They are large, bureaucratic and risk-averse, and have much to lose if they make mistakes. They also typically lack the expertise in the emerging technologies and are held back by those in the company who are committed to the status quo. Meanwhile, lots of start-ups can compete for the emerging market with little to lose but huge upside if they are ultimate winners. Horse breeders did not come to dominate the tractor business, nor horseless carriages. IBM missed out on software, Microsoft on social media, the Yellow Pages on internet search, NYC taxi medallion owners were not the backers of Uber. Then there were makers of rotary dial phones, beat by the likes of Motorola, in turn beaten by the likes of Nokia, which was trounced by BlackBerry, which in turn lost out to Samsung and Apple.  The list of big, established, market-dominating companies ‘doing a Kodak’ is very, very long. Also, if Big Tobacco really wanted to facilitate a rapid transition to low risk products they would act very differently. They are, after all, in possession of the best market intelligence. They know what happens when vape products compete directly with cigarettes. They know how many smokers would seriously try to switch if adequately informed about relative risks, and they know how things like risk-proportionate regulation and taxation is likely to impact the markets. But they stay pretty quiet. I think it is helpful to think of Big Tobacco and alternative nicotine the way we would think of the House of Saud and alternatives to fossil fuels. Big Tobacco must prepare as best they can for a market they think is fundamentally changing. They must sound like they are very supportive, for public relation and legal liability reasons. But the slower the transition, the longer they can reap the rewards of their exceedingly lucrative cartel. Substituting market intelligence for the current ‘if they seem to want to do it, we will oppose it’ thinking, and the application of some strategy could lead to some quite extraordinary breakthroughs. Original author: Brad Rodu
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In Completely Irresponsible and Negligent Message, American Lung Association Warns against E-Cigarette Use, but Not against Vaping THC

In response to the alarming outbreak of severe, acute respiratory disease that has now affected more than 450 people in 33 states and has killed six people, the American Lung Association issued a statement yesterday stating that no one should continue using electronic cigarettes, which it says can cause "irreversible lung damage." According to the statement: "E-cigarettes are not safe and can cause irreversible lung damage and lung disease. No one should use e-cigarettes or any other tobacco product. This message is even more urgent today following the increasing reports of vaping-related illnesses and deaths nationwide."The Rest of the StoryThis is an irresponsible and I believe negligent message that is going to cause a lot of harm. By hiding from the public the fact that the overwhelming majority of cases have been associated not with electronic cigarettes, but with the vaping of marijuana, this message is actually going to result in many youth continuing to vape THC products.Rather than tell the truth and issue a clear and unequivocal warning that people should stop vaping THC vape cartridges, this message to avoid e-cigarettes is not only failing to prevent further cases of the disease, but it is essentially going to cause more diseases because youth are going to be misled into thinking that the risk is associated with e-cigarettes, not vaped marijuana.Furthermore, banning flavored e-cigarettes, as the White House is apparently considering, would not doing anything to stem the outbreak, since e-cigarettes do not appear to be causing the outbreak. Instead, a ban on flavored e-cigarettes would lead many ex-smokers to go back to smoking.Original author: Michael Siegel
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Mayor Michael Bloomberg and the Campaign for Tobacco-Free Kids are Lying to the Public

Whether one supports or opposes a ban on flavored e-cigarettes, I would hope we would all agree that it is unethical to lie to the public in order to support one's position. But that is exactly what Mayor Bloomberg and the Campaign for Tobacco-Free Kids have done in an op-ed they published today in the New York Times.The op-ed states: "Any adult knows that if you want to get a child’s attention, there is no enticement like candy. This currency of youth has become the weapon of choice for tobacco companies. They are making huge investments in nicotine-loaded e-cigarettes and selling them in a rainbow of sweet and fruity flavors like cotton candy, gummy bear, mango and mint."It is simply not true that the tobacco companies are selling electronic cigarettes in cotton candy or gummy bear flavors. Those flavors are certainly on the market, but they are not being sold by tobacco companies. In the U.S., there are four major brands of electronic cigarettes that are sold, at least in part, by tobacco companies: Juul, blu, Logic, and Vuse. While each of these brands has flavored e-liquids or pods, none of them sells gummy bear or cotton candy flavors.The Rest of the StoryWhy is it necessary to lie to make the point that tobacco companies are selling e-liquids in flavors that are attractive to youth?I don't understand this. I have worked in the tobacco control movement for 34 years and have been involved in numerous public campaigns against the tobacco industry and tobacco products. But never have I lied about the facts in order to try to support my policy positions.Honesty and transparency are important ethical values in the practice of public health. We shouldn't flush them down the sink just to try to make a more jarring appeal to the public. The truth should be enough.Beyond this lie, the piece is misleading in tying the respiratory disease outbreak that has affected more than 450 people and caused five deaths to electronic cigarettes. By the CDC's own admission, 80% of the cases have been tied to vaping illicit marijuana/THC cartridges, not legal e-cigarettes. It is disingenuous and frankly, dishonest, to suggest to the public that this terrible outbreak is being caused by e-cigarettes, when there is no solid evidence to back up that claim.As I have pointed out before, youth are understandably reluctant to report illicit use of marijuana vape cartridges purchased off the black market, so it is quite possible that there is a significant amount of under-reporting. Because of this under-reporting, it is possible that all of the cases are associated with e-cannabis rather than e-cigarettes.We live at a time when some politicians have no trouble simply making up the facts as they go along to support their positions. Public health organizations should not be doing the same thing.Original author: Michael Siegel
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Heads Up – News – Updates 9.10.2019

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Pieces of the Mysterious Lung Disease Puzzle Starting to Come Together, But CDC Continues to Endanger Health by Hiding the Critical Pieces

The pieces of the puzzle of what is causing the "mysterious" outbreak of acute, severe lung disease among more than 450 people--mostly youth and young adults--are starting to come together. Yesterday, new cases of this illness were reported in at least three states. They were said to be associated with "vaping." However, if you read the fine print, it turns out that all of these cases were associated with the use of black market THC vaping cartridges.Georgia Public Radio announced two new cases of "vaping-related illness" in the state of Georgia. If you read down further in the article, you'll find out that "Both cases have a history of vaping, including THC."The Lake County News-Sun announced a new case of respiratory illness in Illinois caused by the use of "electric cigarettes." If you read further down, you'll find out that the patient admitted that last year, he "began smoking sold-on-the-street 'dab sticks,' THC-filled devices made for e-cigs."WSB-TV in Atlanta reported a new case of "vaping-related" respiratory illness in Georgia. If you read a little further down in the article, you'll find out that "he had recently vaped a liquid cannabis product."The more cases that are closely examined, the more clear it becomes that this outbreak is primarily, if not entirely, explained by the vaping of illicit, black market THC cartridges.  Importantly today, another piece of the puzzle came together. One of the inconsistent pieces of the puzzle was that although most of the cases appeared to be associated with black market THC cartridges, there was one death in Oregon that was reportedly associated with a THC vaping product purchased from a licensed dispensary. How could that have happened? Well today that mystery may have been solved. A leading Oregon cannabis extraction company revealed that just this spring, it began selling THC cartridges that had been cut with vitamin E acetate oil. The product was apparently approved by the Oregon Liquor Control Commission (OLCC) for use in legal recreational marijuana products sold at licensed dispensaries in the state.Furthermore, the owner of this company explained that recently, there was a "revolutionary" change: the widespread introduction of a new diluent thickening agent (a vitamin E acetate oil) that was soon adopted "everywhere." As explained in Willamette Week: "Jones is a leading figure in one of the most lucrative segments of the cannabis industry: butane hash oil, the honeylike distilled essence of cannabis plants. That extract can be used in vaporizer pens. He claimed in 2017 that he was making millions of dollars from the machine, called "Mr. Extractor," used to extract the hash oil. ... Jones writes that a Los Angeles-based company called HoneyCut first revolutionized diluent thickeners. He writes that these products have become hugely popular. "Through our research and testing we have found that almost every terpene and flavor manufacturer in the country is selling their version of Tocopheryl Acetate," Jones writes. Jones writes that when he met with the OLCC in the spring, he expressed to them that these additives would be "everywhere" within the next six months. ... Jones also writes that many of these diluent thickening products are now available through wholesale retailers online." In light of the recent outbreak, Jones' company has discontinued the use of its vitamin E acetate product and apparently all other diluents. The Rest of the StoryAlthough the cause of this outbreak is becoming clearer and clearer, the CDC's messages to the public are becoming vaguer and vaguer. Instead of honing in on the importance of youth immediately stopping the use of black market THC vape cartridges, the CDC is instead continuing to put the blame on vaping in general, including electronic cigarettes manufactured by legally by reputable companies. The CDC is deviating from standard protocol used in disease outbreak investigations and health emergencies, and I believe this is because they have such a bias against electronic cigarettes that they refuse to let this opportunity to further demonize e-cigarettes go by, even though the evidence points in a completely different direction.Not only is this putting the lives of our nation's youth at risk because the CDC is not warning them about the risks of using THC vape cartridges, but it is leading to irresponsible and irrational public policy. Within the past few days, the governor of Michigan implemented a ban on all flavored e-cigarettes, and politicians in the states of New York and Delaware announced that they will introduce similar legislation in those states.These proposed flavored e-cigarette bans would be a public health disaster. They would result in thousands of ex-smokers returning to smoking as the products that are keeping them smoke-free are taken off the shelves. It would also create a new black market for e-cigarette products where one does not currently exist. And the most ironic result would be that in May 2020, when e-cigarettes in all of the other states fall under the jurisdiction of the FDA, these states' vaping products would be the only ones in the country that are unregulated. If this outbreak has taught us anything, it is the dangers posed by the black market. Who knows what kind of public health disasters lie ahead in Michigan and other states that ban e-cigarettes and then are hit with a huge black market for vaping products that are in extremely high demand by smokers and ex-smokers who want to protect their health.Original author: Michael Siegel
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