Guest Post: DHHS Secretary’s Statement on “E-Cigarette-Related” Respiratory Illnesses is Irresponsible; Does Not Even Mention E-Cannabis

By September 3, 2019News

DHHS Secretary’s Statement on “E-Cigarette-Related” Respiratory Illnesses is Irresponsible; Does Not Even Mention E-Cannabis

Last Friday, the Secretary of the Department of Health and Human Services (DHHS) issued a statement on the recent upsurge in reported cases of respiratory illnesses that have occurred among more than 200 youth and young adults, all of whom reported “vaping.”

The statement made two recommendations to the public:

  • “Americans who use e-cigarettes and are concerned about these specific, potential risks of illness should consider refraining from their use, and should not buy them off the street or modify them or add substances in ways not intended by the manufacturer.”
  • “Youth, young adults, and pregnant women should never be using e-cigarettes, and Americans who do not use tobacco products should not start using e-cigarettes.”

So essentially, the warning from the nation’s leading public health official regarding this alarming outbreak of severe respiratory disease is: “Do not use e-cigarettes.”

The Rest of the Story

What is so irresponsible about this warning is not what is says, but what it doesn’t say. Nowhere in the statement does it even mention that the majority of the cases have been associated not with the use of e-cigarettes, but with the use of e-cannabis, specifically, with THC oils purchased off the black market. Nowhere does it warn the public not to use THC oils, unless they are purchased from a licensed and regulated cannabis dispensary.

What the HHS secretary is telling the public is that all we know is that these cases are associated with vaping, so don’t vape. That’s ridiculous advice. First of all, it will have no effect because it’s far too vague to change anyone’s behavior. Second of all, it is not specific enough to provide an appropriate warning.

Inexplicably, the CDC has not released the most critical information that we need: What percentage of cases have been attributed to the use of THC oils, synthetic marijuana, or e-joints, as they are sometimes called? Why is the CDC hiding this information from the public?

So far, three health departments have been responsible enough to tell us exactly what percentage of cases were linked to e-joints compared to e-cigarettes:

California
21 of 21 cases apparently were linked to vaping THC oil (100% of cases)

New Mexico
8 out of 8 cases confirmed to be associated with vaping THC oil (100% of cases)

Wisconsin
24 of 27 cases confirmed to be associated with vaping THC oil (89% of cases)

Across these three states combined, 95% of the cases have been linked to the use of e-joints, not e-cigarettes.

Even in the cases that have not been linked to the use of e-cannabis, it is still very possible that e-cannabis was involved. Youth may simply be reluctant to report that they were using cannabis that was purchased illegally from drug dealers. You can certainly understand why a youth may not want to readily admit this. In many cases, youth have initially failed to report the use of e-cannabis, but only reported it after further questioning. As the recent New York Times article reports, at least some youth did not reveal their THC use. This is understandable: in many high schools, the use of cannabis is punishable by a suspension of as much as 180 days.

I am not arguing that we have enough information to conclude that no e-cigarette products are involved in these cases. However, we do have enough information to conclude thatmost of these cases are associated with the use of illicit e-cannabis products. Thus, it is imperative that people be warned very specifically about this connection.

A fascinating question is why health officials are failing to describe this as an e-cannabis problem, rather than a “vaping” or “e-cigarette” problem. I don’t think there’s any doubt why: the CDC and other health agencies have demonstrated a strong bias against e-cigarettes from the beginning and are taking advantage of this unique opportunity to further bash e-cigarettes. They’ve been doing that for years. Only now, there’s one difference. The health and lives of many youths are imminently at risk.

Michael Siegel, MD, MPH

Professor

Department of Community Health Sciences

Boston University School of Public Health

801 Massachusetts Avenue, 4th Floor

Boston, MA 02118

617-358-1347

FAX 617-358-1700

This commentary appears today on my tobacco blog, at: https://tobaccoanalysis.blogspot.com/2019/09/dhhs-secretarys-statement-on-e.html.