Trump responds to a vaping crisis by attacking another

The marijuana vaping epidemic has given the Trump administration the perfect opportunity to tackle another public health problem: the consumption of e-cigarettes by teens.

But the two are not directly related.

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One of the crises mainly concerns the pot, the other the nicotine. One is motivated by the illegal drugs of marijuana, the other by nicotine vapors with fruity taste. But the deadly pneumonia epidemic this summer has created an opportunity that has been seized, with this week's announcement by President Donald Trump's Oval Office to ban the "flavored vodas" that have attracted millions of dollars. teens.

Trump did not say that he understood the distinction between the two substances when he announced the ban on Wednesday. "People are dying of vaping," he said. "Many people think that vaping is wonderful, it's great. It's really not wonderful.

Her comments have conveniently combined the alarming growth of teenage vaping with the epidemic of lung disease that officials have often linked to vaping products containing THC, the main psychoactive component of marijuana. The administration took a crisis and used it to embellish another one that had regularly caught Washington 's attention.

The White House's action against flavored electronic cigarettes will have no effect on marijuana inhalation regulations, which are the responsibility of states where marijuana has been legalized. But the FDA and legislators have long had flavored vases in sight because of their role in a disconcerting increase in nicotine consumption among teenage girls over the past two years, after decades of decline.

The government is fiercely pressuring vaping companies, who are wary of federal regulations, while encouraging marijuana companies, who want more.

"It's like having salmonella in romaine lettuce and asking for the ban on peanut butter. It's literally a public health mistake, "said Mike Hogan, lobbyist for the Smoke-Free Alternatives Association. Critics like Hogan say Trump's focus on e-cigarettes completely ignores early state-level data linking lung disease cases and cartons containing THC.

A preliminary report from Illinois and Wisconsin revealed that 84% of their cases of lung disease were related to marijuana vows. New York State officials cited vitamin E acetate in THC oils as the main culprit. California and Oregon each reported a marijuana cartridge death.

The Administration's prohibitions on flavors were motivated by figures from a sobering national survey showing that teenage smoking is on the rise. Former FDA commissioner, Scott Gottlieb, has stood up against flavored electronic cigarettes during his tenure and supports the ban.

But the mystery of lung disease is a different challenge, he said, and "you really have to separate these two issues."

The measures taken by the administration contrasted with the cautious approach taken by the federal authorities to link the diseases caused by vaping with a product or substance until the investigation is completed.

FDA Acting Commissioner Ned Sharpless and CDC Director Robert Redfield have request consumers to avoid street products and THC oil, even though Redfield has taken a further step in suggesting that all users of electronic cigarettes should "consider not using [e-cigarette] some products."

Some public health officials view these two strategies as different parts of an imperfect policy.

"CDC has meditated so much on the risks of vaping that it literally did not say anything about marijuana vaping in young people," said Michael Siegel, a researcher in public health and tobacco control at Boston University. "They almost want to blame the usual electronic cigarette products for telling them," I told you so. ""

The FDA said its investigations on the outbreak "involved a wider use of vaping products – including those used with substances such as THC". She pointed out that the ban on flavored was meant to keep electronic cigarettes out of teenagers' hands – not necessarily out of reach of teenagers. fully market.

And a CDC spokesman warned that not all lung diseases were definitely caused by a marijuana-derived product. "Most, but not all, patients reported using electronic cigarettes containing THC. Many report using THC and nicotine. Some report using only products containing nicotine. "

Under federal law, the government could raid state-approved clinics and remove all products for spraying, but even the White House can not create new surveillance for marijuana products at the same time. beyond what is described in the Controlled Substances Act. To change that, Congress should reclassify marijuana – a measure much less likely to reach the president's office than the laws targeting the electronic cigarette industry.

Many lawmakers already had in mind the electronic cigarette. After Trump's action, active Democrats in Congress debated further evidence that the epidemic of lung disease was related to the vape of marijuana, far more than to e-cigarettes in general.

E & C's oversight subcommittee chair, Diana DeGette, who is planning a hearing on the lung disease epidemic and the safety of e-cigarettes later this month, said the pulmonologists in her legal state are not willing to attribute the disease entirely to the vape of weeds.

The announcement made by DeGette at the hearing makes no mention of marijuana. In addition, 23 Democrat Senators asked the federal agencies to answer questions about the harmful effects of electronic cigarettes on health. Senator Jeff Merkley (D-Ore.) Has been calling for restrictions on the electronic cigarette since 2009 – never mentioning a jar. A spray product from a legal marijuana dispensary in Oregon is linked to one of the deaths due to lung disease.

Merkley's spokesman said "the details are still obscure" about the death, adding that the senator expects the FDA, once its research is over, to act against the offending products, " whether or not they contain nicotine, THC or both ".

"You have to go to the schools, you have to adopt state laws," said Donna Shalala (D-Fla.), HHS Secretary of the Clinton, who introduced radical legislation to ban the flavors of electronic cigarette and to limit sales. "Everyone has to do something."

The federal ban on marijuana means that the decision to change or impose new regulations on marijuana vape cartridges rests entirely with the 33 states that have legalized marijuana for medical purposes or for use adult.

The state legislature in California planned to regulate electronic cigarettes, but not marijuana cartridges. In Massachusetts, cannabis commissioner Shawn Collins asked all the vapor cartridges to list all ingredients, including additives and thickeners. Democratic Democrat Steve Sweeney, president of the New Jersey Senate, said he wants a law banning all spray products, both tobacco and marijuana. And in Oregon, the AP reported that the authorities will ask marijuana dispensaries to revise their inventories and post warnings about the potential dangers of vaping.

In the absence of federal supervision or guidelines, said Collins, Massachusetts and other states must consult on appropriate policies.

"It's the legalized cannabis environment, you know; States are in a way left to their own devices in many ways, "he said.

According to the National Cannabis Industry Association, many marijuana-related health problems have been linked to unlicensed marijuana vows on the black market. A death in Oregon, however, would have been caused by a cartridge purchased at a legal clinic.

But there has been no real call for action to have marijuana legal states review existing regulations.

States send samples of marijuana vapor to FDA laboratories for testing, but since marijuana is illegal at the federal level, there is no baseline for testing samples. And without standard lists of packaging and ingredients, it's hard for the agency to know what to look for.

"There is a regulatory vacuum here. States have legalized cannabis but they have no infrastructure to regulate it properly, "Gottlieb said. In the meantime, the market is filled with regulated and unregulated THC, as well as cannabidiol, or CBD, another marijuana derivative, recently legalized in part.

The federal prohibition on marijuana limits the FDA's ability to regulate marijuana, although vaping products like CBD have apparently gained popularity, Gottlieb said.

"It's not fair to say that it's the fault of the FDA," he said. "It might not be within the reach of the FDA."

Paul Demko contributed to this report.