Vaping has been the focus of intense attention and scrutiny across the nation in recent weeks, as hundreds of cases of mysterious – and often sudden – lung injuries have been reported in what health officials have described as an epidemic.
Last week, two Rhode Island cases – the first reported in the state – were added to that growing list. According to the Department of Health, both of the affected people – one between the ages of 18 and 24, the other between the ages of 25 to 35 – experienced the onset of symptoms in early September and have since been discharged from the hospital.
Meanwhile, the health department has instituted a temporary ban on the sale of flavored vaping products, as ordered by Gov. Gina Raimondo.
Johnston Mayor Joseph Polisena, a nurse by trade, said that he thinks Raimondo is “on to something” with her executive order. He said he backs the ban because he said vaping can lead to people developing lung disease, cancer or other illnesses at a younger age.
“I think the governor has a plan. I’m very confident in what she wants to do, and I support what she wants to do,” he said. “Our youth are our future, and if they’re all going to be sitting, 15, 25 years from now, in a chair on oxygen, not good … The vaping hasn’t been around a long time, but you’re seeing these people die. I don’t want to see a generation of people on oxygen.”
Polisena said that while an outright ban on vaping products – as Gov. Charlie Baker has instituted on a temporary basis in Massachusetts – may not be an effective, or legal, answer, stricter enforcement is essential to cracking down on the matter.
He proposed a possible series of penalties, such as six-month license suspension if a business is caught selling to a minor, followed by one year and then subsequent punishment.
“I think that the store owners will be responsible,” Polisena said. “Now they know that the state is breathing down their neck, as well as the government’s breathing down their neck, I think they’ll be more responsible and say, ‘I need to see your ID.’ It’s not worth selling it not asking for someone’s ID. I’d rather lose the sale than get suspended for six months selling the product.”
Polisena recalled his days working for the Fire Department, describing people they would take in with chronic obstructive pulmonary disease, or COPD. He expressed concern that there could be “a different type of lung disease for a different generation.”
“They’re like a chimney,” he said. “When you take a puff of a cigarette, some smoke comes out. There’s like a big cloud. That’s going into their lungs, and it can’t be good. I have a concern with the youth sales, no doubt about it … I do understand it’s a legal product and you’re going to put people out of business, I don’t want to see that. Obviously we’re very pro-business in this town, but I think possibly maybe the alternative would be stricter enforcement.”
Raimondo’s order, which went into effect on Oct. 4, prohibits the sale of flavored electronic nicotine-delivery systems – or ENDS – in Rhode Island for four months with an option for a 60-day extension. Compassion centers that offer THC-based vaping products to medicinal marijuana patients and licensed cultivators are exempt from the ban. A letter was sent to all registered ENDS retailers regarding the emergency rules.
“Compassion centers and licensed cultivators registered with the State of Rhode Island are already highly regulated by RIDOH and the Department of Business Regulation,” a statement from the health department reads. “RIDOH will consider taking further action regarding THC-based vaping in conjunction with the advice of the Vaping Advisory Committee being formed pursuant to Governor Raimondo’s Executive Order.”
The health department said its regulations were formulated based on “extensive community outreach” with “the business industry, healthcare providers, community partners, other state agencies, prevention and cessation advocates, parents, youth, and members of the General Assembly.”
According to the statement, approximately one in five Rhode Island high school students and 15 percent of the state’s middle school students report regularly using vaping products. Most, the statement reads, reporting using products with flavors such as “mango, cucumber, vanilla, cherry, mint and cotton candy.”
“I’m deeply concerned about the rapid increase and effects of e-cigarette use among youth. That’s why in Rhode Island we’re taking action to ensure that companies can no longer market these products with colorful packaging and candy-based flavors,” Raimondo said in the statement. “This is a public health crisis, and the regulations announced today will help to protect our kids’ health.”
In terms of the local lung injury cases, the health department said that the two incidents were “not linked.” Products used by each of the people involved have been sent to a state lab for testing, the department said.
“The specific chemical exposures causing lung injury associated with vaping have not yet been identified,” a statement from the department reads. “Given the unknowns about this lung injury cluster, the [Centers for Disease Control and Prevention] is reporting the number of cases in each state using the single designation ‘confirmed and probable cases.’ Rhode Island’s two cases are among these ‘confirmed and probable cases.’”
The latest figures from the CDC show 1,080 reported lung injury cases across 48 states and one U.S. territory. Eighteen related deaths have been confirmed in 15 states.
“There have been no deaths in Rhode Island,” the health department’s statement reads. “All patients have a history of vaping. The latest findings from the investigation suggest that products containing tetrahydrocannabinol (THC) play a role in the outbreak. THC is a component in cannabis.”
“While we do not yet know what exactly is causing people to become ill across the country, we do know that these lung injuries are serious, and in some instances even fatal,” said Director of Heath Nicole Alexander-Scott said.