Gov. Steve Bullock announced a temporary ban on all flavored e-cigarettes Tuesday, responding to a public health emergency after at least two reported illnesses in Montana were linked to vaping.
Bullock directed the Montana Department of Public Health and Human Services to implement emergency administrative rules, starting Oct. 22, to temporarily prohibit the sale of flavored e-cigarettes. The emergency rules will be in effect for 120 days, the maximum time allowed by law.
The ban includes flavored nicotine, THC and CBD vaping products, in-store and online. The ban does not require retailers to destroy their existing inventory.
“Businesses do not have to destroy flavored products under the emergency rule and they are still permitted to sell unflavored vaping products,” said the announcement from Bullock’s office.
“Young Montanans are using e-cigarettes at an alarming rate, while officials investigate the possible causes of a national outbreak of e-cigarette-related injury and death, leaving us at a crossroads,” said Bullock. “Today, I choose action.”
The ban on flavored e-cigarettes, which are widely marketed to and used by young people, seeks to curb e-cigarette use while authorities investigate what product or chemical is causing critical illnesses across the country and develop an evidence-based response.
The two Montana cases include a 20-something individual from Gallatin County and a 30-something e-cigarette user from Yellowstone County. Nationwide, 1,080 confirmed and probable cases and 21 deaths have been linked to e-cigarette use in 48 states and one U.S. territory.
More than half the cases involve patients under 25 years old.
“Protecting the health, safety and well-being of all Montanans – especially our kids – is one of my top priorities as governor, and I join the other parents across this state knowing we cannot rest until we do everything we can to keep our kids safe,” Bullock said Tuesday. “This is the right thing to do during the outbreak of these illnesses and deaths and it’s the right thing to do for the future leaders of our state.”
Missoula vaping shops blamed the illnesses on distorted information and pre-filled tetrahydrocannabinol cartridges, probably purchased illegally – not legitimate e-cigarette users who buy from legal, FDA-regulated shops.
Tyler Courter, The Vape Shop manager in Missoula, responded to the governor’s upcoming ban: “It’s a waiting game until we find out what’s going on.”
Courter said about 98 percent of The Vape Shop’s inventory consists of flavored e-cigarettes and vaping products, including “menthol, fruity, dessert-flavored and tobacco with vanilla or caramel.”
A former regular tobacco cigarette smoker, Courter holds himself up as an example of a convert to flavored e-cigs – which often reportedly help someone hooked on cigarette nicotine to stop or reduce their tobacco intake.
“We only have a couple flavored with tobacco blend because customers tend to notice the tobacco,” added Courter. “After my first bottle of tobacco-flavored juice, it didn’t taste good to me, so I went to something more fruity like raspberry because it didn’t taste like tobacco.”
Following a Food and Drug Administration warning in September about potentially dire health effects of vaping, the Trump administration has failed to enact a ban, as the president originally promised.
Bullock’s office has run out of patience with the White House, said the governor’s spokeswoman, Marissa Perry: “It’s unacceptable to the governor to sit idly by while we wait on action that was promised at the federal level and while we wait to learn more about what is causing illness and death. This state action is about protecting the health and safety of our kids.”
Bullock is running for the Democratic presidential nomination to challenge Trump in 2020.
Meanwhile, some local Missoula vape shops have reported an uptick in customers – or at least a return to normal averages – after the national media reported that THC-tainted and suspiciously tainted vaporizers sold on the black market were pinpointed as causing some of the serious illnesses.
The CDC reported on Oct. 3 that of 18 deaths confirmed in 15 states, most patients reported a history of using THC-containing products.
“The latest national and regional findings suggest products containing THC play a role in the outbreak,” reported the CDC.
Bullock’s mandate is in keeping with nationwide health officials, many of whom have advised people to stop vaping entirely.
Montana joins six other states that have taken similar action, including Washington, Oregon, Michigan, Rhode Island, New York and Massachusetts. Utah, too, passed emergency rules limiting where e-cigarettes can be sold. California Gov. Gavin Newsom issued an executive order to increase public awareness and develop warning labels.
E-cigarettes are now the most commonly used tobacco product among all youth.
The 2019 Montana Youth Risk Behavior Survey showed 30% of Montana high school students currently use e-cigarettes and more than 58% have tried them. In Montana, 28% of middle school students report having tried e-cigarettes, and 16% report currently using them.
About 43,000 Montana youth between ages 12 and 18 have tried vaping products and 22,000 Montana youth are currently using vaping products. Between 2017 and 2019, the percentage of Montana high school students using these products frequently – on 20 or more of the past 30 days – has increased by 243% and daily use has increased by 263%.
Greg Holzman, DPHHS state medical officer, said the federal government banned all flavors for conventional cigarettes except for menthol in 2009.
“Since then, current use of cigarettes among U.S. youth has decreased significantly,” said Holzman. “However, this ban did not include e-cigarettes which had recently entered the market. It is evident that flavored e-cigarettes have helped fuel this current epidemic.”
Youth are uniquely at-risk for long lasting effects of nicotine exposure because the brain continues to develop until age 25, said Cathy White, a pediatrician at Southwest Montana Community Health Center and the president of the Montana Chapter of American Academy of Pediatrics.
Nicotine exposure during adolescence harms the part of the brain that controls attention, learning, mood and impulse control.
Since pediatricians in Montana see tobacco use continue as a major health threat to children, adolescents and adults, White said the state’s pediatricians support Bullock’s aim to end the “vaping epidemic.”
“We are creating nicotine addiction among a whole new generation of children, who will then go on to suffer from tobacco-related diseases,” said White.
Capital High School principal Brett Zanto said parents and schools are responsible for talking to kids in middle school and high school about the harmful effects of vaping. Tuesday’s announcement highlights an issue impacting middle school and high school students across the state. He said parents can play an integral role in addressing this public health epidemic.
“As a school administrator, we see the impact this is having on our youth,” said Zanto, “and it’s disturbing to think about all that is unknown about the long-term health consequences.”
Several resources are available statewide to help Montanans quit using tobacco products: the Montana Tobacco Quit Line, the American Indian Commercial Tobacco Quit Line and the Quit Now Montana Pregnancy program.
The My Life, My Quit Youth program for youth ages 12 to 17 who want to quit all forms of tobacco – including vaping – may be contacted at 1-855-891-9989 or text ‘Start My Quit.’