He was a healthy 20-something with no history of medical conditions, but he passed away at his home, unable to reach the hospital in time. The only thing doctors knew for certain was that he suffered a severe lung injury.
On Oct. 9, 2019, the Utah Department of Health officially confirmed the state’s first vaping-related death.
Although there has only been one confirmed death in Utah, the state has had an unusually high number of vaping-related injuries, with 98 reported cases (6.5%) out of the almost 1,500 cases nationwide. Like Utah’s lone vaping death, most patients are between 18-24 years old.
“Utah has the highest number of cases per capita of all the states. We don’t know why just yet, but we’re collecting samples, testing samples, interviewing patients, and looking for an answer,” says Ryan Bartlett, media coordinator for the health department’s Tobacco Prevention and Control Program.
Bartlett notes that vaping products containing illicit tetrahydrocannabinol — more commonly known as THC — have been linked to almost all lung-injury cases in Utah.
“Almost 95% of Utah cases have been linked to the use of street-bought THC cartridges,” he says. “Only a few confirmed cases were strictly nicotine vaping-related injuries.”
A Salt Lake County autopsy of the one vaping death in Utah later found no other cause of death besides a lung injury, according to the Salt Lake Tribune. Additionally, a toxicology report indicated the use of THC, the psychoactive substance in marijuana. Authorities also found THC vape cartridges in the deceased’s home.
To mitigate an increase in these cases, the health department enacted an emergency rule on Oct. 3, requiring all tobacco specialty shops to display signs warning against the use of THC vaping products. In addition, the ruling effectively removed all flavored vaping products from general tobacco retailers.
“The rule states that general tobacco retailers — that’d be like Walgreens, convenience stores, gas stations — would not be permitted to sell flavored vaping products for the duration of the ruling,” says Bartlett.
The ruling was proposed to be in effect for 90 days but has since been rescinded by Utah’s 3rd District Court.
“There’s been dozens and dozens hospitalized in Utah as a result of vaping, mostly vaping THC. For the sake of public health, we’re going to speak with policy makers and the owners of these general tobacco retailer stores in the hopes of making this regulation permanent,” says Bartlett.
As of Oct. 28, however, Utah Vapors Business Association won in a court hearing against the health department, ruling that the emergency vaping rule would be repealed.
“We are disappointed in the outcome of the hearing,” says Christy Cushing, policy analyst at the health department. “Our top priority is stopping the outbreak of vaping-associated lung injuries, and we believe the emergency rule is one of the tools that can help us achieve that goal.”
Many stores selling tobacco, including vaping products, have already complied with the emergency rule, Cushing says.
“The plaintiffs who brought this suit represent a small minority of tobacco businesses,” says Cushing. “The vast majority of both general tobacco retailers and specialty tobacco shops are already in compliance with the emergency rule and we encourage them to remain so.”
But Cushing says they will continue with other efforts to stop this outbreak and to protect the public’s health. In accordance with the new ruling, they will notify local health departments to cease enforcement of the emergency rule for the time being. The health department plans to present cases in future hearings.
Utah is also on track to enact a regulation that mandates an increase in the legal purchase age of tobacco products, according to the Public Health Law Center. As of July 1, 2020, the legal purchase age increases to 20. The following year, the purchase age increase will conclude on July 1, 2021, raising the age to 21.
On a national setting, Michigan, New York, Massachusetts, Rhode Island and Washington state have all enacted some form of ban on the sale of vaping products. Massachusetts, a state where recreational and medical marijuana is legal, has placed a more severe ruling on vaping products, halting the sale of all nicotine and THC vaping products regardless of flavor and contents for four months. This ruling includes e-sales of these products.
“The regulation they’ve put in place is on an extreme end of the spectrum,” says 22-year-old Massachusetts native and vaper, Dylan Hayashi. “They’re targeting reputable businesses when they should be cracking down on the sale of illegal THC cartridges.”
Hayashi admits, however, that the regulations, news stories and his personal experience are changing his stance on vaping, whether its nicotine or THC.
“The ban made me decide that it could be a good time to stop vaping,” says Hayashi. “After hearing some of these stories, it also makes you want to reconsider.”
Comparatively, Utah’s emergency ruling is much less stringent as it only removes flavored e-liquids from general retail stores. Tobacco specialty shops, informally known as smoke shops, can continue selling their usual products.
Noel Jensen, a 22-year-old Utah resident and vaper, hasn’t noticed a difference in the accessibility of nicotine vaping products since the emergency ruling.
“I noticed the signs warning people about THC products, but I can still get the flavors I want,” says Jensen.
Jensen says he typically buys his vaping product from specialty tobacco shops.
While vaping as a general means of consumption has come under attack, the reality is that illicit THC cartridges distributed across the nation are causing the bulk of the cases, according to the Centers for Disease Control.
The primary cause of illness can vary from state to state, but it is undeniable that vaping THC is linked to lung injury. More specifically, in a report released by the New York Times, Mayo Clinic researchers found that Vitamin E Acetate, a common filler in home-made THC vaping products, is a likely cause of many vaping-related cases.
To combat the consumption of these unsafe and illegal products, legitimate cannabis vaping businesses have begun to add QR codes to cartridge boxes. Consumers can scan the code and verify whether it is a legitimate product, that undergoes adequate quality control. However, for those who don’t reside in a cannabis-legal state, steering clear of illicit THC vaping products is the best course of action in avoiding any chance of lung injury.
“The message we really want to drive home is for the general public to avoid buying or consuming illegal THC cartridges,” affirms Bartlett.