The state's ban on nicotine vape sales has now been lifted. It was put in place in September, as thousands of people across the country were experiencing lung illnesses tied to vaping. Dozens have died. There have been nearly 100 probable and reported cases in Massachusetts, with three deaths. Simultaneously, state cannabis regulators are letting marijuana vape products go back on sale so long as they are newly manufactured and tested for certain contaminants. At the start of the vape ban, WGBH All Things Considered Anchor Arun Rath spoke with Boston University Pulmonologist Dr. Hasmeena Kathuria about what local health care workers were seeing on the ground. Arun spoke with Kathuria Friday for an update on vaping and vaping-related illnesses. The transcript below has been edited for clarity.
Arun Rath: It's been about two months since we last spoke. Could you bring us up to speed with what you and your colleagues have been seeing, patients you may have seen and how their cases have progressed?
Hasmeena Kathuria: So, since September at Boston Medical Center, where I work, we have seen now five cases of EVALI, or E-cigarette Vaping Associated Lung Injury. I think part of that is increased awareness — we're looking for it. There's some suggestion that there might be a slowing of cases in Massachusetts. That could be a reporting lag, it could be due to the ban that was in place. So we'll be hearing more about that.
Rath: We've also had new information that's been released by the CDC and by other health authorities. The last time that we spoke, it was just especially scary because everyone, it sounds like, was struggling to figure out what was going on. Do we have more of a sense now of what is behind these illnesses?
Kathuria: Since we last spoke, THC-containing products continue to be the most commonly reported constituent in e-cigarettes. And it does appear that vitamin E acetate, which is a product that is placed in mostly THC products, has been identified. But the CDC also warns us that while the investigation continues, all persons should consider refraining from the use of all e-cigarettes or vaping products as there may be other substances that may be involved, and those are being investigated as well.
Rath: This ban initially was supposed to last well into the winter, but it was cut back by the courts, and Gov. Baker then moved to end it early after the legislature passed new regulations on flavored vape products. Of course, though, aside from the flavored vape products, people will now be able to buy products and supplies to legally vape un-flavored nicotine. It doesn't sound, though, from what you're saying, that that's necessarily safe.
Kathuria: I think it's a very important step and, I'm very pro-ban on flavored products. We know that the reason why youth use these products is because of the flavorings. So I think while our goal here is to stop uptake of e-cigarette products in general, a flavoring ban, making it difficult for youth to want to use these products, I think all of these are very positive steps.
Rath: In terms of the un-flavored nicotine, though, are you OK with the ban's expiration? Do you think this is moving in the right direction now?
Kathuria: I would love to see the continued ban on all products, and I think many of the advocacy agencies, the lung associations, are in favor of at least a moratorium, where we take the products off the market, we evaluate and test the effectiveness, and those that may be used safely in certain populations — for example, for tobacco cessation — there may be a role that that we need more evidence for. But that the safer thing, when you see three deaths in Massachusetts, 48 deaths nationwide, is to have a ban. Unfortunately, that's hard to do.
Rath: And, you know, I think in fairness, we should point out, I feel like every time I've heard Gov. Baker talk about what's happening at the state level, he expresses being flummoxed basically, or a bit befuddled, by the fact that there's not much happening in terms of the federal level. Would that be helpful for you, again as a doctor working on the ground?
Kathuria: Absolutely. And that's what we work as — I'm vice chair of the Tobacco Action Committee for the American Thoracic Society, and we push policy at the federal level for all of these bans. Especially right now, flavoring, including menthol bans, making sure that the age of access to these products, including e-cigarettes, is increased to 21. So at the federal level, all of these things are really important. What I love and what I'm so proud of in Massachusetts is while the FDA has been sluggish, Massachusetts has really taken positive steps.