State officials want to take a page from their playbook on addressing opioid overdoses to confront a growing epidemic of people with vaping-related lung illnesses.
Lawmakers earlier this month approved the first steps of a plan to spend $1.7 million in funds from a settlement with Johnson & Johnson to help curb vaping. As of Dec. 3, there have been 48 confirmed deaths from vaping illness and 2,291 hospitalizations reported nationwide to the Centers for Disease Control and Prevention.
“Millions of dollars have been spent on preventing youth from smoking, but vaping presents an entirely new threat,” Attorney General Aaron Ford told lawmakers on the Interim Finance Committee at a Dec. 13 meeting.
Fifteen percent of high schoolers in Nevada reported they had vaped in 2017, compared with less than 7 percent who said they had smoked cigarettes during that time period. The Southern Nevada Health District has reported five vaping-related lung illness cases in the last three months, including that of a 19-year-old College of Southern Nevada student who had to be put into an induced coma and on a ventilator to breathe, Ford said.
Of the five cases, four involved vaping cannabis products — either THC or CBD.
Ford’s plan for the funds mirrors how the state faced the opioid crisis in the past five or so years: A statewide summit on vaping and cannabis to start developing a strategic plan for preventing youth use, close analysis of data and a marketing campaign targeted to any Nevada-specific emerging trends.
Similarly, Nevada held a two-day opioid summit in 2016 and has taken a long list of actions since, including bills cracking down on overprescribing, tracking overdoses and increasing the availability of anti-overdose drug naloxone. Nevada’s opioid prescription rate has dropped from 74.9 per 100 Nevada residents in 2017 to 52 per 100 in 2018, and there were 360 opioid deaths in 2018, down from 401 in 2017.
“We are moving the dial on opioid addiction and it’s a difficult dial to move,” Gov. Steve Sisolak said at an opioid-response summit in August.
State officials acknowledged that they want their anti-vaping marketing to be targeted to Nevada-specific issues, with messages focused on where they can make a difference, but they don’t yet know their campaign should say. That determination will come after the state can bring on a contractor to analyze the data that is currently being collected.
Mark Krueger, a deputy attorney general with the Bureau of Consumer Protection, offered some broad-strokes data on where problems lie.
He noted that 38 percent of patients with vaping lung illness were aged 18 to 24. Eighty percent reported using THC products, and 54 percent reported vaping nicotine products.
Federal officials have identified vitamin E acetate, a chemical used as an additive to dilute THC, as a chemical of concern. The CDC announced in November that it found the chemical in all 29 lung fluid samples it collected from vaping illness patients, although it’s not sure if other chemicals may be causing the illness too.
“Vaping sounds safe, like you’re inhaling water, but these products contain a lot of chemicals,” Krueger said. “Vitamin E acetate, when it liquefies and solidifies in the lungs — it causes those risks.”
Lawmakers ultimately authorized money for the summit and epidemiological data analysis efforts — expected to cost $500,000 — but asked the attorney general’s office and public health officials to come back later and seek the remaining $1.2 million for marketing money when they have a better idea of what the campaign will look like.
Dr. Stephanie Woodard of the Division of Public and Behavioral Health said the anti-vaping push will work in tandem with legislation authorized this spring through SB263 — a bill that imposes a 30 percent tax on vaping products and is expected to send $5 million over the next two years to the Department of Health and Human Services for anti-tobacco activities.
Ford pointed out to lawmakers that just four years ago, a proposal to tax vaping died in the Legislature over concerns that some nicotine comes from tobacco and some is synthetic, so it would be hard to classify it as a tobacco product for purposes of taxation. The vaping tax proposal had much smoother sailing in 2019.
“I just want to acknowledge the change in the trajectory of the conversation,” Ford said, adding that he wanted to nip the vaping problem in the bud. “We’re four years since first talking about this. I don’t want to be four years down the road, and having had the opportunity, to miss actual cessation of this product.”