Vaping-related illnesses on the rise in North Texas as lawmakers identify ways to combat it
As the Centers for Diseases Control and Prevention investigates an outbreak of vaping-related illnesses nationwide, Texas lawmakers assessed the crisis and steps they could take to combat it.
Members of the Senate Committee on Health and Human Services heard testimony Tuesday from health experts and advocacy groups about the more than 200 cases that have emerged in Texas — where over half are in the Dallas-Fort Worth region.
“This is a playbook that the vaping industry took from,” Sen. Charles Perry, R-Lubbock, said in reference to the tobacco industry’s marketing tactics. “They market it to kids, they made it appealing, they made it taste good. They sold it under the guise of the idea that you can get off of cigarettes, which is probably not true either.”
But missing from the conversation were some of the most well-known e-cigarette manufacturers. Sen. Lois Kolkhorst, a Republican from Brenham and chair of the committee, said the e-cigarette manufacturer Juul, which has faced a flurry of lawsuits, declined an invitation to testify. Juul did not immediately respond to a request for comment Tuesday morning.
As of Dec. 2, the Texas Department of State Health Services identified 273 possible cases of severe lung disease in Texas related to vaping, said Manda Hall, the associate commissioner of community health improvement with the Texas Department of State Health Services. Of those, 210 have been identified as confirmed or probable, and in 90% of the cases, patients reported using some THC-containing product, Hall said.
North Texas had 109 cases. And it’s where the first death from a vaping-related illness in Texas occurred in early October. As of late September, Tarrant County had 13 cases of lung illness believed to be linked to vaping.
Symptoms of lung illnesses believed to be related to vaping include coughing and shortness of breath, chest pain, nausea, fever and more, according to the CDC.
Many of the reported cases have included the presence of vitamin E acetate, an additive in some THC-containing vaping products, according to the CDC. But other aspects, like the flavors added to vaping products, may also be a cause for concern, said Ernest Hawk, vice president and division head for Cancer Prevention and Population Sciences at the University of Texas MD Anderson Cancer Center.
“The flavorings that are added, many of them have been proven to be safe for human consumption, ingestion, swallowing and digesting,” Hawk said. “But the same doesn’t apply for inhalation into the lungs. That’s one of my greatest concerns. These haven’t been standardized, they haven’t been tested regularly to know whether they’re effective for their intended use.”
As of Nov. 20, there have been 2,290 cases of lung injuries associated with vaping across 49 states, Washington, D.C., Puerto Rico and the U.S. Virgin Islands, and 47 deaths have been confirmed in 25 states and Washington, D.C., according to the CDC.
And the use of e-cigarettes has dramatically risen among youth both nationwide and in Texas, Hall said.
In the 2018-19 school year, 27.5% of high school students and 10.5% of middle school students in the U.S. reported using e-cigarettes. And in Texas, the percentage of youth reporting using e-cigarettes increased from 3% in 2012 to 13% in 2018, Hall said.
In Dallas County hospitals, there have been 46 confirmed or possible patients hospitalized for vaping related illnesses, and 14 have required mechanical ventilation to assist with breathing. The median age of those patients has been 22, said Philip Huang, the director of Dallas County Health and Human Services.
“These are previously normal, healthy teenagers — young kids — that are being intubated and being put on mechanical ventilation,” Huang said. “That’s why the seriousness of this really cannot be overstated.”
But some e-cigarette users and local Texas retailers, like the founders of the Vapor Bar and Create A Cig, said vaping was the most effective means to help people quit smoking cigarettes, and urged lawmakers not to restrict options for adults.
Texas lawmakers have taken some steps to restrict minors’ access, and raised the minimum age to buy or use tobacco products from 18 to 21 this past session. The law went into effect on Sept. 1, but military members can still purchase them at 18.
In 2015, lawmakers made it an offense to sell or give e-cigarettes to minors, and established additional requirements for retailers selling e-cigarettes, and required the Department of State Health Services to report on vaping use.
The Comptroller’s Office is limited in its enforcement abilities, in part because vaping retailers aren’t regulated in the same way tobacco retailers are, said Joshua Thigpen, who oversees the Comptroller’s account maintenance division.
In Texas, a retailer selling e-cigarette products only needs a sales tax permit to operate, while tobacco retailers are required to have an additional permit to sell those products.
There are roughly 775,000 retailers with sales tax permits, and while the Comptroller’s Office has identified about 1,200 locations by name that may sell vaping products, there are likely more they’re not aware of, Thigpen said.
Sen. Nathan Johnson, D-Dallas, suggested regulating e-cigarette retailers in a similar manner to those that sell tobacco, and requiring an additional permit that could be revoked if rules are broken.
Sen. Borris Miles, D-Houston, proposed enhancing the penalty for retailers selling illegally or to minors.
Last week, Massachusetts was the first state to set sweeping restrictions to limit the sale of flavored tobacco and vaping products, and imposed a 75% tax on e-cigarettes.
While a handful of states have temporarily banned flavored e-cigarettes, many, like Montana, have been challenged in the courts.
And while Texas does have regulations restricting access to minors, it has yet to put in a temporary ban.
Some universities have taken steps of their own, with the Texas A&M University System banning vaping across all its campuses, including Tarleton State University, in October. Jay Maddock, Texas A&M University’s chief wellness officer, said while there was initially pushback, the ban has gone smoothly as students are educated on the rules.
“At Texas A&M University we’re at 68,000 students. This is the equivalent of banning vaping in an entire town,” Maddock said.
While Perry said outlawing e-cigarette products statewide is an option, but an unlikely one, he suggested classifying the products as prescription drugs, like Chantix, which is used to help people stop smoking.
Meanwhile, the Texas Department of State Health Services has continued to try and educate Texans on the dangers of vaping, and is partnering with schools like the University of Texas at Austin and Texas State University to reach students.
Sen. Beverly Powell, D-Burleson, said she hears from her high-school aged grandchildren about the issue of vaping more than anything else.
“I’m very concerned that the approach that we take with our young people and our school districts needs to be less nebulous and much more specific and much more aggressive,” Powell said.
This story was originally published December 3, 2019 at 2:17 PM.
