STATE

More than 100 vaping-related illnesses confirmed in Texas

Julie Chang, jchang@statesman.com
State Sen. Lois Kolkhorst, R-Brenham, chairwoman of the Senate Health and Human Services Committee, speaks about the dangers of vaping during a hearing on Tuesday. [RICARDO B. BRAZZIELL/AMERICAN-STATESMAN]

With more than 100 vaping-related illnesses confirmed statewide since April, Texas lawmakers on Tuesday mulled remedies that included limiting the flavors of e-cigarettes, ratcheting up marketing campaigns against their use and increasing fines against retailers who sell to minors.

As of Tuesday, the Texas Department of State Health Services had received 108 reports of confirmed vaping-related illnesses, an additional 102 cases of probable illnesses, 62 cases reported as a possible illness but have been ruled out or are under investigation, and one case of a person who has died from vaping.

Nearly a quarter of all reported cases involved children under the age of 18. More than half of confirmed and probable cases have occurred in North Texas and 25 of them in Central Texas.

Texas is among the top three states with most cases of vaping-related illnesses, which typically lead to hospitalization. Common symptoms of vaping-related illnesses include coughing, chest pain, shortness of breath, abdominal pain, nausea, vomiting, diarrhea, fatigue, fever and weight loss.

“What we should have learned is we as legislatures have to pick up the cost associated with (vaping), so until the industry wants to write the check, I’m going to be a pretty … vocal person against this kind of crap,” said Sen. Charles Perry, R-Lubbock.

Texas lawmakers this year passed legislation banning the sale of tobacco products and e-cigarettes to people younger than 21. The sale of vaping products previously was barred for minors under 18. The Texas comptroller which ensures compliance of tobacco-related laws, investigated 83 retailers between July 2018 and November 2019, finding that three of them sold vaping products to minors as young as 16.

Joshua Thigpen, supervisor of the tobacco tax section of the comptroller’s office, said his job is made more difficult by the fact that retailers selling vaping products are not required to have a special permit to do so. Retailers must have a special permit to sell traditional cigarettes and tobacco products.

“Because of this, we are unable to identify retailers who only sell e-cigarette products to conduct our compliance inspection,” Thigpen said.

Thigpen agreed that increasing fines to retailers would discourage sales to minors.

Nicotine and THC

E-cigarettes are devices that are filled with liquid — typically containing nicotine and/or tetrahydrocannabinol, or THC, the high-inducing component in marijuana — that when heated turns into vapor that is sucked into the lungs by users. Although it is not clear what chemicals have caused illnesses, cases have been linked to vitamin E acetate found in THC-containing products. The federal Centers for Disease Control and Prevention has advised that vitamin E acetate not be used in products.

About 90% of all possible vaping-related illnesses in Texas were reported by people who said they used some THC products, according to the state health department. THC vaping products are illegal in the state.

Although e-cigarettes have been in existence for the last two decades, the devices have grown in popularity in recent years, marketed to curb the use of tobacco products. But research has shown that some e-cigarettes contain as much or more nicotine, a highly addictive chemical, than cigarettes, said Steven Kelder of the UTHealth School of Public Health.

Advocates of e-cigarettes told lawmakers that only a certain subset of e-cigarettes — typically those manufactured by JUUL — contain the high amounts of nicotine. Users credited the devices for helping them quit cigarette smoking and reducing their overall nicotine intake. Vape storeowners said they are stringent about checking the ages of customers to ensure children aren’t purchasing the products, and they blamed convenience store owners for selling to young people.

Senate committee members invited representatives from JUUL to testify, but they declined, committee Chairwoman Lois Kolkhorst, R-Brenham, said.

“I have seen nothing but everybody … treating us like drug dealers,” said Justin Gibson, an Austin vape storeowner. “The difference between the people who actually own vape shops and ... convenient stores is that we started our businesses because we are passionate about how it helped us live a healthier lifestyle.”

Flavored vaping

Massachusetts has banned the sale of vaping products.

Some states including Washington, New York and Rhode Island, have issued bans on flavored vaping. President Donald Trump earlier this year proposed banning flavored vaping but then backed off the idea.

“The flavors — you can’t have Capn’ Crunch. That’s not something an adult wants to use. It’s something that a child wants to use,” Jay Maddock, chief wellness officer at Texas A&M University, told lawmakers.

The University of Texas and Texas A&M systems have banned vaping on all campuses. The Austin City Council in 2017 banned vaping in public places.

E-cigarette supporters said banning flavored devices won’t discourage youth from vaping because they are attracted to the buzz they get from vaping.

Public health officials said vaping products should be further regulated, including requiring ingredients be listed clearly. They also recommended more research on the efficacy of devices to help reduce tobacco use.

“Largely, the flavorings that are added, many of them have been proven to be safe for human consumption, ingestion, swallowing and digesting … but the same doesn’t apply for inhalation into the lungs,” said Dr. Ernest Hawk, vice president and division head for cancer prevention and population sciences with MD Anderson Cancer Center.

Sens. Kolkhorst and Borris Miles, D-Houston, urged the Texas Association of School Boards to help spread information to school districts about a free program created by UTHealth School of Public Health to curb vaping called CATCH My Breath.

Almost all Texas school districts prohibit student e-cigarette use on school property and during school-related activities.

Patrick Hinson, Lake Travis High School assistant principal, told lawmakers that many student users they have encountered did not know that vaping was addictive.

“Our kids just don’t know the danger of it,” Hinson said. “And some kids will come to me crying because they’re addicted.”