Washington State Board of Health bans vape products that contain vitamin E acetate

The Washington State Board of Health voted to ban vitamin E acetate in vape products amid a national health crisis that has led to dozens of deaths and thousands of serious lung injuries.

The 120-day emergency rule made Monday morning came shortly after White House officials confirmed to the Associated Press that the Trump administration would back off its plans to ban flavored vaping products.

The health board already banned flavored vape products statewide in October. Vape industry leaders and local vape shop owners asked the board to reconsider on Monday.

Brad Bellinger, who owns a Spokane vape shop, said the flavor ban has affected his business. He has laid off employees and is losing customers.

“The hardest part has been, well, hearing people say, ‘I guess I will go to Idaho or get cigarettes,’ or ‘Well, I’ll just order it online,’ ” Bellinger told the board.

Not all public comments decried the flavor or vitamin E acetate vapor ban, however.

Dr. Ben Arthurs, of Spokane, wrote a letter in support of banning flavored and vitamin E acetate vaping products in public comments to the board. He described one of his patients with vaping-associated lung injury, who denied vaping initially but then later admitted to vaping marijuana. His injury has become life-threatening now.

“When I asked specifically about vaping marijuana he nodded vigorously, unable to speak as he is now on life support. Given the rapidity of his illness, I worry he may not live to leave the hospital,” Arthurs wrote. “… I fear that acute lung injuries, such as the one we may have diagnosed today, may only be the tip of the iceberg with regards to the public health issues from these products.”

Two weeks ago, the Centers for Disease Control and Prevention found that vitamin E acetate was associated with 29 lung injury cases from 10 states they examined, but Kathy Lofy, state health officer, cautioned the board against drawing distinct conclusions, especially about a single actor at fault for vaping-related lung disease.

The CDC had tested patients who had all undergone the same procedure to test the material on their lungs, which, Lofy said, is usually only done on very sick patients.

“It’s an easily accessible sample,” said Bob Lutz, Spokane Regional Health District officer, who is also a member of the state board. “It leaves an opening for the fact that we don’t know what else could be causing the problems.”

Lofy said there is a need for more research and study as to what is causing vaping-associated lung injuries, including more thorough studies of vitamin E acetate.

The majority of vitamin E acetate cases the CDC reported also contained THC, and vitamin E acetate can be used as a thickening agent in some THC products. Vitamin E acetate might impair lung function when inhaled, however.

“I do think the THC products are driving the outbreak we’re seeing, but I am worried that there is a background of lung injury that maybe we haven’t been recognizing,” Lofy said.

There are 15 vaping-associated lung injuries reported in Washington so far, with two confirmed cases in Spokane County. Lofy said the state health department has sent samples from five cases to the CDC for testing.

The vitamin E acetate ban might not have a large effect on the regulated vaping market, although not all vaping products must disclose their chemical ingredients.

“I am less certain about that than I think I was last time when I was hopeful we could find one single cause and hopefully move on. As the investigations are continuing, that seems to me to be less likely,” said state Secretary of Health John Wiesman.

Gov. Jay Inslee supports action by the state Legislature.