In the wake of the recent lung illness outbreak linked to more than 2,000 illnesses and over 40 deaths across the country, as well as a spike in youth e-cigarette use, the American Medical Association has called for a ban on all e-cigarette and vaping products that do not meet Food and Drug Administration approval as cessation tools.
At the Interim Meeting of the AMA House of Delegates, physicians, residents and medical students from across the country voted to adopt policies building on the AMA's efforts to prevent younger generations from becoming addicted to nicotine.
Among the new policies are advocating for regulatory, legislative and/or legal action at the federal and state levels to ban the sale and distribution of all e-cigarette and vaping products, with the exception of those approved by the FDA for tobacco cessation purposes and made available by prescription.
The AMA also called for research funding to study the safety and effectiveness of e-cigarette and vaping products for tobacco cessation purposes.
According to the Centers for Disease Control and Prevention, Evali, the lung disease associated with vaping, has been linked to vitamin E acetate -- a solution most commonly found in black-market THC vaping cartridges, and rarely found in e-cigarette products. Though vitamin E acetate seems to be the most likely culprit, health officials caution it's too soon to rule out other causes.
The CDC has reported that 86% of the people who had become ill from vaping had used THC vaping products during the previous three months. THC, the psychoactive ingredient in cannabis, is illegal in most countries, perhaps explaining why Evali outbreaks have not been reported elsewhere.
The AMA has called for thorough study of the use of pharmacologic and nonpharmacologic treatment strategies for tobacco use disorder and nicotine dependence resulting from the use of non-combustible and combustible tobacco products in people under 18. The agency has also signaled its intent to persuade retail pharmacies to cease sales of tobacco products, and is advocating for diagnostic codes for e-cigarette and vaping associated illnesses, including pulmonary toxicity.
WHAT'S THE IMPACT
The AMA has long been engaged in anti-tobacco efforts, including prohibiting smoking in public places and on public transportation and airplanes, and calling on tobacco companies to stop targeting children in their advertising campaigns.
In addition to the new policies, the AMA has called on media organizations to reject advertising that markets e-cigarette products to young people, supported laws setting the minimum age for purchasing tobacco products, including e-cigarettes, at 21, and urged e-commerce CEOs to vigorously enforce their existing policies to keep illicit vaping products off their platforms.
THE LARGER TREND
Today, the Centers for Disease Control and Prevention released updated guidance to help healthcare providers diagnise and treat patients with vaping-associated lung injury. In particular, the guidance points out that symptoms can resemble that of the flu, making it more of a challenge to identify during the winter months.
Former FDA Commissioner Dr. Scott Gottlieb, who left in March, was known for his hard-hitting stance on vaping and the use of tobacco products among young people. Upon his resignation, his advocacy drew praise from industry figures such as former CMS acting administrator Andy Slavitt and Bill Barnes, Intermountain Healthcare director of federal government relations.
ON THE RECORD
"The recent lung illness outbreak has alarmed physicians and the broader public health community and shined a light on the fact that we have very little evidence about the short- and long-term health consequences of e-cigarettes and vaping products," said AMA President Patrice A. Harris. "For decades we have led the public health fight to combat the harmful effects of tobacco products, and we will continue to support policies and regulations aimed at preventing another generation from becoming dependent on nicotine."