Health

As more fall ill, Iowa lags many states in regulating vaping

Survey shows e-cigarette use among state's youths increasing quickly

A man uses a vape device in this illustration picture. The number of vaping-related illnesses continues to climb, with 23 cases in Iowa as of Friday. (Reuters file photo)
A man uses a vape device in this illustration picture. The number of vaping-related illnesses continues to climb, with 23 cases in Iowa as of Friday. (Reuters file photo)
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DES MOINES — As the number of vaping-related illnesses continues to climb — 23 in Iowa as of Friday — state leaders are trying to determine what steps should be taken to address the issue.

Uncertainty and a lack of data are undermining the discussion, some state officials say.

Public officials across the country are dealing with health issues related to vaping, a form of smoking that uses an electronic device that produces an aerosol from a liquid that contains nicotine but no tobacco.

Some people use the devices to vape THC, the chemical in marijuana that produces a psychoactive effect.

Iowa’s public health department Friday afternoon announced its latest tally: 23 cases of severe respiratory illness associated with vaping. While the patients skew young, they range in ages from 17 to 60, and most are males. No deaths have been reported in Iowa, though 12 have been reported nationwide.

Of those 23 cases of severe respiratory illness in Iowa, 18 reported vaping with THC.

Even more alarming, state officials say, is a spike in the use of vaping products, which they fear could cause those numbers to also increase exponentially. The abuse of e-cigarettes among sixth-, eighth- and 11th-graders jumped from 4 percent in 2016 to 10 percent in 2018, according to the Iowa Youth Survey, a poll conducted jointly by several departments of state government.

The survey also found the number of young Iowans who reported using e-cigarettes more than doubled from 2016 to 2018 among eighth-graders (from 3 percent in 2016 to 8 percent in 2018) and 11th-graders (from 9 percent in 2016 to 22 percent in 2018).

vaping-related illness remains a mystery

But despite the increased use and the potential for harm, health officials say the cause of vaping-related illness remains a mystery and data is preliminary and scarce, making it difficult for them to advocate for specific public policies.

“Unfortunately at this point in the investigation we just don’t have a lot of information,” Dr. Caitlin Pedati, the state public health department’s medical director, said Friday at a meeting of the state commission on tobacco use prevention and control. “I fully appreciate that that’s frustrating. We’re working pretty hard to try and gather some additional data to help narrow the focus of things. But at this point, unfortunately, I’m not sure if we can narrow it further.”

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Pedati said she hopes Iowans with vaping-related illnesses report their ailments and medical professionals work with the state to achieve a more complete picture of the issue.

Meantime, despite that uncertainty and lack of data, the state public health department is suggesting Iowans not use vaping products.

“Iowans should not use vaping and e-cigarette products since the cause of this outbreak is not yet clear and the long-term health impacts of these products are unknown,” read a department news release.

Panel backs raising vaping age to 21

George Belitsos, chairman of the state tobacco use prevention and control commission, said the lack of data is hindering health officials’ efforts to address vaping-related health issues. The commission at its meeting voted to produce a public statement urging state and federal lawmakers to enact policies designed to reduce vaping, including raising the legal age from 18 to 21 and banning flavored vaping products that critics say entice youth.

Multiple members of the commission — which comprises medical professionals, state agency representatives and members of the public — spoke passionately about the need for action designed to reduce vaping.

“A lot of the concerns that we have been talking about for years about vaping have suddenly become a very big public concern. Kids are dying,” Belitsos said. “I think you heard the frustration from some (commission members). We’ve known about this problem for health (issues) from vaping, and why did it take this before the public wakes up? So this is a springboard for us to take action, and I think that’s what we did today.

“We’re calling on the people of Iowa and the (Iowa) Legislature and our federal representatives to begin to take action.”

States take action to address vaping concerns

Some states already have taken actions to address the budding issue. According to data compiled by the Public Health Law Center at the Mitchell Hamline School of Law in St. Paul, Minn.:

• 21 states have included e-cigarettes in their legal definition of tobacco products, making them subject to the same regulations. Iowa does not.

• 15 states tax the sales of e-cigarettes. Iowa does not.

• 29 states have laws that require product packaging of e-cigarettes. Iowa does not.

• 24 states, including Iowa, require state licenses for the sale of e-cigarettes.

• 49 states restrict legal youth access to e-cigarettes. In Iowa, an individual must be 18 to purchase an e-cigarette, matching the lowest threshold in the United States. Four states set the bar at 19, and 16 states set it at age 21.

Fate of vaping bills in Iowa Legislature uncertain

Two Iowa lawmakers who are non-voting members of the commission said Friday the prospects for vaping legislation are uncertain. Lawmakers return to work for the 2020 legislative session in January.

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Sen. Herman Quirmbach, a Democrat from Ames, said he is “cautiously optimistic” state lawmakers will address vaping. He has introduced legislation that would raise the legal age for purchasing vaping products to 21 with no exceptions.

Sen. Julian Garrett, a legislator from Indianola and member of the Republican Party, which has an agenda-setting majority in both chambers of the Iowa Legislature to go with Republican Gov. Kim Reynolds, said he thinks there will be an interest in vaping-related legislation but cautioned that the devil will be in the details.

Sen. Charles Schneider, a fellow Republican from West Des Moines, this past session introduced legislation similar to Quirmbach’s, although Schneider’s bill carved out an exception for military members.

“The question is what do you do that really is effective. It’s so easy to pass a law on something and it sometimes doesn’t have much impact,” Garrett said. “My concern is that if we’re going to pass something, let’s try to get as good a handle as we can on what’s going on here — this is all so new — and do something that’s really going to be effective.”

The nuances of the debate create more issues in getting legislation passed. For example, the American Cancer Society’s lobbying arm supports legislation that aims to reduce vaping, but advocates specifically for including vaping products in the legal definition of tobacco products. A representative for the organization attended Friday’s meeting and made that case to the commission.

State officials pledged to continue to work on the issue while also attempting to collect more information.

“I wish we had more information. ... We have a dearth of data on this,” said Dale Woolery, with the governor’s drug control policy office. Woolery said the issue is uniquely challenging because of “the speed with which the use of these products has grown when we haven’t known a whole lot about them.”

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