States Employ Wide Array of Policy Options to Address the Risks of Vaping

October 17, 2019|4:27 p.m.| ASTHO Staff

Several states are taking swift action to address the rise of vaping among youth and the nationwide outbreak of vaping-related lung injuries. Earlier this month, ASTHO reviewed some of the recent state executive orders, emergency rules, and state legislation aimed at restricting the sale and distribution of flavored vaping products. The governors of Michigan, Montana, New York state, Oregon, Rhode Island, and Washington state directed their state health departments and other state agencies to adopt emergency rules to temporarily prohibit the sale of flavored vaping products in their states. In Massachusetts, Gov. Baker declared a public health emergency and Health Commissioner Monica Bharel issued an order prohibiting the sale or display of all vaping products (including all non-flavored and flavored vaping products), and in Utah, the state health agency issued rules limiting the sale of flavored vaping products to retail tobacco specialty businesses.

While the prohibition of flavored vaping products has garnered much attention, the executive orders and directives contain many other actions states can take to address youth vaping and vaping-related lung injuries. In New Jersey, Gov. Murphy directed the establishment of an Electronic Smoking Device Task Force to provide recommendations for a strategy to address vaping in the state. The task force’s report sets out a variety of policy options beyond the prohibition of flavored vaping products. Below is a review of some of the additional policy options that are found in the state executive orders, emergency rules, and reports and that are centered on informing the public about vaping, identifying the extent and cause of the vaping-related lung injuries, and expanding the direct regulation of the vaping industry.

Changing the Informational Environment
Public health can help people make more healthy choices by educating and raising awareness, as well as, requiring the disclosure of useful information and restricting the use of deceptive information. Requiring the posting of information about vaping-related lung injuries and the disclosure of vaping product ingredients allows people to make informed decisions about whether to use vaping products. To better inform the public about the risks of vaping Oregon, Washington state, and Utah now require retailers to post signs warning of vaping-related lung injuries. Executive orders in California and Rhode Island also directed the state health agency to develop warning signs about vaping health risks for display by retailers.

To help consumers know what’s in vaping products, the Washington Department of Health was directed by Gov. Inslee to develop a plan for manufacturers of non-THC vaping products to disclose the product compounds (e.g., ingredients, solvents, additives, etc.) and source of the products. The Rhode Island executive order tasks the state’s health and business agencies to recommend disclosure and packaging requirements for vaping products. Prohibiting the use of misleading or fraudulent statements lets people exercise their best judgment about the vaping products they are being sold. To this end, Michigan’s emergency rules disallow retailers from suing terms such as “clean,” “safe,” “harmless,” and “healthy” in statements about vaping products. Michigan’s rules also prohibit advertisements of vaping products within 25 feet of the point of sale, candy, food, and soft drinks. Advertisements that can be seen outside the building by a person 25 feet away are also prohibited under Michigan’s rule.

Reporting Vaping-Related Lung Injuries
As the number of vaping-related lung injury cases grows, state and federal health agencies continue to investigate the cause and source of the injuries. Making sure as many vaping-related lung injury cases as possible are identified and investigated by health agencies can help to better resolve the ongoing outbreak. To gain better and more timely information, many states are requiring healthcare providers to report suspected cases of vaping-related lung injury to their state or local health department. For example, Washington state’s emergency rules require healthcare providers and facilities to report vaping-related lung injury cases within one business day to their local health department who in turn report the cases to the state health department. The emergency rules in Montana add vaping-related lung injury cases as a reportable disease and condition under state law. In Oregon, Gov. Brown’s executive order directs the Oregon Health Authority to also adopt rules requiring healthcare providers to report vaping-related lung injury cases to public health. Another example is In Ohio, where Dr. Amy Acton, Director of the Ohio Department of Health has ordered that all healthcare providers report suspected vaping-related lung injury cases within one business day.

Direct Regulation of Vaping Industry
Some states are also moving to directly regulate and oversee the vaping industry. For example, California’s executive order directed its state tax agency to establishment requirements for distributors to report all distributions of vaping products to the state. In Rhode Island, the executive order directs the state’s business and revenue departments to make recommendations as to pricing and licensing requirements for vaping products and distributors and retailers. The Rhode Island executive order also directs the state health department and other agencies recommend density limits for vaping distributors in order to prevent increased vaping product sales within 500 feet of schools and other after-school providers.

State health agencies play an important role in implementing strong action to protect the public from the harms of vaping products are equipped with the data and scientific evidence to advance and advocate for policies that protect both young and old from the harms associated with vaping products and nicotine addiction. ASTHO will continue to monitor the state activity related to this important public health issue and inform our members.