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A fourth person has died of a vaping-associated lung injury, the Massachusetts Department of Public Health (DPH) announced today. The patient, a man in his 70s from Middlesex County, reported vaping tetrahydrocannabinol (THC), an ingredient found in marijuana. The case is among the 36 confirmed cases of e-cigarette or vaping-associated lung injury (EVALI) that DPH has reported to the US Centers for Disease Control and Prevention (CDC) since September 11, 2019, when the state began requiring clinicians to report any unexplained lung injury in a patient to the department.
Since the state began mandating the report, DPH has received 341 reports from clinicians of suspected vaping-associated lung injuries. Of those, 109 cases of EVALI have been identified, with 36 confirmed cases and 73 probable cases reported to the CDC.
“Today’s news is a tragic reminder that we must remain vigilant about the dangers of vaping,” said Public Health Commissioner Monica Bharel, MD, MPH. “There are resources available to help people quit and we encourage anyone to use these resources.”
In November, DPH reported the death of a man in his 50s from Worcester County who reported vaping both nicotine and THC. In October, the state reported the vaping-associated lung injury deaths of a woman in her 40s from Middlesex County and a woman in her 60s from Hampshire County, both of whom vaped nicotine.
In December, the state’s Public Health Council approved new regulations that restrict the sale of nicotine vaping and flavored vaping and tobacco products. This action followed the Legislature’s passing and Governor Charlie Baker’s signing into law an Act Modernizing Tobacco Control, which provided DPH with additional authority to regulate access to tobacco and electronic nicotine delivery systems, including vapes.
The state’s Cannabis Control Commission has also taken steps to strengthen its regulation of marijuana vaping products. As part of an ongoing investigation to determine whether Massachusetts licensees may be connected to lung injury cases, the Commission has entered into a data-sharing agreement with DPH and continues to test samples of quarantined vaping products. So far Independent Testing Labs have not found detectable levels of vitamin E acetate in products manufactured by licensed Marijuana Establishments or Medical Marijuana Treatment Centers. The US Centers for Disease Control has identified vitamin E acetate as a chemical of concern among people with e-cigarette, or vaping, product use associated lung injury.
The Commission maintains a quarantine order on all marijuana vaporizer products, except for devices used exclusively to vape flower that were manufactured by licensees prior to December 12, 2019. Newly manufactured vaping products are authorized to be sold only after they have passed tests for the presence of impermissible levels of toxicants or contaminants, including vitamin E acetate and heavy metals.
Of the 109 Massachusetts confirmed or probable cases that have been reported to the CDC, 55 are male and 54 are female. Fifty-two percent are under the age of 30. Thirty-five percent vaped only nicotine, 40 percent vaped only THC, and 27 percent reported vaping nicotine and THC. DPH’s online dashboard posted weekly provides detailed information on vaping cases that the Department has reported to the CDC.
DPH offers resources to help people quit through the Massachusetts Smoker’s Helpline at 1-800-QUIT-NOW or by visiting makesmokinghistory.org or Mass.gov/QuitVaping to connect to treatment. The Helpline has doubled the availability of free over-the-counter nicotine replacement products from 4 weeks to 8 weeks, once a person receives counseling by phone.
As of January 1, 2020, Massachusetts commercial health insurance plans, plus the Group Insurance Commission and MassHealth, must cover smoking cessation counseling and FDA-approved products such as gum, lozenges, or patches without cost-sharing.
