November 6, 2019
The biggest problem scientists who want to help figure out what is causing the epidemic of vaping-induced lung injury is that it is impossible for investigators to study the actual products that are being used.
This is because the Drug Enforcement Administration DEA prohibits investigators going out and buying legal (at the state level) cannabis products to study. A university that violates this DEA policy could lose all federal funding under the Safe and Drug Free Schools Act. The only cannabis that can be studied is from a farm in Mississippi that grows it under contract with NIDA. This cannabis is not like cannabis grown today. DEA has said they are going to authorize more grower contracts (they just got sued over this), but is moving very slowly. More important in terms of the vaping lung disease epidemic, even if DEA allows more growers, this will not solve the problem of the need to study the THC devices that are causing the disease.
Fixing this does not require a change in the law. All that has to happen is for the Administration to tell the DEA to allow legitimate investigators to go buy products for study and study them.
Of course, DEA might worry that local pot shops could declare themselves researchers and exploit this rule to sell more product.
This could be avoided by implementing the following policy:
November 6, 2019
After putting $18 million into a campaign to try to trick San Francisco voters into letting Juul rewrite our public health laws, Juul only got 19.5% of the vote.
In other words, 80.5% of San Franciscans uphed the flavor ban, effective T21 legislation, and the Board of Supervisors' decision that e-cigarettes should not be sold or delivered in SF until they have won FDA authorization.
That is an even bigger defeat than RJR suffered when they tried to overturn the flavor ban.
This victory should help speed the spread of comprehensive e-cigarette control legislation at the local and state level.
Congratulations to all the health advocates who worked so hard against what some people through were impossible odds.
November 1, 2019
Yesterday, working with collagues at CDC and Breath California Sacramento, we published "Tobacco Use in Top-Grossing Movies — United States, 2010–2018," in the CRC's Morbidity and Mortality Weekly Report, continuing the CDC's parctice of monitoring the presence of smoking in movies, a major stimulus for youth tobacco use. (Other articles in the same issue were on diabetes, opiod overdoses, dracunculiasis, and the outbreak of serious lung disease among e-cigarette users.) Like much in public health, it is a good news-bad news story. The good news is that pressure from the Smokefree Movies campaign, its public health partners, state attorneys general and investors have cut tobacco use (mostly smoking) almost 95% in the youth rated fictional films. The bad news is that the media companies have turned the exception for smoking by real people who actually smoked (i.e., Winston Churchill) in the recommended R rating for films with tobacco into a huge loophole to load biographical dramas with smoking to the point that over progress stopped.
October 31, 2019
After examining tobacco content in U.S. films since 2010, the U.S. Centers for Disease Control (CDC) has put renewed weight behind R-rating future films with tobacco.
A November 1, 2019, article in the CDC's premier journal, MMWR, reports that smoking incidents more than doubled in PG-13 films between 2010 and 2018 — years when major studios' tobacco depiction policies supposedly aimed to reduce on-screen smoking.
The CDC also noted that a recent wave of heavy-smoking biographical films wiped out substantial gains against smoking in the studios' large-budget, all-fiction films. The article adds that three-quarters of the smokers depicted in those "true story" films were invented characters, with no biographical basis.
The CDC frames the R-rating as an effective solution three times in the article, and states in its summary:
Continued efforts are needed to reduce tobacco incidents in movies, particularly in PG-13 biographical dramas. Giving movies with tobacco incidents an R-rating would eliminate tobacco product imagery from youth-rated films.
October 29, 2019
Nicotine e-cig enthusiasts (and, to some extent, FDA) like to point out that most vapers who develop serious lung disease, now named e-cigarette, or vaping, product use associated lung injury (EVALI), are using THC e-cigarettes. That is correct, but two-thirds of the people developing serious lung disease. The CDC’s latest breakdown is
Among 867 patients with information on substances used in e-cigarette, or vaping, products in the 3 months prior to symptom onset** (as of October 15, 2019):
About 86% reported using THC-containing products; 34% reported exclusive use of THC-containing products.
About 64% reported using nicotine-containing products; 11% reported exclusive use of nicotine-containing products.
In other words,
- 11% are exclusively using nicotine e-cigs
- 34% are exclusively using THC e-cigs
- 55% are using both (dual users)
It may well be that there are different mechanisms for the effects of the THC and nicotine e-cigs, which would mean that the dual users are getting a double whammy.