Areas with higher marijuana and E-cig use, actually had fewer vape-related lung injuries, new study suggests

Areas with higher marijuana and E-cig use, actually had fewer vape-related lung injuries, new study suggests

Legislation banning e-liquid sales was been a little hasty

VicesAugust 27, 2020 By Will Brendza

Remember last year, when the biggest medical story in America was the outbreak of vape-related lung injuries?

People were going to the hospitals, some of them were dying – and states started clamping down on e-cigarette and vape businesses, banning them outright in some places. Fingers were pointed. Accusations were flying. Juul, a billion-dollar company, spiraled out of control as their products became one the primary targets for legislators and angry parents.

Panic was in the air, the media seized on the story and suddenly it was everywhere. Hospitalization and death counts started, study after study came out, trying to determine what exactly was causing these peculiar vape-related lung injuries (EVALI). In total, since August of 2019, there have been 2,800 recorded cases of EVALI and 68 deaths.

That story all but evaporated when COVID-19 showed up. But recent research from Yale University sheds new light on this mysterious outbreak of EVALI. By analyzing data from every state and comparing it with local and state regulations, the Yale researchers found that areas that had higher rates of marijuana and e-cig use, actually had fewer EVALI cases per capita.

"If e-cigarette or marijuana use per se drove this outbreak, areas with more engagement in those behaviors should show a higher EVALI prevalence," Assistant Professor Abigail Friedman, the study's author, explained in a press release. "This study finds the opposite result. Alongside geographic clusters of high EVALI prevalence states, these findings are more consistent with locally available e-liquids or additives driving the EVALI outbreak than a widely used, nationally-available product."

Which is to say, all of those policies banning vapes like Juul were going after the wrong behavior. Both state and federal legislation, in response to the EVAPI outbreak, restricted the sales of e-cigarettes, banned flavors, and in Massachusetts, vapes were outlawed entirely in a hasty attempt to get a handle on the situation.

But, according to these findings, that was all wrong. Friedman says, that this study suggests that in markets where cannabis was legal and vape-sales allowed, the number of EVALI hospitalizations and deaths were notably lower. In the five states where cannabis is recreationally legal (Colorado, California, Alaska and Washington) there was less than one EVALI case per 100,000 state residents.

Conversely, the states where cannabis is still federally illegal (Utah, Delaware, Indiana, North Dakota and Minnesota) had the highest rates of EVALI cases in the nation.

That suggests to Friedman that markets with readily available, tested and regulated products crowded out the illicit and much riskier vape products. Similarly, in states where cannabis is illegal, people have a higher inclination to use vape products bought off the street — hence their higher rates of EVALI.

It’s counterintuitive, but it’s a totally reasonable explanation. Any time you make something illegal — be it drugs, prostitution, guns or anything else — it forces that market underground, into an unregulated space where anything goes and no one’s checking for safety. It makes products and services riskier and more dangerous for both providers and users.

Whereas, in places where these products are legal, people don’t need to go looking on the black market to get their nicotine juice or hash oil. The can simply go to the store and buy something that’s been tested and regulated — something safe.

Sadly, all of the policy that was passed during the height of this EVALI scare, is not likely to change. All of the bans and strict regulations that were hastily made, will likely remain, even though we’re starting to understand that they were misguided from the start.