As the state and the nation are seeing increases in lung illness related to the use of electronic cigarettes, New Jersey’s Governor Phil Murphy issued an executive order creating the Electronic Smoking Device Task Force. The Task Force is directed to formulate a comprehensive strategy to protect New Jersey residents from the hazards of electronic cigarettes.
Electronic Smoking Device Task Force
The Task Force, which convened on September 16, 2019, is charged with examining all options to address electronic cigarette use, including the following:
- Providing warning signs to be posted in stores that sell electronic smoking devices
- Expanding the State’s ability to investigate, track and monitor any cases of severe pulmonary disease
- Recommending legislative and regulatory changes needed to protect young people from electronic cigarettes
- Developing a statewide public awareness campaign on the risks of electronic cigarette use
- Reviewing and providing feedback on current efforts to address the dangers of electronic cigarette use and considering methods for expansion of those efforts
- Cooperating with local, state, federal and private or non-profit entities while the multistate investigation continues
- Adopting similar policies with respect to traditional cigarettes
Serious Lung Illnesses Related To Vaping
The Governor took this urgent action because of the serious rise in lung illnesses related to vaping. As of October 8, 2019, there are 1,299 cases of lung illness reported from 49 states, the District of Columbia and 1 U.S. territory. Twentysix deaths have been confirmed in 21 states.1 On October 1, 2019, the New Jersey Department of Health announced the first New Jersey death associated with the national vaping outbreak. The total number of confirmed and probable cases of serious lung disease in the state has risen to 14, including two probable cases. In addition, 32 reports of severe lung illness are current under investigation. The age of individuals affected range from 15 to 51.2 All individuals were hospitalized.
The Centers for Disease Control and Prevention and the Food and Drug Administration have not identified any specific e-cigarette or vaping product (devices, liquids, refill pods and/or cartridges) or substance that is linked to all cases. CDC is recommending that individuals refrain from using e-cigarette or vaping products until more is known about the cause of this illness.1
Skyrocketing Use Of E-Cigarettes
The use of electronic cigarettes has skyrocketed since they were introduced to the U.S. market a dozen years ago. In New Jersey, about 21 percent of youth reported trying e-cigarettes, and nearly 10 percent reported using them in 2016.3 Nationally, in 2018, more than one in five high school students and about 1 in 20 middle school students reported using electronic smoking devices in the previous year, which is double the usage in just one year.4
As demonstrated in the accompanying charts (Figures 1 and 2), electronic cigarette use is in on the rise among New Jersey youth, and traditional cigarette use is declining.
Equally alarming, 43 percent of young people who have tried electronic smoking devices say they did so because of flavored vaping oils with names such as cotton candy, strawberry cheesecake and razzleberry, which appear to be deliberately marketed to attract young people despite the fact that it is illegal in New Jersey to sell these products to anyone under the age of 21.5 Vaping devices can also be used to deliver marijuana and other drugs, and it is difficult to know what each individual product contains—especially those sold on the black market.
The Role Of Healthcare Providers
The Department has sent a statewide health alert to healthcare providers and local health departments following recent reports of severe lung disease in people who have used vaping products.
The Department is asking that healthcare providers treating patients with significant respiratory disease in the outpatient setting assess their patients for recent or prior use of vaping products and consider the potential for worsening disease progression if risk factors are present. Healthcare providers in the inpatient setting who are managing patients with severe pulmonary disease should assess patients for a vaping history, including vaping tobacco, tetrahydrocannabinol (THC) and/or other products. Additionally, providers should consider this illness in patients, particularly in those who have prior history of respiratory disease and no apparent cause, infectious or otherwise. They should also consult with a pulmonologist to further guide diagnoses.
The Department is also asking healthcare providers to educate all patients on the risks associated with vaping and the use of tobacco products. The New Jersey Department of Health has created a public awareness campaign with resources for public health officials, parents, teachers, coaches and healthcare providers about the risks of electronic smoking devices; this material can be found at vapefactsnj.com. We encourage you to share this resource with your patients.
The Department will continue to provide updates on its vapefactsnj.com page. Please continue to monitor and educate your patients about the dangers of electronic cigarette use.
Judith M. Persichilli, RN, BSN, MA, is the Acting Commissioner of the New Jersey Department of Health.
