Montana health officials are urging people to consider not using e-cigarettes as the state investigates whether some new cases of severe pulmonary illnesses are related to the devices.

The Department of Public Health and Human Services sent out a notice on Tuesday saying e-cigarette products should never be used by youth, young adults, pregnant women or adults who do not currently use tobacco products.

As of Sept. 6, 2019, the Centers for Disease Control and Prevention reported that 33 states have identified 450 potential cases of severe pulmonary illnesses possibly linked to e-cigarette use. Six deaths associated with severe pulmonary (lung) illness have occurred. Montana does not yet have a confirmed case, but a few potential cases in Montana are being investigated.

Sheila Hogan, the director at the department, said vaping (the use of e-cigarettes) is now the most common way tobacco products are consumed by high school students in the state, and the rate of use is growing. The 2019 Montana Youth Risk Behavior Survey showed 30% of Montana high school students currently use e-cigarettes and more than half (58%) have tried them. That’s a rate five times higher than the adult rate.

“This is a serious health concern and it should be treated as such,” Hogan said in a statement. “I’m urging Montanans to take note about what is happening in other states and respond accordingly. While this investigation is ongoing, people should consider not using e-cigarette products. Montanans using any tobacco product, including e-cigarettes, should also consider quitting permanently.”

The CDC reported that all patients with the mysterious illness reported using e-cigarette products prior to becoming ill, but no single substance or e-cigarette product has been consistently associated with the illness. Symptoms include coughing, shortness of breath, chest pain and fatigue. Nausea, vomiting, and diarrhea are also common. Symptoms worsen over a period of days or weeks and do not appear to be caused by a pulmonary infection, according to state medical officer Dr. Greg Holzman.

“Vaping products emit an aerosol that exposes users to a number of different substances of which the long-term health effects are unknown,” Holzman said. “If you do not use tobacco products, do not start using vape products. If you are trying to quit commercial tobacco products, we recommend talking with your doctor who can provide FDA-approved cessation medications.”

Holzman said the state is recommending that people never buy e-cigarette products off the street, modify them or add any substances not intended by the manufacturer.

He added that e-cigarette products are poorly regulated, and a CDC study found that 99% of e-cigarettes sold in convenience stores contain nicotine, which is highly addictive.

Information from St. Patrick Hospital and Community Medical Center about whether there had been any vaping illness cases here was not immediately available.

On Wednesday, President Donald Trump said his administration will propose banning thousands of flavors used in e-cigarettes amid an outbreak of breathing problems tied to vaping.

Ron Marshall, who with his wife owns three Freedom Vapes shops in Bozeman, Belgrade and Hamilton, told the Missoulian he authored a bill during the last legislative session that would have increased the punishment for vendors who sell e-cigarettes to minors. The bill, HB266, was sponsored by Rep. Nancy Ballance, R-Hamilton, but died in committee.

“It would have put the same punishments that people who supply alcohol to minors get,” Marshall explained. “It would have been the same across the board. But the Republicans on the House Judiciary Committee all voted against it. I have no idea why.”

Marshall said he’s been vaping for seven years and doesn’t believe it causes health problems, as long as the liquid isn’t manipulated or adulterated.

“A lot of this has to do with the illegal THC (cartridges) sold on the street,” he said.

His shops don’t sell to minors, he added.

“We card. It’s mandatory or you lose your job,” he said. “But they’re coming off the internet and off people who are old enough to buy.” 

He also doesn't believe flavored e-cigarettes are marketed toward only teens.

"Adults like flavor, too," he said. "Unless all you eat is rice cakes, everyone likes flavor."

Montana health officials say current tobacco users, including e-cigarette users, trying to quit should use evidence-based strategies, which include counseling, FDA-approved medications, and calling the Montana Tobacco Quit Line at 1-800-QUIT-NOW (1-800-784-8669).

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