Fatality Probed: How Close Are Vapes to an Outright Ban?

When the first death case related to e-cigarettes emerged, the once rapidly advancing industry finally seemed to hit the brakes. The dual pressure from the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) has once again brought the safety issues of e-cigarettes to the forefront. However, even as skepticism about e-cigarettes rises in the United States, industry giant Juul continues to assert, "We have a responsibility," while making significant strides in financing and expansion.

215 Cases

E-cigarettes are facing a dual attack from the CDC and FDA. On August 30, local time, the CDC and FDA announced that they are investigating 215 cases of severe lung disease associated with e-cigarette use.

The CDC stated that it has received over 200 reports of respiratory illnesses following e-cigarette use, spread across half of the states in the U.S. According to the latest news from the FDA, the various lung disease cases reported in these states share many similar symptoms. In addition to chest pain and difficulty breathing, some patients have also experienced gastrointestinal issues such as diarrhea and vomiting.

The CDC and FDA are being cautious, stating that it is unclear whether these cases are linked to a specific e-cigarette product or e-liquid, emphasizing the need for more information to investigate the causes. However, many patients have added tetrahydrocannabinol (THC) and cannabidiol (CBD) to their e-cigarettes, with the former being the psychoactive component of cannabis.

Currently, e-cigarettes have become more popular in the U.S. than expected. In 2018, global e-cigarette sales exceeded $14.5 billion, with the largest consumer market being the U.S., accounting for nearly half of the global market. In 2010, the global e-cigarette market was approximately $800 million, and by 2018, this figure had risen to $14.5 billion, with a compound annual growth rate of 43%. In contrast, the traditional cigarette market is experiencing an annual decline of 1%-2%.

In fact, earlier in August, the CDC announced that it was investigating nearly 100 cases of lung injuries related to vaping products containing nicotine e-liquids. These 100 incidents spanned 14 states in the U.S., with the first case originating from Wisconsin, followed by similar cases in Illinois and Minnesota.

Who is to Blame?

The CDC and FDA's decision to take action was prompted by a "bloody lesson." On August 23, an adult in Illinois died after using e-cigarettes and suffering from severe respiratory illness. The CDC suspects that the cause of death is related to e-cigarette use, and health authorities will conduct further tests and investigations to determine the specific cause of death and the harmful substances involved.

Although the CDC and FDA have not explicitly targeted e-cigarettes, officials from the Illinois Department of Public Health (IDPH) stated that this is the first death case related to e-cigarettes in the U.S. However, Professor Michael Siegel from Boston University School of Public Health expressed dissatisfaction: "The CDC's approach is irresponsible; based on the cases reported so far, the cause of illness should point to THC, not e-cigarettes—patients commonly used THC liquids purchased from the black market, not nicotine e-liquids sold through legitimate channels." A report released in January of this year had already identified THC as the number one "suspect," clearly stating that THC can lead to severe respiratory diseases.

Even if THC is more suspicious, it does not mean that e-cigarettes are safe. In July of this year, the World Health Organization released the "2019 Global Tobacco Control Report," which stated that there is no evidence that "heated tobacco products" are less harmful than traditional tobacco products, and using such products may also lead to nicotine addiction in non-smokers.

Zhang Jianshu, president of the Beijing Smoking Control Association, stated that the main component of e-cigarettes is nicotine, so it has the same addictive properties as traditional cigarettes. Therefore, e-cigarettes can also be addictive: "From what we currently understand, although e-cigarettes are purified, nicotine still exists; it is just that tar may have been filtered out, but new chemical substances have been added, such as propellants, flavorings, glycerin, propylene glycol, and compounds like formaldehyde and acetaldehyde that were not present in traditional cigarettes. We cannot say that e-cigarettes are less harmful than traditional cigarettes because they now contain some new uncertain substances."

"The so-called 'less harmful e-cigarettes' claims are merely marketing strategies by tobacco companies," stated Vinayak Prasad, an official from the WHO Tobacco Control Department, emphasizing that products like e-cigarettes carry the same risks as traditional cigarettes, with the main difference being that the former does not produce visible smoke, and he stressed that the e-cigarette market must be better regulated. #p#分页标题#e#

Regarding whether some e-cigarettes involve false advertising, Zhang Jianshu told Beijing Business Daily that many e-cigarettes claim they can help quit smoking, but in practice, they have not helped people quit smoking. Instead, many non-smokers have become addicted to e-cigarettes, eventually becoming traditional cigarette users, thus increasing the number of smokers. Therefore, e-cigarettes cannot be considered a smoking cessation tool.

The Rampant Giants

When public opinion places the blame for deaths on e-cigarettes, industry giant Juul cannot escape criticism. "Don't use e-cigarettes, don't use Juul," said Kevin Burns, CEO of Juul Labs, showing a strong desire to survive. Of course, this warning is aimed at consumers who have never been exposed to nicotine.

Juul, which has gained significant market share, faces not only the scrutiny of the CDC and FDA but also the interest of the Federal Trade Commission (FTC), which is investigating whether Juul has engaged in deceptive marketing aimed at minors and how it has employed influencers to promote its products. On the 25th of last month, in Juul's hometown of San Francisco, the regulatory committee unanimously passed a resolution stating that no e-cigarette products may be sold or distributed in San Francisco without FDA approval.

Regarding whether Juul has adequately explained the risks of e-cigarettes and taken measures to curb their prevalence among youth, Beijing Business Daily contacted Juul's media relations center, but as of the time of publication, no specific response had been received.

Currently, Juul is still in the phase of reaping market benefits. A document recently submitted to government agencies by Juul indicates that the company has recently raised $785.2 million through stock and bond issuance, seeking to expand its business globally. A source familiar with the matter stated that this document is an expansion of a financing transaction that took place earlier this month.

Last week, Juul's parent company, Altria Group, and another tobacco giant, Philip Morris International, were in talks for a merger, which could lead to the world's two largest tobacco companies merging after more than a decade. In April of this year, Philip Morris received FDA approval to sell a heated tobacco product called iQOS in the U.S. "Juul is the ideal partner for Philip Morris International's expansion," wrote Wells Fargo analyst Bonnie Herzog in a report.