State governments & the MSA

Ignoring the purpose of MSA

In the first section of the MSA, this agreement was made “to avoid the further expense, delay , inconvenience, burden and uncertainty of continued litigation” by the state against the tobacco industry for expenses occurred to Medicaid as a result of smoking.

Unfortunately, the MSA did not make clear provisions for how the MSA money is to be spent and very little of it is being spent on the intended purpose.

MSA protects the 4 tobacco companies

Since the 4 tobacco giants entered an agreement to pay the state though the MSA, other tobacco companies are to be penalized by the state for doing business because the state doesn’t get a cut of their sales. So, since vaping helps smokers get off of cigarettes (which would lower MSA payments) the FDA catigorized vaping as tobacco and the states can ‘dilligently enforce’ laws against them.

It’s important to note that vaping is no more tobacco than vitamin C is an orange.

Spending money before they had it

Some of the state governments issued bonds based on the projections for future MSA payments. Unfortunately, they underestimated the rate at which smokers would stop smoking which means the payments were lower than they banked on. The actual payments were too insufficient to pay the bonds when due.

S&P bond ratings sound alarm

The S&P Global Ratings rates publically trading securities such as bonds. Ratings range from AAA to D which indicates the reliablility of the security to pay out when due. They assessed the immerging vaping industry as reducing the amount of smokers and therefore the ability of what is backing the bonds (MSA payments) to cover the pay out. This means the governments that issued the bonds have to find money elsewhere to pay the bonds out when due.

What went wrong in the USA

Governments, health authorities, medical professionals, anti-smoking groups and health-related nonprofits utilized mainstream media to repeatedly claim that vaping was injuring people without specifying that the injuries were caused from illegal THC cartridges.

Over and over again, they included vaping nicotine in their conversations, statements and announcements. A false narrative that blamed vaping nicotine for the lung injuries spread throughout the public and the health community.

CDC contradicts their evidence

As a national health authority, the Center of Disease Control and Prevention (CDC) has a responsibility to report on the facts. Their publications influence medical policies in the USA and all over the world. During the lung injury outbreak, despite the growing evidence that vaping street-level drugs were the cause, the CDC continued to allude that vaping nicotine was to blame.

FDA vs CDC accuracy

The Food and Drug Administration (FDA) and the CDC advised the public about the facts on the lung injuries. Both released reports on Sept. 6, 2019. It is very clear, when reading the titles of the two reports that the CDC chose a fear-based narrative about vaping nicotine and omitted the cause of EVALI. It’s important to note that the word “e-cigarettes” means vaping nicotine.

Health-related regulatory bodies

During the outbreak, health-related regulatory bodies, such as the American Medical Association (AMA), joined the CDC in avoiding identifying the causality of the outbreak. They continued to scare the public about vaping nicoine with the fear-based narratives they have been promoting for years. As a result, health professionals continue to be misinformed about tobacco harm reduction.

State officials & harm reduction

Utilizing the outbreak, Gov. Baker discouraged the smokers in Massachusetts from switching to vaping. He banned most flavours which are essential to helping smokers detox and withdrawal from cigarettes by making vaping appealing. He added a tax which makes vaping more expensive for the poor which have the highest smoking rates.

Federal government complicit

During the EVALI outbreak, the US House of Representatives attempted to ban vaping nicotine which didn’t cause EVALI and promote cannabis use which did cause EVALI.

Fake news

The United Kingdom (UK) promotes vaping for smokers. They are different than most of the world because they independently reviewed the science on vaping before the global narrative that Canada has adopted was dictated. The deceptions about EVALI were so pervasive that even their citizens became misinformed!

The lies are working

The misinformation campaign through authority and media has convinced the public that vaping nicotine is the source of EVALI. Within 15 months, an increase of 13% of the people wrongly believe that vaping is MORE harmful than smoking, The public now demands eliquid flavour bans and other restrictions on tobacco harm reduction (vaping).

For over 20 years, RealClearPolicy has been reviewing US domestic policy and analyzes “the most pivotal information on the day’s need-to-know issues”. They reviewed how the CDC handled EVALI in their article titled, Heads Should Roll at CDC after Botched Vaping Investigation.

Filter is a nonprofit, their mission is to …”advocate through journalism for rational and compassionate approaches to drug use, drug policy and human rights”. Their critique of how CDC handled EVALI is titled, Vapes and Lung Disease: The CDC’s Lesson in How Not to Handle an Illness Outbreak.

Expert warnings from the UK

Since the 2016 publication of ‘Nicotine Without Smoke‘, UK health authorities have been promoting vaping as a smoking cessation aid for their citizens.

The UK health community understood that the cause of the 2019 vaping-related lung injuries (EVALI) was not from vaping nicotine. Yet, North American experts were saying it was. Scientists, health authorities and doctors in the UK issued statements and reports to help people learn the truth.

“Complete madness”

Dr. Britton calls out the deception

When asked about the USA authority’s reaction to EVALI (which was to blame vaping nicotine), Dr. Britton said that their reaction was “complete madness.”

Smoking experts in the UK spoke out against the misinformation spread about EVALI and continue to encourage smokers to choose harm reduction.

Quotes from experts

Prof. Newton reassures smokers

We can argue that authorities in Canada and the USA have grossly mismanaged the response to EVALI. They continue to discourage smokers from harm reduction and therefore encouraging continued smoking, smoking-related diseases, disability, and premature death.

Dr. Leonard observes misinformation

Smoking kills over 40,000 Canadians and over 480,000 Americans every single year! How many North Americans have been diagnosed with a chronic smoking-related disease because they didn’t know they had an effective and safe harm reduction option?

Dr. Shahab addresses false belief

Smoking is the primary cause of preventable disease & death in North America. Yet, health authorities and nonprofits in Canada and the USA, wrongly blame vaping nicotine as the cause of the lung injuries and as a result demand stricter restrictions on tobacco harm reduction.

Dr. Aberegg sums it up

It’s important to note that dispite being surrounded by deceptive health authorities, Utah health authorities and community remained objective with the evidence. Dr. Aberegg identifies the obvious reason why EVALI patients would omit illegal drug use when self-reporting: people are simply afraid to say they used illegal drugs.

Repeated fear provoking narrative

The pervasive message in North America is that we have to ban vaping because their is a ‘youth vaping epidemic’.

In Great Britain, vaping is recognized as a significant harm reduction strategy and is promoted by their public health. Yet, less than 2% of 11-18 year olds vape more than once a week.

WHERE is the youth vaping epidemic in Great Britain?

Teens mess with stuff they shouldn’t

Youth experiment with adult activities, this is why 52% vaped “to give it a try”. Cigarette smoke is far more addictive than nicotine vapour and far more harmful. Since smoking tastes gross, perhaps the flavours in eliquid are preventing youth from becoming smokers.

CALL TO ACTION

Australasian Professional Society on Alcohol and other Drugs wrote a referenced paper about EVALI. It is the perfect document to enlighten health professionals about how they have been deceived about EVALI and vaping.

Click Here

Learn more about tobacco harm reduction:

Basic Vaping information

Explore the Vaping & Lung Injuries section:

what happened

what went wrong in Canada

Canada gov't THC cartridges

what went wrong in the USA

state governments & the MSA

Canada gov’t THC cartridges

by Kellie Ann Forbes | Mar ,Sat, 2021 | education, evali, shareables

Canadian government & THC cartridges

The Canadian federal government controls the sale of cannabis products and makes revenue through a cannabis federal excise duty.

On October 19, 2019, during the EVALI outbreak, THC cartridges were approved for sale in Canada. Remember, the lung injuries were caused from illegal THC cartridges.

Health Canada acknowledges the cause

In December 2019, Health Canada was questioned by CBC News about the cause of EVALI because the Canadian government approved the sale of THC cartridges during the EVALI outbreak. Health Canada clearly communicates that they understood EVALI was being caused by illegal THC cartridges and not from vaping nicotine.

Myths or facts

In late February 2020, the CDC closes the case on EVALI because they had identified the source, took action and the injuries stopped occuring.

However, over a year later the Health Canada, Vaping-Associated Lung Illness, page states: “The cause or causes of cases in Canada is still under investigation.”

Protecting THC cartridges revenue

March 2021 Health Canada website: “In Canada, most cases of vaping associated lung illness do not appear to have been associated with the use of THC-containing products.”

When reading this statement, consider that Health Canada relied on patient self-reporting during a time when THC carts were all black-market. They did not conduct biopsies, product analysis nor toxicology screening.

Hiding the truth

As of March 2021, the Government of Canada’s webpage on EVALI mentions nicotine 5 times but only mentions vitamin E acetate just once.

This is the source of information that all provincial health authorities and all Canadian health professionals would consider to be the most current, unbiased and accurate.

Increased cannabis sales

Due to the deception that vaping nicotine was the cause of EVALI, sales of the new cannabis products were not interrupted but how many vapers switched back to the most lethal form of nicotine: tobacco cigarettes?

What went wrong in Canada

Governments, health authorities, medical professionals, anti-smoking groups and health-related nonprofits utilized mainstream media to repeatedly warn the public that vaping was injuring people without specifying that the injuries were caused from illegal THC cartridges.

Over and over again, they included vaping nicotine in their conversations, statements and announcements. A false narrative that blamed vaping nicotine for the lung injuries spread throughout the public and the health community.

First case of EVALI in Canada

Dr. Chris Mackie, the medical officer for the Middlesex-London Health Unit in Ontario, declared the first of the 19 EVALI cases in Canada. His diagnosis was lipoid pneumonia caused by vaping nicotine. Countless headlines, articles, TV news programs and experts created fear about vaping nicotine.

Enduring false causation

For weeks, Dr. Mackie continued to blame vaping nicotine for the lung injury during interviews with media. As a result of this deception, anti-smoking agencies, health authorities and health-related nonprofits across Canada demanded banning flavours in eliquid and make nicotine vaping less attractive to smokers.

The science is clear

Several years earlier, a 2016 study “Respiratory infections and pneumonia: potential benefits of switching from smoking to vaping” concluded vaping nicotine cannot cause lipoid pneumonia. Water-based vapor cannot cause an oil-based lung injury.

First case of EVALI in Canada

Dr. Chris Mackie, the medical officer for the Middlesex-London Health Unit in Ontario declared the first of 19 cases in Canada. His diagnosis was lipoid pneumonia. Countless headlines, articles, TV news programs and experts created fear about vaping nicotine.

The science is clear

Several years earlier, a 2016 study “Respiratory infections and pneumonia: potential benefits of switching from smoking to vaping” concluded vaping nicotine cannot cause lipoid pneumonia. Water-based vapor cannot cause an oil-based lung injury.

Enduring false causation

For weeks, Dr. Mackie continued to blame vaping nicotine for the lung injury during interviews with media. As a result of this deception, anti-smoking agencies, health authorities and health-related nonprofits across Canada demanded banning flavours in eliquid and make nicotine vaping less attractive to smokers.

Anti-harm reduction advocates

Daily, health experts were featured on mainstream media spreading fear about vaping nicotine. Experts repeatedly referred to vaping as causing the injuries without specifying that it was illegal THC cartridges that was hurting people. They repeatedly include vaping nicotine in their discussions!

Recommends inhaling nicotine

Dr. Tereza Martinu, respirologist, was a guest on media. She admitted that vitamin E acetate was found in all the American EVALI lung biopsies & is used in THC concentrates. However, she suggests that inhaling nicotine through vaping as the cause of the lung injuries. Then she encourages smokers to use nicotine inhalers.

Trying hard to blame harm reduction

Question: since vaping has been around for 10 years, why the sudden outbreak of EVALI? Dr. Martinu’s answer was there was such an increase in vaping that there are now enough cases to see it. She failed to give the percent of increase or the time frame because there wasn’t a significant increase in vaping to warrant the outbreak.

Deceptive authority

With endless resources and funding, the government is fully capable of reviewing the evidence on vaping. Yet, they are still deceiving the public by blaming vaping nicotine specifically for EVALI. Why are Canadian health authorities so misinformed about vaping? They must be aware of the billions of dollars it costs to treat smoking-related diseases.

Fake news

The United Kingdom (UK) promotes vaping for smokers. They are different than most of the world because they independently reviewed the science on vaping before the global narrative that Canada has adopted was dictated. The deceptions about EVALI were so pervasive that even their citizens became misinformed!

The lies are working

The misinformation campaign through authority and media has convinced the public that vaping nicotine is the source of EVALI. Within 15 months, an increase of 13% of the people wrongly believe that vaping is MORE harmful than smoking, The public now demands eliquid flavour bans and other restrictions on tobacco harm reduction (vaping).

What happened

Suddenly, there were hundreds of cases of severe lung injuries in areas around the USA. All the patients had vaped.

Yet, millions of smokers had been vaping nicotine for more than a decade without any cases of severe lung injuries.

Vaping history of 15 years with no lung injuries

In August of 2019, the Centers for Disease Control and Prevention (CDC) announced they were investigating an outbreak of lung injuries.

Over 2800 cases were identified, causing 68 deaths in the USA; in Canada there were 19 cases and no deaths.

76% of the patients were under 35 and 66% were male.

The investigation and resolution

Injuries were isolated to North America

Vaping nicotine is a harm reduction strategy used by millions of smokers all over the world. Since the injuries only occurred in North America, it was clear the injuries were being caused by something other than standard nicotine eliquid.

Patients admitted illegal drug use

Almost 100% of the injured patients reported using illegal THC cartridges. Despite the evidence, the injury was named EVALI (E-cigarette or Vaping product use-Associated Lung Injury) implying the cause was vaping nicotine.

Lung biopsies found vitamin E acetate

To identify the substance causing the injuries, lung samples from the patients were analyzed. The fat-based substance, vitamin E acetate, was identified as causing the injuries. This substance can not be dissolved in water-based nicotine eliquid; they would separate in the container.

Vaping products used were analyzed

The patients surrendered the products they were vaping to help identify the cause of the injuries. Nicotine eliquids contained no unexpected or harmful chemicals but 9 out of 10 illegal THC carts contained vitamin E acetate which is used as a cutting agent.

EVALI patients use of vaping products vs vapers without injuries

Vaping habits of 66 vapers that suffered with the lung injury were compared to the vaping habits of 519 vapers that didn’t have the lung injuries. The injured vapers clearly showed a significant increase in THC vaping, illegal THC use and purchased the illegal brand that was associated with the lung injuries. This study further confirmed the safety of commercial nicotine eliquid.

Public warnings from the FDA

The Food and Drug Administration issued warnings that were specific to the injuries. To best ensure the public can make informed decisions about safety, the more specific information about the dangers, the better. The FDA issued warnings that were based in the evidence discovered.

Lung injuries declined rapidly

Word spread on the street that illegal THC cartridges were making people sick. Law enforcement busted several illegal THC cartridge makers and distributors. A legal thinning agent, ‘Honey Cut’ was removed from the market. The injuries declined.

Law enforcement seizures

Confiscated illegal THC cartridges from 2018 and 2019 found that the vitamin E acetate was only detected in the 2019 cartridges and not the 2018 cartridges. This shows that the causative agent was recently introduced into illegal THC cartridges.

Vaping nicotine is proven safe

Illegal THC cartridges caused the death of 68 people. Smoking kills half a million Americans and over 45,000 Canadians every year. Vaping nicotine has helped millions of smokers quit and has not killed anyone.

More on what happened

Shocking images alarmed the public

Despite the overwhelming evidence, the public were constantly bombarded with claims that vaping nicotine caused EVALI. Thousands of vapers that had successfully quit smoking with vaping, returned to smoking out of fear.

Utah Department of Health warnings

The media featured health experts and authority figures that blamed vaping nicotine for what was causing EVALI. Utah Department of Health were one of the few health authorities that told the public the truth.

Cannabis was/is still illegal

Because illegal drug use has legal consequences, patients living in areas where a drug consumed is illegal, sometimes lie about what they have taken because they are afraid of being charged. Even though, initially, THC cartridges were illegal in Canada, authorities didn’t verify the patients’ self-reporting by testing lung samples, performing toxicology screening nor analyzing the patients’ vaping products used.

Buy products from legitimate sources

Since May, 2018, eliquid with or without nicotine has been regulated by the Canadian federal government. Prior to 2018, (and currently in the USA), the vaping industry self-regulated product manufacturing safety. No serious lung injuries from vaping commercial nicotine eliquid have been reported. Vaping nicotine is less than 5% the risk of smoking and therefore, a significant harm reduction strategy for smokers.

Wording matters

When we say “smoking” we mean smoking cigarettes. When people smoke something else, we specify such as smoking a pipe or smoking a joint. When we say “vaping” we mean vaping nicotine. When people vape something else, we specify such as vaping nicotine-free eliquid or vaping THC carts (cartridges).

Warnings were not specific enough

North American health authorities such as the CDC recommended people stop all vaping and did not specify the injuries were caused from THC cartridges. Cannabis users were left at risk because “vaping” commonly means vaping nictoine NOT vaping THC carts.

Utah activated vape shops

With a disease outbreak, it’s important to notify the public, especially the population at risk. Vape shops across Utah were utilized to get the word out about the cause of EVALI & ensured their customers could make informed decisions about harm reduction for not only smoking but drug use.

Confirmation with mouse study

30 mice were studied: 10 with aerosolized vitamin E acetate; 10 with aerosolized eliquid (propylene glycol & glycerine); and 10 with air (control). The first group were given the equivalent dose of vitamin E acetate that a person vaping the illegal THC cart would get. Those mice developed the same lung injury. The injury was not present in the eliquid nor the air groups.