Sunday, December 22, 2019

Response to State Sen. Gabriel Ramos and Rep. Patricia Roybal Caballero Column in the Albuquerque Journal: "NM should lead in regulating vaping industry"



Response To: NM should lead in regulating vaping industry
BY SEN. GABRIEL RAMOS / SILVER CITY DEMOCRAT AND REP. PAT RUILOBA / ALBUQUERQUE DEMOCRAT
Sunday, December 22nd, 2019 at 12:02am
Read the original column here on the Albuquerque Journal website: 


Article Broken Down With Response to Each Section (black is the original ABQ Journal article text and blue text is the response for Lawmakers to please review and consider)

"Vaping in New Mexico is completely unregulated, and once again our state is the Wild West when it comes to a new industry."

The opening sentence is completely false. All the vaping products in the New Mexico Medical Cannabis Program are strictly regulated through a laboratory testing process.

The state is doing absolutely nothing to regulate the manufacturing process for nicotine based e-cig vapes sold in the state.

Have either one of you met with the Environmental Department to learn what they are doing to test and regulated Hemp CBD Vape products, since many come from out of state?

And a new study out last week shows that legal nicotine only e-cig vapes sold over the counter to the public are far worse on the human body, according to the new research out.
"The first study on the long-term health effects of electronic cigarettes finds that the devices are linked to an increased risk of chronic lung diseases, according to research published Monday (Dec. 16 2019) in the American Journal of Preventive Medicine."
"Most adults who use e-cigarettes continue to smoke," Glantz told NBC News. "And if they do that, they get the risks of the smoking plus the risk of the e-cigarette."
“Combining regular and e-cigarettes more than tripled the risk for developing chronic lung diseases, the study found.”
[https://www.nbcnews.com/health/vaping/e-cigarettes-linked-lung-problems-first-long-term-study-vaping-n1101641]

Latest Outbreak Information from the CDC as of Dec. 17 2019:
“1,782 hospitalized patients had complete information* on substances used in e-cigarette, or vaping, products in the 3 months prior to symptom onset, of whom (as of December 3, 2019)
[https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html#latest-outbreak-information]



"We are parents, and strongly believe it is imperative to protect the health of our children, protect the public health of New Mexicans, eliminate bad actors and underground products.
The only true way to eliminate the bad actors and underground products is to stop the Chinese companies that are fueling the blackmarket and bad actors, as the Chinese companies are responsible for selling and shipping to the US the fake packaging and e-cig cartridges used.
“Dank Vapes was the brand used by 56% of the hospitalized patients nationwide.
Dank is not a licensed product coming from one business, it is empty packaging that can be ordered from Chinese internet sites. Illicit vaping cartridge makers can buy the empty packages and then fill them with whatever they choose.
Other product names at the top of the list from CDC were TKO (15%), Smart Cart (13%) and Rove (12%).”

 [https://www.pbs.org/newshour/health/officials-list-pot-vape-brands-reported-in-u-s-outbreak-of-lung-illnesses]

There is nothing in your proposed bill that addresses this illegal activity by the Chinese. 



"We will reintroduce the Vaping Act to promote greater public health through smart regulations and responsible public policies. To date, no other state has enacted a comprehensive e-cigarette regulatory bill, and New Mexico could lead the way."
Have either one of you taken the time to meet with any of the Manufacturers of Vape products for the New Mexico Medical Cannabis Program? Or toured any of these Manufacturers production facilities? Have either one of you ever had the chance to go and visit a medical cannabis dispensary with medical cannabis patient or caregiver?


"Recent knee-jerk policy responses to lung illnesses will not lead to a desired outcome. But a comprehensive regulatory framework can, and will."
While the Vape Warning Label on medical cannabis products was clearly misguided and a knee-jerk policy response, so is the proposed legislation that has been put forth.

This from the Dept. of Health, highlights the need to be honest with the general public:
“This statement on the Dept. of Health proposed Medical Cannabis Program Vape Warning label is completely false and even worse it misleads the general public and program participants about the scientific facts about THC and it’s many medical benefits. 

“WARNING: Vaping THC has been associated with cases of severe lung injury, leading to difficulty breathing, hospitalization, and even death”

I would please like to ask the Department of Health to reconsider the current language now being used as a “warning label” for medical cannabis vaping products. The warning label is very misleading and to clear that up, I would suggest adding the following factual statement to the Warning Label: “It is important to note that this illness is not caused by anything intrinsic to cannabis. ”
[‘New Mexico hits the panic button with medical cannabis vape warning label, despite facts from CDC.’ | http://www.cannabisnewsjournal.co/2019/10/new-mexico-hits-panic-button-with.html ]



"Most people reading recent stories don’t know the full range of facts behind the illnesses reported from e-cigarette usage. That is, that the majority of the illnesses reported due to e-cigarette usage is directly linked to THC (tetrahydrocannabinol), or illicit unregulated drug use, in vaping devices. On Oct. 3, the Centers for Disease Control and Prevention (CDC) updated its findings on e-cigarette illnesses and hospitalizations. The CDC noted that, of the confirmed lung injury cases associated with e-cigarette usage, 78% of patients “reported using THC-containing products, with or without nicotine-containing products.” Thirty-seven percent of the patients also reported “exclusive use of THC-containing products.” And on Nov. 21, the CDC further announced “the latest national and state findings suggest THC-containing e-cigarette, or vaping, products, particularly from informal sources like friends, or family, or in-person or online dealers, are linked to most of the cases and play a major role in the outbreak.”
This entire paragraph misrepresents the facts, probably due to new research by the CDC on December 19 2019, and it is very important as you have said that most people understand the true facts.

Dr. Anne Schuchat, the CDC's principal deputy director, says this sharp spike strongly points to a single culprit for most of these cases: vitamin E acetate, an additive found in illicit containing vapes.

Vitamin E Acetate has been found in nicotine vapes, CBD vapes and THC vapes.

Vitamin E Acetate and those Chinese companies mentioned - these are the real problems of concern.

Isolated and eliminate those variables and the problem is solved.
[https://www.npr.org/sections/health-shots/2019/12/20/790154919/cdc-confirms-a-thc-contaminant-vitamin-e-acetate-the-culprit-in-most-vaping-deat]



"Prohibition does not work."
Regulation for the wrong reasons, Over regulation, Lack of Public Input, and over Taxation are all items that will foster the black market for products like this.

Since 2017, NMDOH has been dodging to responsibilities of testing cannabis products and now amidst the Vaping Illness they now try to blame the medical cannabis products...and do so with zero proof about in state products.

And the New Mexico Department of Health does not test New Mexico cannabis for Heavy Metals, Pesticides and other toxins that they should be testing for - hence this is putting people at risk. And we are also a state that tested the Atom bomb and all kinds of military equipment/weaponry, there are all kinds of contaminants/heavy metals all over the state and its soil (ie Gold King Mine spill).

Steep Hill labs warned the NMDOH and lawmakers about this in Oct. 2017 at a Legislative Health and Human Services Committee Meeting and lawmakers ignored them.
Link to those materials presented in 2017: [https://www.nmlegis.gov/handouts/LHHS%20101617%20Item%209%20Dr.%20Reggie%20Gaudino%20Testimony%20with%20NM%20Samples%2010_17_17.pdf]



"One critically important fact is being ignored in the rush to respond to the reported illnesses. Since their introduction to the U.S. market in 2007, vaping devices have helped millions of Americans quit smoking. And a lot of those people, 10 million to 13 million, are using flavored products to help them quit, or limit, cigarette smoking. “In the largest survey of American adult vapers, flavors were vital in helping smokers quit combustible cigarettes and remain abstinent from smoking.” The removal of products that have helped the vast majority of former smokers quit smoking cigarettes will have morbid impacts and only serves to drive those smokers back to combustible products, or cigarettes. This should be the most compelling argument for regulating e-cigarettes, not eliminating them."
Personally as a medical cannabis patient, I was a cigarette smoker for 15 years and I was able to quit smoking cigarettes by using and smoking cannabis CBD products. I started smoking years ago to cover up and hide the smell of cannabis smoke from the cannabis I used. When I tried nicotine e-cig vape products, they made me feel sick to my stomach and gave me a dry cough for weeks.

Addiction to nicotine and other substance should be an accepted health condition in the New Mexico medical cannabis program. Adding that to you legislation would help people quit smoking cigarettes with the available smokable and non-smokable medical cannabis products. And the NM Dept. of Health is even considering this Petition to do just that:
Petition: Requesting The Inclusion Of A New Medical Condition: Substance Abuse Disorder (To Include: Alcohol Use Disorder (AUD), Tobacco Use Disorder, Stimulant Use Disorder, Hallucinogen Use Disorder, and Opioid Use Disorder) | http://lecuanmmcpmcabpetitions.blogspot.com/2019/11/2019-petition-requesting-inclusion-of_13.html

And we also now know these e-cig nicotine vapes can be just as harmful as smoking a regular cigarette:
"The first study on the long-term health effects of electronic cigarettes finds that the devices are linked to an increased risk of chronic lung diseases, according to research published Monday in the American Journal of Preventive Medicine."
"Most adults who use e-cigarettes continue to smoke," Glantz told NBC News. "And if they do that, they get the risks of the smoking plus the risk of the e-cigarette."
Combining regular and e-cigarettes more than tripled the risk for developing chronic lung diseases, the study found.”
[https://www.nbcnews.com/health/vaping/e-cigarettes-linked-lung-problems-first-long-term-study-vaping-n1101641]

New research this year (Feb 27, 2019) at Harvard Health concluded: “Ultimately, we’ll need good studies to assess the long-term safety of vaping, to confirm that when used to aid smoking cessation we aren’t just replacing one bad habit with another.”
[https://www.health.harvard.edu/blog/can-vaping-help-you-quit-smoking-2019022716086]

Dr. Barry Ramo is right, “The problem needs to be approached the same way cigarette smoking was successfully attacked, using education and legislation.” [https://www.abqjournal.com/1383622/nm-needs-to-snuff-out-ecigs-now.html]

**Only way any legislation will work is if Vape Manufacturers from the medical cannabis program are given a seat at the policy table. And lawmakers should consult with industry experts, like Americans for Safe Access and Sean Khalepari, who is a Regulatory Affairs Coordinator (email: sean@safeaccessnow.org phone: (202) 857-4272 x. 2) . [https://www.safeaccessnow.org/staff]

As poorly written legislation for the Clean Indoor Act in 2019 has now created housing issues for medical cannabis patients by enabling landlords the ability to refuse housing to medical cannabis patients.



"Digging a little deeper, the vapor products mentioned above have been FDA-registered and FDA-regulated since 2016. No new legal vapor products have entered the market since 2016. Of the vapor products on the market, some are completely nicotine-free. There are already strict FDA warning label requirements in place for all nicotine-containing e-cigarette products. So, what would the regulatory framework look like?"

"Since last December, our team has met with Gov. Michelle Lujan Grisham’s office, the N.M. Department of Health and N.M. Regulation and Licensing Department to discuss the depth of the regulatory framework. Our proposed Regulatory Act would establish a 21 years of age restriction for all purchases, licensing requirements for manufacturers, distributors and retail stores, an enforcement mechanism within the state’s Alcohol and Gaming Division, and strict marketing guidelines that would prohibit youth-targeted marketing."

President Donald Trump on Friday (Dec. 20 2019) signed a sweeping spending bill into law, including a measure that prohibits the sale of tobacco products to anyone under the age of 21. This also included vape products. [https://www.cnn.com/2019/12/20/health/tobacco-age-21-trump-spending-bill-bn/index.html]

*Vaping Devices Themselves Are Not Regulated (the pen and battery parts)*
“Researchers at the University of California San Francisco said the patient had hard-metal pneumoconiosis, typically found in people exposed to metals such as cobalt or tungsten used in tool sharpening or diamond polishing.”
"This was similar to other studies, suggesting that the metals were coming from the heating coils found in vaping devices, rather than from any particular type of re-fill - as has been previously thought."
[https://www.channelnewsasia.com/news/world/vaping-linked-to-rare-lung-disease-industrial-metals-study-12154578]



"Finally, during the 2018 legislative session, the Legislature enacted a point-of-sale tax on e-cigarettes. But without a comprehensive regulatory framework that includes licensing, it will be impossible to track sales and know who to tax. The creation of a regulatory framework guarantees more gross receipts dollars for the state of New Mexico."

"With the adoption of statewide regulations during the 2020 legislative session, New Mexico can lead the way in creating a comprehensive framework that would legitimize the vapor industry, serve to help combat youth usage, and create a clear avenue for revenue generation."

"We encourage the public to comment on our legislation. It will be available on the New Mexico Legislative website once prefiled legislation is published."
Article (in black) By: 
Representative Patricia Roybal Caballero - (D) pat.roybalcaballero@nmlegis.gov
Senator Gabriel Ramos - (D) gabriel.ramos@nmlegis.gov


The CDC investigation is focusing its investigation on electronic nicotine delivery systems (ENDS), which include vape/dab pens, electronic cigarettes, and the liquids they contain, which can include nicotine, cannabis oil, and other substances and additives.

Whether due to better healthcare surveillance and reporting, the addition of new cutting agents or other additives, the presence of pesticides or other contaminants, issues with certain types, brands, or manufacturers of cartridges and other delivery mechanisms, a combination of these factors, or something else, it is clear that the use of ENDS is not without risk. ASA strongly recommends patients and consumers stop using cannabis-containing cartridges entirely (or at least to the extent possible) until there is clarity as to what is causing these illnesses and deaths.

Americans for Safe Access does not support outright bans on cannabis-containing cartridges or devices intended for the consumption of cannabis concentrates, which could simply drive more people to the unregulated market and exacerbate the spread of VAPI. Rather, we recommend bans on the inclusion of any additives (e.g., diluents, thickeners, flavoring agents) not derived from cannabis. Additionally, we recommend patients and consumers only purchase cannabis products that have undergone testing at an independent, third-party laboratory that has verified composition and potency and screened for adulterants, contaminants, heavy metals, residual solvents, chemical residues, and other health concerns, such as mold and dangerous bacteria.
[‘Patient-Focused Recommendations Regarding the Vaping Crisis’ | Americans For Safe Access | https://www.safeaccessnow.org/patient_focused_recommendations_regarding_the_vaping_crisis]

Response in blue text by Jason Barker  safeaccessnewmexico@gmail.com 


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