Governor Bullock Directs Ban on Flavored E-Cigarettes to Address Public Health Emergency

Statement

Governor Steve Bullock today directed the Montana Department of Public Health and Human Services (DPHHS) to implement emergency administrative rules to temporarily prohibit the sale of flavored e-cigarettes.

"Young Montanans are using e-cigarettes at an alarming rate, while officials investigate the possible causes of a national outbreak of e-cigarette-related injury and death, leaving us at a crossroads," Governor Bullock said. "Today, I choose action."

"Protecting the health, safety and well-being of all Montanans -- especially our kids -- is one of my top priorities as governor, and I join the other parents across this state knowing we cannot rest until we do everything we can to keep our kids safe," continued Governor Bullock. "This is the right thing to do during the outbreak of these illnesses and deaths and it's the right thing to do for the future leaders of our state."

The emergency rules will be filed by DPHHS today, October 8, and will be effective on October 22. The emergency rules will be in effect for 120 days, the maximum time allowed by law. The ban includes the sale of all flavored e-cigarette products, including flavored nicotine, THC, and CBD vaping products, in-store and online. The ban does not require retailers to destroy their existing inventory.

The ban on flavored e-cigarettes, which are widely marketed to and used by young people, will seek to curb e-cigarette use while authorities investigate what product or chemical is causing critical illness across the country and develop an evidence-based response.

Two cases were recently confirmed in Montana, including an individual in their 20s from Gallatin County and an individual in their 30s from Yellowstone County. Nationwide, 1,080 confirmed and probable cases and 21 deaths linked to e-cigarette use have been identified in 48 states and one U.S. territory. More than half the cases involve patients under 25 years of age.

Montana joins six other states who have taken similar action including Washington, Oregon, Michigan, Rhode Island, New York and Massachusetts. In addition, Utah has passed emergency rules limiting where e-cigarettes can be sold and California's governor has issued an executive order to increase public awareness and develop warning labels. The Trump administration said last month it would ban the sale of most flavored e-cigarettes, but has yet to release specifics or commit to a timeline.

E-cigarettes are now the most commonly used tobacco product among all youth. The 2019 Montana Youth Risk Behavior Survey showed 30% of Montana high school students currently use e-cigarettes and more than 58% have tried them. In Montana, 28% of middle school students report having tried e-cigarettes, and 16% report currently using them. Approximately 43,000 Montana youth between ages 12 and 18 have tried vaping products and 22,000 Montana youth are currently using vaping products. Between 2017 and 2019, the percentage of Montana high school students using these products frequently (on 20 or more of the past 30 days) has increased by 243% and daily use has increased by 263%.

"The federal government banned all flavors for conventional cigarettes in 2009, with the exception of menthol. Since then, current use of cigarettes among U.S. youth has decreased significantly. However, this ban did not include e-cigarettes which had recently entered the market." DPHHS State Medical Officer Dr. Greg Holzman said. "It is evident that flavored e-cigarettes have helped fuel this current epidemic."

A recent national study concluded that flavored tobacco products might attract young users and serve as starter products to regular tobacco use. A recent report by the FDA states that 96% of 12 to 17-year-olds who initiated e-cigarette use started with a flavored product, and 70% report the flavors as the reason they use e-cigarettes.

Dr. Cathy White, a pediatrician at Southwest Montana Community Health Center and the President of the Montana Chapter of American Academy of Pediatrics, said youth are uniquely at-risk for long lasting effects of nicotine exposure because the brain continues to develop until age 25. Nicotine exposure during adolescence harms the part of the brain that controls attention, learning, mood and impulse control.

"Tobacco use continues to be a major health threat to children, adolescents and adults. We are creating nicotine addiction among a whole new generation of children, who will then go on to suffer from tobacco-related diseases," Dr. White said. "The pediatricians of Montana stand in support of Governor Bullock and his action to help us end this vaping epidemic."

Capital High School principal Brett Zanto said today's announcement highlights an issue impacting middle school and high school students across the state. He said parents can play an integral role in addressing this public health epidemic.

"I urge parents to talk to their kids about why vaping is harmful," Principal Zanto said. "As a school administrator, we see the impact this is having on our youth, and it's disturbing to think about all that is unknown about the long-term health consequences."

The CDC and DPHHS are advising all Montanans not to use any type of vaping product.

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