ST. GEORGE — The Utah Department of Health has issued an emergency rule regulating the sale of flavored e-cigarettes in the state. 

The regulations are being implemented to help address recent cases of lung injury which are suspected to be related to vaping unregulated THC products, according to the Utah Department of Health. 

As of Oct. 1, there have been 1,080 cases of e-cigarette-related lung injury reported in the U.S. in 48 states, resulting in 18 deaths so far, according to the Centers for Disease Control and Prevention. 

In Utah, 71 cases have been reported across the state, including one confirmed case in southwest Utah.

“Utah has quite a high number for our state,” Southwest Utah Public Health Department Public Information Director Dave Heaton said. 

The rule was announced Wednesday, which restricts the sale of flavored e-cigarette products so that only licensed retail tobacco specialty businesses can sell them. The rule also requires those stores to post signs warning customers not to use e-cigarettes to consume unregulated THC, the active ingredient in marijuana. 

While the regulations were initially supposed to be in effect starting Monday, the health department has since delayed enforcement of the rule to Oct. 21 to allow stores more time to comply. 

There are currently seven licensed businesses that will be able to sell flavored e-cigarette products after the ruling goes into effect in southwest Utah, four of which are located in Washington County while three are in Iron county, according to the Southwest Utah Public Health Department. 

Brendon Gunn, owner of Cloud 9 Vapor in St. George, says it’s not likely the ruling will have much effect on his business. 

“It’s not going to change much for us,” he said. “As far as what we generally specialize in, which is manufacturing custom e-liquids, it’s not going to change much about that at all.” 

The reason that flavored e-cigarette products specifically have been regulated has to do with their appeal to youth. By restricting access to flavored vaping products, the health department hopes to reduce the number of teens and young adults affected by lung injury. Around 80% of patients in the U.S. are under 35 years old, and 16% are under 18, according to the CDC. 

“The biggest concern about the vaping popularity is its effect on youth,” Heaton said. “We’re finding a lot of kids, especially younger kids, are fascinated by the flavors and the scents that are in the e-cigarettes. They have names like ‘cotton candy’ or ‘ captain crunch’ and things along those lines, so it does appeal to a youthful market.”

Teens are not the only ones who enjoy flavored e-cigarette products, however. Gunn says that many adults enjoy flavored products as opposed to plain tobacco-flavored vaping. 

“It’s a fact that adults also like flavors,” he said. 

Gunn voiced approval of the way that Utah has chosen to regulate flavored e-cigarette products as opposed to banning them altogether.

“We believe the state of Utah has been very responsible in the way that they’re addressing this. … We all need to do our part to prevent kids from getting their hands on these products so that adults can,” he said. 

Utah’s ruling comes after several other states have either limited the sale of flavored e-cigarette products or banned them altogether. 

Several Utah representatives, Rep. Jennifer Dailey-Provost, D-Salt Lake City; and Rep. Norm Thurston, R-Provo; now have plans to co-sponsor a bill similar to the health department’s rule, permanently banning the sale of flavored e-cigarette products from unlicensed stores in the state.

A similar bill was proposed earlier this year by Rep. Dailey-Provost which was not passed during the 2019 legislative session. 

But Gunn believes that more than just restricting flavored e-cigarettes needs to be done to prevent teen vaping. 

“We as an industry support the idea of not only requiring special licensing to sell these products, but also regulating the amount of nicotine that these products may contain. That way we don’t have to worry about people becoming severely addicted to nicotine,” he said. 

The most common level of nicotine that Cloud 9 sells is between three and six milligrams, while products like Juul, the top-selling vaping product in the U.S., contain as much nicotine as an entire pack of cigarettes, according to the CDC. 

Not only do Juul products contain more nicotine, but they produce a smaller vape cloud when exhaled. Gunn said he believes that if the legal levels of nicotine were reduced, all e-cigarettes would produce more vapor, making it more difficult for teens to conceal. 

“It achieves the most important thing and that is a far lower risk of someone becoming severely addicted to nicotine, especially a young, growing mind,” he said. “The last thing you want is for a substance to be intervening with that development.” 

The recent outbreak of lung injury, however, may not be related to nicotine-based e-cigarettes at all. 

Most of the associated lung injury patients self-reported that they had vaped a product containing THC. According to the Utah Department of Health, 94% of patients in the state said they had vaped THC and 64% of them reported vaping nicotine. Only 6% of patients self-reported vaping nicotine. 

Most of the patients who had acquired e-cigarettes containing THC did so illegally and from an informal source like a friend or dealer as opposed to a licensed dispensary. 

The health department reports that 88% of patients who vaped THC said they had acquired the product either from a friend or dealer, 10% said it came from a dispensary and 2% said they got it from a Utah vape shop. 

Of those who vaped a nicotine product, 42% said they got it from a Utah vape shop, around 35% got it from a friend or dealer. 

Because of the high number of patients who used illegally obtained THC products, the U.S. Food and Drug Administration is warning users not to use e-cigarettes containing THC, especially if it has been modified or was purchased illegally. 

“Consumers who choose to use any vaping products should not modify or add any substances such as THC or other oils to products purchased in stores and should not purchase any vaping products, including those containing THC, off the street or from other illicit channels,” the FDA wrote in a statement. 

Because most of the cases are a result of people using illegal THC vape products, officials are having difficulties narrowing down what exactly is causing the lung injuries. 

“We’re having a hard time finding out who made them, what are the actual contents, and so that is the risk. People are getting them from informal sources a lot of the time,” Heaton said. 

More information about the outbreak of lung injury can be found on the CDC’s website. To read the Utah Department of Health’s administrative rule and to learn more about the state’s investigation into lung injury, click here. 

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