U.S. doctors group calls for total ban on vaping, e-cigarette products

The American Medical Association (AMA) on Tuesday called for a total ban on all e-cigarette and vaping products that are not approved by the U.S. Food and Drug Administration as smoking cessation tools.

The AMA is urging regulators and legislators at the state and local levels to ban the sale and distribution of all e-cigarette and vaping products, and stipulates that those products should only be available by prescription.

The group also called for more study on the use of drug and non-drug treatment strategies to deal with nicotine addiction, and is advocating for diagnostic codes for e-cigarette and vaping associated illnesses, which would help better identify patients with lung injuries associated with vaping.

"The recent lung illness outbreak has … shined a light on the fact that we have very little evidence about the short- and long-term health consequences of e-cigarettes and vaping products," AMA president Dr. Patrice Harris said in a statement.

Separately, a federal proposal to ban flavoured e-cigarettes has been stalled for more than two months. U.S. President Donald Trump and Health and Human Services Secretary Alex Azar announced the plan in September, saying a final decision was expected "in the coming weeks," but so far no announcement has been made.

Democratic lawmakers and public health groups have pressured the administration to follow through on the flavour ban, accusing the administration of bowing to industry pressure.

The vaping industry has argued that such a prohibition could hurt Trump's re-election prospects next year.

New York sues 

Also on Tuesday, New York's attorney general filed a suit against Juul, joining the ranks of U.S. states suing the e-cigarette company, saying the it used deceptive marketing practices to reel in young users.

Attorney General Letitia James announced the lawsuit Tuesday against San Francisco-based Juul Labs Inc. It alleges the company contributed to a youth vaping epidemic by using misleading sales tactics on popular social media sites. The suit also alleges that Juul advertising touted e-cigarettes, which contain nicotine, as a safer alternative to traditional cigarettes.

In a written statement, Juul said it had yet to review the lawsuit.

"We remain focused on resetting the vapour category in the U.S. and earning the trust of society by working co-operatively with attorneys general, regulators, public health officials and other stakeholders to combat underage use and convert adult smokers from combustible cigarettes," it said.

The company previously ended the U.S. advertising campaigns and shut down the social media accounts that are the subject of the lawsuit. It also stopped selling most flavours of its e-cigarettes after complaints that they were aimed at attracting young users — not just smokers looking for an alternative to cigarettes.

New York's lawsuit comes one day after California also sued the company for its advertising practices, and six months after North Carolina filed a similar suit. California's suit further alleges Juul failed to adequately verify the age of its consumers in that state.

"We've worked too hard, committed our hard-earned money for too long, combating harmful tobacco use to stand idly by as we now lose Californians to vaping and nicotine addiction," California Attorney General Xavier Becerra said in a statement Monday.

Illinois, Massachusetts and several other states are also investigating Juul, which James said represents 70 per cent of the e-cigarette market.

In the latest U.S. government survey, one in four high school students reported using e-cigarettes the previous month, despite a federal law banning sales to those under 18.

"Juul basically took a page from Big Tobacco's playbook," James told a news conference at her Manhattan office.

The lawsuit was filed in state court in Manhattan. It requires Juul to stop targeting minors and pay fines for various alleged violations.

42 deaths 

The suit comes as health officials have been investigating deaths and illnesses tied to some vaping products. Most who got sick said they vaped products containing THC, the high-inducing ingredient in marijuana. Officials believe a thickening agent used in black-market THC vaping products appears to be a culprit.

The Centres for Disease Control and Prevention (CDC) has reported 42 deaths linked to vaping and 2,172 injuries, according to the federal agency's latest count. 

In Canada, there have been eight confirmed or probable cases of severe lung illness related to vaping.

Juul's products contain nicotine, not THC, but politicians have used the illnesses and deaths to hammer all e-cigarette makers.

James said the death of a 17-year-old boy in the Bronx, linked to vaping, spurred her to file the lawsuit.

"As a result of all of their advertising, a significant number of young people thought that e-cigarettes were safe," James said.

She said other companies that produce e-cigarettes may be targeted in the future.

"All individuals who are responsible for the destruction that has been caused in the state of New York, you can be assured this office will pursue those individuals and not be limited to any one particular company," James said.

Gov. Andrew Cuomo issued a statement saying that "it is undeniable that the vaping industry is using flavoured e-cigarettes to get young people hooked on potentially dangerous and deadly products, and the predatory marketing practices used by these companies have no place in New York."