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"title": "Marin Woman Dies of Vaping-Related Illness in First Recorded Bay Area Fatality Linked to E-Cigarettes",
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"content": "\u003cp>A previously healthy Marin County woman in her 40s who started vaping six months ago has died, county officials announced Wednesday.\u003c/p>\n\u003cp>“With sadness, we report that there has been a death in our community suspected to be caused by severe lung injury associated with vaping,” said Dr. Matt Willis, a public health officer with Marin Health and Human Services, in a news release.\u003c/p>\n\u003cp>Marin County Chief Deputy Coroner Robert Fielding identified the victim as Amanda Arconti, a 45-year-old Marin County resident who also had an apartment in Vacaville, \u003ca href=\"https://www.ktvu.com/news/health-dept-woman-dies-after-complications-related-to-e-cigarettes-could-be-fourth-possible-vaping-fatality-in-california\" target=\"_blank\" rel=\"noopener noreferrer\">KTVU reported\u003c/a>. She died on Nov. 7 at Novato Community Hospital.\u003c/p>\n\u003cp>Her death appears to be linked to either vaping or previous tobacco use, Fielding said, but noted that a coming autopsy would determine the final cause of death.\u003c/p>\n\u003cp>Arconti was admitted to the hospital last Thursday, describing symptoms that had persisted for about four days, including coughing, shortness of breath, chest pain and fever, Willis said. Her condition then rapidly progressed to respiratory distress, he added, at which point she was transferred to the hospital’s intensive care unit and placed on a breathing machine before dying the following day.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“This is one of the characteristics of this kind of lung injury: It can be really rapidly progressive in people who are otherwise healthy,” he said.\u003c/p>\n\u003cp>Her death marks the fourth vaping-related fatality in California since July, and the 40th recorded nationally \u003ca href=\"https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html\" target=\"_blank\" rel=\"noopener noreferrer\">by the U.S. Centers for Disease Control and Prevention\u003c/a>. The agency has also documented over 2,000 suspected cases nationwide of lung damage associated with e-cigarettes in the growing epidemic.[aside label=\"related content\" tag=\"e-cigarettes\"]\u003c/p>\n\u003cp>Marin Health and Human Services issued a warning in September recommending that residents cease e-cigarette use and vaping until the cause of the outbreak is discovered. Most cities in Marin County also recently moved to ban the sale of flavored tobacco beginning in January 2020.\u003c/p>\n\u003cp>Willis said his agency is working with the CDC and the California Department of Public Health to obtain test samples of the vaping liquid the woman used and hopes to determine what specifically contributed to her death.\u003c/p>\n\u003cp>“We’re refining what those compounds might be and are going to be using the public health lab to actually test samples themselves that we have collected,” Willis said. His team is relying on the victim’s family members to collect and provide additional evidence, and hopes to have test results within a few weeks, he said.\u003c/p>\n\u003cp>Although the specific products or compounds that cause lung injury after use of e-cigarettes are still unknown, the CDC \u003ca href=\"https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html\" target=\"_blank\" rel=\"noopener noreferrer\">announced last week\u003c/a> that vitamin E acetate may be a contributor in some cases.\u003c/p>\n\u003cp>Oil-based vitamin E is sometimes added to vaping liquids, especially those containing the psychoactive cannabis compound THC, but numerous confirmed cases of lung injury have not been tied to THC, county officials said.\u003c/p>\n\u003cp>There are several thousand formulations of vaping liquids, many of which have not been tested for safety, according to the county.\u003c/p>\n\u003cp>Symptoms of e-cigarette and vaping-associated lung injury, (EVALI) can include shortness of breath, coughing or chest pain, often accompanied by nausea, fever, vomiting or diarrhea. Anyone experiencing these symptoms after using e-cigarettes should seek prompt medical attention, health officials said.\u003c/p>\n\u003cp>“The message is simple: It’s not safe to vape,” Willis said. “Until we have a better understanding of the cause of this outbreak, it’s best to avoid these products entirely.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This article includes reporting from Bay City News’ James Lanaras.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>A previously healthy Marin County woman in her 40s who started vaping six months ago has died, county officials announced Wednesday.\u003c/p>\n\u003cp>“With sadness, we report that there has been a death in our community suspected to be caused by severe lung injury associated with vaping,” said Dr. Matt Willis, a public health officer with Marin Health and Human Services, in a news release.\u003c/p>\n\u003cp>Marin County Chief Deputy Coroner Robert Fielding identified the victim as Amanda Arconti, a 45-year-old Marin County resident who also had an apartment in Vacaville, \u003ca href=\"https://www.ktvu.com/news/health-dept-woman-dies-after-complications-related-to-e-cigarettes-could-be-fourth-possible-vaping-fatality-in-california\" target=\"_blank\" rel=\"noopener noreferrer\">KTVU reported\u003c/a>. She died on Nov. 7 at Novato Community Hospital.\u003c/p>\n\u003cp>Her death appears to be linked to either vaping or previous tobacco use, Fielding said, but noted that a coming autopsy would determine the final cause of death.\u003c/p>\n\u003cp>Arconti was admitted to the hospital last Thursday, describing symptoms that had persisted for about four days, including coughing, shortness of breath, chest pain and fever, Willis said. Her condition then rapidly progressed to respiratory distress, he added, at which point she was transferred to the hospital’s intensive care unit and placed on a breathing machine before dying the following day.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“This is one of the characteristics of this kind of lung injury: It can be really rapidly progressive in people who are otherwise healthy,” he said.\u003c/p>\n\u003cp>Her death marks the fourth vaping-related fatality in California since July, and the 40th recorded nationally \u003ca href=\"https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html\" target=\"_blank\" rel=\"noopener noreferrer\">by the U.S. Centers for Disease Control and Prevention\u003c/a>. The agency has also documented over 2,000 suspected cases nationwide of lung damage associated with e-cigarettes in the growing epidemic.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Marin Health and Human Services issued a warning in September recommending that residents cease e-cigarette use and vaping until the cause of the outbreak is discovered. Most cities in Marin County also recently moved to ban the sale of flavored tobacco beginning in January 2020.\u003c/p>\n\u003cp>Willis said his agency is working with the CDC and the California Department of Public Health to obtain test samples of the vaping liquid the woman used and hopes to determine what specifically contributed to her death.\u003c/p>\n\u003cp>“We’re refining what those compounds might be and are going to be using the public health lab to actually test samples themselves that we have collected,” Willis said. His team is relying on the victim’s family members to collect and provide additional evidence, and hopes to have test results within a few weeks, he said.\u003c/p>\n\u003cp>Although the specific products or compounds that cause lung injury after use of e-cigarettes are still unknown, the CDC \u003ca href=\"https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html\" target=\"_blank\" rel=\"noopener noreferrer\">announced last week\u003c/a> that vitamin E acetate may be a contributor in some cases.\u003c/p>\n\u003cp>Oil-based vitamin E is sometimes added to vaping liquids, especially those containing the psychoactive cannabis compound THC, but numerous confirmed cases of lung injury have not been tied to THC, county officials said.\u003c/p>\n\u003cp>There are several thousand formulations of vaping liquids, many of which have not been tested for safety, according to the county.\u003c/p>\n\u003cp>Symptoms of e-cigarette and vaping-associated lung injury, (EVALI) can include shortness of breath, coughing or chest pain, often accompanied by nausea, fever, vomiting or diarrhea. Anyone experiencing these symptoms after using e-cigarettes should seek prompt medical attention, health officials said.\u003c/p>\n\u003cp>“The message is simple: It’s not safe to vape,” Willis said. “Until we have a better understanding of the cause of this outbreak, it’s best to avoid these products entirely.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This article includes reporting from Bay City News’ James Lanaras.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>San Francisco Mayor London Breed and Supervisors Matt Haney and Hillary Ronen announced a deal Tuesday reconciling their dueling plans to reform the city’s fragmented mental health care system.\u003c/p>\n\u003cp>The trio introduced the agreement outside of City Hall, following months of often tense negotiations on ways to overhaul the treatment of residents grappling with homelessness, mental health and substance abuse issues.\u003c/p>\n\u003cp>In October, Breed announced she was backing her own comprehensive health care plan — called Urgent Care SF — geared towards some 4,000 homeless San Franciscans suffering from mental illness and substance abuse, an initiative she placed on the March 2020 ballot.\u003c/p>\n\u003cp>Similarly, Ronen and Haney also announced last month they had filed paperwork to put their own proposal — dubbed Mental Health SF — on the same ballot. That more sweeping plan pushed for systemic change to the city’s mental health system, a proposal Breed criticized as too broad and costly.\u003c/p>\n\u003cp>[aside label=\"related coverage\" tag=\"mental-health-sf\"]Under the new deal, both sides are pulling their respective measures from the ballot, avoiding what promised to be a long, costly fight in the coming months. Instead, the new plan — still called Mental Health SF — is now being introduced as legislation to the Board of Supervisors.\u003c/p>\n\u003cp>“People didn’t want to see competing ballot measures — a bunch of politics that actually would’ve delayed the solution,” Haney said on Tuesday. “What we’ve put forward here with Mental Health SF is the vision and the framework and the accountability structure to have a system that actually works, because the one we have right now is disjointed, disconnected and is failing our city.”\u003c/p>\n\u003cp>The agreement incorporates Breed’s original demand to prioritize treatment for the city’s most vulnerable population. But it also retains Ronen and Haney’s push to create an Office of Private Insurance Accountability to make sure residents with mental health needs, including those with insurance, receive adequate care.\u003c/p>\n\u003cp>The new program would also include a 24-hour drop-in center with access to psychiatrists and medication for anyone who needs it, regardless of insurance status.\u003c/p>\n\u003cp>“I am so excited for the future of mental health in San Francisco because I know this is the right way to do it,” Breed said. “We have to start looking at mental health in a whole other way than we did in the past. What happens when someone is a schizophrenic? What happens when someone develops dementia or all these other things? What are we doing to make sure we are helping these people and meeting them where they are?”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>However, without a funding source, the effort to approve and implement the program may be far from over.\u003c/p>\n\u003cp>City officials still need to identify a funding source, Haney noted. The program is estimated to cost at least $100 million annually, on top of the $400 million the city already spends on behavioral health services.\u003c/p>\n\u003cp>Funding sources could include a public housing bond, a gross receipts business tax or funding from Proposition C, the a measure passed by voters in 2018 that increases taxes on the city’s biggest corporations to fund housing and homelessness services.\u003c/p>\n\u003cp>Despite the funding vagaries, Ronen said she was optimistic the program would be fully operational within the next two years.\u003c/p>\n\u003cp>“We just created the first universal mental health and substance use system in the country,” she said. “We’re no longer going to waste money, time and the goodwill of patients, and the rest of us quite frankly, by watching people cycle from the street to emergency services, to residential treatment and then right back out on the street, where it is almost impossible to get better.”\u003c/p>\n\u003cp>\u003cem>Additional reporting included from Bay City News’ Daniel Montes.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>San Francisco Mayor London Breed and Supervisors Matt Haney and Hillary Ronen announced a deal Tuesday reconciling their dueling plans to reform the city’s fragmented mental health care system.\u003c/p>\n\u003cp>The trio introduced the agreement outside of City Hall, following months of often tense negotiations on ways to overhaul the treatment of residents grappling with homelessness, mental health and substance abuse issues.\u003c/p>\n\u003cp>In October, Breed announced she was backing her own comprehensive health care plan — called Urgent Care SF — geared towards some 4,000 homeless San Franciscans suffering from mental illness and substance abuse, an initiative she placed on the March 2020 ballot.\u003c/p>\n\u003cp>Similarly, Ronen and Haney also announced last month they had filed paperwork to put their own proposal — dubbed Mental Health SF — on the same ballot. That more sweeping plan pushed for systemic change to the city’s mental health system, a proposal Breed criticized as too broad and costly.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Under the new deal, both sides are pulling their respective measures from the ballot, avoiding what promised to be a long, costly fight in the coming months. Instead, the new plan — still called Mental Health SF — is now being introduced as legislation to the Board of Supervisors.\u003c/p>\n\u003cp>“People didn’t want to see competing ballot measures — a bunch of politics that actually would’ve delayed the solution,” Haney said on Tuesday. “What we’ve put forward here with Mental Health SF is the vision and the framework and the accountability structure to have a system that actually works, because the one we have right now is disjointed, disconnected and is failing our city.”\u003c/p>\n\u003cp>The agreement incorporates Breed’s original demand to prioritize treatment for the city’s most vulnerable population. But it also retains Ronen and Haney’s push to create an Office of Private Insurance Accountability to make sure residents with mental health needs, including those with insurance, receive adequate care.\u003c/p>\n\u003cp>The new program would also include a 24-hour drop-in center with access to psychiatrists and medication for anyone who needs it, regardless of insurance status.\u003c/p>\n\u003cp>“I am so excited for the future of mental health in San Francisco because I know this is the right way to do it,” Breed said. “We have to start looking at mental health in a whole other way than we did in the past. What happens when someone is a schizophrenic? What happens when someone develops dementia or all these other things? What are we doing to make sure we are helping these people and meeting them where they are?”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>However, without a funding source, the effort to approve and implement the program may be far from over.\u003c/p>\n\u003cp>City officials still need to identify a funding source, Haney noted. The program is estimated to cost at least $100 million annually, on top of the $400 million the city already spends on behavioral health services.\u003c/p>\n\u003cp>Funding sources could include a public housing bond, a gross receipts business tax or funding from Proposition C, the a measure passed by voters in 2018 that increases taxes on the city’s biggest corporations to fund housing and homelessness services.\u003c/p>\n\u003cp>Despite the funding vagaries, Ronen said she was optimistic the program would be fully operational within the next two years.\u003c/p>\n\u003cp>“We just created the first universal mental health and substance use system in the country,” she said. “We’re no longer going to waste money, time and the goodwill of patients, and the rest of us quite frankly, by watching people cycle from the street to emergency services, to residential treatment and then right back out on the street, where it is almost impossible to get better.”\u003c/p>\n\u003cp>\u003cem>Additional reporting included from Bay City News’ Daniel Montes.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>San Francisco voters \u003ca href=\"http://bit.ly/2WWaweU\" target=\"_blank\" rel=\"noopener\">overwhelmingly rejected\u003c/a> Juul-funded Proposition C, which would have overturned the ban on the sale and distribution of e-cigarettes in the city.\u003c/p>\n\u003cp>In June, the San Francisco Board of Supervisors voted unanimously for the ban until vaping products are reviewed by the U.S. Food and Drug Administration.\u003c/p>\n\u003cp>San Francisco-based Juul Labs — which received a multi-billion dollar cash infusion from tobacco giant Altria last year — poured over $18 million into pushing Proposition C.\u003c/p>\n\u003cp>Amid greater attention to health risks caused by vaping and with a new CEO, Juul \u003ca href=\"https://www.kqed.org/news/11778007/juuls-19-million-change-of-heart\" target=\"_blank\" rel=\"noopener\">pulled the plug\u003c/a> on its support for the ballot measure before Tuesday’s election.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>E-cigarette maker Juul Labs announced Thursday it will suspend sales of most of its flavored products — including mango, fruit and cucumber — which are widely considered an on-ramp to vaping for teenagers.\u003c/p>\n\u003cp>The move comes as the industry faces immense scrutiny. Several states have instituted bans on flavored products, and the Trump administration has signaled that a\u003ca href=\"https://www.npr.org/sections/health-shots/2019/09/11/759851853/fda-to-banish-flavored-e-cigarettes-to-combat-youth-vaping\"> federal ban may be in the works.\u003c/a>\u003c/p>\n\u003cp>Juul Labs’ new CEO K.C. Crosthwaite said the company is focused on “earning the trust of society” and is working to “combat underage use while providing an alternative to adult smokers,” according to a \u003ca href=\"https://newsroom.juul.com/juul-labs-suspends-sale-of-non-tobacco-non-menthol-based-flavors-in-the-u-s/\">company release\u003c/a> announcing the change.\u003c/p>\n\u003cp>At a time when an estimated 25% of high school seniors in the U.S. say they’ve vaped within the last 30 days, the company is also under pressure to limit marketing and advertising to youth.[aside label=\"more e-cigarette coverage\" tag=\"e-cigarettes\"]\u003c/p>\n\u003cp>Juul’s move to suspend flavors comes the same day that a small nonprofit group, Center for Environmental Health, announced a \u003ca href=\"https://www.ceh.org/news-events/press-releases/content/ceh-settles-juul-worlds-largest-e-cigarette-provider-signs-first-legally-binding-agreement-restricting-marketing-children-teens/\">legally binding agreement\u003c/a> of its lawsuit with the company that will limit Juul’s marketing to kids and teens in specific ways.\u003c/p>\n\u003cp>For instance, Juul cannot advertise at sporting events or concerts that allow people under the age of 21 to attend. The company may not pay for or permit company employees to appear at schools. And, the company can’t use models in their ads that are under the age of 28.\u003c/p>\n\u003cp>In a statement to NPR, a Juul spokesperson wrote, “We agree that no youth should use JUUL products and we are committed to combating underage use.” The statement goes on to say that this “settlement affirms voluntarily responsible marketing practices that JUUL Labs has had in place.”\u003c/p>\n\u003cp>The company says it does not market to youth. “Our products exist solely to help adult smokers find an alternative to combustible cigarettes,” the spokesperson concludes.\u003c/p>\n\u003cp>But Center for Environmental Health CEO Michael Green says the settlement can help hold Juul accountable.\u003c/p>\n\u003cp>“We don’t trust them, we think that their entire model is based on addicting a new generation of young people,” Green says. “The fact that [the agreement is] court-enforceable means that we are going to watch them very closely — and if they violate it by one inch we can go back to court and we can force them to stop.”\u003c/p>\n\u003cp>The settlement is enforceable only in California — and only for a finite period. Public health experts say it’s a step in the right direction, but more action from federal regulators is needed to rein in the epidemic of teen vaping.\u003c/p>\n\u003cp>“The tobacco industry has a long history of making loud, public pronouncements and then failing to follow through,” says \u003ca href=\"https://www.lung.org/about-us/our-leadership/paul-billings.html\">Paul Billings\u003c/a>, the senior vice president for advocacy at the American Lung Association.\u003c/p>\n\u003cp>Billings says the federal government needs to remove flavored e-cigarette products from the market. And he says the Food and Drug Administration, the agency that has regulatory authority, needs to act. \u003c/p>\n\u003cp>“FDA has been dragging its feet for more than a decade,” Billings says. “It’s past time for FDA to enforce the law to provide oversight over e-cigarette products.”\u003c/p>\n\u003cp>As concern over the vaping-related lung illnesses has grown this year, there has been renewed focus on the wider epidemic of teen vaping. And many Americans seem to be in favor of federal action — according to the results of a \u003ca href=\"https://www.kff.org/other/issue-brief/data-note-vaping-and-e-cigarettes/\">new poll from the Kaiser Family Foundation.\u003c/a>\u003c/p>\n\u003cp>“When it comes to banning the sale of flavored e-cigarettes, 52% [of respondents] were in support of a ban,” says \u003ca href=\"https://www.kff.org/person/liz-hamel/\">Liz Hamel\u003c/a>, director of public opinion and survey research at KFF. The poll also found that about half of respondents also support a ban on sales of all e-cigarettes.\u003c/p>\n\u003cp>Some anti-smoking advocates say Juul’s voluntary suspension of its flavored products may have minimal impact, given that the company plans to continue to sell mint- and menthol-flavored e-cigarettes.\u003c/p>\n\u003cp>Robin Koval, CEO and president of Truth Initiative, said in a statement that those two flavors are among the most popular among youth. \u003c/p>\n\u003cp>“We also know, as does the tobacco industry, that menthol has been, and continues to be, the starter flavor of choice for young cigarette users,” she added.\u003c/p>\n\u003cp>\u003ca href=\"https://www.mikebloomberg.com/news/mike-bloomberg-statement-on-todays-juul-announcement/\">In a statement\u003c/a>, Michael Bloomberg, former New York City mayor and philanthropist, called Juul’s move to suspend flavors “too little and too late.”\u003c/p>\n\u003cp>Bloomberg Philanthropies launched its \u003ca href=\"https://urldefense.proofpoint.com/v2/url?u=https-3A__fightflavoredecigs.org_&d=DwMFAg&c=E2nBno7hEddFhl23N5nD1Q&r=jYlnX1OnItymBcYNYHda_Q&m=9NqFOgYvRR4y0R6-Jb50J76nsEUqcpmRz1mfp4W6U9U&s=B3lbzaD6jBYNJfnIKH9YIrTkFxZdyxH_k4RrE52CSfg&e=\">“Protect Kids: Fight Flavored E-Cigarettes”\u003c/a> initiative last month. \u003c/p>\n\u003cp>“Juul’s decision to keep mint- and menthol-flavored e-cigarettes on the shelves is a page right out of the tobacco industry’s playbook,” Bloomberg said.\u003c/p>\n\u003cp>There is evidence that vaping has hooked millions of teenagers on nicotine, a very addictive compound that may be \u003ca href=\"https://www.npr.org/sections/health-shots/2019/10/10/768588170/how-vaping-nicotine-can-affect-a-teenage-brain\">harmful to the teenage brain.\u003c/a>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Some evidence also suggests that teens get addicted to nicotine faster by vaping than by smoking cigarettes. Stan Glantz, a professor of medicine at UC San Francisco who has studied tobacco, says one reason may be the use of the nicotine salts in the newest generation of vaping products. \u003c/p>\n\u003cp>“It allows kids to inhale a much higher dose of nicotine per puff,” Glantz says.\u003c/p>\n\u003cp>And that can make it harder to kick the habit.\u003c/p>\n\u003cp>Copyright 2019 NPR. To see more, visit https://www.npr.org.\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>E-cigarette maker Juul Labs announced Thursday it will suspend sales of most of its flavored products — including mango, fruit and cucumber — which are widely considered an on-ramp to vaping for teenagers.\u003c/p>\n\u003cp>The move comes as the industry faces immense scrutiny. Several states have instituted bans on flavored products, and the Trump administration has signaled that a\u003ca href=\"https://www.npr.org/sections/health-shots/2019/09/11/759851853/fda-to-banish-flavored-e-cigarettes-to-combat-youth-vaping\"> federal ban may be in the works.\u003c/a>\u003c/p>\n\u003cp>Juul Labs’ new CEO K.C. Crosthwaite said the company is focused on “earning the trust of society” and is working to “combat underage use while providing an alternative to adult smokers,” according to a \u003ca href=\"https://newsroom.juul.com/juul-labs-suspends-sale-of-non-tobacco-non-menthol-based-flavors-in-the-u-s/\">company release\u003c/a> announcing the change.\u003c/p>\n\u003cp>At a time when an estimated 25% of high school seniors in the U.S. say they’ve vaped within the last 30 days, the company is also under pressure to limit marketing and advertising to youth.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Juul’s move to suspend flavors comes the same day that a small nonprofit group, Center for Environmental Health, announced a \u003ca href=\"https://www.ceh.org/news-events/press-releases/content/ceh-settles-juul-worlds-largest-e-cigarette-provider-signs-first-legally-binding-agreement-restricting-marketing-children-teens/\">legally binding agreement\u003c/a> of its lawsuit with the company that will limit Juul’s marketing to kids and teens in specific ways.\u003c/p>\n\u003cp>For instance, Juul cannot advertise at sporting events or concerts that allow people under the age of 21 to attend. The company may not pay for or permit company employees to appear at schools. And, the company can’t use models in their ads that are under the age of 28.\u003c/p>\n\u003cp>In a statement to NPR, a Juul spokesperson wrote, “We agree that no youth should use JUUL products and we are committed to combating underage use.” The statement goes on to say that this “settlement affirms voluntarily responsible marketing practices that JUUL Labs has had in place.”\u003c/p>\n\u003cp>The company says it does not market to youth. “Our products exist solely to help adult smokers find an alternative to combustible cigarettes,” the spokesperson concludes.\u003c/p>\n\u003cp>But Center for Environmental Health CEO Michael Green says the settlement can help hold Juul accountable.\u003c/p>\n\u003cp>“We don’t trust them, we think that their entire model is based on addicting a new generation of young people,” Green says. “The fact that [the agreement is] court-enforceable means that we are going to watch them very closely — and if they violate it by one inch we can go back to court and we can force them to stop.”\u003c/p>\n\u003cp>The settlement is enforceable only in California — and only for a finite period. Public health experts say it’s a step in the right direction, but more action from federal regulators is needed to rein in the epidemic of teen vaping.\u003c/p>\n\u003cp>“The tobacco industry has a long history of making loud, public pronouncements and then failing to follow through,” says \u003ca href=\"https://www.lung.org/about-us/our-leadership/paul-billings.html\">Paul Billings\u003c/a>, the senior vice president for advocacy at the American Lung Association.\u003c/p>\n\u003cp>Billings says the federal government needs to remove flavored e-cigarette products from the market. And he says the Food and Drug Administration, the agency that has regulatory authority, needs to act. \u003c/p>\n\u003cp>“FDA has been dragging its feet for more than a decade,” Billings says. “It’s past time for FDA to enforce the law to provide oversight over e-cigarette products.”\u003c/p>\n\u003cp>As concern over the vaping-related lung illnesses has grown this year, there has been renewed focus on the wider epidemic of teen vaping. And many Americans seem to be in favor of federal action — according to the results of a \u003ca href=\"https://www.kff.org/other/issue-brief/data-note-vaping-and-e-cigarettes/\">new poll from the Kaiser Family Foundation.\u003c/a>\u003c/p>\n\u003cp>“When it comes to banning the sale of flavored e-cigarettes, 52% [of respondents] were in support of a ban,” says \u003ca href=\"https://www.kff.org/person/liz-hamel/\">Liz Hamel\u003c/a>, director of public opinion and survey research at KFF. The poll also found that about half of respondents also support a ban on sales of all e-cigarettes.\u003c/p>\n\u003cp>Some anti-smoking advocates say Juul’s voluntary suspension of its flavored products may have minimal impact, given that the company plans to continue to sell mint- and menthol-flavored e-cigarettes.\u003c/p>\n\u003cp>Robin Koval, CEO and president of Truth Initiative, said in a statement that those two flavors are among the most popular among youth. \u003c/p>\n\u003cp>“We also know, as does the tobacco industry, that menthol has been, and continues to be, the starter flavor of choice for young cigarette users,” she added.\u003c/p>\n\u003cp>\u003ca href=\"https://www.mikebloomberg.com/news/mike-bloomberg-statement-on-todays-juul-announcement/\">In a statement\u003c/a>, Michael Bloomberg, former New York City mayor and philanthropist, called Juul’s move to suspend flavors “too little and too late.”\u003c/p>\n\u003cp>Bloomberg Philanthropies launched its \u003ca href=\"https://urldefense.proofpoint.com/v2/url?u=https-3A__fightflavoredecigs.org_&d=DwMFAg&c=E2nBno7hEddFhl23N5nD1Q&r=jYlnX1OnItymBcYNYHda_Q&m=9NqFOgYvRR4y0R6-Jb50J76nsEUqcpmRz1mfp4W6U9U&s=B3lbzaD6jBYNJfnIKH9YIrTkFxZdyxH_k4RrE52CSfg&e=\">“Protect Kids: Fight Flavored E-Cigarettes”\u003c/a> initiative last month. \u003c/p>\n\u003cp>“Juul’s decision to keep mint- and menthol-flavored e-cigarettes on the shelves is a page right out of the tobacco industry’s playbook,” Bloomberg said.\u003c/p>\n\u003cp>There is evidence that vaping has hooked millions of teenagers on nicotine, a very addictive compound that may be \u003ca href=\"https://www.npr.org/sections/health-shots/2019/10/10/768588170/how-vaping-nicotine-can-affect-a-teenage-brain\">harmful to the teenage brain.\u003c/a>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Some evidence also suggests that teens get addicted to nicotine faster by vaping than by smoking cigarettes. Stan Glantz, a professor of medicine at UC San Francisco who has studied tobacco, says one reason may be the use of the nicotine salts in the newest generation of vaping products. \u003c/p>\n\u003cp>“It allows kids to inhale a much higher dose of nicotine per puff,” Glantz says.\u003c/p>\n\u003cp>And that can make it harder to kick the habit.\u003c/p>\n\u003cp>Copyright 2019 NPR. To see more, visit https://www.npr.org.\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"content": "\u003cp>As a teenager, Floyd Hijada eventually came to understand why his dad had given him the nickname “Mr. Earthquake.”\u003c/p>\n\u003cp>“It confused me at first because the earthquake happened in October, but I was born in July,” said Hijada, the sixth and youngest child in his family. “But I guess, you know, that’s how it works.”\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation=\"Floyd Hijada\"]‘It confused me at first because the earthquake happened in October, but I was born in July. But I guess, you know, that’s how it works.’[/pullquote]\u003c/p>\n\u003cp>Hijada’s parents worked opposite schedules, he explained, so the two normally spent little time together. But that changed in the days after the Loma Prieta earthquake in 1989, when their routine came to an abrupt halt and the couple found themselves cooped up in their Daly City home without power.\u003c/p>\n\u003cp>“I already had five kids and we didn’t want any more,” Eleanor Hijada, then 37, \u003ca href=\"https://www.chicagotribune.com/news/ct-xpm-1990-07-31-9003040182-story.html\" target=\"_blank\" rel=\"noopener\">told San Francisco Examiner\u003c/a> reporter Annie Nakao in July 1990, after giving birth to her son just about nine months after the big quake.\u003c/p>\n\u003cp>“I was afraid. I rushed home,” Hijada’s mother said, recounting that fateful day. “My husband didn’t go to work. I was so scared. I had to be close to him. … I was very, very close.”\u003c/p>\n\u003cp>That Examiner article made the front page of the paper, which his parents framed and proudly displayed in the living room.\u003c/p>\n\u003cfigure id=\"attachment_11780895\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"https://ww2.kqed.org/news/2019/10/18/did-the-bay-area-have-a-birthquake-after-loma-prieta/floyd2/\" rel=\"attachment wp-att-11780895\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11780895\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/10/floyd2.jpeg\" alt=\"\" width=\"400\" height=\"711\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/10/floyd2.jpeg 567w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/10/floyd2-160x284.jpeg 160w\" sizes=\"(max-width: 400px) 100vw, 400px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The front page of the San Francisco Examiner from July 1990, featuring an article about the Bay Area’s potential “baby boomlet.” Floyd Hijada, then a newborn, is pictured being held by his father. \u003ccite>(Courtesy of Floyd Hijada)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“I kind of grew up hearing about it,” said Floyd Hijada, who now lives in Concord and works as a graphic designer. “It became like this little discussion piece.”\u003c/p>\n\u003cp>The article described a “baby boomlet” of sorts that had occurred that July in the maternity ward of Seton Medical Center in Daly City.\u003c/p>\n\u003cp>Births at Seton had risen 25% since the first of the month, Nakao reported. On July 10, 1990, Hijada was one of 23 babies in the hospital’s newborn nursery, as compared to eight on the same day the previous year.\u003c/p>\n\u003cp>“We can’t account for it,” Dr. Gwen Marcus, of Seton, told Nakao at the time. But Marcus said talking to the expectant mothers had led to speculation that the temblor was indeed a factor, so much so that the hospital had dubbed the newborns “quake babies.”\u003c/p>\n\u003cp>Asked if he’d ever gotten a chance to meet any of his nursery companions, Hijada said, “No, man. I wish I did. You know, we’d be like a league of superheroes or something. I know there were a lot more [of them].”\u003c/p>\n\u003cp>In her story, Nakao acknowledged that the birth spike at Seton may have been an aberration. None of the other local hospitals she contacted at the time reported any unusual increases, although some said it was too soon to tell.\u003c/p>\n\u003cp>“I can’t say it’s all due to the quake,” Kathy Kohrman, Seton’s spokeswoman at the time, told Nakao. “But when we talk to some of the moms about quake babies, they kind of giggle, look away and turn red.”\u003c/p>\n\u003cp>It’s been a longstanding but largely unsubstantiated theory that mini baby booms occur after natural disasters or other events that confine people indoors.\u003c/p>\n\u003cp>Major natural disasters \u003ca href=\"https://qz.com/1313810/fact-or-fiction-disasters-spur-baby-booms/\" target=\"_blank\" rel=\"noopener\">are commonly followed\u003c/a>, roughly nine months later, by headlines pronouncing a spike in new humans. Such was the case with Hurricanes\u003ca href=\"https://www.nytimes.com/2013/05/27/nyregion/preparing-for-hurricane-babies.html\"> Sandy, \u003c/a>\u003ca href=\"http://www.orlandosentinel.com/health/os-hurricane-babies-20180620-story.html\">Irma\u003c/a>, \u003ca href=\"http://www.orlandosentinel.com/news/breaking-news/96396028-132.html\">Maria\u003c/a> and \u003ca href=\"https://www.cbsnews.com/news/hurricane-harvey-babies-some-hospitals-see-spike-in-births-months-after-the-storm/\">Harvey.\u003c/a>The supposed phenomenon has even been linked to government shutdowns in Washington, D.C. — dubbed “\u003ca href=\"https://www.washingtonpost.com/lifestyle/style/is-washington-in-the-midst-of-a-post-shutdown-baby-boom/2014/07/28/2b561522-1349-11e4-9285-4243a40ddc97_story.html\" target=\"_blank\" rel=\"noopener\">furlough fertility\u003c/a>” — when federal workers have a lot more time on their hands.[aside label=\"related stories\" tag=\"loma-prieta\"]\u003c/p>\n\u003cp>But aside from anecdotal evidence from local hospitals, few population studies have established any strong relationship between natural disasters and birth rates.\u003c/p>\n\u003cp>\u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/11915406\">A 2002 study published in the Journal of Family Psychology\u003c/a> found that in in 1990, the year after Hurricane Hugo struck, marriages and births spiked in the 24 South Carolina counties that had been declared disaster areas. But, to the researchers’ surprise, so too, did divorce rates.\u003c/p>\n\u003cp>Meanwhile, a \u003ca href=\"http://www.econ2.jhu.edu/people/hu/fertility_jpope2010.pdf\" target=\"_blank\" rel=\"noopener\">2008 study\u003c/a> in the Journal of Population Economics, examining six years of birth and storm-advisory data from 47 Atlantic and Gulf Coast counties, found that low-severity storm advisories are “associated with a positive and significant fertility effect,” while high-severity advisories “have a significant negative fertility effect.”\u003c/p>\n\u003cp>Hijada, who turns 30 in July, can’t say for sure if he’s an anomaly or a data point in a wider trend. But the theory, he said, does seem pretty plausible.\u003c/p>\n\u003cp>These days, when Hijada feels the earth shake, as he did intensely on Monday night during the 4.5 magnitude quake in nearby Pleasant Hill, he said he tries not to overthink it.\u003c/p>\n\u003cp>“It does remind me of how I came to be,” he said. “I joke around about it a lot. Like, ‘Oh yeah, I felt that before it came. I knew it was coming.’ ”\u003c/p>\n\u003cp>Hijada quips that the fame and fortune he thought would come from being a “quake baby” never really materialized, despite his front-page splash early on in life.\u003c/p>\n\u003cp>“It took 29 years for somebody to hit me up about it [again],” he said, referring to this interview. “But I’m glad somebody did.”\u003cbr>\n[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>As a teenager, Floyd Hijada eventually came to understand why his dad had given him the nickname “Mr. Earthquake.”\u003c/p>\n\u003cp>“It confused me at first because the earthquake happened in October, but I was born in July,” said Hijada, the sixth and youngest child in his family. “But I guess, you know, that’s how it works.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Hijada’s parents worked opposite schedules, he explained, so the two normally spent little time together. But that changed in the days after the Loma Prieta earthquake in 1989, when their routine came to an abrupt halt and the couple found themselves cooped up in their Daly City home without power.\u003c/p>\n\u003cp>“I already had five kids and we didn’t want any more,” Eleanor Hijada, then 37, \u003ca href=\"https://www.chicagotribune.com/news/ct-xpm-1990-07-31-9003040182-story.html\" target=\"_blank\" rel=\"noopener\">told San Francisco Examiner\u003c/a> reporter Annie Nakao in July 1990, after giving birth to her son just about nine months after the big quake.\u003c/p>\n\u003cp>“I was afraid. I rushed home,” Hijada’s mother said, recounting that fateful day. “My husband didn’t go to work. I was so scared. I had to be close to him. … I was very, very close.”\u003c/p>\n\u003cp>That Examiner article made the front page of the paper, which his parents framed and proudly displayed in the living room.\u003c/p>\n\u003cfigure id=\"attachment_11780895\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"https://ww2.kqed.org/news/2019/10/18/did-the-bay-area-have-a-birthquake-after-loma-prieta/floyd2/\" rel=\"attachment wp-att-11780895\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11780895\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/10/floyd2.jpeg\" alt=\"\" width=\"400\" height=\"711\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/10/floyd2.jpeg 567w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/10/floyd2-160x284.jpeg 160w\" sizes=\"(max-width: 400px) 100vw, 400px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The front page of the San Francisco Examiner from July 1990, featuring an article about the Bay Area’s potential “baby boomlet.” Floyd Hijada, then a newborn, is pictured being held by his father. \u003ccite>(Courtesy of Floyd Hijada)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“I kind of grew up hearing about it,” said Floyd Hijada, who now lives in Concord and works as a graphic designer. “It became like this little discussion piece.”\u003c/p>\n\u003cp>The article described a “baby boomlet” of sorts that had occurred that July in the maternity ward of Seton Medical Center in Daly City.\u003c/p>\n\u003cp>Births at Seton had risen 25% since the first of the month, Nakao reported. On July 10, 1990, Hijada was one of 23 babies in the hospital’s newborn nursery, as compared to eight on the same day the previous year.\u003c/p>\n\u003cp>“We can’t account for it,” Dr. Gwen Marcus, of Seton, told Nakao at the time. But Marcus said talking to the expectant mothers had led to speculation that the temblor was indeed a factor, so much so that the hospital had dubbed the newborns “quake babies.”\u003c/p>\n\u003cp>Asked if he’d ever gotten a chance to meet any of his nursery companions, Hijada said, “No, man. I wish I did. You know, we’d be like a league of superheroes or something. I know there were a lot more [of them].”\u003c/p>\n\u003cp>In her story, Nakao acknowledged that the birth spike at Seton may have been an aberration. None of the other local hospitals she contacted at the time reported any unusual increases, although some said it was too soon to tell.\u003c/p>\n\u003cp>“I can’t say it’s all due to the quake,” Kathy Kohrman, Seton’s spokeswoman at the time, told Nakao. “But when we talk to some of the moms about quake babies, they kind of giggle, look away and turn red.”\u003c/p>\n\u003cp>It’s been a longstanding but largely unsubstantiated theory that mini baby booms occur after natural disasters or other events that confine people indoors.\u003c/p>\n\u003cp>Major natural disasters \u003ca href=\"https://qz.com/1313810/fact-or-fiction-disasters-spur-baby-booms/\" target=\"_blank\" rel=\"noopener\">are commonly followed\u003c/a>, roughly nine months later, by headlines pronouncing a spike in new humans. Such was the case with Hurricanes\u003ca href=\"https://www.nytimes.com/2013/05/27/nyregion/preparing-for-hurricane-babies.html\"> Sandy, \u003c/a>\u003ca href=\"http://www.orlandosentinel.com/health/os-hurricane-babies-20180620-story.html\">Irma\u003c/a>, \u003ca href=\"http://www.orlandosentinel.com/news/breaking-news/96396028-132.html\">Maria\u003c/a> and \u003ca href=\"https://www.cbsnews.com/news/hurricane-harvey-babies-some-hospitals-see-spike-in-births-months-after-the-storm/\">Harvey.\u003c/a>The supposed phenomenon has even been linked to government shutdowns in Washington, D.C. — dubbed “\u003ca href=\"https://www.washingtonpost.com/lifestyle/style/is-washington-in-the-midst-of-a-post-shutdown-baby-boom/2014/07/28/2b561522-1349-11e4-9285-4243a40ddc97_story.html\" target=\"_blank\" rel=\"noopener\">furlough fertility\u003c/a>” — when federal workers have a lot more time on their hands.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But aside from anecdotal evidence from local hospitals, few population studies have established any strong relationship between natural disasters and birth rates.\u003c/p>\n\u003cp>\u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/11915406\">A 2002 study published in the Journal of Family Psychology\u003c/a> found that in in 1990, the year after Hurricane Hugo struck, marriages and births spiked in the 24 South Carolina counties that had been declared disaster areas. But, to the researchers’ surprise, so too, did divorce rates.\u003c/p>\n\u003cp>Meanwhile, a \u003ca href=\"http://www.econ2.jhu.edu/people/hu/fertility_jpope2010.pdf\" target=\"_blank\" rel=\"noopener\">2008 study\u003c/a> in the Journal of Population Economics, examining six years of birth and storm-advisory data from 47 Atlantic and Gulf Coast counties, found that low-severity storm advisories are “associated with a positive and significant fertility effect,” while high-severity advisories “have a significant negative fertility effect.”\u003c/p>\n\u003cp>Hijada, who turns 30 in July, can’t say for sure if he’s an anomaly or a data point in a wider trend. But the theory, he said, does seem pretty plausible.\u003c/p>\n\u003cp>These days, when Hijada feels the earth shake, as he did intensely on Monday night during the 4.5 magnitude quake in nearby Pleasant Hill, he said he tries not to overthink it.\u003c/p>\n\u003cp>“It does remind me of how I came to be,” he said. “I joke around about it a lot. Like, ‘Oh yeah, I felt that before it came. I knew it was coming.’ ”\u003c/p>\n\u003cp>Hijada quips that the fame and fortune he thought would come from being a “quake baby” never really materialized, despite his front-page splash early on in life.\u003c/p>\n\u003cp>“It took 29 years for somebody to hit me up about it [again],” he said, referring to this interview. “But I’m glad somebody did.”\u003cbr>\n\u003c/p>\u003c/div>",
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"slug": "californias-new-transparency-law-reveals-steep-rise-in-wholesale-drug-prices",
"title": "California’s New Transparency Law Reveals Steep Rise in Wholesale Drug Prices",
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"headTitle": "California’s New Transparency Law Reveals Steep Rise in Wholesale Drug Prices | KQED",
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"content": "\u003cp>Drugmakers fought hard against California’s groundbreaking drug price transparency law, passed in 2017. Now, state health officials have released their \u003ca href=\"https://oshpd.ca.gov/visualizations/prescription-drug-wholesale-acquisition-cost-increases/\">first report\u003c/a> on the price hikes those drug companies sought to shield.\u003c/p>\n\u003cp>Pharmaceutical companies raised the “wholesale acquisition cost” of their drugs — the list price for wholesalers without discounts or rebates — by a median of 25.8% from 2017 through the first quarter of 2019, according to the Office of Statewide Health Planning and Development. (The median is a value at the midpoint of data distribution.)\u003c/p>\n\u003cp>Generic drugs saw the largest median increase of 37.6% during that time. By comparison, the annual inflation rate during the period was 2%.\u003c/p>\n\u003cp>[aside link1=\"https://www.kqed.org/stateofhealth/223329/drug-price-transparency-laws-may-not-drive-down-spiraling-costs-for-consumers,Drug Price Transparency Laws May Not Drive Down Spiraling Costs for Consumers\" link2=\"https://www.kqed.org/stateofhealth/361263/other-states-closely-watching-fate-of-californias-drug-price-transparency-bill,Other States Closely Watching Fate of California Drug Price Transparency Bill\" label=\"Drug Price Transparency\"]Several drugs stood out for far heftier price increases: The cost of a generic liquid version of Prozac, for example, rose from $9 to $69 in just the first quarter of 2019, an increase of 667%. Guanfacine, a generic medication for attention deficit hyperactivity disorder (ADHD), on the market since 2010, rose more than 200% in the first quarter of 2019 to $87 for 100 2-milligram pills. Amneal Pharmaceuticals, which makes Guanfacine, cited “manufacturing costs” and “market conditions” as reasons for the price hike.\u003c/p>\n\u003cp>“Even at a time when there is a microscope on this industry, they’re going ahead with drug price increases for hundreds of drugs well above the rate of inflation,” said Anthony Wright, executive director of the California advocacy group Health Access.\u003c/p>\n\u003cp>The national debate over exorbitant prescription drug prices — and how to relieve them — was supposed to take center stage in recent weeks, as House Speaker Nancy Pelosi released \u003ca href=\"https://www.kqed.org/news/11775310/pelosi-unveils-plan-to-lower-prescription-drug-costs-a-rare-priority-shared-with-trump\" target=\"_blank\" rel=\"noopener\">a plan\u003c/a> to negotiate prices for as many as 250 name-brand drugs, including high-priced insulin, for Medicare beneficiaries. Another \u003ca href=\"https://www.cnbc.com/2019/07/23/key-senate-panel-unveils-bipartisan-bill-to-lower-drug-prices-for-seniors.html\">plan\u003c/a> under consideration in the Senate would set a maximum out-of-pocket cost for prescription drugs for Medicare patients and penalize drug companies if prices rose faster than inflation.\u003c/p>\n\u003cp>President Trump has also highlighted drug prices as an issue in his reelection campaign. But lawmakers’ efforts to hammer out legislation are likely to be overshadowed, for now, by presidential impeachment proceedings. In Nevada, health officials in early October \u003ca href=\"https://thenevadaindependent.com/article/nevada-levies-17-million-in-fines-on-drug-companies-for-noncompliance-with-diabetes-drug-transparency-law\">fined companies $17 million\u003c/a> for failing to comply with the state’s 2-year-old transparency law requiring diabetes drug manufacturers to disclose detailed financial and pricing information.\u003c/p>\n\u003cp>California’s new drug law requires companies to report drug price increases quarterly. Only companies that met certain standards — they raised the price of a drug within the first quarter and the price had risen by at least 16% since January 2017 — had to submit data. The companies that met the standards were required to provide pricing data for the previous five years. In its initial report, the state focused its analysis on drug-pricing trends for about 1,000 products from January 2017 through March 2019.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>California’s transparency law also requires drugmakers to state why they are raising prices. Over time, that information, in addition to cost disclosures, could create “one of the more comprehensive and official drug databases on prices that we have nationwide,” Wright said. “That, in itself, is progress, so that we can get better information on the rationale for drug price increases.”\u003c/p>\n\u003cp>But the data does not reflect discounts and rebates for insurers and pharmacy benefit managers and bears little resemblance to what consumers actually pay, said Priscilla VanderVeer, a spokeswoman for the trade group Pharmaceutical Research and Manufacturers of America. The group filed a \u003ca href=\"https://www.documentcloud.org/documents/6440510-PHRMA-v-California-SB-17-COMPLAINT-12-8-17.html\">lawsuit\u003c/a> seeking to overturn the California legislation that has not yet been resolved.\u003c/p>\n\u003cp>“If transparency legislation only looks at one part of the pharmaceutical supply chain, without getting into the various middlemen like insurers and pharmacy benefit managers that ultimately determine what patients have to pay at the pharmacy counter, it won’t help patients access or afford their medicines,” VanderVeer said in an email.\u003c/p>\n\u003cp>State Sen. Richard Pan, D-Sacramento, a pediatrician who chairs the Senate Health Committee, agrees — up to a point.\u003c/p>\n\u003cp>“Transparency always has value,” Pan said. But policymakers need more data on how much insurers and consumers are spending on prescription drugs, he said.\u003c/p>\n\u003cp>And he wonders why the price of generic drugs, including those with plenty of competition, rose at higher rates.\u003c/p>\n\u003cp>His concerns were echoed by University of Southern California policy researchers, who recently published a \u003ca href=\"https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2751892\">study\u003c/a> that concluded most state-level drug-transparency laws are “insufficient” to reveal the true transaction prices for prescription drugs, or where in the distribution system excessive profits lie.\u003c/p>\n\u003cp>[aside postID=\"news_11740765\"]“The question is, why are these prices going up? Typically, there are competing stories for that,” said Neeraj Sood, vice dean of the University of Southern California’s School of Public Policy and an author of the study. “Maybe cost of production is going up,” he said. “Maybe there’s a drug shortage, or some competitors got eliminated. This reporting of [wholesale acquisition cost] data doesn’t really tell us which of these stories is true.”\u003c/p>\n\u003cp>For now, California’s new data is not likely to be of much help to consumers, Pan said. But he said it might help state officials in their bid to overhaul the way the state purchases drugs for 13 million people served by Medi-Cal, the state’s Medicaid program for low-income residents. Gov. Gavin Newsom’s \u003ca href=\"https://www.sfchronicle.com/business/article/Will-Gavin-Newsom-s-plan-lower-prescription-14404947.php\">controversial plan\u003c/a> to have the state, rather than individual Medi-Cal managed-care plans, negotiate directly with drugmakers would save the state an estimated $393 million a year by 2023, according to the administration.\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://khn.org\">KHN\u003c/a> story first published on \u003ca href=\"http://www.californiahealthline.org/\">California Healthline\u003c/a>, a service of the \u003ca href=\"http://www.chcf.org/\">California Health Care Foundation\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"http://www.kaiserhealthnews.org/\">Kaiser Health News\u003c/a> (KHN) is a national health policy news service. It is an editorially independent program of the \u003ca href=\"http://www.kff.org/\">Henry J. Kaiser Family Foundation\u003c/a> which is not affiliated with Kaiser Permanente.\u003c/em>\u003c/p>\n\u003cp>\u003cimg decoding=\"async\" src=\"https://ssl.google-analytics.com/collect?v=1&t=event&ec=Republish&tid=UA-53070700-2&z=1571082607988&cid=2bb4d33e-9a0c-4133-b010-815b74d09391&ea=https%3A%2F%2Fkhn.org%2Fnews%2Fcalifornias-new-transparency-law-reveals-steep-rise-in-wholesale-drug-prices%2F&el=California%E2%80%99s%20New%20Transparency%20Law%20Reveals%20Steep%20Rise%20In%20Wholesale%20Drug%20Prices\">\u003c/p>\n\u003cp>\u003c/p>\n",
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"excerpt": "The first transparency report on drug company pricing shows increases in costs by a median of 25.8% — but a number of advocates say that information might not be enough to help consumers.",
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"nprByline": "\u003cstrong>Barbara Feder Ostrov and Harriet Blair Rowan\u003cbr>\u003ca href=\"https://khn.org/news/californias-new-transparency-law-reveals-steep-rise-in-wholesale-drug-prices/view/republish/\">Kaiser Health News\u003c/a>\u003c/strong>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Drugmakers fought hard against California’s groundbreaking drug price transparency law, passed in 2017. Now, state health officials have released their \u003ca href=\"https://oshpd.ca.gov/visualizations/prescription-drug-wholesale-acquisition-cost-increases/\">first report\u003c/a> on the price hikes those drug companies sought to shield.\u003c/p>\n\u003cp>Pharmaceutical companies raised the “wholesale acquisition cost” of their drugs — the list price for wholesalers without discounts or rebates — by a median of 25.8% from 2017 through the first quarter of 2019, according to the Office of Statewide Health Planning and Development. (The median is a value at the midpoint of data distribution.)\u003c/p>\n\u003cp>Generic drugs saw the largest median increase of 37.6% during that time. By comparison, the annual inflation rate during the period was 2%.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"link1": "https://www.kqed.org/stateofhealth/223329/drug-price-transparency-laws-may-not-drive-down-spiraling-costs-for-consumers,Drug Price Transparency Laws May Not Drive Down Spiraling Costs for Consumers",
"link2": "https://www.kqed.org/stateofhealth/361263/other-states-closely-watching-fate-of-californias-drug-price-transparency-bill,Other States Closely Watching Fate of California Drug Price Transparency Bill",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Several drugs stood out for far heftier price increases: The cost of a generic liquid version of Prozac, for example, rose from $9 to $69 in just the first quarter of 2019, an increase of 667%. Guanfacine, a generic medication for attention deficit hyperactivity disorder (ADHD), on the market since 2010, rose more than 200% in the first quarter of 2019 to $87 for 100 2-milligram pills. Amneal Pharmaceuticals, which makes Guanfacine, cited “manufacturing costs” and “market conditions” as reasons for the price hike.\u003c/p>\n\u003cp>“Even at a time when there is a microscope on this industry, they’re going ahead with drug price increases for hundreds of drugs well above the rate of inflation,” said Anthony Wright, executive director of the California advocacy group Health Access.\u003c/p>\n\u003cp>The national debate over exorbitant prescription drug prices — and how to relieve them — was supposed to take center stage in recent weeks, as House Speaker Nancy Pelosi released \u003ca href=\"https://www.kqed.org/news/11775310/pelosi-unveils-plan-to-lower-prescription-drug-costs-a-rare-priority-shared-with-trump\" target=\"_blank\" rel=\"noopener\">a plan\u003c/a> to negotiate prices for as many as 250 name-brand drugs, including high-priced insulin, for Medicare beneficiaries. Another \u003ca href=\"https://www.cnbc.com/2019/07/23/key-senate-panel-unveils-bipartisan-bill-to-lower-drug-prices-for-seniors.html\">plan\u003c/a> under consideration in the Senate would set a maximum out-of-pocket cost for prescription drugs for Medicare patients and penalize drug companies if prices rose faster than inflation.\u003c/p>\n\u003cp>President Trump has also highlighted drug prices as an issue in his reelection campaign. But lawmakers’ efforts to hammer out legislation are likely to be overshadowed, for now, by presidential impeachment proceedings. In Nevada, health officials in early October \u003ca href=\"https://thenevadaindependent.com/article/nevada-levies-17-million-in-fines-on-drug-companies-for-noncompliance-with-diabetes-drug-transparency-law\">fined companies $17 million\u003c/a> for failing to comply with the state’s 2-year-old transparency law requiring diabetes drug manufacturers to disclose detailed financial and pricing information.\u003c/p>\n\u003cp>California’s new drug law requires companies to report drug price increases quarterly. Only companies that met certain standards — they raised the price of a drug within the first quarter and the price had risen by at least 16% since January 2017 — had to submit data. The companies that met the standards were required to provide pricing data for the previous five years. In its initial report, the state focused its analysis on drug-pricing trends for about 1,000 products from January 2017 through March 2019.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>California’s transparency law also requires drugmakers to state why they are raising prices. Over time, that information, in addition to cost disclosures, could create “one of the more comprehensive and official drug databases on prices that we have nationwide,” Wright said. “That, in itself, is progress, so that we can get better information on the rationale for drug price increases.”\u003c/p>\n\u003cp>But the data does not reflect discounts and rebates for insurers and pharmacy benefit managers and bears little resemblance to what consumers actually pay, said Priscilla VanderVeer, a spokeswoman for the trade group Pharmaceutical Research and Manufacturers of America. The group filed a \u003ca href=\"https://www.documentcloud.org/documents/6440510-PHRMA-v-California-SB-17-COMPLAINT-12-8-17.html\">lawsuit\u003c/a> seeking to overturn the California legislation that has not yet been resolved.\u003c/p>\n\u003cp>“If transparency legislation only looks at one part of the pharmaceutical supply chain, without getting into the various middlemen like insurers and pharmacy benefit managers that ultimately determine what patients have to pay at the pharmacy counter, it won’t help patients access or afford their medicines,” VanderVeer said in an email.\u003c/p>\n\u003cp>State Sen. Richard Pan, D-Sacramento, a pediatrician who chairs the Senate Health Committee, agrees — up to a point.\u003c/p>\n\u003cp>“Transparency always has value,” Pan said. But policymakers need more data on how much insurers and consumers are spending on prescription drugs, he said.\u003c/p>\n\u003cp>And he wonders why the price of generic drugs, including those with plenty of competition, rose at higher rates.\u003c/p>\n\u003cp>His concerns were echoed by University of Southern California policy researchers, who recently published a \u003ca href=\"https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2751892\">study\u003c/a> that concluded most state-level drug-transparency laws are “insufficient” to reveal the true transaction prices for prescription drugs, or where in the distribution system excessive profits lie.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“The question is, why are these prices going up? Typically, there are competing stories for that,” said Neeraj Sood, vice dean of the University of Southern California’s School of Public Policy and an author of the study. “Maybe cost of production is going up,” he said. “Maybe there’s a drug shortage, or some competitors got eliminated. This reporting of [wholesale acquisition cost] data doesn’t really tell us which of these stories is true.”\u003c/p>\n\u003cp>For now, California’s new data is not likely to be of much help to consumers, Pan said. But he said it might help state officials in their bid to overhaul the way the state purchases drugs for 13 million people served by Medi-Cal, the state’s Medicaid program for low-income residents. Gov. Gavin Newsom’s \u003ca href=\"https://www.sfchronicle.com/business/article/Will-Gavin-Newsom-s-plan-lower-prescription-14404947.php\">controversial plan\u003c/a> to have the state, rather than individual Medi-Cal managed-care plans, negotiate directly with drugmakers would save the state an estimated $393 million a year by 2023, according to the administration.\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://khn.org\">KHN\u003c/a> story first published on \u003ca href=\"http://www.californiahealthline.org/\">California Healthline\u003c/a>, a service of the \u003ca href=\"http://www.chcf.org/\">California Health Care Foundation\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"http://www.kaiserhealthnews.org/\">Kaiser Health News\u003c/a> (KHN) is a national health policy news service. It is an editorially independent program of the \u003ca href=\"http://www.kff.org/\">Henry J. Kaiser Family Foundation\u003c/a> which is not affiliated with Kaiser Permanente.\u003c/em>\u003c/p>\n\u003cp>\u003cimg decoding=\"async\" src=\"https://ssl.google-analytics.com/collect?v=1&t=event&ec=Republish&tid=UA-53070700-2&z=1571082607988&cid=2bb4d33e-9a0c-4133-b010-815b74d09391&ea=https%3A%2F%2Fkhn.org%2Fnews%2Fcalifornias-new-transparency-law-reveals-steep-rise-in-wholesale-drug-prices%2F&el=California%E2%80%99s%20New%20Transparency%20Law%20Reveals%20Steep%20Rise%20In%20Wholesale%20Drug%20Prices\">\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"content": "\u003cp>PG&E’s planned power outages are sparking panic among people with health conditions who rely on electricity to power medical devices at home — devices that help them stay comfortable, or stay alive.\u003c/p>\n\u003cp>Patients who need oxygen machines running nonstop to breathe began calling their nurses as soon as the outages were announced, asking what they should do.\u003c/p>\n\u003cp>“We’ve dealt with power outages before, but never to this extent,” said Emma Baron, a nurse and vice president of quality, education and compliance at Hospice East Bay. “This is not that the electricity is out for 10 hours or six hours. This is going to be days, five or six days.”\u003c/p>\n\u003cp>PG&E decided to start cutting power to 800,000 customers in California earlier this week to reduce risks of wildfires amid forecasts of windy, dry weather. A PG&E spokesperson said Thursday that 29,819 customers with medical needs would be affected by the outages. These are households enrolled in the utility’s \u003ca href=\"https://www.pge.com/en_US/residential/save-energy-money/help-paying-your-bill/longer-term-assistance/medical-condition-related/medical-baseline-allowance/medical-baseline-allowance.page#targetText=The%20Medical%20Baseline%20Program%2C%20also,due%20to%20qualifying%20medical%20conditions.&targetText=A%20lower%20rate%20on%20your,a%20Public%20Safety%20Power%20Shutoff\" target=\"_blank\" rel=\"noopener\">medical baseline program\u003c/a>, which offers lower energy rates for older and disabled people who need extra power to operate ventilators, dialysis machines or mechanized wheelchairs.\u003c/p>\n\u003ch3>PG&E to Customers With Disabilities: You Need to Prepare\u003c/h3>\n\u003cp>Utilities tell these customers to plan for power loss by purchasing backup generators. But there are other medically vulnerable people who are not part of the program, who do not get this warning and are not sure what to do.\u003c/p>\n\u003cp>One of the first things the nurses at Hospice East Bay did to help patients in their care was go shopping.\u003c/p>\n\u003cp>Nurses called their medical supplier to order backup oxygen tanks that can run without power. They were told supplies were already starting to run low because of increased demand related to the outages.\u003c/p>\n\u003cp>[aside label=\"more PG&E shutoff coverage\" tag=\"power-shutoff\"]\u003c/p>\n\u003cp>Next, they went to Target to buy foam mattresses for patients with bed sores or skin conditions who usually rely on airflow mattresses that must be plugged in to stay inflated and keep air streaming continuously. Regular mattresses can be too hard and aggravate sensitive or infected skin.\u003c/p>\n\u003cp>“We bought the foam pads as a temporary measure,” Baron said, “because we’re not able to get egg crate foam from the vendors we have. They’re backlogged now because of all the requests.”\u003c/p>\n\u003cp>Finally, nurses called all the families who have an electric bed at home that allows people to sit up, raise their feet or lower the whole bed to make it easier to get in and out of.\u003c/p>\n\u003cp>“We advised them that they need to put the bed in the most comfortable position for the patient, because once the electricity goes off, they’re not going to be able to reposition that bed for as many days as it’s off,” Baron said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003ch3>Hospitals and Outpatient Clinics Coordinate Care\u003c/h3>\n\u003cp>Hospitals don’t anticipate any major interruptions to care because they have emergency generators that keep all critical systems running during an outage.\u003c/p>\n\u003cp>But some outpatient appointments and procedures may need to be rescheduled at affected Kaiser Permanente and Sutter Health locations, which so far include Santa Rosa, Lakeport, Auburn and Jackson.\u003c/p>\n\u003cp>“We will communicate with members who are affected, by phone and text,” said Tom Hanenburg, chief operating officer for Kaiser Permanente Northern California.\u003c/p>\n\u003cp>Hospital officials echoed the recommendation for a generator for people who rely on medical devices at home, as well as rechargeable batteries to run CPAP machines that help people with sleep apnea breathe at night.\u003c/p>\n\u003cp>They also recommend that “refrigerated medications be moved to small coolers packed with ice or cooling bricks, but not cold enough to freeze the medication. A closed refrigerator can maintain its temperature for 2-3 hours.”\u003c/p>\n\u003cp>Besides the logistics of keeping life-sustaining devices running, nurses at Hospice East Bay are also working hard to keep patients calm. Nurses, social workers and spiritual advisors were told to fill up their gas tanks so they won’t miss any home visits.\u003c/p>\n\u003cp>“These are people who are frail, elderly and in the last six months of their lives,” Baron said. “So every day counts for them.”\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>PG&E’s planned power outages are sparking panic among people with health conditions who rely on electricity to power medical devices at home — devices that help them stay comfortable, or stay alive.\u003c/p>\n\u003cp>Patients who need oxygen machines running nonstop to breathe began calling their nurses as soon as the outages were announced, asking what they should do.\u003c/p>\n\u003cp>“We’ve dealt with power outages before, but never to this extent,” said Emma Baron, a nurse and vice president of quality, education and compliance at Hospice East Bay. “This is not that the electricity is out for 10 hours or six hours. This is going to be days, five or six days.”\u003c/p>\n\u003cp>PG&E decided to start cutting power to 800,000 customers in California earlier this week to reduce risks of wildfires amid forecasts of windy, dry weather. A PG&E spokesperson said Thursday that 29,819 customers with medical needs would be affected by the outages. These are households enrolled in the utility’s \u003ca href=\"https://www.pge.com/en_US/residential/save-energy-money/help-paying-your-bill/longer-term-assistance/medical-condition-related/medical-baseline-allowance/medical-baseline-allowance.page#targetText=The%20Medical%20Baseline%20Program%2C%20also,due%20to%20qualifying%20medical%20conditions.&targetText=A%20lower%20rate%20on%20your,a%20Public%20Safety%20Power%20Shutoff\" target=\"_blank\" rel=\"noopener\">medical baseline program\u003c/a>, which offers lower energy rates for older and disabled people who need extra power to operate ventilators, dialysis machines or mechanized wheelchairs.\u003c/p>\n\u003ch3>PG&E to Customers With Disabilities: You Need to Prepare\u003c/h3>\n\u003cp>Utilities tell these customers to plan for power loss by purchasing backup generators. But there are other medically vulnerable people who are not part of the program, who do not get this warning and are not sure what to do.\u003c/p>\n\u003cp>One of the first things the nurses at Hospice East Bay did to help patients in their care was go shopping.\u003c/p>\n\u003cp>Nurses called their medical supplier to order backup oxygen tanks that can run without power. They were told supplies were already starting to run low because of increased demand related to the outages.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003ch3>Hospitals and Outpatient Clinics Coordinate Care\u003c/h3>\n\u003cp>Hospitals don’t anticipate any major interruptions to care because they have emergency generators that keep all critical systems running during an outage.\u003c/p>\n\u003cp>But some outpatient appointments and procedures may need to be rescheduled at affected Kaiser Permanente and Sutter Health locations, which so far include Santa Rosa, Lakeport, Auburn and Jackson.\u003c/p>\n\u003cp>“We will communicate with members who are affected, by phone and text,” said Tom Hanenburg, chief operating officer for Kaiser Permanente Northern California.\u003c/p>\n\u003cp>Hospital officials echoed the recommendation for a generator for people who rely on medical devices at home, as well as rechargeable batteries to run CPAP machines that help people with sleep apnea breathe at night.\u003c/p>\n\u003cp>They also recommend that “refrigerated medications be moved to small coolers packed with ice or cooling bricks, but not cold enough to freeze the medication. A closed refrigerator can maintain its temperature for 2-3 hours.”\u003c/p>\n\u003cp>Besides the logistics of keeping life-sustaining devices running, nurses at Hospice East Bay are also working hard to keep patients calm. Nurses, social workers and spiritual advisors were told to fill up their gas tanks so they won’t miss any home visits.\u003c/p>\n\u003cp>“These are people who are frail, elderly and in the last six months of their lives,” Baron said. “So every day counts for them.”\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"content": "\u003cp>President Trump \u003ca href=\"http://bit.ly/fioreimmigranthealthcare\" target=\"_blank\" rel=\"noopener\">issued a proclamation\u003c/a> late Friday that blocks immigrants from entering the United States if they can’t afford health care.\u003c/p>\n\u003cp>While the order doesn’t apply to asylum-seekers, it would prevent other immigrants from entering the U.S. unless they can prove they have health coverage or will have it secured within 30 days.\u003c/p>\n\u003cp>I guess not being able to afford our unique style of incredibly convoluted and exorbitantly priced health care is a privilege only citizens can enjoy.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>President Trump \u003ca href=\"http://bit.ly/fioreimmigranthealthcare\" target=\"_blank\" rel=\"noopener\">issued a proclamation\u003c/a> late Friday that blocks immigrants from entering the United States if they can’t afford health care.\u003c/p>\n\u003cp>While the order doesn’t apply to asylum-seekers, it would prevent other immigrants from entering the U.S. unless they can prove they have health coverage or will have it secured within 30 days.\u003c/p>\n\u003cp>I guess not being able to afford our unique style of incredibly convoluted and exorbitantly priced health care is a privilege only citizens can enjoy.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Only two years ago, electronic cigarettes were viewed as a small industry with big potential to improve public health by offering a path to steer millions of smokers away from deadly cigarettes.\u003c/p>\n\u003cp>That promise led U.S. regulators to take a hands-off approach to e-cigarette makers, including a Silicon Valley startup named Juul Labs, which was being praised for creating “the iPhone of e-cigarettes.”\u003c/p>\n\u003cp>Today Juul and hundreds of smaller companies are at the center of a political backlash that threatens to sweep e-cigarettes from store shelves nationwide as politicians scramble to address two separate public health crises tied to vaping: underage use among teenagers and a mysterious and sometimes fatal lung ailment that has affected more than 1,000 people.\u003c/p>\n\u003cp>New restrictions at the local, state and federal level are poised to wipe out thousands of fruit-, candy- and dessert-flavored vapes that have attracted teens. But experts who study tobacco policy fear the scattershot approach of the clampdown could have damaging, unintended consequences, including driving adults who vape back to cigarette smoking, which remains the nation’s leading preventable cause of death.\u003c/p>\n\u003cp>“This could take us from potentially the single biggest improvement in public health in the United States toward a public health disaster in which cigarettes continue to be the dominant nicotine product,” said Jonathan Foulds, an addiction researcher and tobacco specialist at Penn State University.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Foulds and many other experts continue to view e-cigarettes as a potential “off-ramp” for smokers, allowing them to continue using nicotine — the addictive chemical in cigarettes — without inhaling all the toxic byproducts of burning tobacco.\u003c/p>\n\u003cp>But they warn the vaping backlash could do irreparable harm to the public perception of e-cigarettes, while ignoring the riskiest products that are most likely to blame for the recent outbreak.\u003c/p>\n\u003cp>Federal investigators say that nearly 80% of people who have come down with the vaping illness reported using products containing THC, the high-inducing chemical found in marijuana. They have not traced the problem to any single product or ingredient. But investigators are increasingly focused on thickeners and additives found in illegal THC cartridges sold on the black market.\u003c/p>\n\u003cp>On Friday, the Food and Drug Administration specifically warned the public not to vape THC or purchase any vaping products off the street.\u003c/p>\n\u003cp>THC vapes are separate from the legal, nicotine-filled e-cigarettes being targeted by President Donald Trump and politicians across the country.\u003c/p>\n\u003cp>Democratic governors in New York, Michigan, Washington, Rhode Island and Oregon have followed the president’s plan to ban flavored e-cigarettes nationally with their own state-level flavor restrictions. Massachusetts’ Republican governor has gone even further, placing a four-month moratorium on sales of vaping products of any kind.\u003c/p>\n\u003cp>“The problem here is we have convinced adult America that vaping is as dangerous as smoking — and nothing could be further from the truth,” said Kenneth Warner, professor emeritus at the University of Michigan’s school of public health.\u003c/p>\n\u003cp>E-cigarettes generally heat a flavored nicotine solution into an inhalable aerosol. There is little research on the long-term effects of inhaling the chemicals in vaping, such as vegetable glycerin. Despite those unknowns, most experts agree e-cigarettes pose a much smaller risk than cigarettes, which cause cancer, lung disease and stroke and account for some 480,000 U.S. deaths each year.\u003c/p>\n\u003cp>Even before the current uproar over vaping, most adults considered e-cigarettes dangerous. A 2017 government survey found 55% of Americans considered e-cigarettes as harmful as regular cigarettes.\u003c/p>\n\u003cp>And while the flavor bans are likely to curb teen vaping, Warner and others point out that those policies won’t prohibit flavors in traditional tobacco products. That means both teens and adults could wind up switching to deadlier menthol cigarettes or flavored cigars, which come in coffee, raspberry, chocolate and hundreds of other varieties.\u003c/p>\n\u003ch3>Walking a Policy Tightrope\u003c/h3>\n\u003cp>The policy debate underscores the challenge of finding the right regulatory scheme for e-cigarettes, products for which there is little high-quality research.\u003c/p>\n\u003cp>More than 30 countries prohibit vaping products. In contrast, the United Kingdom has fully embraced them as a public health tool, urging doctors to promote them to help smokers quit.\u003c/p>\n\u003cp>The U.S. FDA has been struggling to find the right approach since it gained authority over e-cigarettes in 2016.\u003c/p>\n\u003cp>The agency repeatedly delayed its deadline to begin reviewing e-cigarettes, a step that critics say allowed products like Juul to catch on with teenagers. At the same time, e-cigarette companies and proponents say the agency’s new review deadline of next May is too aggressive and will force most companies out of business.\u003c/p>\n\u003cp>Now the agency is trying to walk a tightrope between keeping e-cigarettes away from teens but preserving them for an estimated 10 million adults who use them, most of whom also smoke.\u003c/p>\n\u003cp>Further complicating the picture is the fact that no e-cigarette brand has yet been shown to help smokers quit in rigorous studies. But large-scale surveys suggest smokers who use e-cigarettes daily are up to six times more likely to quit than those who don’t use them.\u003c/p>\n\u003ch3>Risk of Smoking Relapse\u003c/h3>\n\u003cp>The statistics favoring e-cigarettes are bolstered by the experiences of people like Laura Adams, 52, of Battle Creek, Michigan.\u003c/p>\n\u003cp>A smoker since age 16, Adams was rushed to the hospital in April when a coughing fit left her struggling to breathe. Doctors diagnosed her with chronic obstructive pulmonary disorder, or COPD, and told her she needed to quit cigarettes.\u003c/p>\n\u003cp>For more than 25 years previously, Adams had smoked clove-flavored cigarettes. When the government banned those in 2009, she switched to flavored cigars.\u003c/p>\n\u003cp>“I always liked the flavors better than regular tobacco,” Adams said.\u003cbr>\nAfter her medical emergency, Adams tried a series of e-cigarettes at a local vape shop before settling on a large, refillable device that allowed her to switch between flavors like blueberry, watermelon and peach.\u003c/p>\n\u003cp>“As far as I’m concerned, flavored vaping juice saved my life,” Adams said. “It gave me the option of continuing with my nicotine but without destroying my lungs.”\u003c/p>\n\u003cp>As Michigan stores pull their flavored products to comply with the state ban, Adams has been researching out-of-state suppliers and even do-it-yourself kits for mixing flavors.\u003c/p>\n\u003cp>But some public health advocates fear less motivated ex-smokers will simply return to cigarettes. Even with the success of Juul, e-cigarettes remain a tiny slice of the U.S. tobacco market, accounting for $8.6 billion in sales compared to $95 billion for cigarettes, according to Euromonitor.\u003c/p>\n\u003cp>Industry analysts point to early indicators that e-cigarette sales are beginning to flag amid the bans and negative headlines. E-cigarette sales slowed by 11% over the four weeks ended Sept. 22, according to retail data tracked by Nielsen.\u003c/p>\n\u003cp>The trend “could result in improved combustible cigarette” sales “as vapers potentially return” to smoking, Wells Fargo analyst Bonnie Herzog told investors in a recent note.\u003c/p>\n\u003cp>That’s exactly the opposite of what public health officials have been trying to achieve, noted former FDA Commissioner Scott Gottlieb, who stepped down in April.\u003c/p>\n\u003cp>As FDA chief, Gottlieb outlined an ambitious anti-smoking plan intended to shift most of the nation’s 34 million smokers away from cigarettes and toward less risky products. The unprecedented plan involved a two-step process: cutting nicotine in traditional cigarettes to make them virtually nonaddictive and then promoting FDA-sanctioned, lower-risk alternatives, such as e-cigarettes.\u003c/p>\n\u003cp>But the agency has yet to unveil its proposal for cutting nicotine. And a separate proposal to ban menthol cigarettes is still in regulatory limbo.\u003c/p>\n\u003cp>So as the agency begins sweeping flavored e-cigarettes off the market in coming months, Gottlieb fears smokers may revert to regular cigarettes and cigars, which will still have nicotine levels and flavors designed to addict users.\u003c/p>\n\u003cp>“This was always a package deal, and it’s become even more critical than ever to advance that entire policy agenda,” he said.\u003cbr>\nThe FDA says it remains committed to Gottlieb’s vision of lower-nicotine cigarettes and less-harmful alternative products. The agency’s regulatory calendar lists this month as the target date to release its proposal for regulating nicotine. But that effort will take years to implement and will almost certainly face lawsuits from tobacco companies.\u003c/p>\n\u003cp>Meanwhile, it remains unclear which e-cigarettes — if any — will survive the FDA review process set to begin in May.\u003cbr>\nUnder agency standards, only vaping products that represent a net benefit to the nation’s public health are supposed to be permitted.\u003c/p>\n\u003cp>Proving that standard will require companies to submit detailed analysis of their ingredients and population-level estimates of how their products will impact both adult and underage users.\u003c/p>\n\u003cp>Industry observers say few, if any, of the thousands of vape shops that mix their own custom flavors and solutions will be able to meet the threshold.\u003c/p>\n\u003cp>“It’s ironic that the vape shops, who really championed e-cigarettes for smoking cessation, are going to be out of business,” said Dr. Neal Benowitz, a nicotine and tobacco researcher at the University of California San Francisco.\u003c/p>\n\u003cp>That leaves a handful of industry heavyweights such as Juul, which could benefit from billions in research funding from Marlboro-maker Altria, the tobacco company that owns a 35% stake in the vaping firm.\u003c/p>\n\u003cp>But Juul has been besieged by lawsuits and investigations into its alleged role in triggering the explosion of teen vaping. That history could block the company from ever winning FDA approval for its current device, according to former FDA officials.\u003c/p>\n\u003ch3>A Third Way\u003c/h3>\n\u003cp>The uncertainty swirling around vaping could clear the path for another product that is neither a traditional cigarette nor an e-cigarette.\u003c/p>\n\u003cp>Earlier this year, the FDA authorized the sale of a first-of-a-kind device, IQOS, that heats tobacco without burning it. The approach is designed to mimic the experience of smoking while producing fewer toxic chemicals than paper-and-tobacco cigarettes.\u003c/p>\n\u003cp>The battery-powered device is getting a preliminary launch this month in Atlanta ahead of a wider rollout. But IQOS’s pedigree underscores the persistence of Big Tobacco companies, even in a world increasingly focused on vaping and other alternative products.\u003c/p>\n\u003cp>IQOS was developed by Philip Morris International, the global tobacco giant that sells Marlboro cigarettes overseas. It will be sold in the U.S. by the biggest American cigarette maker, Altria, which is also Juul’s biggest investor.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Only two years ago, electronic cigarettes were viewed as a small industry with big potential to improve public health by offering a path to steer millions of smokers away from deadly cigarettes.\u003c/p>\n\u003cp>That promise led U.S. regulators to take a hands-off approach to e-cigarette makers, including a Silicon Valley startup named Juul Labs, which was being praised for creating “the iPhone of e-cigarettes.”\u003c/p>\n\u003cp>Today Juul and hundreds of smaller companies are at the center of a political backlash that threatens to sweep e-cigarettes from store shelves nationwide as politicians scramble to address two separate public health crises tied to vaping: underage use among teenagers and a mysterious and sometimes fatal lung ailment that has affected more than 1,000 people.\u003c/p>\n\u003cp>New restrictions at the local, state and federal level are poised to wipe out thousands of fruit-, candy- and dessert-flavored vapes that have attracted teens. But experts who study tobacco policy fear the scattershot approach of the clampdown could have damaging, unintended consequences, including driving adults who vape back to cigarette smoking, which remains the nation’s leading preventable cause of death.\u003c/p>\n\u003cp>“This could take us from potentially the single biggest improvement in public health in the United States toward a public health disaster in which cigarettes continue to be the dominant nicotine product,” said Jonathan Foulds, an addiction researcher and tobacco specialist at Penn State University.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Foulds and many other experts continue to view e-cigarettes as a potential “off-ramp” for smokers, allowing them to continue using nicotine — the addictive chemical in cigarettes — without inhaling all the toxic byproducts of burning tobacco.\u003c/p>\n\u003cp>But they warn the vaping backlash could do irreparable harm to the public perception of e-cigarettes, while ignoring the riskiest products that are most likely to blame for the recent outbreak.\u003c/p>\n\u003cp>Federal investigators say that nearly 80% of people who have come down with the vaping illness reported using products containing THC, the high-inducing chemical found in marijuana. They have not traced the problem to any single product or ingredient. But investigators are increasingly focused on thickeners and additives found in illegal THC cartridges sold on the black market.\u003c/p>\n\u003cp>On Friday, the Food and Drug Administration specifically warned the public not to vape THC or purchase any vaping products off the street.\u003c/p>\n\u003cp>THC vapes are separate from the legal, nicotine-filled e-cigarettes being targeted by President Donald Trump and politicians across the country.\u003c/p>\n\u003cp>Democratic governors in New York, Michigan, Washington, Rhode Island and Oregon have followed the president’s plan to ban flavored e-cigarettes nationally with their own state-level flavor restrictions. Massachusetts’ Republican governor has gone even further, placing a four-month moratorium on sales of vaping products of any kind.\u003c/p>\n\u003cp>“The problem here is we have convinced adult America that vaping is as dangerous as smoking — and nothing could be further from the truth,” said Kenneth Warner, professor emeritus at the University of Michigan’s school of public health.\u003c/p>\n\u003cp>E-cigarettes generally heat a flavored nicotine solution into an inhalable aerosol. There is little research on the long-term effects of inhaling the chemicals in vaping, such as vegetable glycerin. Despite those unknowns, most experts agree e-cigarettes pose a much smaller risk than cigarettes, which cause cancer, lung disease and stroke and account for some 480,000 U.S. deaths each year.\u003c/p>\n\u003cp>Even before the current uproar over vaping, most adults considered e-cigarettes dangerous. A 2017 government survey found 55% of Americans considered e-cigarettes as harmful as regular cigarettes.\u003c/p>\n\u003cp>And while the flavor bans are likely to curb teen vaping, Warner and others point out that those policies won’t prohibit flavors in traditional tobacco products. That means both teens and adults could wind up switching to deadlier menthol cigarettes or flavored cigars, which come in coffee, raspberry, chocolate and hundreds of other varieties.\u003c/p>\n\u003ch3>Walking a Policy Tightrope\u003c/h3>\n\u003cp>The policy debate underscores the challenge of finding the right regulatory scheme for e-cigarettes, products for which there is little high-quality research.\u003c/p>\n\u003cp>More than 30 countries prohibit vaping products. In contrast, the United Kingdom has fully embraced them as a public health tool, urging doctors to promote them to help smokers quit.\u003c/p>\n\u003cp>The U.S. FDA has been struggling to find the right approach since it gained authority over e-cigarettes in 2016.\u003c/p>\n\u003cp>The agency repeatedly delayed its deadline to begin reviewing e-cigarettes, a step that critics say allowed products like Juul to catch on with teenagers. At the same time, e-cigarette companies and proponents say the agency’s new review deadline of next May is too aggressive and will force most companies out of business.\u003c/p>\n\u003cp>Now the agency is trying to walk a tightrope between keeping e-cigarettes away from teens but preserving them for an estimated 10 million adults who use them, most of whom also smoke.\u003c/p>\n\u003cp>Further complicating the picture is the fact that no e-cigarette brand has yet been shown to help smokers quit in rigorous studies. But large-scale surveys suggest smokers who use e-cigarettes daily are up to six times more likely to quit than those who don’t use them.\u003c/p>\n\u003ch3>Risk of Smoking Relapse\u003c/h3>\n\u003cp>The statistics favoring e-cigarettes are bolstered by the experiences of people like Laura Adams, 52, of Battle Creek, Michigan.\u003c/p>\n\u003cp>A smoker since age 16, Adams was rushed to the hospital in April when a coughing fit left her struggling to breathe. Doctors diagnosed her with chronic obstructive pulmonary disorder, or COPD, and told her she needed to quit cigarettes.\u003c/p>\n\u003cp>For more than 25 years previously, Adams had smoked clove-flavored cigarettes. When the government banned those in 2009, she switched to flavored cigars.\u003c/p>\n\u003cp>“I always liked the flavors better than regular tobacco,” Adams said.\u003cbr>\nAfter her medical emergency, Adams tried a series of e-cigarettes at a local vape shop before settling on a large, refillable device that allowed her to switch between flavors like blueberry, watermelon and peach.\u003c/p>\n\u003cp>“As far as I’m concerned, flavored vaping juice saved my life,” Adams said. “It gave me the option of continuing with my nicotine but without destroying my lungs.”\u003c/p>\n\u003cp>As Michigan stores pull their flavored products to comply with the state ban, Adams has been researching out-of-state suppliers and even do-it-yourself kits for mixing flavors.\u003c/p>\n\u003cp>But some public health advocates fear less motivated ex-smokers will simply return to cigarettes. Even with the success of Juul, e-cigarettes remain a tiny slice of the U.S. tobacco market, accounting for $8.6 billion in sales compared to $95 billion for cigarettes, according to Euromonitor.\u003c/p>\n\u003cp>Industry analysts point to early indicators that e-cigarette sales are beginning to flag amid the bans and negative headlines. E-cigarette sales slowed by 11% over the four weeks ended Sept. 22, according to retail data tracked by Nielsen.\u003c/p>\n\u003cp>The trend “could result in improved combustible cigarette” sales “as vapers potentially return” to smoking, Wells Fargo analyst Bonnie Herzog told investors in a recent note.\u003c/p>\n\u003cp>That’s exactly the opposite of what public health officials have been trying to achieve, noted former FDA Commissioner Scott Gottlieb, who stepped down in April.\u003c/p>\n\u003cp>As FDA chief, Gottlieb outlined an ambitious anti-smoking plan intended to shift most of the nation’s 34 million smokers away from cigarettes and toward less risky products. The unprecedented plan involved a two-step process: cutting nicotine in traditional cigarettes to make them virtually nonaddictive and then promoting FDA-sanctioned, lower-risk alternatives, such as e-cigarettes.\u003c/p>\n\u003cp>But the agency has yet to unveil its proposal for cutting nicotine. And a separate proposal to ban menthol cigarettes is still in regulatory limbo.\u003c/p>\n\u003cp>So as the agency begins sweeping flavored e-cigarettes off the market in coming months, Gottlieb fears smokers may revert to regular cigarettes and cigars, which will still have nicotine levels and flavors designed to addict users.\u003c/p>\n\u003cp>“This was always a package deal, and it’s become even more critical than ever to advance that entire policy agenda,” he said.\u003cbr>\nThe FDA says it remains committed to Gottlieb’s vision of lower-nicotine cigarettes and less-harmful alternative products. The agency’s regulatory calendar lists this month as the target date to release its proposal for regulating nicotine. But that effort will take years to implement and will almost certainly face lawsuits from tobacco companies.\u003c/p>\n\u003cp>Meanwhile, it remains unclear which e-cigarettes — if any — will survive the FDA review process set to begin in May.\u003cbr>\nUnder agency standards, only vaping products that represent a net benefit to the nation’s public health are supposed to be permitted.\u003c/p>\n\u003cp>Proving that standard will require companies to submit detailed analysis of their ingredients and population-level estimates of how their products will impact both adult and underage users.\u003c/p>\n\u003cp>Industry observers say few, if any, of the thousands of vape shops that mix their own custom flavors and solutions will be able to meet the threshold.\u003c/p>\n\u003cp>“It’s ironic that the vape shops, who really championed e-cigarettes for smoking cessation, are going to be out of business,” said Dr. Neal Benowitz, a nicotine and tobacco researcher at the University of California San Francisco.\u003c/p>\n\u003cp>That leaves a handful of industry heavyweights such as Juul, which could benefit from billions in research funding from Marlboro-maker Altria, the tobacco company that owns a 35% stake in the vaping firm.\u003c/p>\n\u003cp>But Juul has been besieged by lawsuits and investigations into its alleged role in triggering the explosion of teen vaping. That history could block the company from ever winning FDA approval for its current device, according to former FDA officials.\u003c/p>\n\u003ch3>A Third Way\u003c/h3>\n\u003cp>The uncertainty swirling around vaping could clear the path for another product that is neither a traditional cigarette nor an e-cigarette.\u003c/p>\n\u003cp>Earlier this year, the FDA authorized the sale of a first-of-a-kind device, IQOS, that heats tobacco without burning it. The approach is designed to mimic the experience of smoking while producing fewer toxic chemicals than paper-and-tobacco cigarettes.\u003c/p>\n\u003cp>The battery-powered device is getting a preliminary launch this month in Atlanta ahead of a wider rollout. But IQOS’s pedigree underscores the persistence of Big Tobacco companies, even in a world increasingly focused on vaping and other alternative products.\u003c/p>\n\u003cp>IQOS was developed by Philip Morris International, the global tobacco giant that sells Marlboro cigarettes overseas. It will be sold in the U.S. by the biggest American cigarette maker, Altria, which is also Juul’s biggest investor.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>President Trump signed a \u003ca href=\"https://www.whitehouse.gov/presidential-actions/presidential-proclamation-suspension-entry-immigrants-will-financially-burden-united-states-healthcare-system/\" target=\"_blank\" rel=\"noopener\">proclamation\u003c/a> late Friday barring legal immigrants who cannot prove they will have health care coverage or the means to pay for it within 30 days of their arrival to the United States.\u003c/p>\n\u003cp>Trump said uninsured individuals are a burden on the health care industry and U.S. taxpayers.\u003c/p>\n\u003cp>“Immigrants who enter this country should not further saddle our health care system, and subsequently American taxpayers, with higher costs,” Trump declared.\u003c/p>\n\u003cp>Beginning Nov. 3, only immigrants covered by approved health insurance or those who can show they can pay for “reasonably foreseeable medical costs” will be allowed entry into the U.S.\u003c/p>\n\u003cp>The announcement affects immigrants applying for visas from overseas. It doesn’t apply to non-citizen children of U.S. citizens. Refugees and asylum-seekers are also exempt.\u003c/p>\n\u003cp>[aside tag='immigration' label='More Coverage']\u003c/p>\n\u003cp>However, it would apply to the spouses and parents of U.S. citizens and the immediate family members of lawful permanent residents.\u003c/p>\n\u003cp>The proclamation is the latest effort by the Trump administration to limit the number of low-income immigrants coming to the United States. The administration also plans to make it harder for immigrants to get green cards if they use a wide range of public benefits. That new rule is set to take effect this month, although it is facing legal challenges.\u003c/p>\n\u003cp>The new proclamation is also expected to be challenged.\u003c/p>\n\u003cp>“If this policy survives the inevitable court challenges and is implemented, it will create a new and arbitrary hurdle for some half a million green card applicants each year,” Doug Rand, who worked on immigration policy in the Barack Obama administration, told NPR.\u003c/p>\n\u003cp>“Consular officers will deny the parents of U.S. citizens based on a snap judgment about their apparent health. U.S. citizens will be separated from their husbands and wives abroad based on a failure to demonstrate health insurance coverage or a subjective level of wealth.”\u003c/p>\n\u003cp>\u003cem>Copyright 2019 \u003ca href=\"http://www.npr.org\" rel=\"noopener\" target=\"_blank\">NPR\u003c/a>.\u003c/em> \u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>President Trump signed a \u003ca href=\"https://www.whitehouse.gov/presidential-actions/presidential-proclamation-suspension-entry-immigrants-will-financially-burden-united-states-healthcare-system/\" target=\"_blank\" rel=\"noopener\">proclamation\u003c/a> late Friday barring legal immigrants who cannot prove they will have health care coverage or the means to pay for it within 30 days of their arrival to the United States.\u003c/p>\n\u003cp>Trump said uninsured individuals are a burden on the health care industry and U.S. taxpayers.\u003c/p>\n\u003cp>“Immigrants who enter this country should not further saddle our health care system, and subsequently American taxpayers, with higher costs,” Trump declared.\u003c/p>\n\u003cp>Beginning Nov. 3, only immigrants covered by approved health insurance or those who can show they can pay for “reasonably foreseeable medical costs” will be allowed entry into the U.S.\u003c/p>\n\u003cp>The announcement affects immigrants applying for visas from overseas. It doesn’t apply to non-citizen children of U.S. citizens. Refugees and asylum-seekers are also exempt.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>However, it would apply to the spouses and parents of U.S. citizens and the immediate family members of lawful permanent residents.\u003c/p>\n\u003cp>The proclamation is the latest effort by the Trump administration to limit the number of low-income immigrants coming to the United States. The administration also plans to make it harder for immigrants to get green cards if they use a wide range of public benefits. That new rule is set to take effect this month, although it is facing legal challenges.\u003c/p>\n\u003cp>The new proclamation is also expected to be challenged.\u003c/p>\n\u003cp>“If this policy survives the inevitable court challenges and is implemented, it will create a new and arbitrary hurdle for some half a million green card applicants each year,” Doug Rand, who worked on immigration policy in the Barack Obama administration, told NPR.\u003c/p>\n\u003cp>“Consular officers will deny the parents of U.S. citizens based on a snap judgment about their apparent health. U.S. citizens will be separated from their husbands and wives abroad based on a failure to demonstrate health insurance coverage or a subjective level of wealth.”\u003c/p>\n\u003cp>\u003cem>Copyright 2019 \u003ca href=\"http://www.npr.org\" rel=\"noopener\" target=\"_blank\">NPR\u003c/a>.\u003c/em> \u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>It’s a widely known vaping cartridge in the marijuana economy, but it’s not a licensed brand. And it’s got the kind of market buzz no legitimate company would want.\u003c/p>\n\u003cp>The vaping cartridges that go by the catchy, one-syllable name “Dank” — a slang word for highly potent cannabis — are figuring prominently in the federal investigation to determine what has caused a rash of \u003ca href=\"https://apnews.com/51256e90d63a41af9b33f2682d641053\" target=\"_blank\" rel=\"noopener\">mysterious and sometimes fatal lung illnesses\u003c/a> apparently linked to vaping. Most of the cases have involved products that contain the marijuana compound THC, often obtained from illegal sources.\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation=\"Allison Margolin, cannabis attorney\"]‘It doesn’t look very different from what you can buy in a [legal] dispensary.’[/pullquote]\u003c/p>\n\u003cp>The suspect Dank vapes are a familiar product in the underground marijuana economy — it’s not a legal, tested brand. It’s merely a name on a box or a cartridge, packaging that’s easily obtained online and used by \u003ca href=\"https://apnews.com/5817cb09f1b941878013e19e27990fc2\" target=\"_blank\" rel=\"noopener\">illicit producers to lure customers.\u003c/a>\u003c/p>\n\u003cp>But with colorful boxes and names like Cherry Kush and Blue Dream, the homemade vapes appear alluring on the shelf.\u003c/p>\n\u003cp>“It doesn’t look very different from what you can buy in a [legal] dispensary,” said Beverly Hills-based cannabis attorney Allison Margolin.\u003c/p>\n\u003cp>So far, investigators have not identified a culprit in the illnesses reported in dozens of states. But officials say patients have mentioned the Dank name frequently. Many of the people who got sick in Illinois and Wisconsin, for example, said they used cartridges sold in Dank packaging.\u003c/p>\n\u003cp>The raw materials to produce a Dank vape aren’t hard to find: Ready-to-fill Dank boxes and cartridges can be ordered from Chinese internet sites for pennies apiece. A Craigslist post last week offered a box stuffed with empty Dank packages for $16. And you can buy the boxes and empty cartridges in shops in downtown Los Angeles.\u003c/p>\n\u003cp>A rogue producer adds cannabis oil — almost certainly untested — and it’s ready for sale.\u003c/p>\n\u003cp>“It’s a generic product name that doesn’t really tie back to one store or one distributor,” Dr. Jennifer Layden, chief medical officer for the Illinois Department of Public Health, said last month. “Folks are getting it from friends or folks on the street, with no understanding of where it came from prior to that.”\u003c/p>\n\u003cp>The chief selling point for vapes in Dank packaging: It’s a quick high on the cheap, available for as little as $20 a gram on the illicit market, roughly one-third of what a customer would pay for a cartridge in a legal marijuana shop in California.\u003c/p>\n\u003cp>But they come with real risk: Products in the \u003ca href=\"https://apnews.com/Marijuana\" target=\"_blank\" rel=\"noopener\">legal marijuana market\u003c/a> are tested for safety and purity, while those in the illicit market are not, and could contain pesticides, heavy metals or other dangerous contaminants.\u003c/p>\n\u003cp>According to California records, no licensed company in the state is manufacturing a cannabis vape carrying the Dank name.\u003c/p>\n\u003cp>“It was never a legitimate company,” said Los Angeles dispensary owner Donnie Anderson. “It was always an underground brand.”\u003c/p>\n\u003cp>Given the shadowy pedigree of Dank vapes, it’s not surprising that details about the product’s history are scarce. In California, the Dank name appears to have emerged during the largely unregulated medical cannabis era, prior to broad legalization that began in 2018.\u003c/p>\n\u003cp>Dispensary owner Jerred Kiloh, who heads the Los Angeles-based \u003ca href=\"https://ucba.com/\" target=\"_blank\" rel=\"noopener\">United Cannabis Business Association\u003c/a>, recalls seeing Dank vapes for the first time about seven years ago. Kiloh remembers being visited by vendors interested in selling them at his shop, though that stopped long ago.\u003c/p>\n\u003cp>What remains is the name, which has managed to retain a surprising cachet in the underground industry.\u003c/p>\n\u003cp>Last month, Wisconsin authorities uncovered an illegal vaping-cartridge operation that they said was producing thousands of cartridges, each loaded with THC oil, every day for nearly two years. Photographs released by the Kenosha County Sheriff’s Department showed neatly stacked Dank boxes and cartridges, apparently ready for shipment.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Also last month, Minnesota authorities seized nearly 77,000 THC vaping cartridges, some of which were packaged in Dank boxes.\u003c/p>\n\u003cp>[aside label=\"more vaping stories\" tag=\"vaping\"]In November 2018, authorities in Lorain County, Ohio, intercepted four packages mailed from California holding individually wrapped and sealed packages of Dank cartridges. They believed numerous similar packages were sent to the area previously.\u003c/p>\n\u003cp>“Dank Vapes appears to be the most prominent in a class of largely counterfeit brands, with common packaging that is easily available online and that is used by distributors to market THC-containing cartridges with no obvious centralized production or distribution,” said a report by Illinois and Wisconsin officials, and from the federal Centers for Disease Control and Prevention.\u003c/p>\n\u003cp>Doctors say the vaping-related illnesses resemble an inhalation injury. Symptoms have included shortness of breath, fatigue, chest pain, diarrhea and vomiting.\u003c/p>\n\u003cp>Ron Gershoni, co-founder of vape producer Jetty Extracts, who sits on the board of the California Cannabis Manufacturers Association, said the strictly regulated legal industry has been working to distinguish itself from the underground market that continues to thrive in California.\u003c/p>\n\u003cp>His company doesn’t view Dank vapes as a competitor, but he understands how the name has survived in the illegal market.\u003c/p>\n\u003cp>They “essentially sell empty packaging, and anyone can fill it,” he said. “It’s a business model that made sense [to] anybody who wanted to make a buck.”\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Also last month, Minnesota authorities seized nearly 77,000 THC vaping cartridges, some of which were packaged in Dank boxes.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>In November 2018, authorities in Lorain County, Ohio, intercepted four packages mailed from California holding individually wrapped and sealed packages of Dank cartridges. They believed numerous similar packages were sent to the area previously.\u003c/p>\n\u003cp>“Dank Vapes appears to be the most prominent in a class of largely counterfeit brands, with common packaging that is easily available online and that is used by distributors to market THC-containing cartridges with no obvious centralized production or distribution,” said a report by Illinois and Wisconsin officials, and from the federal Centers for Disease Control and Prevention.\u003c/p>\n\u003cp>Doctors say the vaping-related illnesses resemble an inhalation injury. Symptoms have included shortness of breath, fatigue, chest pain, diarrhea and vomiting.\u003c/p>\n\u003cp>Ron Gershoni, co-founder of vape producer Jetty Extracts, who sits on the board of the California Cannabis Manufacturers Association, said the strictly regulated legal industry has been working to distinguish itself from the underground market that continues to thrive in California.\u003c/p>\n\u003cp>His company doesn’t view Dank vapes as a competitor, but he understands how the name has survived in the illegal market.\u003c/p>\n\u003cp>They “essentially sell empty packaging, and anyone can fill it,” he said. “It’s a business model that made sense [to] anybody who wanted to make a buck.”\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"content": "\u003cp>With a brand new CEO and more reports of deaths tied to vaping, Juul Labs Inc. announced it will \u003ca href=\"http://bit.ly/fiorejuulstakeholders\" target=\"_blank\" rel=\"noopener\">stop funding a ballot measure\u003c/a> to overturn San Francisco’s anti-vaping law.\u003c/p>\n\u003cp>Juul, the only funder supporting Proposition C, has already dumped $19 million into the campaign.\u003c/p>\n\u003cp>It seems like the company’s new leadership realized it may be a tad difficult to sell San Francisco on the wonders of high-tech vaping amid reports of \u003ca href=\"https://www.kqed.org/news/11777195/many-vaping-illnesses-linked-to-black-market-dank-vapes-or-other-thc-products\" target=\"_blank\" rel=\"noopener\">death and illness\u003c/a> linked to e-cigarettes.\u003c/p>\n\u003cp>To be clear, although hundreds of people have suffered lung ailments tied to vaping, \u003ca href=\"https://www.kqed.org/news/11777462/juul-stops-funding-san-francisco-vaping-measure\" target=\"_blank\" rel=\"noopener\">no major e-cigarette company\u003c/a> has been linked to them. Many patients said they vaped products that included THC, the psychoactive chemical in cannabis.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
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"marketplace": {
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"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
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"masters-of-scale": {
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},
"mindshift": {
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"order": 12
},
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5",
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"onourwatch": {
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"tagline": "Deeply-reported investigative journalism",
"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
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},
"pbs-newshour": {
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},
"perspectives": {
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"order": 14
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"info": "The economy explained. Imagine you could call up a friend and say, Meet me at the bar and tell me what's going on with the economy. Now imagine that's actually a fun evening.",
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"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/planetmoney.jpg",
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"politicalbreakdown": {
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"title": "Political Breakdown",
"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
"airtime": "THU 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Political-Breakdown-2024-Podcast-Tile-703x703-1.jpg",
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"order": 5
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"possible": {
"id": "possible",
"title": "Possible",
"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
"airtime": "SUN 2pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.possible.fm/",
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"source": "Possible"
},
"link": "/radio/program/possible",
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"spotify": "https://open.spotify.com/show/730YpdUSNlMyPQwNnyjp4k"
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},
"pri-the-world": {
"id": "pri-the-world",
"title": "PRI's The World: Latest Edition",
"info": "Each weekday, host Marco Werman and his team of producers bring you the world's most interesting stories in an hour of radio that reminds us just how small our planet really is.",
"airtime": "MON-FRI 2pm-3pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-World-Podcast-Tile-360x360-1.jpg",
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},
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},
"radiolab": {
"id": "radiolab",
"title": "Radiolab",
"info": "A two-time Peabody Award-winner, Radiolab is an investigation told through sounds and stories, and centered around one big idea. In the Radiolab world, information sounds like music and science and culture collide. Hosted by Jad Abumrad and Robert Krulwich, the show is designed for listeners who demand skepticism, but appreciate wonder. WNYC Studios is the producer of other leading podcasts including Freakonomics Radio, Death, Sex & Money, On the Media and many more.",
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