Guide Vaping Public Health Emergency

Information about the declaration of public health emergency in response to the outbreak of severe lung disease associated with e-cigarettes and vaping products and the epidemic of e-cigarette use among youth.


Table of Contents

Learn about the ban

On September 24, 2019, the Governor declared a public health emergency in response to the outbreak of severe lung disease associated with e-cigarettes and vaping products and the epidemic of e-cigarette use among youth.  While the national investigation has not yet identified a specific e-cigarette or vaping product or substance that is linked to all cases, a common factor is a history of e-cigarette use and vaping. This led the Governor to declare this public health emergency.

With the goal of protecting the health of Massachusetts residents, and in accordance with Governor Baker’s public health emergency declaration, Dr. Monica Bharel, Commissioner of the Massachusetts Department of Public Health (DPH), issued the following order:

The sale or display of all vaping products to consumers in retail establishments, online, and through any other means, including all non-flavored and flavored vaping products, including mint and menthol, including tetrahydrocannabinol (THC) and any other cannabinoid, is prohibited in the Commonwealth.

Additionally, at its meeting on October 25, 2019, the Public Health Council approved emergency regulation 105 CMR 801: Severe Lung Disease Associated with Vaping Products.

On October 28, 2019, the Department filed the regulatory action with the Secretary of the Commonwealth and this emergency regulation became effective upon filing.

Information for local boards of health

Boards of Health have demonstrated the capacity and commitment to help protect our residents across the state. Diligent work with retailers will be crucial to our success in preventing further illness and death from vaping products. Initial guidance is provided in both the Implementation of Order re Vaping Products and in the new regulation 105 CMR 801.

Key Actions for Information for local boards of health

Information for providers

Although the investigation into severe lung disease associated with the use of vaping has not yet identified any specific e-cigarette or vaping product or substance that is linked to all cases, the common factor that is linked to all cases is a history of e-cigarette use and vaping.

Potential and probable cases have been coming into the State Public Health Laboratory at an alarming rate– on average of 5-10 per day since it was made a reportable condition just a short time ago. Massachusetts is taking this action now because it is prudent to response quickly, before we have large numbers and deaths.

This along with the information that has been coming in from across the United States has led the Governor to declare this public health emergency. View national information from the CDC: Outbreak of Lung Injury Associated with E-Cigarette Use, or Vaping.

Information for retailers

The Department of Public Health is developing guidance documents to assist retailers in complying with this order and regulation.  In addition, local health departments will be assisting in the education of retailers. Because this is a temporary ban, at this time retailers are not being asked to destroy products, however, products need to be taken off of the shelves immediately. View details about implementation.

The attached signage can be posted to notify your customers:

Key Actions for Information for retailers

Report a violation

The Department of Public Health has a tobacco complaint line to assist in the monitoring and enforcement of the emergency order. If you observe a violation of this order, a complaint can be filed by calling 1-800-992-1895.  Please leave a message and your call will be documented.

Get help quitting

The Massachusetts Tobacco Cessation and Prevention Program provides information and resources that can to help as you attempt to quit

There are medicines which can improve your chances of quitting. MassHealth covers these FDA-approved medicines, and many other plans offer them for free or at low cost with a prescription.

The Commissioner of Public Health has issued a Standing Order for Dispensing Nicotine Replacement Therapy Products which means that you may be eligible for NRT products for the price of a co-pay. Your private insurance may cover this benefit; MassHealth does. The Standing Order authorizes licensed pharmacists to dispense medically appropriate NRT products to a person 18 years old or older with proper identification who requires the products in connection with smoking cessation or vaping cessation. The Standing Order applies to FDA-approved, OTC NRT products including gum, lozenges and patches. Pharmacists are authorized to create a prescription with this Standing Order using the manufacturer’s FDA approved dosing instructions.   

Please contact the Board of Registration in Pharmacy at (800) 414-0168 if your pharmacist is not aware of this Standing Order. 

If you have a child under the age of 18 who might need help quitting, talk to their pediatrician about whether a prescription for one of these quit-smoking medicines is right for them.

Combining medication with coaching support can triple your chances of success. So call the Massachusetts Smokers’ Helpline at 1-800-QUIT-NOW for free advice and support. It’s confidential and is available in multiple languages.

Visit MassHealth Coverage Updates to view important changes to MassHealth member co-pays for products and medications that help people quit smoking and vaping.

Resources for youth and parents

Frequently asked questions

With the goal of protecting the health of Massachusetts residents, and in accordance with Governor Baker’s public health emergency declaration, Dr. Monica Bharel, Commissioner of the Massachusetts Department of Public Health, issued an Order and DPH adopted an emergency regulation, 105 CMR 801, temporarily banning the sale of all e-cigarettes and vaping products.

When did the ban go into effect?

On September 24, 2019, Governor Baker declared a public health emergency in the Commonwealth due to severe lung disease associated with the use of e-cigarettes and vaping products and the epidemic of e-cigarette use among youth. All vaping products and e-cigarettes must be removed from public display immediately until further notice.

What factors led to the ban?

There is a multistate outbreak of severe lung disease associated with the use of vaping including but not limited to e-cigarettes.  The investigation has not yet identified any specific e-cigarette or vaping product or substance that is linked to all cases.  The only common factor that is linked to all cases is a history of e-cigarette use and vaping.  In Massachusetts, potential and probable cases have been coming into the Public Health State Lab at an alarming rate since this lung disease was made a reportable condition on September 11, 2019. This indicates that we are experiencing the outbreak here in Massachusetts. This, along with the information that has been coming in from across the United States, led the Governor to declare this public health emergency. View national information from the CDC: Outbreak of Lung Injury Associated with E-Cigarette Use, or Vaping.

What is included in the ban?

The sale of all e-cigarettes and all vaping products in retail establishments, online, and through any other means is prohibited.  This includes all flavored and non-flavored e-cigarettes and vaping devices, including mint and menthol.  It applies to products used to vape marijuana, THC and any other cannabinoid as well as nicotine.

Why is the ban for 4 months?

The multistate investigation is in the early stage.  This initial time period gives Massachusetts and our national partners time to work towards identifying the specific cause of the illness.  

Does the Commissioner’s Order apply to the sale or display of items such as butane tanks?

The Commissioner’s Order only applies to vaping products, which are defined in the order.

Will the ban be extended if, after four months, we still don’t know what the cause is?

Although we are hopeful that the investigation will move quickly to determine the cause, we will need to evaluate status as we approach the four month mark.

Why does this include the sale of products to adults?

This disease is being seen in adults as well as youth, so this action is addressing the health and safety of all residents in the Commonwealth.  The investigation has not yet identified any specific e-cigarette or vaping product or substance that is linked to all cases. The only common factor that is linked to all cases is a history of e-cigarette use and vaping, so it is important to stop the sale of all products at this time. 

What about adults who vape and use e-cigarettes rather than smoke tobacco?

Although some adults are using e-cigarettes as harm reduction from smoking tobacco, and some have had success in quitting smoking tobacco with this product, the investigation has not yet identified any specific e-cigarette or vaping product or substance that is linked to all cases.  The only common factor that is linked to all cases is a history of e-cigarette use and vaping.  Therefore, we believe it is important to stop the sale of all product at this time

What are your plans for helping people who use these vape products to cope without them?

The Massachusetts Smokers’ Helpline is a free and confidential service for Massachusetts residents who want help to end their nicotine use. If you are looking to quit tobacco including e-cigarettes, you can get help from a quit coach over the phone, use online tools and resources or a combination of these online features and telephone coaching.  Support includes counseling and 8 weeks of free nicotine replacement therapy such as the nicotine patch, gum or lozenge.  Go to www.makesmokinghistory.org for more tools and information or call 1-800-QUIT NOW (1-800-784-8669).  Using coaching and quit smoking medicines you are 3X more likely to quit for good.

Teens who vape aren’t old enough to buy a nicotine patch or gum. How do you help them?

Parents of youth under age 18 can speak with their child’s healthcare provider about a prescription for nicotine replacement therapy.

Massachusetts partners with national resources for teens who are interested in quitting smoking or vaping:

  • My Life, My QuitTM is a specially designed program to help young people quit vaping or other tobacco products. My Life, My QuitTM  provides five free and confidential coaching sessions by phone, live texting, or chat with a youth coach specialist. Text "Start My Quit" to 855-891-9989 or call toll-free 1-855-891-9989 for real-time coaching. Youth can also visit mylifemyquit.com to sign up online, chat with a live coach, get information about vaping and tobacco, and activities to help them quit.
  • This is Quitting powered by truth® is a texting program for young people who want to quit vaping. It is a free, confidential 60-day program during which participants receive texts with information, tips, and support. They receive daily text messages to help them prepare to quit and supportive texts from young people who have been through the program and know what it’s like to quit. They can also text “CRAVE,” “SLIP,” “STRESS,” or “MORE” at any time for instant support, or “MASSINFO” for information specific to Massachusetts.  Young people can sign up even if you they aren’t ready to quit – the texts they receive will give them strategies and practice quits to help build confidence and help them feel ready to quit.  To enroll in the program, youth text “VapeFreeMass” to 88709.  Youth can also connect with their school nurse, counselor, or coach to help get them started. 

May a pharmacist dispense NRT to people who are under 18?

A pharmacist may dispense NRT to a person who is under 18 if the person has a patient-specific prescription.  If there are questions as to instructions for use, the pharmacist should consult the prescriber.

What should store owners do with all the products they have in their inventory?

The Department of Public Health is developing guidance documents to assist retailers in complying with this order.  In addition, local health departments will be assisting in the education of retailers.

Because this is a temporary ban, at this time we are not expecting that product be destroyed.  Rather we are requiring that products be taken off of the shelves immediately.

Does the regulation ban advertising of vaping products?

No. The regulation temporarily bans the sale and/or display on the shelf for the purpose of selling  the vaping products themselves.

What is required for stores that that sold vaping products before the temporary ban but now wish to sell cigarettes? 

Information about the Cigarette and Tobacco Excise tax administered by the Massachusetts Department of Revenue (DOR) can be found here: DOR Cigarette and Tobacco Excise Tax

What actions should Local Boards of Health or other municipal officials be taking with respect to the temporary ban on the sale or display of vaping products?

Local officials should ensure that retailers are aware of and complying with the temporary ban. DOR sent notice to nicotine retailers licensed by DOR on September 25, 2019 and October 25, 2019. A template notice letter is available from DPH. An order to cease and desist should be issued to retailers that are not in compliance with the Commissioner’s Order and the emergency regulations.

Should Local Boards of Health be enforcing the regulation as it applies to entities licensed or permitted by the Cannabis Control Commission?

The Cannabis Control Commission (CNB) has the jurisdiction to enforce the regulation as it applies to CNB licensed or permitted entities such as marijuana establishments. 

Should police officers be confiscating vaping products from retailers? 

As stated in the regulation, State Police or local law enforcement may seize vaping products sold or kept on the shelf for sale in violation of the regulation if the State Police or local law enforcement have a valid court order to do so. 

I work for a municipality and have questions about how our municipal regulations will work with the regulation.

Municipalities should seek legal advice from town counsel.

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