Within hours of Governor Charlie Baker’s emergency ban last week on vape sales, products that consumers and medical marijuana patients had relied on for years suddenly disappeared from store shelves.
Ten days later, the unintended consequences of the country’s strictest anti-vaping measure are coming into focus: customers crossing the border to buy e-cigarettes in New Hampshire, former smokers switching back to cigarettes, sick patients fearfully experimenting with unfamiliar alternatives, and others turning to the illicit market despite the risk of tainted products.
Now, the Baker administration is facing a series of lawsuits and protests, part of a growing backlash from critics who insist the hastily conceived ban will ultimately harm, not improve, public health.
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“I was really depressed to buy my first pack of cigarettes in a year — they are just so gross,” said Wes Ritchie, 34, a Boston political consultant. “I’m lucky I can go to New Hampshire and I have the money to stock up [on e-cigarettes], but not everyone can do that.”
Baker has said the four-month ban is necessary to protect the public while scientists work to find the cause of the vaping-related lung injuries that now number at least 1,080 and have claimed 18 lives across the country. Federal officials said most of the cases were linked to marijuana vapes, largely from unlicensed sellers, but no single chemical or product accounts for all the illnesses.
Asked if he worried vapers would turn to cigarettes, Baker said last week, “In two or three weeks, you’re not going to have the kind of impact on your physical health, smoking cigarettes, that these devices have delivered to people around the country.”
Vaping nicotine has become a popular tool for people trying to quit cigarettes because e-cigarettes contain far fewer dangerous chemicals, although scientists know little about their harms. The governor’s office has said medical marijuana patients can use alternative cannabis products and has urged nicotine consumers to quit by using patches and gum, which the state is offering for free.
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Since the ban took effect, sales of e-cigarettes have more than doubled at the three southern New Hampshire locations of VERC Enterprises, a chain of 28 convenience stores in New England, said owner Leo Vercollone. Meanwhile, he said, sales of cigarettes — which fell 7 percent last year and 10 percent so far this year — are increasing at the chain’s Massachusetts stores. The New England Convenience Store & Energy Marketers Association said other businesses are seeing the same pattern.
Don Perkins, a construction worker in Yarmouth, said he had felt less wheezy since switching to mint-flavored Juul e-cigarettes after 40 years of smoking. Now, he’s back to Camels.
“The taste sucked, but it fixed my nicotine habit,” Perkins said. “I feel I was forced into it — being 60 years old, I don’t think I should be told what to do, especially when there’s other things out there that carry just as much, or worse, of a danger.”
Tobacco experts are divided over the ban’s implications, just as they have long been divided over e-cigarettes — devices that were pitched as safer than cigarettes and which have helped many adults stop smoking, yet also hooked many nonsmoking teenagers on nicotine.
A report last year by the National Academies of Sciences, Engineering, and Medicine concluded that e-cigarettes are harmful, but likely pose less risk of cancer, heart disease, and lung disease than combustible cigarettes. Cigarettes are the United States’ leading cause of premature death.
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If a policy forces ex-smokers to return to smoking, “that’s probably not a good thing from a public health perspective,” said David Eaton, a toxicologist at the University of Washington who chaired the report committee.
Stanton Glantz, director of the University of California-San Francisco’s Center for Tobacco Control Research and Education disagreed, saying Baker’s ban is prudent, since the lung illnesses are likely linked to a range of chemicals in vapes.
“To allow these products to stay on the market would be the height of irresponsibility,” Glantz said.
But critics — including members of the state’s Cannabis Control Commission — are worried the ban is overly broad and will push consumers and patients to use riskier, unregulated products. Evidence is mounting that most of the acute respiratory illnesses are linked to additives in illicit-market marijuana vapes, not nicotine vapes or those sold by licensed marijuana firms.
Cannabis commissioner Shaleen Title shared a message on Twitter she received from a patient with a seizure disorder.
“Tonight I risked my health on a tincture as a substitute to my usual cannabis vape pen,” the patient wrote to Title. “I’ve never felt so defeated and so afraid for both my life and my livelihood.”
“We are only beginning to see the effects of this ban,” Title said, adding that it’s imperative for state health officials to quickly release information about the name and source of possibly tainted products linked to lung illnesses, so consumers can avoid them. So far, at least 83 suspected cases have been reported in Massachusetts.
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Baker’s office has pointed to the deaths of two men in Oregon who purchased products at licensed cannabis stores.
In the meantime, medical cannabis patients said they’re struggling to find alternatives for their vape products.
Margaret Brown, 23, a food shop worker in Dorchester, said she and many other medical marijuana patients rely on the quick relief provided by vaping to treat acute medical episodes — in her case, of depression and anxiety. Edibles can take an hour or more to kick in, she said, while smoking cannabis is harsh and less discreet.
“I got really angry as I started to process how [the ban] was going to affect my daily life,” Brown said, adding she planned to drive to Rhode Island, where dispensaries can sell medical marijuana to registered patients from any state.
Brown said the state should have instead enacted stronger regulations on additives in regulated cannabis vapes.
A group of medical marijuana patients and advocates is planning a sit-in outside Baker’s State House office on Friday to protest the ban.
“This stuff [at the licensed marijuana stores] is lab-tested to the most stringent standards in the country, but they’re getting banned and called dangerous?” Peter Bernard, one of the organizers, said. “What’s dangerous is everyone going to the black market.”
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Some of the state’s licensed cannabis operators are mounting a coordinated response through the Massachusetts Cannabis Business Association. Among their ideas: drafting self-imposed safety standards, and launching a marketing campaign to build consumer trust in the industry.
“If there’s an actual problem [with regulated products], we have to get our arms around that,” said David O’Brien, the association’s president. “I suspect it’s more of a perception problem.”
Meanwhile, consumers are turning to unlicensed delivery services for marijuana vapes, and to Craigslist, eBay, and other websites for e-cigarettes.
Jay Wolfe, a 46-year-old Roxbury resident who quit smoking last year, said that he planned to drive to New Hampshire to buy nicotine vapes, but that others who lacked transportation would soon grow desperate and buy unlicensed products.
The ban “created this gigantic underground market for people,” Wolfe said. “[Baker] has incentivized people to go out and do this to make money on it, which is even worse.”
Naomi Martin can be reached at naomi.martin@globe.com. Dan Adams can be reached at daniel.adams@globe.com.