WSR 19- 24-001 
EMERGENCY RULES  
STATE BOARD OF HEALTH  
[Filed November 20, 2019, 3:03 p.m., effective November 20, 2019, 3:03 p.m.]  
Effective Date of Rule: Immediately upon filing.  
Purpose: Chapter 246-80 WAC, Vapor products and flavors, the Washington state board of health 
has adopted an emergency rule to create WAC 246 -80-021 that bans the sale of vapor products containing 
vitamin E acetate. This applies to the sale, offer for sale, or possession with intent to sell or offer for sale 
vapor products containing vitamin E acetate at any location or by any means including by telephone or 
other method of voice transmission, the mail or any other delivery service, or the internet or other online 
service.  
Citation of Rules Affected by this Order: New WAC 246 -80-021.  
Statutory Authority for Adoption: RCW 43.20.050  (2)(f).  
Under RCW 34.05.350  the agency for good cause finds that immediate adoption, amendment, or 
repeal of a rule is necessary for the preservation of the public health, safety, or general welfare, and that 
observing the time requirements of notice and opportunity to comment upon adoption of a permanent rule 
would be contrary to the public interest.  
Reasons for this Finding: The outbreak of lung disease continues to grow; therefore, the adoption 
of a rule prohibiting the sale of vapor products containing vitamin E acetate is necessary for the 
preservation of the public health, safety, and general welfare.  
In July 2019, the United States Centers for Disease Control and Prevention (CDC), United States 
Food and Drug Administration (FDA), state and local health departments, and other clinical and public 
health partners began investigating outbreaks of lung injury associated with e -cigarette product use, or 
vaping. In September 2019, the CDC activated its Emergency Operations Center to aid in the 
investigation  of the multistate outbreak. As of November 13, 2019, there have been two thousand one 
hundred seventy -two confirmed cases reported across forty -nine states, the District of Columbia, Puerto 
Rico and the United States Virgin Islands, including forty -two de aths confirmed in twenty -four states. 
Fourteen cases of lung injury have been reported in Washington state.  
As part of the investigation into the multistate outbreak of lung disease associated with the use of 
vapor products, the CDC conducted laboratory te sts of twenty -nine samples of fluid collected from the 
lungs of patients with vaping-associated lung disease from ten states. An article released on November 8, 
2019, showed that all of the samples contained vitamin E acetate, providing direct evidence of vitamin E 
acetate at the primary site of injury in the lungs. Vitamin E acetate is a chemical that is used as an additive 
or thickening ingredient in vapor products. The CDC has not determined that vitamin E acetate is present 
in only THC vapor products or  only non -THC vapor products. THC was identified in eighty -two percent 
of the samples, and nicotine was identified in sixty -two percent of the samples. None of a range of other 
potential chemicals of concern was detected in the samples, but evidence is not  yet sufficient to rule out 
the contribution of other chemicals, substances, or product sources to the disease. The CDC has identified 
vitamin E acetate as a chemical of concern and stated that, until the relationship of vitamin E acetate and 
lung health i s better characterized, it is important that vitamin E acetate not be added to vapor products.  
Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, 
Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State 
Statutes: New 0, Amended 0, Repealed 0.  
Number of Sections Adopted at the Request of a Nongovernmental Entity: New 0, Amended 0, 
Repealed 0.  
Number of Sections Adopted on the Agency's own Initiative: New 1, Amended 0, Repealed 0.  
Numbe r of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: 
New 0, Amended 0, Repealed 0.  Number of Sections Adopted using Negotiated Rule Making: New 0, Amended 0, Repealed 0; 
Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 1, Amended 
0, Repealed 0.  
Date Adopted: November 18, 2019.  
Michelle A. Davis  
Executive Director  
NEW SECTION  
WAC 246 -80-021Prohibition—Vitamin E acetate.  
(1) Vitamin E acetate is a chemical that is used as an additive or thickening ingredient in vapor 
products. As part of the investigation into the multistate outbreak of lung disease associated with the use 
of vapor products, the Centers for Disease Control (CDC) conducted laboratory tests of twenty-nine 
samples of fluid colle cted from the lungs of patients with vaping-associated lung disease from ten states. 
All of the samples contained vitamin E acetate, providing direct evidence of vitamin E acetate at the 
primary site of injury in the lungs. The CDC has not determined that vitamin E acetate is present in only 
THC vapor products or only non-THC vapor products. THC was identified in 82 percent of the samples, 
and nicotine was identified in 62 percent of the samples. None of a range of other potential chemicals of 
concern was d etected in the samples, but evidence is not yet sufficient to rule out the contribution of other 
chemicals, substances, or product sources to the disease. The CDC has identified vitamin E acetate as a 
chemical of concern and stated that, until the relation ship of vitamin E acetate and lung health is better 
characterized, it is important that vitamin E acetate not be added to vapor products. Because the outbreak 
of lung disease continues to grow, adoption of a rule prohibiting the sale of vapor products cont aining 
vitamin E acetate is necessary for the preservation of the public health, safety, and general welfare.  
(2) No person including, but not limited to, a person licensed under chapter 69. 50 or 70.345  
RCW, may sell, offer for sale, or possess with intent to sell, or offer for sale vapor products containing 
vitamin E acetate. The foregoing prohibition applies to the sale, off er for sale, or possession with intent to 
sell or offer for sale vapor products containing vitamin E acetate at any location or by any means in this 
state including, but not limited to, by means of a telephonic or other method of voice transmission, the 
mail or any other delivery service, or the internet or other online service.