WSR 20-08-007 
EMERGENCY RULES  
STATE BOARD OF HEALTH  
[Filed March 19, 2020, 3:40 p.m., effective March 20, 2020]  
Effective Date of Rule: March 20, 2020.  
Purpose: WAC 246-80-021 Prohibition —Vitamin E acetate, the Washington state board of health has 
adopted an emergency rule to continue the ban on the sale of vapor products contai ning 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 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 state or federal law or federal rule or a 
federal deadline for state receipt of federal funds requires immediate adoptio n of a rule.  
Reasons for this Finding: The standards in this emergency rule have not changed from the previous 
emergency rule.  
In July 2019 the United States Centers for Disease Control and Prevention (CDC), United States Food and 
Drug Administration, stat e and local health jurisdictions and other clinical and public health partners 
began investigation [of] 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 
multi -state outbreak. As of February 18, 2020, CDC reported a total of two thousand eight hundred 
seven cases of hospitalized e -cigarette, or vaping, product use associated lung injury (EVALI) cases, and 
sixty -eight deaths in t wenty -nine states and the District of Columbia. Twenty -seven cases of lung injury, 
including two deaths have been reported in Washington state.  
As part of the investigation into the multistate outbreak of lung disease associated with the use of vapor 
produ cts, a recent study cited by the CDC conducted laboratory tests of fifty -one samples of fluid 
collected from the lungs of patients with vaping -associated lung disease from sixteen states. Forty -nine 
samples contained vitamin E acetate, providing direct evidence of vitamin E acetate at the primary site 
of the injury in the lungs. Vitamin E acetate is a chemical that is used as an additive or thickening 
ingredient in vapor products. THC was identified in forty -seven of fifty samples and nicotine was 
identifie d in thirty of forty -seven 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 recommends that vitamin E acetate not be added to any vapor products.  
This legislative session, the governor submitted request legislation (SB 6254) aimed at increasing 
regulation of vapor pr oducts in Washington. The bill included a ban of vitamin E acetate, however the 
legislature failed to pass SB 6254. Due to the clear association of vitamin E acetate with EVALI and absent legislative action to ban vitamin E acetate the board has determined that continuing a ban is 
necessary to protect the public health, safety and welfare.  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.  
Number of Sect ions 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 Altern ative Rule Making: New 1, Amended 0, 
Repealed 0.  
Date Adopted: March 19, 2020.  
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 ingr edient 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 collected from t he 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 did not determine that vitamin E ac etate was 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. Subsequently, tests of fifty -one samples of 
fluid collect ed from the lungs of patients with vaping-associated lung disease in sixteen states identified 
vitamin E acetate in forty -eight of the samples. THC was identified in forty -seven of fifty samples and 
nicotine was identified in thirty of forty -seven samples.  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 it is important that vitamin E acetate not be 
added to any vapor products. 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.  
(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, offer for sale, or possession with intent to sell or 
offer for sale vapor products containing vitamin E acetate a t 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.