Public Health Emergency in the Commonwealth - Use of E-Cigarette and Vaping Products

Dear Providers,

On September 24, 2019, Governor Charles D. Baker declared a public health emergency in the Commonwealth due to severe disease associated with the use of e-cigarettes and vaping products and the epidemic of e-cigarette use among youth. As of September 19, 2019, the CDC had confirmed 530 cases across 39 states and U.S. territories, including seven fatalities in six different states. The commonality in all reported cases is a history of vaping, and a history of using vaping products containing tetrahydrocannabinol (THC), nicotine, or a combination of both.

On September 11, 2019, I declared possible cases of unexplained vaping-associated pulmonary disease to be immediately reportable to the Massachusetts Department of Public Health (DPH) and further authorized DPH to conduct surveillance activities necessary for the investigation, monitoring, control and prevention of this disease. As a result of this declaration, 61 preliminary intake reports have been received by DPH to date.
There is still much to learn about the causes and associated dangers relating to vaping. With the goal of protecting the health of Massachusetts residents, and in accordance with Governor Baker’s public health emergency declaration, I issued the following order:

The sale or display of all e-cigarettes and 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. The following guidance details initial actions for residents of the Commonwealth to proceed with this order. DPH will continue to update the guidance as necessary.

Your patients—both youth and adults—will need your help adjusting to this change. This may be especially true for patients who have a behavioral health or substance use issue. People who vape with the goal of reducing the amount of cigarettes they smoke should be steered toward FDA-approved options for nicotine replacement therapy. Supporting them through the process of quitting vaping and smoking is crucial. As a healthcare provider, you already know the most effective way to quit tobacco and nicotine is to pair medication with counseling, and that this complementary management can triple the chances of successfully quitting. On the next page, we provide resources to help you guide your patients toward both of these options.

For those with pediatric and young adult patients, please pay particular attention to the recent resources related to vaping and youth, as we know that many of the nation’s youth begin smoking before the age of 18. This early adoption of tobacco and nicotine can harm the developing brain—potentially leading to negative physical and mental health outcomes.

In your continued efforts to help your patients lead healthier lives, including through quitting vaping products or combustible cigarettes, I would like to point you all to the resources from the Massachusetts Tobacco Cessation and Prevention Programs at the Massachusetts Department of Public Health, which are provided on the next page.

Dr. Monica Bharel, Commissioner of the Massachusetts Department of Public Health

Massachusetts Tobacco Cessation and Prevention Program
Massachusetts Department of Public Health
Clinical Provider Resources for
Vaping Cessation and Smoking Cessation

A combination of medication and counseling has been shown to triple chances of successful cessation:
  • Refer to QuitWorks. QuitWorks is a free, evidence-based referral service that connects patients with phone-based counseling through the Massachusetts Smokers’ Helpline to help them stop smoking. Once a referral is made to Quitworks, providers receive feedback reports to stay informed of their patient’s progress.
  • Encourage patients to call the Massachusetts Quitline 1-800-QuitNow (7 days per week/24 hours per day, holiday hours may vary) to receive counseling online, by phone or through eChat and at least four weeks of free nicotine patches.
  • When appropriate, recommend or prescribe quit smoking medications. Many medicines help with withdrawal symptoms and are not addictive.  The nicotine patch, gum or lozenges, are available over the counter without a prescription. The prescription medication include Chantix, Zyban, inhaler, and spray.

Encourage young people to ask their school nurse or counselor, athletic coach, doctor, parent or other trusted adult for help, and recommend that your youth and young adult patients consider these resources:

  • My Life, My Quit™  has youth coach specialists trained to help young people by phone or text. Call or text "Start My Quit" to 855-891-9989 for free and confidential help. For more information or to sign up online, visit
  • This is Quitting powered by truth® is a free and confidential texting program for young people who vape. Young people can text “VapeFreeMass” to 88709 to get started.  In partnership with the Massachusetts Department of Public Health.
  • Visit for tools and tips.
  • Visit to learn about vaping addiction, health, and quitting.
  • Information for parents/adults is available at