Temporary ban on flavored vaping products

Effective October 15, 2019 through April 11, 2020, the sale of flavored vaping products is prohibited​ in the state of Oregon for 180 days.

  • No retailer may sell a flavored vaping product to a consumer in Oregon.
  • Online sales of flavored vaping products to people in Oregon are also prohibited during the ban.
  • The temporary ban applies to THC and non-THC vaping products.

Governor Kate Brown’s Executive Order 19-09 to enact a temporary ban on the sale or display of flavored vaping products is an evidence-based strategy to prevent youth, as well as adults attracted to flavors, from becoming exposed to the health risks from vaping products and from becoming addicted to nicotine. These recommendations from the Governor, taken together, will help us protect the health of all Oregonians. The Oregon Health Authority urges all Oregonians who use vaping products to stop vaping immediately.

OHA continues to work with health care providers in Oregon to identify cases of vaping-related illnesses and to partner with federal officials to investigate the causes ​of vaping-related lung injuries and deaths.

The Oregon Health Authority will work closely with the Oregon Liquor Control Commission, the Oregon Department of Justice and other agencies to implement the Governor’s Executive Order, including launching a statewide public education effort to warn Oregonians about the risks e-cigarette use or vaping products pose to youth and adults. Nearly 90 percent of Oregon high school students who exclusively use e-cigarettes use flavored products.

Read the Governor’s press release.​ 

The Oregon Health Authority is urging Oregonians to stop using all vaping products until federal and state officials have determined the cause of serious lung injuries and deaths linked to the use of both cannabis and nicotine vaping products. State health officials will continue to work closely with the federal Centers for Disease Control and Prevention and the Food and Drug Administration to determine the cause of deaths and illnesses in Oregon and across the nation.

No vaping products should be considered safe. Until health experts can identify why people who have used these products have become seriously ill, and in some cases died, no vaping product should be used.

People who experience symptoms of the illness after using vaping products, such as shortness of breath, cough or chest pain, should immediately seek medical attention.

Get Help Quitting

Oregon Quit Line

The Oregon Quit Line is a free, telephone and web-based program that helps youth and adults quit vaping ​cannabis and nicotine. It offers free confidential, evidence-based counseling and materials. Callers 18 years and older can receive Nicotine Replacement Therapy in the form of patches or gum.

The Quit Line is open 24 hours a day, seven days a week.


This is Quitting

This is Quitting powered by truth® is a free, confidential, 24-7 texting program for young people who vape. 


Oregon’s Drug and Alcohol Helpline​

The Alcohol and Drug Helpline serves anyone in Oregon who needs information, support or access to resources and treatment for alcohol or drug use. If you or someone you know needs help, the Alcohol and Drug Helpline is free, confidential, and available 24-7, 365 days a year.

  • Call 800-923-4357 or Text RecoveryNow to 839863.

SAMHSA’s National Helpline

SAMHSA’s National Helpline is a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families who need support quitting substances other than nicotine. 

  • ​Call 1-800-662-HELP (4357).

For more information, visit the Oregon Health Authority page on Vaping and Your Health

LGBTQIA+ Welcome

The Malheur County Health Department (MCHD) provides compassionate, high quality care for all people in Malheur County, including LGBTQIA+ individuals. We are proud to offer many services for the health and well-being of our community, including:

  • Rapid HIV testing, referral, and case coordination
  • Sexually Transmitted Infections testing and treatment
  • Communicable disease testing and case coordination, including tuberculosis and hepatitis
  • Wide range of birth control options
  • Immunizations, including HPV for all genders ages 9-26
  • Home Visiting programs for parents with children age 5 and under
  • Pregnancy testing and counseling
  • Tobacco prevention and education
  • Birth and death certificates, available within 6 months of event
  • WIC nutrition program for qualifying families with children age 5 and under

We are a community of all sexual orientations and gender identities and have a variety of health needs. MCHD serves all people regardless of ability to pay, with a few low-cost exceptions. No one will be denied services based on immigration status, sex, gender identity, sexual orientation, race, nationality, or religious affiliation. MCHD also accepts Medicare, Medicaid, and most private health insurance. If you do not have insurance, we have staff who can help you sign up for the Oregon Health Plan or determine your eligibility for other assistance programs.

All services are confidential and open to all ages. Call 541-889-7279 to make an appointment. Walk ins welcome. Se habla Español.

Crisis Resources and Support

Resources for LGBT Youth and Friends/Supporters

Some LGBT youth are more likely than their heterosexual peers to experience negative health and life outcomes. It is important that at-risk LGBT youth have access to resources and support to deal with the questions and challenges they may face as they mature.

Resources for Educators and School Administrators

Because some LGBT youth are more likely than their heterosexual peers to experience bullying or other aggression in school, it is important that educators, counselors, and school administrators have access to resources and support to create a safe, healthy learning environment for all students.

Resources for Parents, Guardians, and Family Members

Some LGBT youth are more likely than their heterosexual peers to experience negative health and life outcomes, so it is critical for the parents, guardians, and other family members of LGBT youth to have access to the resources they need to ensure their LGBT children are protected and supported.

Resources from the Centers for Disease Control and Prevention (CDC) LGBT Youth Resources

Public Health Warning: People should stop vaping immediately

oha logo
Second vaping-related death in state confirmed; people who vape are at risk, officials say

The Oregon Health Authority is issuing a public health warning urging people to immediately stop using all vaping products. On September 26, 2019, the agency confirmed a second vaping-related death in the state.

This is the second death among the five previously reported cases. Oregon’s first fatality was announced on Sept. 3. All five cases are part of a national outbreak of severe lung injury linked to vaping and e-cigarette use.

“People should stop vaping immediately,” said Dean Sidelinger, MD, state health officer. “If you vape, whether it’s cannabis, nicotine or other products, please quit. These are addictive substances, and we encourage people to take advantage of free resources to help them quit.”

He added: “If you haven’t started vaping, don’t start.”

OHA officials say the most recent death was an individual who had been hospitalized with respiratory symptoms after vaping cannabis products. Nationally, there have been more than 800 cases, primarily among youths and young adults, in 46 states and one U.S. territory. A total of 12 additional deaths, including Oregon’s first fatality, have been reported in 10 states.

Those who have fallen ill in Oregon have been hospitalized after experiencing worsening symptoms, including shortness of breath, cough or chest pain. CDC and the FDA have not identified a cause, but all cases have reported e-cigarette use or vaping.

OHA investigators and local public health authorities continue to urge clinicians to be on alert for signs of severe respiratory illness among patients and report any cases.

Before the new illness reports, OHA was already concerned about the health risks of vaping products. A recent report by the agency details the health risks for the products including nicotine addiction, exposure to toxic chemicals known to cause cancer and increases in blood pressure.

Individuals who have recently vaped and are having difficulty breathing should seek medical attention immediately.

If you or someone you know smokes or vapes, we urge you to quit now. Free help is available from the following resources:

Switching to cigarettes or other combustible products is not a safer option.

Public Health Warning: Stop using vaping products

Public health officials have now linked a second Oregon death to the use of vaping products. The Oregon Health Authority urges Oregonians to stop using all vaping products until federal and state officials have determined the cause of serious lung injuries and deaths linked to the use of both cannabis and nicotine vaping products. No vaping products should be considered safe. Until health experts can identify why people who have used these products have become seriously ill, and in some cases died, no vaping product should be used. State health officials will continue to work closely with the federal Centers for Disease Control and Prevention and the Food and Drug Administration to determine the cause of deaths and illnesses in Oregon and across the nation

Oregon Health Authority Media contact: Jonathan Modie, 971-246-9139, phd.communications@dhsoha.state.or.us

Oregon Health Authority Report on Tobacco Retailer Inspections

The Oregon Health Authority recently released a report highlighting a slight decrease in illegal cigarette sales, but illegal sales of little cigars doubled. For Malheur County, what was most striking was how few stores were inspected, giving us an incomplete snapshot of the scale of illegal sales. Only 8 out of 26 retailers in Malheur County were inspected in 2019.

This incomplete snapshot is particularly concerning given the rise of the vaping epidemic among our youth and the recent fatality in Oregon connected with vaping.

The Oregon Health Authority’s Public Health Division conducts retail inspections in collaboration with Oregon State Police. In 2019, the state inspected 1,100 retailers out of about 3,200 retailers who sell tobacco and e-cigarette products statewide. If a retailer violates the law, a citation is issued to the store’s clerk, manager on duty or owner. The annual inspection report shows which stores passed inspection and which sold illegally to people under age 21.

One of the challenges of our inspection process in the state is that only a few counties in Oregon require a license to sell tobacco – and there’s no state license. This means it is extremely difficult to enforce the minimum legal sales age by holding retailers accountable for illegal sales. A tobacco retail license would make it possible to track who is selling tobacco (and thoroughly inspect each one), educate retailers on how to comply with the law and have meaningful penalties for repeat offenders.

The list of Oregon tobacco retailers that violated the tobacco sales is available on the OHA Public Health Division website here.

For more information about how the tobacco industry markets in Oregon, see the recent Tobacco Retail Assessment Report here.

Vaping Sicknesses Rising: 153 Cases Reported in 16 States

Sean Bills, a West Valley City, Utah resident, on life support in Jordan Valley Hospital. Bills’ family said he was admitted to the hospital Saturday after vaping gave him lipoid pneumonia. More on his story HERE.

Sixteen states have now reported 153 cases of serious, vaping-related respiratory illnesses in the past two months, and many of the patients are teenagers or young adults.

In a statement on Wednesday, the Centers for Disease Control and Prevention said that all of the cases occurred in people who acknowledged vaping either nicotine or tetrahydrocannabinol, known as THC, the high-inducing chemical in marijuana.

Federal and state officials say that they are mystified as to what is causing the illnesses, but that it does not appear that an infectious disease is responsible. No one product or device is common among the cases, the agency said. It also was unclear whether a contaminant in a used cartridge or a home-brewed concoction of vaping liquids contributed to some of the ailments.

The patients, most of whom were adolescents or young adults, were admitted to hospitals with difficulty breathing. Many also reported chest pain, vomiting and fatigue.

The most seriously ill patients had serious lung damage that required treatment with oxygen and days on a ventilator. Some are expected to have permanent lung damage. Some severe cases were earlier reported in Wisconsin, Minnesota, Illinois and California.

In an email, the C.D.C. said that while more study was needed, vaping either cannabis or nicotine could be dangerous.

“E-cigarettes are still fairly new, and scientists are still learning about their long-term health effects,” said Brian King, deputy director for research translation in the agency’s smoking and health office. “Adverse respiratory effects associated with e-cigarette use could be the result of a variety of factors, including intended and unintended constituents of these products.”

Mr. King said numerous ingredients in e-cigarette aerosol could harm the lungs, including ultrafine particles that could be inhaled deeply, heavy metals like lead, volatile organic compounds and cancer-causing agents.

The C.D.C. urged doctors to report suspected cases to their state health agencies. The Food and Drug Administration is also collecting information about illnesses related to e-cigarettes and vaping.

“Oftentimes people are vaping both nicotine and the THC products, so it’s unclear which may be responsible,” said Dr. Michael Lynch, medical director of the poison center at the University of Pittsburgh Medical Center. “Probably this has been happening occasionally and we haven’t been aware of it, because the association with vaping wasn’t necessarily made. Now people are on the lookout, which is good, because we want to make sure we have an understanding of how prevalent an issue this is.”

Article adapted from The New York Times. A version of this article appears in print on Aug. 21, 2019, Section A, Page 13 of the New York edition with the headline: More Youth Getting Sick From Vaping, C.D.C.

7 Things You Should Know About Bats and Rabies

70% of Americans who die from rabies in the US were infected by bats – CDC Vital Signs. But bats are not bad! We need to know more to prevent infection and protect this species that protects us from other diseases.

As the weather warms up, adult bats come out of hibernation, baby bats are learning to fly, and humans get outdoors, which means a big increase in human-bat interactions compared to other times of year. Bats can be infected with rabies and can spread that infection to humans who have bare skin contact with bats or bat saliva. 

Oregon has 15 species of bats. Learn more about them at the Oregon Department of Fish & Wildlife. Bats are flying mammals that can reach speeds of 20 to 30 mph. Some of Oregon’s species migrate south in winter while some remain here and hibernate. Bats have ecolocation which allows them to make high-pitched sounds then listen to the echo of those sounds to locate where objects are. Echolocation helps them find even the smallest insect. 

Kate Cole from Public Health Insider compiled seven important things to know about bats and rabies. Please share this information with your friends, family, and children to make sure they know how to protect themselves from rabies in bats.

7. Bats are the main source of rabies in the United States. 

All mammals can get rabies, but in the United States, bats are the primary animal source of rabies. 

6. If you see a bat, do not touch it!! 

Any bare skin contact with a bat or its saliva, or waking up to a bat in your room, could put you at risk for exposure to rabies. Teach your kids not to touch bats, or any wild animal, and be sure to keep your pets away from bats. Talk to your family about the importance of respecting wildlife from a distance.  

5. If you think you or your children or pets may have touched or picked up a bat, take immediate action: 

  • Immediately wash the area that came into contact with the bat thoroughly with soap and water.  
  • Call your medical provider. If a person has been exposed to rabies, an injection of immune globulin and a series of rabies vaccinations need to be given as soon as possible to prevent infection and death. 
  • If you think you had contact with a bat, try to trap it! Trapping it means it can be tested for rabies and people potentially exposed can get the treatment they need. “How am I supposed to trap a bat?” you ask. Good news – there’s a how-to video.

4Pets are at-risk for getting rabies from bats, too. 

Vaccinate your pets against rabies to protect them in case they are exposed. Talk to your veterinarian to see if your furry family members need to update their rabies vaccine.  

Keep your pet under direct supervision so they don’t come into contact with bats. If you suspect your pet has come into contact with a bat, call your veterinarian, even if your pet is up to date on its vaccinations. Your veterinarian may need to give it a booster shot to protect it! 

3If you have problems with bats getting inside your house, you can do a lot to make your home more bat-proof. 

Putting screens on windows can prevent bats from accidentally flying into your home. Sometimes, bats are attracted to nesting in attics or inside a wall. The Washington State Department of Fish and Wildlife has excellent tips on easy things you can do to your home or building to prevent bats from getting inside

2. Most bats don’t have rabies. 

Although exact numbers are not known, it is estimated that less than 1% of bats are infected with rabies. Unfortunately, you cannot tell if a bat has rabies by looking at it; only testing the brain tissue on a dead bat can confirm if a bat has rabies (live bats need to be humanely euthanized before they can be tested for rabies). So, assume all bats may have rabies and never touch them. 

1. Bats are a vital part of our local ecosystem.  

Don’t let all this information about rabies give you a negative opinion on bats. What bats enjoy is eating large amounts of night-flying insects like mosquitos, termites, and agricultural pests, diminishing mosquito-related diseases and the need for pesticides in our community. In fact, some people try to attract bats to their property to help reduce the number of insects. For information on how to build a bat house for your yard, check out this resource.

Article adapted from Public Health Insider.

Housing as a Platform for Health and Equity

Recently in the American Journal of Public Health, Diana Hernández PhD, and Carolyn B. Swope MPH, assess the current state of research on housing and health disparities, and share recommendations for achieving opportunities for health equity centered on a comprehensive framing of housing.

The links between housing and health are now known to be strong and multifaceted and to generally span across 4 key pillars: stability, affordability, quality and safety, and neighborhood opportunity. Housing disparities in the United States are tenaciously patterned along axes of social inequality and contribute to the burden related to persistently adverse health outcomes in affected groups. Appreciating the multidimensional relationship between housing and health is critical in moving the housing and health agenda forward to inspire greater equity.

Despite the vastness of existing research, we must contextualize the housing and health disparities nexus in a broader web of interrelated variables emerging from the same roots of structural inequalities.

Source: Am J Public Health. Diana Hernández PhD, and Carolyn B. Swope MPH. Published online ahead of print August 15, 2019: e1–e4. doi:10.2105/AJPH.2019.305210

A Framework for Increasing Equity Impact in Obesity Prevention

One of the most pressing unmet challenges for preventing and controlling epidemic obesity is ensuring that socially disadvantaged populations benefit from relevant public health interventions. Obesity levels are disproportionately high in ethnic minority, low-income, and other socially marginalized US population groups. Current policy, systems, and environmental change interventions target obesity promoting aspects of physical, economic, social, and information environments but do not necessarily account for inequities in environmental contexts and, therefore, may perpetuate disparities.

In THIS ARTICLE recently published in the American Journal of Public Health, Shiriki K. Kumanyika, PhD, MPHI, proposes a framework to guide practitioners and researchers in public health and other fields that contribute to obesity prevention in identifying ways to give greater priority to equity issues when undertaking policy, systems, and environmental change strategies. The core argument is that these approaches to improving options for healthy eating and physical activity should be linked to strategies that account for or directly address social determinants of health. Kumanyika provides research and practice examples of its use in the US context. The approach may also apply to other health problems and in countries where similar inequities are observed.

Source: Am J Public Health. Shiriki K. Kumanyika. Published online ahead of print August 15, 2019: e1–e8. doi:10. 2105/AJPH.2019.305221

Local Health Departments on the Front Lines of the Opioid Epidemic

According to the National Association of County and City Health Officials, local health departments play a critical role in responding to opioid misuse and overdose within their own communities and are well suited to serve as conveners or supporters of coalitions and partnerships.

According to the Centers for Disease Control and Prevention’s 2018 report, Morbidity and Mortality Weekly Report, 47,600 Americans died because of opioid-related overdoses in 2017—far outpacing the mortalities associated with car crashes in 2017 and those of the peak years of the AIDS epidemic. While success has been made in recent years to curb the severity of the epidemic, these recent numbers are a stark reminder of the continued suffering of individuals, families, and communities across the country.

On the “front line” of the epidemic, LHDs are well suited to serve as conveners or supporters of coalitions and partnerships. This is critical, given that collaboration at the local level is essential to address the multifaceted nature of the opioid epidemic. The coordination of federal, state, and local partners, along with the engagement of community agencies and organizations, is imperative in implementing strategies to prevent and respond to opioid misuse and overdose.

Activities located within a local health department are beneficial because opioid use looks different across jurisdictions. To support individuals living with Opiod Use Disorder (OUD), local health departments can help their communities build out treatment options, including medication-assisted treatment, and can improve community linkages to care for OUD treatment, as well as for other physical and mental health services related to opioid use. They are also well-suited to support active drug use communities and to develop and enhance support systems for individuals engaging in treatment.

The opioid epidemic skyrocketed to public consciousness on the back of the immense suffering addiction has inflicted on American communities. There will always be another crisis, and the lessons learned from a variety of domestic drug use epidemics tell us that when we fail to prepare, we fail far too many. Instead of reactionary responses to each new public health emergency, local health departments have a unique opportunity to harness the national conversation around opioids to push for structural improvements in our official response to drug use of all kinds.

Article by Evans, Higgins, and Stanford. Adapted from Journal of Public Health Management & Practice.

10 Ways to Lower the Cancer Risk of Grilling

If you plan to grill often experts suggest taking some small steps to make a big difference in lowering your exposure to compounds that are tied to cancer.

Many people would be surprised to hear that grilling carries potential cancer risks. But each year, the American Institute for Cancer Research publishes guidance for “cancer-safe grilling,” cautioning consumers to avoid two types of compounds that have been tied to cancer. These compounds, called polycyclic aromatic hydrocarbons and heterocyclic amines, get generated when food, especially meat, is cooked on a grill. They have not been proven to cause cancer in people, but lab studies have shown they alter DNA in a way that could lead to cancer.

“Polycyclic aromatic hydrocarbons are formed when any kind of organic matter,” primarily fat that drips off meat and down into the grill grates, “gets burned, because the carbon inside is being combusted in the flames, and those hydrocarbons get carried up in the smoke,” said Rashmi Sinha, senior investigator in the Division of Cancer Epidemiology and Genetics at the National Cancer Institute. The resulting smoke can envelop the meat and coat it in the potentially carcinogenic compounds.

The black char we’ve all seen on grill grates and grilled food? That’s the heterocyclic amines, or HCAs, which occur when high temperatures meet muscle meat, which includes red meat (pork, beef, lamb, goat), poultry (turkey, chicken) and fish. “Grilling — or even pan-frying — at these high temps causes amino acids found in the meat to react with another substance found in meat called creatine,” said Colleen Doyle, managing director of nutrition and physical activity at the American Cancer Society and a registered dietitian. Creatine is found only in muscle meat.

“It’s the reaction of those amino acids and the creatine that form the HCAs, which is why we don’t see HCAs formed when grilling asparagus, squash, peppers and other vegetables.”

As with most lifestyle choices related to dialing up or down one’s cancer risk, the dose makes the poison. Which means if you’re grilling once or twice a year, don’t sweat it. But if you plan to grill often — once or twice a week throughout the summer, say — experts suggest taking some small steps to make a big difference in lowering your exposure to these compounds.

Grill fish, seafood, poultry or plant-based foods rather than red meat and especially processed meats like hot dogs; the World Health Organization considers processed meats a carcinogen and red meat a probable carcinogen. While HCAs are still formed while grilling fish and seafood, Ms. Doyle pointed out that you typically don’t have to cook seafood as long as beef and chicken, which reduces the accumulation of the compounds.

Research suggests that marinating for at least 30 minutes can reduce the formation of HCAs on meat, poultry and fish. The reason for this is not entirely clear to researchers, but one possibility is a kind of shield effect. “If you put a barrier of basically sugar and oil between the meat and the heat, then that is what becomes seared instead of the meat,” said Nigel Brockton, vice president of research at the American Institute for Cancer Research. It also makes your meat more flavorful.

Many kinds of fruits and vegetables are actually protective as far as cancer risk, and they don’t form HCAs when grilled. Several experts recommend using meat as a condiment. Think of alternating cubes of chicken with peppers and onions or peaches and pineapple on a skewer, for instance. This trick, which also works when pan frying, reduces the surface area of meat exposed to the hot surface, Dr. Brockton explained, since the meat is also touching other ingredients throughout the cooking process.

According to Dr. Brockton, cooking your meat with herbs, spices, tea, chili peppers and the like — ingredients with phenolic compounds — can be a helpful approach because “it seems they quench the formation of the potentially carcinogenic compounds because of the antioxidant properties of those ingredients.”

Try to minimize how much smoke you’re breathing in, the Harvard T.H. Chan School of Public Health recommends as part of a helpful resource on healthy summer picnic practices.

The black, crispy crust that you often see on the bony edges of ribs or steak is more likely to contain a higher concentration of potentially carcinogenic compounds. Ms. Doyle also recommends cleaning the grill grates ahead of time, to remove any previously generated char.

“The longer you cook something, the longer the chemical reaction is happening, the higher the amount of HCAs are formed,” Dr. Brockton said. If you partially precook your meat, such as by baking or cooking in the microwave, the layer of HCAs that gets formed won’t be as thick. The same goes for meat cut into smaller pieces, such as with kabobs, because it cooks faster. Grilling in foil can also help protect the food from smoke and speed up the cooking time, according to the Harvard resource on healthy picnics.

“Types of wood can influence HCA formation,” Ms. Doyle said. “Hardwoods, such as hickory and maple, and charcoal all burn at lower temperatures than soft woods, such as pine. Cooking with wood that burns at a lower temperature is desirable.”

To minimize your exposure to polycyclic aromatic hydrocarbons, experts recommend selecting leaner cuts of meat or trimming any visible fat, which can lower the amount that drips down through the grates and comes back up in the smoke. To minimize dripping, Ms. Doyle suggests not piercing your meats while they’re on the grill.

According to guidance from the National Cancer Institute, fewer HCAs are formed if you turn meat over frequently while cooking it on high heat.

Article by Sophie Egan. Adapted from The New York Times.