Karen Keane had no sooner been appointed public health director than she was enforcing a statewide ban on vaping products on the 61 businesses in town that sell them.

PLYMOUTH – Karen Keane had no sooner been appointed public health director than she was enforcing a statewide ban on vaping products on the 61 businesses in town that sell them.

Gov. Charlie Baker declared a state of emergency Tuesday. The Public Health Council met in an emergency session, according to the governor’s office, and unanimously ratified the ban to a round of applause from doctors and advocates in the audience.

The ban applies immediately to all flavored and unflavored vaping products and devices, including tobacco and both medical and non-medical marijuana. In light of the ban, The Public Health Council has approved making nicotine-replacement products like gum and patches available at pharmacies as a covered insurance benefit without a prescription.

By 10 a.m., Wednesday morning, Keane had already visited 10 of the 61 establishments in town that sell vaping products and devices, to ensure they have suspended those sales until the ban is lifted Jan. 25. The governor reserves the right, however, to extend the ban, she said.

“I would want to say that here in Plymouth we certainly are business friendly and are sensitive to the fact that this may impact some of our businesses, but that this is a health emergency and we have to follow the ban to keep our residents safe,” Keane said.

Board of Health Chairman Birgitta Kuehn noted that her board held a special meeting three weeks ago to discuss the crisis and what the town should do about it.

“We sent up all our information,” she said. “We were horrified that the state was not doing anything. Based on some of our conversations, Baker banned it for four months, and that includes all vaping products with cartridges and the devices and all retail sales and online sales.”

Kuehn said she and her fellow Board of Health members have offered to help enforce the ban by visiting the stores that sell vaping products and devices. But, while Keane said she appreciates the offer, she said she’s not sure if there could be a liability issue. She said her office can handle the directive, and if there is need for more inspectors, she said she can enlist inspectional services to step in and make some of the compliance checks.

Three weeks ago, some news reports suggested that vaping-related lung disease spreading across the country was specific to vaping marijuana with diluents like vitamin E. Today, the 530 cases of lung injury span 38 states, according to the governor’s office, and some are reportedly connected with vaping nicotine, or, in layman’s terms, e-cigarettes. Health experts say they’re not sure what component of vaping is to blame for the lung disease, but it’s not just marijuana vaping that’s causing it.

The Centers for Disease Control and Prevention and the Food and Drug Administration are trying to uncover the cause of the mysterious illness that comes on suddenly and can be deadly as the patient’s airways are so compromised suffocation can result.

The Board of Health’s special meeting three weeks ago, held to address the crisis, began with a news clip featuring a video of a teenager on a hospital gurney gasping for air and clawing at his throat while emergency staff helplessly surrounded him. Keane said there is no known cure for the illness.

According to Baker’s press release on the subject, pediatric pulmonologist Dr. Alicia Casey said she and her colleagues at Boston Children’s Hospital have seen multiple teenagers with chronic symptoms, some becoming more severely ill. She described young patients with cough, mucus production, difficulty breathing, shortness of breath, low oxygen, needing oxygen, breathing tubes and ventilators who did not respond to antimicrobrial treatments, and some who are suffering permanent lung damage as a result.

According to the governor’s office, as of Sept. 17, 530 cases of lung injury associated with e-cigarettes or vaping had been reported to the CDC, and nine confirmed deaths.

While many tout the benefits of using e-cigarettes rather than smoking cigarettes, experts note that this is simply trading one addiction for another of the same ilk.

Those who don’t comply with the ban can be hit with a $1,000 fine, and repeated violations can result in the establishments losing their licenses to operate the store, Keane said.

Meanwhile, vaping itself is not banned. Those with existing cartridges and devices may still use them; they can’t be sold.

Cape Cod Regional Tobacco Control Program Director Bob Collett spoke during the Board of Health’s special meeting earlier this month, noting that one of the problems is there is no oversight into what goes into e-cigarettes. And the resulting “vapor” is actually an aerosol, meaning that the vapor cools when it enters the lungs and becomes droplets. Experts say these fat-laden droplets can coat the lungs, thereby compromising breathing.

Kuehn noted that the unregulated carrier liquid in these e-cigarettes contains everything from nicotine to heavy metals, arsenic, benzene, polypropylene and acetone. The government has not been analyzing these liquids, she said, and only recently has sounded the alarm, demanding vaping companies submit samples of what they’re selling to the FDA so they can be analyzed in the next 10 months.

The mystery, therefore, isn’t just what’s causing these pulmonary illnesses; it is why the federal government has failed to regulate this industry in the 12 years it has been active. Collett and others say vaping flavors like mango and bubblegum are designed to target youth, who are falling prey to advertising in much the same way the cigarette industry hooked them decades ago.