Following an alarming outbreak of respiratory disease, including at least six fatal cases, President Trump has proposed a federal ban on flavored electronic cigarettes. New York, a state that has reported at least 30 cases of the illness, has been the first state to effectively enact the ban.
According to the Center for Disease Control (“CDC”), as of September 12, 380 cases of vaping-related lung disease had been reported in 36 states and the U.S. Virgin Islands. Roughly a month earlier, the agency had pointed to a significantly smaller number of cases, 94, the majority of which had been reported in Wisconsin (30), Illinois, California, Indiana, and Minnesota.
Based on reports by the Wisconsin Department of Health Services, the symptoms observed in patients included shortness of breath, fatigue, chest pain, coughing, and weight loss.
In the majority of cases, vaping has been confirmed as the cause or the most probable cause of the respiratory illness. The CDC had initially reported 450 cases, but that number included a looser definition of “possible causes.” One of the hardest-hit states to date is Utah, with 28 case reports.
Over the last few years, vaping became fashionable in high schools and colleges all over the U.S. Commonly advertised as a “hip” and safer alternative to smoking, vaping is now under scrutiny as the culprit of severe respiratory issues, which are not only affecting teens and young adults, but also older adults, nationwide.
E-cigarette technology is still too new for researchers to determine if vaping causes cancer the way common cigarettes do. However, we know it creates nicotine addicts and, based on the new CDC reports, it may also cause lung disease.
Doctors have reported seeing large numbers of young, “otherwise healthy” patients who end up in intensive care units due to respiratory illness. Salt Lake City pulmonologist Dr. Dixie Harris, recalls seeing a man under 30 who was vomiting, unable to breathe properly, and in severe pain. Naturally, the doctor suspected an infection, but she found none.
Harris told reporters that it is extremely unusual to see a young patient with such severe symptoms and “in that much distress without an obvious infection.” As the cases multiplied, Harris and her colleagues found that about the only thing the patients had in common was vaping.
Six patients have died in connection with the outbreak. All the affected patients reported having vaped products containing nicotine, THC, or both.
The CDC has not confirmed the exact cause of the outbreak, but it advised individuals to stop vaping altogether until further notice. “While this investigation is ongoing, people should consider not using e-cigarette products,” Dana Meaney-Delman, who is running the investigation at the CDC, said. She advised users to stop adding to vaping devices “substances. . . that are not intended by the manufacturer.” In light of the proposed ban of flavored e-cigarettes, the CDC will likely speed up the probe.
Common Characteristics and Symptoms of Respiratory Illness Cases Connected to Vaping
- Symptoms observed days or weeks after vaping
- The majority of patients report using THC and/or nicotine-based products
- Coughing and shortness of breath
- Chest pains
- Difficulty breathing
- Nausea and/or vomiting
- Diarrhea
- Fever
- Weight loss
- Gastrointestinal issues come first, followed by respiratory issues later
- Healthy patients are in their late teens or their 20s
- Patients are otherwise healthy
- X-rays show inflamed lungs
- The majority of cases require hospitalization
- Many patients end up in the ICU
- Many require oxygen support
- Most patients are male
- Steroid-based treatments seem to help some patients
Researchers have pointed out that vaping fluids contain several ingredients that can potentially be toxic. Some specialists suspect that the mix of these ingredients with THC or CBD may be the culprit behind the recent respiratory illness outbreak.
Is Vitamin E Acetate to Blame?
In New York, the State Health Department has identified a single culprit: Vitamin E acetate, traces of which have been found in the cartridges of marijuana vaping products.
According to New York officials, “At least one vitamin E acetate-containing vape product has been linked to each patient who submitted a product for testing. . . . its oil-like properties could be associated with the observed symptoms.”
The chemical is safely used in other products, like nutritional supplements, and though researchers seem pretty confident about their findings in New York, the CDC said in a briefing that the exact cause of the respiratory disease outbreak is yet unknown.
Trump’s Initiative
On September 11, President Trump proposed banning vaping products on a federal level. Trump said in an Oval Office meeting that the U.S. “can’t allow people to get sick. And we can’t have our youth be so affected,” adding that, as the mother of a young teen, his wife Melania felt “very, very strongly” about the ban.
The proposed ban comes at a time when one in every four high school students report having vaped at least once over the past month. Considering the figure was one in five for 2018, it becomes clear that the popularity of e-cigarettes is on the rise among America’s youth.
The company that stands to lose the most with Trump’s ban is Juul Labs, the biggest player in the e-cigarette market. While Juul lobbied actively to secure the favors of the Washington D.C. elite, the company’s efforts have not sufficed to prevent the White House’s crackdown on the industry.
According to Health and Human Services Secretary Alex Azar, the FDA is preparing legislation that will come into effect in about a month. From that point on, Azar told reporters, flavored e-cigarettes will be effectively banned.
A few days before the Oval Office meeting, the Food and Drug Administration sent a letter to Juul Labs, warning that the company’s marketing to young people, including children, and its claims that vaping is safer than cigarettes are in violation of current regulations.
Juul Labs CEO Ken Burns referred to the respiratory disease epidemic as “worrisome,” but assured that Juul would continue to market the products as long as there was no clear evidence that the company was at fault. Back in July, Burns told reporters he had “empathy for parents whose children are addicted.” The company’s CEO has also advised nonsmokers not to try vaping.
After Trump’s initiative was announced, Burns said he was “not at all surprised.” He also referred to “the speed with which [Juul products] were replaced [after we took them off shelves] (by other flavored products made by other companies), usually with higher nicotine strength, all youth-oriented flavors and cheaper, of unknown manufacturing quality.”
Vaping has been linked to several health problems. Researchers have found an increased risk of wheezing among vapers. A link between e-cigarette use and chronic obstructive pulmonary disease (“COPD”) has also been observed. According to the FDA, vaping may also cause rare nicotine-induced seizures.
