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  • Dr. Hicks

Why has vaping been in the news so much lately?

A deadly new illness related to e-cigarettes, or vaping, has been spreading across America– one so serious it has prompted the Centers for Disease Control, the nation’s leading health agency, to issue a Clinicians Alert and activate its Emergency Operations Center. The outbreak began in June 2019, and since then, there have been more than 500 hundred cases of the mysterious lung illness and at least eight deaths, including two in California.

Electronic cigarettes, also called e-cigarettes, vape pens, or pod mods, originated in China and were introduced in the US in 2006. The devices have a cartridge that holds a liquid containing nicotine or THC dissolved in a solvent or oil, and an atomizer that heats the liquid to create a steam-like vapor that is inhaled. Many contain one or more of the thousands of available flavorings. E-cigarettes aim to provide a sensation similar to smoking, but because they do not reach combustion temperature, no smoke is created, and the user is not exposed to the tars and other toxins created when tobacco is burned. Called vaping to distinguish it from smoking a conventional cigarette, it has been promoted as posing fewer health risks than smoking and as an aid to help quit cigarettes.

It hasn’t exactly worked out that way. It may be true that in the long run, vaping nicotine is less harmful than smoking cigarettes. But nicotine is addictive and most adult smokers who vape never quit cigarettes. More concerning is the fact that vaping rates have skyrocketed in recent years, especially among youth. E-cigarettes are now the most frequently used tobacco product among teenagers, far surpassing traditional cigarettes. Approximately 12% of middle and high school students were e-cigarette users in 2017, meaning they said they had vaped within the past 30 days. By 2018, usage shot up to about 21% of high school students and 5% of middle school students. The vast majority had never smoked tobacco, but they were much more likely to start than those who had never vaped. Sleek devices with flavored cartridges are marketed to adolescents. JUUL, a popular vape device that comes in fun flavors, looks like a flash drive and can be charged in a USB port, is especially concerning because it delivers high levels of nicotine, making it extremely addictive. The most frequent symptoms of the new illness are cough, shortness of breath, and fatigue; other symptoms included fever, chest pain, weight loss, nausea, and diarrhea. Patients show up at urgent care facilities and emergency rooms with flu-like symptoms and trouble breathing after suffering for several days to a week. At first, the illness looks like a serious viral or bacterial pneumonia, but tests show no infection. Conventional treatment for pneumonia is not effective, and patients are more likely to need to be in an ICU and require a ventilator. Treatment has been complicated by patients’ lack of knowledge — and sometimes outright denial — about the actual substances they might have inhaled.

Experts agree this illness is a completely new phenomenon and not something that has been around for years but is just now being recognized. It often strikes otherwise healthy teenagers and young adults.

The exact cause is not yet understood, but the cases have in common the use of e-cigarettes. Some of the patients vaped nicotine, some used a cannabis-based product, and some a combination. Researchers are suspicious that new toxins are formed when the various chemicals in the cartridges are heated. Vitamin E oil is a substance commonly found in cartridges and is associated with the severe and sudden respiratory problems in some of the cases. Meanwhile, lobbyists and trade association officials are scrambling to blame unregulated products. Although there is still much more to learn about this illness, the link to vaping is indisputable. The prudent approach is to stop vaping, at least until the cause is understood. No responsible physician would recommend a return to smoking, and there are several safe alternatives to help quit altogether. Nicotine patches and gum and effective anti-smoking programs can easily be prescribed by your doctor or at your local urgent care facility. Kicking the habit is the best thing you can do for your health.

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