A series of vaping-related health illnesses are sweeping the nation, including one case occurring recently in Huntsville.
It came about as a safer alternative to cigarettes. However, most doctors agree that vaping is only marginally safer, and that it is too early to determine longterm effects.
“Regular smoking tobacco is a carcinogen, meaning it can cause lung cancer. Originally it was thought that e-cigs would be safer because users are not inhaling smoke, but now we are learning that inhaling heating chemicals has its own risks,” Sam Houston State University public health coordinator Dr. Stephen Brown said.
E-cigarettes and vapes are electronic devices that heat a liquid – typically containing nicotine – producing an aerosol, or mix of small particles into the air.
While cigarette smoking has decreased dramatically in recent years, e-cigarette use has spiked especially with teenagers across the nation. Sweet and fruity flavors attract youth to the habit, along with the fact that you can virtually smoke it anywhere without the foul odor of traditional cigarettes. The U.S. Surgeon General reports that 68% of e-cigarette users in high school use flavored cartridges, the most popular of which being menthol, alcohol, candy, fruit, chocolate and sweets.
JUUL – the top selling brand of e-cigarette in the U.S. – is popular with youth as it is easily concealed by its resemblance to a USB flash drives and can easily be used in school classrooms and bathrooms. The Center for Disease Control reports the number of middle and high school students using e-cigarettes rose from 2.1 million in 2017 to 3.6 million in 2018.
One JUUL pod contains as much nicotine as a pack of 20 regular cigarettes, and according to the CDC, approximately two thirds of JUUL users aged 15-24 do not know that JUUL always contains nicotine. What’s more, studies show that youth typically do not know what’s inside of their e-cigarettes.
In an effort to eradicate the growing addiction in youth, Texas law, as most of the nation, has raised smoking and vaping age limits to 21 years old, though kids and young adults are still finding ways to obtain cartridges.
Texas A&M University recently banned vaping on university campus amid a swift emergence of vaping related illnesses, while stores such as H-E-B and Walmart have discontinued selling vape supplies as a preventative measure.
Huntsville Memorial Hospital pulmonologist Sudhir Seghal M.D.’s main concerns are about what happens to the liquid contained in cartridges when it is heated and turned into a mist, and says that the jury is out as to whether illegal cartridges, THC additives, CBD, or vitamin E could be factors.
“We don’t know enough of what’s in this product, we’re being told that it’s just nicotine and water, but it has additives that has to be introduced to the vaping device, which heats it up to a very high temperature to mix it into a mist,” Seghal said. “When liquid is turning into this mist, we don’t know what’s happening to those chemicals at that high temperature and we are inhaling them into our lungs. Some people may be sensitive to that and may have adverse reactions.”
According to the CDC, the e-cigarette aerosol that a user inhales and exhales contains harmful substances besides nicotine, including ultra fine particles, flavorings such as diacetyl, volatile organic compounds, cancer-causing chemicals and heavy metals such as nickel, tin and lead.
Seghal believes that these non-active ingredients could be the culprit.
Typically, nicotine serves as the active ingredient accompanied by a stabilizer to preserve it, which is troubling for the doctor. Though, Seghal does note that THC is a large common factor that he believes could be the source of contamination.
“I think experimentation has grown so people are trying to use non-nicotine products, and I feel that’s where the problem is,” Seghal said. “Some of them are not even coming from the manufacturers who sell these devices, they are just coming from somebody’s house or their laboratory and we have no idea … forget even the chemical aspect, I don’t even know what bacteria might be contaminating this product if somebody is making it their house.”
Shortness of breath for no apparent reason, chest pain and a persistent dry cough are symptoms to be aware of if you use vaping products. Other symptoms could include nausea, vomiting, diarrhea, fatigue, fever and weight loss.
“As we enter the cold and flu season a couple months from now, it’s going to be far more difficult to identify the people who have a cold or the flu and someone who has a vaping related pulmonary injury,” Public Health Authority for the Houston Health Department and professor at Baylor Medical School David Persse M.D. said.
The illness is considered to be progressive, those effected won’t go from being well to critically ill in one day’s time – it seems to take several days, so the people who recognize the symptoms early and get treatment right away are more likely to recover quickly.
“Your body has its own defense mechanisms to fight inflammation, depending on the burden of the injury, that’s how bad your situation is going to be, then (followed by) how bad your immunity was to begin with,” Seghal said. “If you’re a chronic smoker, for example, and you get an injury you are going to have less chances of your body being able to fight it, if you are a healthier person who has not had really any lung issues or problems you have a better chance of fighting it.”
“The treatments so far consist of supporting the patient through the illness, its basically keeping them from dying from it. Without that support, the patient will die if the patient is severe enough,” Persse added, noting that we continuously see and expect adolescents to mimic adult-like behaviors, even when they’re not of legal age to do those things.
This recent emergence of vaping illness is not the only health-related risk to vaping, lung damage from heated chemicals and flavors, exposure to heavy metals, lung infections and a life-time addiction to nicotine are all possible outcomes. Using nicotine in adolescence can harm the parts of the brain that control attention, learning, mood and impulse control, according to the CDC.
Health professionals fear of youth and adults switching to tobacco cigarettes or using them concurrently.
“I think that we need to encourage our kids to be more mature than that and recognize that smoking really isn’t cool, being able to say no to smoking, having the personal restraint to say, ‘no, I’m not going to smoke just because everybody is pressuring me into it, that’s what they should be proud of,” Persse said. “The cool thing is being able to say no, having the strength to say no to the peer pressure.”
Seghal feels that an open flow of communication between parents and kids is an important aspect of making sure that kids aren’t using vaping devices.
“I would say please talk to your children and explain to them the bad effects of this. We don’t want to be behind the ball on this one like we were on actual cigarettes some 70 years ago and we were handing it out to people as something to enjoy so I don’t want our kids to go through that,” Seghal said.