Recently there has been a spate of serious lung complications related to vaping with e-cigarettes. The cases have been all over the news and continue to occur. I found a post about the matter on the CDC website from October 3rd. It provides statistics and information for the public, healthcare providers, and government health departments.
According to the post, as of October 1st, 2019, there have been 1,080 cases of lung illness caused by vaping across 48 states. Eighteen of those cases have resulted in deaths. I checked the post again on the 11th. It had been updated to state that as of the 8th of October, those numbers had risen to 1,299 cases with 26 deaths. There was a mix of people affected. Some sufferers said they used nicotine vape products, others used THC products, many said they used both.
The CDC post also pointed out two factors that are not known.
- Neither the CDC or FDA know what the cause of the lung illness outbreak is. Vaping links all these cases together but the chemical or chemicals that actually cause the symptoms is still a mystery.
- The other point is that there may be more than one cause. There are a number of substances and manufacturers being investigated.
I imagine that trying to pin down the cause of this outbreak is a daunting task for researchers. Walk into any vape shop and you’ll see shelves full of dozens of different flavors and brands of vape juice. Walk into a different vape shop and you’ll see just as much variety and most likely, several different brands and flavors that the first shop didn’t have. Some shops make their own juice. There is also a slew of different devices.
One major concern is that vaping may cause a serious medical condition known as popcorn lung. That is the nickname for obliterative bronchiolitis, a treatable but irreversible disease that is believed to be caused by, among other things, breathing in diacetyl. Diacetyl is a naturally occurring byproduct of fermentation and is used in certain food flavorings like caramel, butterscotch, and most notably, the butter flavor of microwave popcorn. The term popcorn lung was the result of a breakout of obliterative bronchiolitis among eight workers at a Missouri microwave popcorn factory in the ’90s. This incident had national coverage on the news and eventually led to the big microwave popcorn companies removing the chemical from their products.
Diacetyl can also be found in certain vape juices. It is commonly found in juice containing vanilla, maple, and coconut flavoring. A widely cited Harvard University study of 51 brands of vape juice showed that 39 of them contained diacetyl.
There are people who refute the claims that vaping is as harmful as the mass media presents it to be. A Snopes.com article from 2016 brings up some interesting points. Now, this is before the current outbreak of lung illnesses started but I think some of these points are valid and should be considered.
First, the Harvard study did find diacetyl in many of those vape juices but there was no definitive link found between vaping and popcorn lung. The published findings of the study concluded that it is important to continue evaluating the effects of vaping and diacetyl on the lungs. The study also received a lot of criticism. A Boston University professor named Michael Siegel cites research that may poke some holes in the vaping-related popcorn lung theory. According to that research, cigarettes contain much more diacetyl than any vape juice; in fact, the highest concentration of diacetyl found in vape juice was far lower than the lowest concentration found in tobacco cigarettes. Furthermore, smoking cigarettes had not been found to be a risk factor for popcorn lung, putting the supposed link between vaping and popcorn lung into question.
The tobacco companies are not standing idly by while vaping encroaches on the cigarette market. Juul is by far the biggest vape company and it had 75% of the e-cigarette market share by the end of last year. In December of last year, Phillip Morris’ parent company, Altia, bought a 35% stake of Juul. R.J. Reynolds has a subsidiary called R.J. Reynolds Vapor Company that last year, had 10% of the e-cigarette market share. These companies and others are lobbying against vaping regulations and public health groups like the American Heart Association and the American Cancer Associated are fighting on the other side.
Now, several states have put a temporary ban on flavored vape juice. In November of 2018, The FDA announced that it will be limiting vape juice flavors to tobacco, menthol, and mint. The main impetus behind that is to cut down on the number of adolescents who vape. According to a newsletter put out by the National Institutes of Health in February of this year, the number of teen vapers is rising rapidly. Over 44,000 students took part in this 2018 survey about drug, alcohol, and cigarette use. Among other things, results showed that the number of 12th graders who reported vaping rose from 28% in 2017 to 37% in 2018.
This topic is a good example of how difficult it can be to suss out fact from fiction when it comes to online information and media coverage. The Snopes article related how, in 2016, several clickbait websites published the same photo gallery posted next to claims that vaping causes popcorn lung. The photos show a man who looks like he’s suffering, lying in a hospital bed. Some investigating uncovered that the man in the photograph had been in the hospital because an e-cigarette device had exploded near his face. It had nothing to do with any lung illness.
Professor Siegel stated that what is happening with the vaping issue, unfortunately, happens with too many scientific studies. Important information is left out when findings are published. It is often easy to manipulate study findings to support your own theory. His example was the Harvard study on diacetyl leaving out any mention of the earlier study showing that cigarettes had much higher levels of the chemical than any vape juice.
There are politicians, companies, media outlets, and government agencies all in the mix. These entities are powerful and have the resources to put their own spin on the story in pursuit of their own agendas. It is sad that a public health crisis like this seems to bring out more opportunism than altruism from the groups with a stake in the matter.
So it’s hard to know what’s really going on. Hopefully, in the near future, we will have a better idea of what is causing these lung illnesses and how vaping affects the body. I read a Wall Street Journal article that said some of President Trump’s advisors are warning against the proposed ban on juice flavors because it may hurt his reelection campaign.
Personally, I don’t feel that this ban will do what the policymakers are hoping it will do. The illegality of a substance doesn’t affect the availability too much. Drugs are everywhere and they’re pretty easy to get. History shows us that, at least in this country, prohibitionist policies towards drugs and alcohol do not work.