In less than a decade, the e-cigarette market in the United States has grown rapidly to 460 brands now available in vape shops and online. The competition led small and big companies to decrease their prices and let into the market fake devices. And death.
According to the U.S. Centers for Disease Control and Prevention, as of the beginning of the month, thirty-three people have died in 24 States and almost 1,500 lung injury cases have been reported in 49 states, the District of Columbia and one U.S. territory, allegedly associated with the use of e-cigarette, or vaping products.
As for the symptoms, patients have reported difficulty breathing, coughing, chest pain, and other signs of acute respiratory distress.
Earlier this month the CDC began using the term EVALI – an acronym for “e-cigarette or vaping product use-associated lung injury” – to describe the ailment. The term is treated by the State Centers as “a diagnosis of exclusion because, at present, no specific test or marker exists for its diagnosis.”
Rumors and Uncertainty
Converging rumors and opinions are creating widespread alarm in the U.S., as the exact cause of the mysterious lung disease remains uncertain.
Some experts believe that is strictly connected to the products on the black market.
“This outbreak does not appear to be associated with traditional legally-sold e-cigarettes, but with illicit and sometimes counterfeit THC vaping cartridges,” Dr. Michael Siegel, a professor at Boston University School of Public Health, told ABC News.
According to the CDC, most patients who were affected by the disease used liquids containing Tetrahydrocannabinol, commonly known as THC, the principal psychoactive substance in cannabis.
Because cannabis products are illegal for non-medical use in most states, the liquids containing THC are often made by amateurs and sold on the black market, leaving users and researchers no way or knowing what else is contained in them.
In a September op-ed for The Globe Post, Sigel said many THC vaping liquids have high levels of vitamin E acetate oil, which he said “could potentially be the cause of many of the outbreak cases.”
Not all patients have reported using THC products however, with some saying they only used nicotine products. Amid the uncertainty, some states aren’t taking any chances. Montana, Massachusetts, Oregon, Michigan, New York, Rhode Island, Utah, Washington, and the city of San Francisco have all temporarily banned the sale of vaping products.
Long-Term Risks
For Dr. S. M. Iftekhar Uddin, a Postdoctoral Research Fellow at the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, it is really hard to say what will be the long-term effects of using e-cigarette and vape products.
“That’s the biggest lack of knowledge we have. We don’t know because devices have been used pretty recently, and not enough time has passed to have the data,” Uddin told The Globe Post.
After the numerous deaths, what is now scaring people and doctors, are the unknown substances used in the e-liquids.
“The bigger issue is that because there are so many varieties of e-cigarettes and liquids, it’s hard to know which compounds are being used. Some of these [compounds] have been shown to have adverse effects. So it’s true. There are legitimate health concerns,” concluded Uddin.
Since the epidemic began in the summer, research on the prevalence of substance abuse associated with vaping has tarted not only at the Johns Hopkins University, but also by government administrations such as the CDC and the U.S. Food and Drug Administration.
In the last five years, vaping has exploded in popularity among middle school and high school students. The frightful data shows that in 2017 and 2018, the number of youth who used e-cigarettes went up by 1.5 million.
Among the different devices, the American electronic cigarette company Juul has become the must-have vaping item for young people, mostly because of its fashion, small size, and portable characteristics. The preliminary data from the 2019 National Youth Tobacco Survey shows more than a quarter of high schoolers are now vaping.
Supporting Young People
That is why the non-profit organization based in Washington D.C., Truth Initiative, kicked off the first-of-its-kind program to help young people quit vaping.
‘This is quitting’ started in January 2019 as a support resource to help people quit vaping.
“People can be supported as they decide on what day to quit. And they can get messages when they are stressed or when they are having bad moments and they need some extra support. More than 40,000 people have already signed up to quit,” Truth Initiative Vice President of Campaigns Cianti Steward-Reid told The Globe Post.
For Steward-Reid, there was a need for young people to have a tool to help them quit, as people addicted to nicotine often difficulty stopping. Another goal of the organization is to inform parents and relatives about the risks the young generation can run and how to help them.
“Eight out of ten young people who start using tobacco products, nicotine products, start with a flavor. And so this is why it’s really important that the FDA bans flavored products. We want these products regulated,” concluded Steward-Reid.
