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Why are people dying from e-cigs and vaping?

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Vaping: CDC investigation continues..

How many cases have there been?

On 23 August the CDC reported that a patient had died after being hospitalized with an unexplained respiratory illness after reported vaping or e-cigarette use. The case is the first death linked to vaping to be reported in the US and followed a spate of reports of severe lung illness which officials said were linked to vaping. As of 23 August, 193 cases of severe lung illness had been reported by 22 states.  I imagine this number will greatly increase as awareness increases.

How old are those affected?

In Illinois, the patient that died was an adult, officials said, but other patients in the state were aged between 17 and 38 and most have been men. In Wisconsin, where there are 16 confirmed cases, teens and young adults were initially affected, but officials have now reported cases in older age groups across the country.

What are the symptoms?

  • increase of symptoms including breathing difficulty
  • shortness of breath, or chest pain before they were hospitalized
  • mild to moderate gastrointestinal illness, including vomiting and diarrhea
  • fatigue

What’s caused this?

So far, CDC investigators haven’t identified a cause and they have found no evidence to suggest that an infection is to blame.

All patients had reported using e-cigarettes. Officials said that they haven’t found a specific product or compound that links all of the cases, but many of the patients had recently used products containing tetrahydrocannabinol (THC) or CBD as well.

In some of the research I found on Pubmed the liquid in the devices, even without the nicotine causes lung inflammation, cellular toxicity in lung and throat tissue causing negative changes to physiology and immunity.  Link here

How prevalent is vaping among young people in America?

  • American high school students increased from 11.7% to 20.8% between 2017 and 2018
  • Increased from 3.3% to 4.9% among middle school students.

UK vs US vaping regulations compare?

UK has much stricter regulatory requirements:

  • All e-cigarettes and e-liquids must be notified to the MHRA before they can be sold.
    • restrict e-cigarette tanks to a maximum capacity of 2 mL, the volume of nicotine containing liquid for sale in one refill container to 10 mL
    • the nicotine strength of liquids to no more than 20 mg/mL
    • Products that contain nicotine must be child resistant, include new labeling requirements and warnings
    • certain ingredients are banned, including coloring, caffeine, and taurine.

In the US, product manufacturers have to comply with Food and Drug Administration requirements.  But the system is pretty lax—I couldn’t find much in the form of regulations on nicotine or chemicals.  If you find this please email me.

What’s the FDA doing about this?

Blaming vaping companies for unscrupulous marketing practices:  click here to read about juul’s marketing practices on blast.

Meanwhile, the FDA continues to have lax regulations on chemicals and amount of nicotine in these ENDS’s.

 

Resource:  BMJ 2019366 doi: https://doi.org/10.1136/bmj.l5320 (Published 29 August 2019)Cite this as: BMJ 2019;366:l5320

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