A firestorm of warnings have followed national reports of nine deaths (two in Kansas) and 500 or so cases of illness, mostly among young men, that include seizures and pneumonia. It’s allegedly connected to vaping and e-cigarettes – but is it just a smokescreen?

The U.S. Centers for Disease Control issued a warning in early Sept. for people to stop vaping immediately until a source was found for the mysterious lung disease affecting e-cig users.

“The CDC has not been putting out very clear information,” Dr. Michael Siegel of Boston University told Boston Public Radio. “About the most specific they’ve gotten is ‘don’t use e-cigarettes and don’t vape.’ What we need is much more specific information, and the only thing that we’ve been able to tease out from the data so far is that 80% to 90% of these patients have reported the use of THC.

“In other words,” he said, “they’re not vaping the traditional nicotine e-liquids that we keep hearing about. What they’re vaping is illicit THC vape cartridges that are essentially purchased off the street. These are black market products. So we truly have no idea what is in those products.”

HIDDEN CAUSE

E-cigarettes were introduced in 2003, gained several million users globally by 2013, then have increased exponentially since, according to the Annals of the New York Academy of Sciences. Now, about 41 million people vape, the BBC reports, creating a global market of nearly $20 billion

The sudden spate of lung illnesses means “it is unlikely it is e-cigarettes that have been on the market for a long time” unless “something was either changed or a new product was introduced into marketplaces,” New York University public health professor Ray Niaura told USA Today.

One potential contaminant that experts have named is Vitamin E acetate oil.

“This is an oil that is being used as a thickening agent in black market THC cartridges,” Siegel said. “It may be that is responsible for at least the bulk of these cases because oil is certainly not meant to be inhaled into the lungs and when the lungs get coated with oil, they literally cannot function.”

With some of the current rash of lung ailments identified as lipoid pneumonia, Siegel says it makes sense if victims are vaping a largely oil-based product.

“Pretty much all nicotine e-liquids are not oil-based. They’re water-based. And so we know for sure that those products can’t cause lipoid pneumonia,” he told Canadian Broadcasting.

REACTION

After the CDC warning, the Food and Drug Administration announced it would investigate the “vaping deaths,” the states of New York and Michigan banned flavored e-cigarette products, Massachusetts will ban all sales for four months, the nation of India pledged to ban all e-cigs, and Walmart and some other stores announced they will stop selling them.

Health officials from several states are going to testify in Washington, D.C., Reuters reported. Several have commented on the threat of e-cigarettes to teenagers, who have been a growing audience for vaping. In many places, like Kansas, sales are illegal to under-18-year-olds, but 16-year-olds can vape if they have products in their possession. There is no national law.

One in four 12th-graders and nearly one in ten 8th-graders reported vaping a nicotine product during the previous 30 days, a study by the University of Michigan-Ann Arbor reported this month.

THE BIG ‘BUT’

Many of the lung illnesses are reported to be young people, but they may not be using store-bought e-cig products. USA Today reported cases in San Francisco, Utah and Wisconsin that involved THC oil.

“What’s going on behind the scenes that youth are not being so upfront about is that they’re actually vaping marijuana,” Siegel, the professor from Boston, said.

“There are THC cartridges that are spreading through distribution channels [and] through our schools,” he said. “And I think what this outbreak is telling us is that the issue is not necessary vaping, the issue is ‘what are you vaping?’ What is going into that product?”

STILL BETTER THAN TOBACCO

In 2017, the journal Tobacco Control published a study on e-cigarettes funded by the National Institute on Drug Abuse and the National Cancer Institute that indicated a switch from cigarettes to e-cigarettes has the potential to prevent almost 90,000 premature deaths in the United States in the year 2026, with growing prevention in following years.

What’s getting lost in the e-cig scare, experts say, is that smoking actual tobacco remains far more dangerous than store-bought, non-THC e-cigarettes.

“The CDC – and physician groups – should be telling the public that nearly a half million Americans die each year from cigarette smoking. That’s over 1,300 … Every. Single. Day. For the past 30-plus years,” said Brad Rodu, health professor and specialist in tobacco harm reduction at the University of Louisville, in a post for RealClearPolitics.com.

“Smokers burn tobacco to release and inhale nicotine laced with a toxic tar containing 7,000 chemicals. After 20 or 30 years, they have high risks for heart diseases, many cancers, asthma, emphysema and more,” he said. “Vaping is a form of harm reduction, and it’s considered 95% safer than cigarettes. Not perfectly safe, but a big improvement over smoking. Not sharing this information – and instead letting a frenzy develop over vaping – is harm escalation.”

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