4 things to know about the outbreak of severe lung disease linked to vaping

12 September 2019 - 12:59 By AFP Relaxnews
E-cigarettes were widely considered a safer alternative to traditional smoking before the current disease outbreak, even though experts had warned that it may take decades to learn about vaping's long-term effects.
E-cigarettes were widely considered a safer alternative to traditional smoking before the current disease outbreak, even though experts had warned that it may take decades to learn about vaping's long-term effects.
Image: Justin Sullivan/Getty Images North America/AFP/File

Amid an outbreak of vaping-related severe pulmonary disease that has killed six people and sickened hundreds, the Trump administration has announced it will soon ban flavoured e-cigarette products to deter an ever growing number of young users. 

Here are four things to know about vaping, and the outbreak of lung disease that's been linked to this habit:

1. IS VAPING SAFER THAN SMOKING?

The truth is, we don't know.

Unlike tobacco cigarettes, e-cigarettes don't "burn." The devices work instead by heating a liquid that turns into vapor and is inhaled.

Therefore e-cigarette smokers are not exposed to the estimated 7,000 chemical compounds in regular cigarettes, and there is no known link between vaping and cancer.

The liquids however contain highly addictive nicotine.

There are also a variety other compounds classed as "potentially harmful" according to a 2018 study compiled by the US National Academy of Sciences.

And there is "substantial evidence" that the vapor contains traces of metals, either from the coil used to heat the liquid or from other parts of the device.

Some flavorings also contain diacetyl, a chemical linked to a serious but relatively rare lung disease.

While most of existing scientific literature holds that vaping is less toxic than smoking, "the implications for long-term effects on morbidity and mortality are not yet clear," and would require decades of more data and studies to know for certain, said the NAS report.

But the bulk of this research was carried out before the current outbreak of severe lung disease in the United States, with more than 450 cases currently under investigation.

2. THE INVESTIGATION INTO THE OUTBREAK

The patients' initial symptoms included breathing difficulty and chest pain before some were hospitalised and placed on ventilators.

Several teens were placed in medically-induced comas, including one who may need a lung transplant if he recovers, according to his doctors.

New York's health department is focusing its probe on counterfeit cannabis cartridges containing vitamin E oil, which is harmful when inhaled. Federal authorities however have yet to identify a single substance common to all cases.

Authorities have yet to identify a single substance common to all cases

Some medics have reported seeing patients developed acute lipoid pneumonia, a non-infectious form of respiratory ailment that occurs when oils or fat-containing substances enter the lungs, a potential clue for what is driving the illness.

That said, it's unclear why these cases have only been reported in the United States, and whether they are even new, or only being recognised after earlier misdiagnoses.

3. US AUTHORITIES ACTING

In June, San Francisco became the first US city to ban the sale and manufacture of electronic cigarettes, and has since been followed by Richmond, Virginia.

Market leading maker JUUL's response to the San Francisco ban was that it would "drive former adult smokers who successfully switched to vapor products back to deadly cigarettes."

That claim is true, according to a study in the New England Journal of Medicine on 886 patients in Britain's National Health Service published in February.

The one-year abstinence rate among e-cigarette users was 18%, compared to 9.9% among a group who used other nicotine replacement products like gum or patches.

But the conversions are not all in one direction.

Recent studies have found that, among adolescents, e-cigarettes provide a gateway toward full-fledged smoking.

4. REGULATION OR PROHIBITION?

The vaping industry is adamant that it doesn't want underage people using its products, and says that more must be done to prevent their sale.

E-cigarettes are already illegal to sell in the US to people under 18 or 21, depending on the state.

But bans also deprive adults addicted to smoking of a valuable tool to quit, the industry says.

"To deprive those smokers from access to e-cigarettes, which we know are substantially less harmful, I think is a terrible decision," said Neil McKeganey, of the UK-based Center for Substance Use Research, which is partly funded by the industry.


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