By Melanie Wells
Our February 2019 editorial, “The Dual Face of JUUL,” warned parents of a threat facing our kids, of nicotine addiction from Juul and other e-cigarette use. The facts reported then still stand – the risk of nicotine addiction and its negative health impacts are substantial – but recently the downside of vaping has risen considerably, now including consequences that may be lethal.
A New York Times Nov. 8, 2019 article reports that “[m]ore than 2,000 Americans who vape have gotten sick since March, many of them teen and young adults, and at least 40 people have died. The bulk of the cases occurred in August and September but new cases are still being reported.” In a previous article, Oct. 2, 2019, the paper had reported that the majority of victims “have vaped THC, the psychoactive ingredient in marijuana, but some say they have vaped only nicotine.” The statistics published then, (1000 illnesses, and 19 deaths) have, in just over a month, doubled, to 2,000 illnesses and 40 deaths.
The Washington Post reports that “Health officials, lawmakers and parents have been raising alarms about vaping for a couple of years, warning that products touted as healthier alternatives for smokers are instead drawing in young people with fun flavors and slick marketing … The caution has taken on new urgency … as authorities scramble to understand a rash of mysterious vaping-linked illnesses that have put healthy people in the hospital with serious lung diseases.” https://www.washingtonpost.com/health/2019/09/07/what-we-know-about-mysterious-vaping-linked-illnesses-deaths/
Vaping turns deadly: While concerns about vaping have led health professionals to sound a steady warning for parents, until recently, fatal lung disease was not part of the story. Now it is. Schools, in response to recent vaping-related deaths, are scrambling to revise policies, with some removing bathroom stall doors and placing vapor sensors strategically, so student vaping can be interrupted in real time. With 40 deaths, the stakes are higher than those set by mere acts of teen rebellion. When a young, otherwise healthy person struggles for breath on a respirator and there is no cure, it is a terrifying scenario for kids, schools and parents.
What can you do?
BE INFORMED. Follow the medical investigation, now ongoing. (Note recent data, below.)
BE INVOLVED: Talk to fellow parents. Ask your schools about their handling of, and current policies around, e-cigarette use.
BE CONNECTED: TALK with your children, frequently and frankly. Ask them what they hear about vaping and be sure they are aware of the devastating lung illnesses among healthy young people who vape. Don’t accuse – but do state your concerns. Tell your kids you want to keep them safe from harm, and note these illnesses may be just the tip of the iceberg. Offer to follow the unfolding research with your kids; full answers to this medical mystery may not yet be available, but the investigation is on. Offer to pool and share new data as it emerges.
BE FIRM: Don’t be shy about urgently making a case against vaping, even while the jury is still out. Tell your child the facts: these illnesses can kill, and there appears to be a higher rate of fatality associated with adding THC (the active ingredient in marijuana) to a vape pen. If you find evidence of vaping paraphernalia or online purchase orders for them in your home, make clear you will intervene to keep your child safe. Below are some recent data points from respected journalistic sources:
Update: Oils or toxic chemical exposure? (New York Times)
Earlier reporting on the lung illnesses focused on THC or other oils as triggers, but further investigation reveals the full picture may be more complex. The New York Times October 2, 2019 article reports, quoting Dr. Brandon T. Larsen, a Mayo Clinic surgical pathologist expert in lung pathology: “All 17 of our cases show a pattern of injury in the lung that looks like a toxic chemical exposure, a toxic chemical fume exposure, or a chemical burn injury,” adding that the injuries resembled those from exposure to mustard gas, a chemical weapon used in WWI. About 70% of the samples were from people who had vaped either marijuana or cannabis oils.
Medical investigators, stymied by the sudden rise in deaths among otherwise healthy e-cigarette users, are working to determine the exact origin of the toxicity apparent in the lung damage. Although recent CDC studies point to inhalation of oily droplets as a potential culprit, further probing and testing are still ongoing. However, one thing is already certain: the effect is devastating and has been fatal in dozens of people.
According to Dr. Larsen, “patients with lung illness from vaping had tissue damage and cell death in the lining of their airways, and in the lungs themselves … I wouldn’t be surprised if we wind up with people down the road having chronic respiratory problems from this,” Dr. Larsen said. “I don’t think we know what the long-term consequences will be.” He also noted it was possible that “the condition had existed for some time, years perhaps, but that the cases were scattered” making it difficult to pinpoint a cause. https://www.nytimes.com/2019/10/02/health/vaping-illnesses.html?action=click&module=Latest&pgtype=Homepage
Update: The role of THC – According to a Sept. 7, 2019 Washington Post article, “CDC officials said 77 percent of [victims] … reported using THC-containing products” or, a combination of THC and nicotine-based products. That is the “most prominent link across all patients,” said Dr. Anne Schuchat, the CDC’s principal deputy director. “We are in the midst of a complex investigation that … involves serious, life-threatening disease in young healthy people…” Schuchat said. Although the pattern consistently shows vaping in the weeks leading up to illness, not all users had the same substances in their vape pens.
A majority vaped THC, the active ingredient in marijuana, but some reported vaping only nicotine. (Some may be reluctant to admit to using THC, but the CDC is investigating both angles.) https://www.washingtonpost.com/health/2019/09/07/what-we-know-about-mysterious-vaping-linked-illnesses-deaths/
Update: JUUL advertising curtailed.
An online Associated Press article from the New York Times website reported on September 25, 2019 that JUUL…”[t]he San Francisco-based company that controls about 70% of the market announced Wednesday that it will no longer run TV, print or digital advertisements for its e-cigarettes.” For now, doctors and health officials recommend people avoid vaping products until medical investigators are able to determine what’s causing the lung damage seen in the illnesses.
Parents, take this message to heart. A full-out effort to help your kids avoid e-cigarettes is the most prudent path. There are too many unknowns surrounding the use of heated vapor as a nicotine or other drug delivery vehicle, to sit out this trend and turn a blind eye. The potential for addiction is bad enough; the danger of irreversible damage to your child’s lungs, whether debilitating long term, or fatal, is worse. Take a stand: protect your kids.