Earlier this week, the U.S. Centers for Disease Control and Prevention (CDC) announced that it was investigating an inexplicable uptick in severe lung disease that seems to be affecting e-cigarette users. In the five days after the investigation was announced, the health agency announced a 60 percent increase in reported cases. The mysterious illness has led to the hospitalization of many of those suffering, and the only commonality identified is the use of a vape.
The disease first caught the CDC's attention when a total of 94 cases were reported across 14 states by health officials. Those instances all took place between June 28 to August 15. Less than a week later, the number of potential cases has increased to 149 across 15 states. The issue doesn't appear to only be tied to a single region, and the CDC stated that it has no evidence at this point to suggest the illnesses are the result of an infectious agent.
Not much is known at this point about the the apparent disease, other than the symptoms. Those with the illness report experiencing difficulty breathing at times, coughing, chest pains, increased levels of fatigue and even weight loss. Some have also reported experiencing stomach and gastrointestinal illnesses, including vomiting and diarrhea. No deaths have been reported in connection with the disease, but the CDC has determined symptoms are serious and widespread enough that the situation warrants further investigation.
All of this has left the CDC and state-level health officials looking for answers and potential causes of the outbreak, and thus far there is only one commonality to show up: vaping. Most people suffering from the illness are teens and young adults — a demographic that are using vaping products in record numbers, according to the National Institute on Drug Abuse. In many of the cases, the patients experiencing symptoms of the disease told their care providers that they had recently used e-cigarette products that contain THC, though the CDC has not identified a particular product or brand.
The reports of a link between lung disease and THC-related products falls in line with some instances that Dr. Shelley Schmidt, a pulmonologist at Spectrum Health — a not-for-profit health organization in Grand Rapids, Michigan that is not affiliated with the research — has run into. She tells Mic that she has "already seen several cases of significant lung injury in patients who have vaped with a variety of substances, such as THC for example." She noted that there is no definitive proof that vaping products are the cause of the harm experienced by patients, but there is "growing concern" that might be the case. "Given all of this, there is a great interest in the further study and understanding of the use of vaping activities," she says.
While this sudden increase in lung disease symptoms plaguing vapers is a cause for concern because of the widespread nature of the illness in a small period of time, illnesses linked to vape use aren't unheard of or even all that uncommon. Research published earlier this year by the American College of Cardiology found links between the use of e-cigarettes and increased risks of heart attacks, coronary artery disease and depression. Vaping has also been shown to result in increased heart rate and blood pressure. A study published earlier this month in the journal Radiology found that smoking e-cigarettes can damage blood vessels and impair blood flow, even if the e-liquid being used contains no trace of nicotine.
Dr. Glenn M. VanOtteren, another pulmonologist at Spectrum Health, told Mic that "there is significant concern that indeed the use of heated tobacco products, 'vaping,' is harmful for users." He noted that "vaping of nicotine-containing products is extremely addictive and also generates the production of many carcinogenic substances," which may have harmful effects on the body.
Because the industry is essentially unregulated, it's next to impossible to guarantee the contents of vape juices or liquids are safe or contain what they claim. Cases of nicotine poisoning have skyrocketed in the U.S. in recent years, tripling from 2012 to 2013 primarily because of e-liquids. Younger users were hit even worse, seeing a 1,000 percent increase in cases of nicotine poisoning according to Harvard Health Publishing. A 2018 study published by the Roswell Park Comprehensive Cancer Center found that e-cigarette users had higher traces of lead, cadmium, pyrene and acrylonitrile in their urine than those who don't smoke, suggesting there are tons of unsavory substances floating around in some vaping juices.
Schmidt says that while it takes years to fully understand the effects of a substance, we are "just now beginning to understand the potential harm from vaping." She noted that much of the production of vaping products, including liquids, are "being manufactured out of this country, where there is even less control over the circumstances of their production."
While it's not clear exactly what is the cause of the sudden uptick in lung disease affected hundreds of people across the U.S., it may at least be enough to give vape users pause. The situation has become bad enough in Wisconsin, where more than 30 cases have been reported, for the state to list the situation as an outbreak.
For the last decade, vaping companies have successfully marketed their products to young users who had otherwise almost entirely given up smoking. CDC reported in 2016 that cigarette use among high-schoolers was at an all-time low, but there is now evidence to suggest that kids who start using e-cigarettes are more likely to try standard cigarettes, reversing the trend of an extremely popular health outcome. According to the CDC and Food and Drug Administration (FDA), use of e-cigarettes by high schoolers has been on the rise, increasing 78 percent between 2017 and 2018 for high schoolers and by nearly 50 percent among middle schoolers. The situation has become so bad that the Surgeon General has declared use of e-cigarettes a health epidemic among young people. But as laws start to crack down on the availability of those products, younger users turn to juices sold outside of legitimate businesses. It appears that, at least in some instances, homemade or traded liquids may have been involved in the recent spate of illnesses. NPR reported that some cases in Wisconsin appear to be linked to an e-liquid sold on the street.
With lack of proper quality controls to ensure that vaping products are safe and free of carcinogens and other potentially harmful substances, we may be seeing some of the negative effects of the sudden and dramatic increase in vape use in the form of a lung disease outbreak. As the CDC continues to investigate the situation and determine the causes and the relation, if any, to e-cigarette use or specific vaping products and liquids, perhaps some users will find it's a good time to set down the vape for a bit.