Vaping Dangers are Frightening

Over the last few months, a rapid rise of vaping related acute lung disease has come to light. Both the CDC and the Food and Drug Administration (FDA), which regulates electronic nicotine delivery systems (ENDS, which includes products known as “e-cigarettes”), are actively engaged in investigating this outbreak, which some are calling an epidemic.  Certainly, vaping is epidemic among our youth.

As of the end of September, the number of confirmed or probable cases of life-threatening vaping-related lung disease has risen to 805 across 46 states and the US Virgin Islands. About three-quarters of the reported cases are male; nearly 4 in 10 are age 21 or younger.   Most importantly, all reported cases have a history of e-cigarette product use or vaping. Patients often require ICU and ventilator support. Thirteen people have died so far.

Authorities don’t know which chemical(s) are responsible for these vaping-related illnesses. An early idea was that only illicit THC products (black market marijuana oils) were to blame, but this evidently is not the case. Yes, these illnesses are more prevalent among THC vapers than users who self-report using only nicotine products, but vapers who don’t use THC are also getting sick. Vitamin E acetate is also being considered as a potential cause, but no single chemical has been consistently identified in all of the samples tested. At the present time, no particular device, brand, flavor or substance has been definitively linked.

According to the Centers for Disease Control and Prevention (CDC), symptoms of lung injury reported by some patients in this outbreak include  cough, shortness of breath, and chest pain, nausea, vomiting, or diarrhea, fatigue, fever, or abdominal pain. These symptoms usually have a rapid onset over a few days, but some patients have reported that their symptoms developed over several weeks. A lung infection does not appear to be causing the symptoms. NPR reports that in all confirmed cases, patients reported vaping within 90 days of developing symptoms, and most had vaped within a week of symptom onset. 

What should you do?

If you vape, stop. There are other ways to control nicotine addiction. Playing Russian roulette with your lungs is not smart and not cool. Certainly, anyone who vapes should not buy products off the street or add any substances, like THC or CBD oils.  If you have recently vaped and you have symptoms, see a healthcare provider, and let them know of your concern. They can notify the health department or CDC if necessary.

Vaping is not a harmless fad. Our lungs are elegant, fragile, life-giving organs that don’t react kindly to smoky chemicals, whatever the source. The acting head of the FDA admitted recently in testimony before a House subcommittee that the FDA “should have acted sooner” to contain the youth vaping epidemic.  And the CEO of Juul, maker of vaping products that targeted kids with enticing flavors like mango, grape, and strawberry lemonade, stepped down amid intensifying scrutiny of the brand’s marketing practices.  His replacement, unfortunately, is a seasoned tobacco executive, so don’t expect Juul to give up the fight. Too much money is at stake.

But our kids’ health and future is at stake as well. We must remove flavored e-cigarettes from the marketplace. And any marketing practices that target kids with addicting and dangerous products are unacceptable. E-cigarette products flooded the marketplace and were never appropriately reviewed. Frankly, the FDA dropped the ball on this, and people are dying as a result. Finally, until and unless sales to kids can be prevented, online sales of e-cigarettes should be stopped.

Let’s hope our federal agencies can act quickly and forcefully both to identify what is causing these illnesses and deaths and to regulate access to e-cigarette products. If the federal government won’t act, our state legislators should. The health and safety of our kids is at stake.

We Need Tobacco 21 Legislation Now

Who knew that candy apple, bubble gum, cherry cola, marshmallow, orange soda, s’mores, chocolate, and taffy were literally so addictive? Every one of those flavors – and thousands more! – are available in e-cigarettes today. Tobacco and e-cigarette use – seductively called vaping – are increasingly sucking our youth into a lifetime quicksand of addiction with health and financial costs certain to follow.

A coalition of many partners, including the American Cancer Society Cancer Action Network, American Heart Association, American Lung Association in Texas, Texas Medical Association, Texas Hospital Association, and numerous health systems throughout the state, have come together as Texas 21 to save lives by preventing tobacco use. One simple legislative change that Texas 21 supports can impact hundreds of thousands of lives down the line: raising the age to buy tobacco products to 21.

Almost all smokers start before age 21. In Texas alone, more than 10,000 kids become daily smokers every year. Lest you think raising the age to buy tobacco products to 21 is a radical idea, six states have already done so, as well as hundreds of cities across the country (including San Antonio in 2018). In fact, more than a quarter of the nation is covered by such T21 legislation.

My home county – Angelina County in deep East Texas – has the dubious distinction of ranking dead last in Texas for health behaviors according to the Robert Wood Johnson Foundation (accessible online at www.countyhealthrankings.org). Our higher than average adult smoking rate is a major factor in that determination. If we are to change the health behaviors of an entire county, we must address some factors more globally. Smoking is one of them.

Raising the smoking age to 21 will not have a big economic impact on retailers, as only 2% of US cigarette sales go to those under age 21. But the long-term impact on our taxes, of which too much goes to smoking-caused healthcare, will be significant. In Texas, Medicaid costs caused by smoking amount to almost $2 billion annually. Total annual healthcare costs in Texas directly caused by smoking reach nearly $9 billion. If fewer kids start smoking, we will – over time – see a significant decrease in smoking-related expenditures. Not to mention that our kids will enjoy longer and healthier lives.

Our children are so vulnerable to influence when they are in their early teens. On average, kids in the US try smoking for the first time even before they are 14 years old. They get their first cigarettes from older teens. Most high school seniors can legally buy cigarettes even before they graduate high school, because the legal age to purchase currently is 18. This gives younger teens easy access to nicotine and tobacco though their peers.

States and cities that have enacted T21 legislation have seen a significant drop in youth smoking initiation. The Institute of Medicine (now the Health and Medicine Division of the National Academy of Medicine) notes that raising the tobacco sale age will not only significantly reduce the number of adolescents and young adults who start smoking, it will reduce smoking-caused deaths and immediately improve the health of adolescents, young adults and young mothers who would be deterred from smoking, as well as their children.

It’s not just about cigarette smoking, though. E-cigarettes must be included in any T21 legislation. The tobacco industry, seeing overall declines in US smoking rates, cleverly (and sinisterly) purchased e-cigarette companies and began refining and marketing these nicotine delivery systems to our kids. Vaping became mainstream.

The power of the tobacco industry to addict people to nicotine is evident in the fact that e-cigarette company Juul – in which tobacco giant Altria owns a large stake – has grown quickly to be worth as much as $38 billion by some estimates. Juul’s annual revenue is said to be $2 billion. Addicting teens with flavors like mango, creme brulee, and mint has resulted in more kids using electronic cigarettes than regular cigarettes. In fact, e-cigarette use among youth is now considered to be an epidemic.

Juul and other vaping devices are not toys. Evidence continues to build that for young people, using e-cigarettes increases the likelihood of smoking cigarettes. Some of the chemicals in e-cigarettes are harmful as well. And the effects of nicotine on developing brains are not fully known. Especially worrisome is evidence that nicotine can cause impaired brain development, especially of the prefrontal cortex, which affects judgement and impulse control. To flavor a highly addictive chemical and sell it to children is not only sinister and dangerous; it is appallingly profitable for the very tobacco companies who have been driving up our healthcare costs killing us with cancer, heart disease, COPD, and many other illnesses for decades.

What can we do right now? Polls show nearly 70 percent of voters across party lines favor T21 legislation. Over half of voters strongly favor it. Sen. Joan Huffman and physician Rep. John Zerwas have introduced Senate Bill 338 and House Bill 749 — both of which include e-cigarettes — to protect kids from tobacco addiction and save lives by raising the tobacco age in the state to 21. This something we can all agree on. Let’s pass T21 legislation in Texas this session.