Time to escape from vapes?

Béibhinn Thorsch

With 19 deaths and counting in the U.S alone, and a mysterious vape-induced lung illness to blame, there are many questions and concerns surrounding the safety of vape products worldwide. 

On October 3rd, the U.S Centers for Disease Control and Prevention (CDC) released a report showing that the U.S has seen 1,080 cases of vaping-related lung injuries since March. This number is growing weekly, and has led to 19 deaths. Interestingly, the vast majority of those affected by the illness were men, and many between the ages of 18 and 34.

Symptoms include fatigue, coughing, breathlessness and vomiting or diarrhoea.

A recent analysis of the affected patients showed that 78 per cent of all affected patients had been vaping THC products. Experts, however, say they are unsure if it is THC products alone that cause the issue, saying it could also be nicotine, synthetic cannabinoids, CBD, and/or flavoured e-liquids. 

Speaking to the New York Times, Dr. Brandon T. Larsen said that the biopsies of 17 patients showed “a pattern of injury in the lung that looks like toxic chemical exposure, a toxic chemical fume exposure, or a chemical burn injury.” He went on to say that injuries resembled those seen in people exposed to poisons like mustard gas during World War I.

E-cigarettes arrived in the U.S in 2007, and have remained largely unregulated, allowing black market products to flourish. The Food and Drug Administration (FDA) has been pressed to explain their position, with FDA member Dr. Ned Sharpless saying “We do not think really anyone should be using them other than people using them in place of combustible tobacco.”

The CDC’s principal deputy director, Dr. Anne Schuchat, advised people to steer clear of vaping products, saying “It is pretty much impossible for you to know what is in the e-cigarette or vaping product that you’re getting, particularly THC-containing products bought off the street or bought from social sources.”

Deaths closer to home are not totally unheard of with this illness, as a 57-year-old British man, Terry Miller, passed away in 2010. His widow now says she blames vaping for the lung disease which caused his death. Investigations suggest he had oil in his lungs from vape e-liquid, which triggered lipoid pneumonia (fat-induced inflammation in the lungs). Now, Miller’s death is said to be one of the first possible deaths caused by vaping.

DCU Communications student Renée Mackey spent some time in the U.S over the summer and said she “unintentionally” switched smoking cigarettes in favour of vaping a JUUL vape. JUUL vapes are very popular in the U.S, with a reputation for being marketed to minors.

Mackey said that after a while of using the vape, she began to feel anxious with a racing heart when she was using the JUUL. Mackey does, however, say that she went from smoking 3 cigarettes a day to now not smoking at all. “I think it actually is a good way to get yourself off cigarettes but only if you stop JUULing [vaping] in time before things get bad.” 

JUUL vapes run off of a pod system instead of using refillable e-liquids, and these pods are known to only be available in much higher nicotine concentrations to regular e-liquids. There are many side effects of nicotine use, including dizziness, nausea, and increased heart rate. 

Public Health England conducted a study which found that vaping is about 95 per cent less dangerous than smoking, and many individuals and organisations, such as anti-tobacco charity Ash, have called for e-cigarettes to be licensed as medicines. These movements go as far as to suggest that e-cigarettes be provided for free to smokers trying to quit.

The U.K’s NHS treat e-cigarettes as another form of nicotine replacement therapy, which has been used by many people for a long time as a safe treatment for those who wish to quit smoking. They have found that the liquid and vapour of e-cigarettes contain some potentially harmful chemicals found in cigarette smoke but at much lower levels. Almost all of the harm from smoking comes from the many other chemicals in tobacco smoke, which is not nicotine, but which are toxic. Second-hand vapour also shows no evidence of being harmful to those around you, unlike second-hand smoke which is known to be extremely harmful.

Minister for Health Simon Harris has drafted legislation to ban the sale of e-cigarettes to under-18s, a move which was supported by the Minister’s predecessor James Reilly, in 2014. It is important to note, however, that many e-cigarette retailers already prohibit the sale of their products to under 18s. Also in 2014, the EU proposed that e-cigarettes be banned entirely if three or more member states banned their use in their own countries. 

Minister Harris has openly disagreed with the decision of politicians to invite vaping company representatives to Leinster House. He says he will “never meet them”, and accused large tobacco industry of targeting underage people with the sale of e-cigarettes. Party of the Minister’s draft legislation is also said to include the prohibition of tobacco products from self-service vending machines, and at locations which could be seen as intended spaces for children or children’s events.

Harris has also said that previous legislation which limited advertising of tobacco products, has now led to the advertisements being replaced with vaping advertisements. Harris says that the companies are targeting teenagers from the ages of 14 and up with “nice colourful things” and tempting flavours. 

The minister has also asked the Health Products Regulatory Authority (HPRA) to carry out a review of the health implications for vaping products and e-cigarettes. This report is due back in March. 

The European Parliament approved new regulations for tobacco products, including e-cigarettes. These forbid the advertising of e-cigarettes, set limits on maximum concentrations of nicotine in liquids, limit maximum volumes of liquid that can be sold, require child-proof and tamper-proof packaging of liquid, set requirements on purity of ingredients, require that the devices deliver consistent doses of vapor, require disclosure of ingredients and nicotine content, and empower regulators to act if the regulations are violated. 

It must be noted that it is up to individual EU countries to develop their own laws with the consideration of the European Parliament regulations, as the regulations themselves are not directly effective. 

Professor Linda Bauld, a public health expert at Edinburgh University spoke to Public Health England, saying “There is no situation where it would be better for your health to continue smoking rather than switching completely to vaping, it seems highly unlikely that widely available nicotine-containing vaping products, particularly of the type regulated in Europe, are causing these cases.” 

Public Health England has advised doctors to promote e-cigarettes, advising that vaping carries a small fraction of the risk of smoking.

Worldwide, more than 30 countries ban e-cigarettes outright, while multiple European countries (Austria, Belgium, Germany, Italy) classify them as tobacco products subject to strict controls. In countries such as Ireland, England, and France, e-cigarettes are sold as consumer products and are controlled by more lax rules. 

Béibhinn Thorsch

Image credit: Béibhinn Thorsch