5th e-Cigarette Death Reported As Illnesses Double

Five deaths from a severe lung illness have now been linked to e-cigarettes. Since an article on the first death was published on Allnurses.com, the number of mystery lung illnesses connected to e-cigarettes has increased to 450, more than doubling from the previous week.

5th e-Cigarette Death Reported As Illnesses Double

On Friday, September 6, 2019, the Center for Disease Control (CDC) warned Americans on the dangers of e-cigarettes after the fifth death from an illness linked to vaping was reported. The five CDC verified deaths occurred in Minnesota, Illinois, Indiana, Oregon and California. In a briefing, the CDC also reported the number of severe lung illnesses connected to e-cigarette increased to 450, more than doubling from 200 in the previous week. The illnesses have occurred in 33 states across the U.S. and the majority were in between the ages of 18 and 25. Read about the first reported death linked to e-cigarettes here.

Narrowing Investigation

Public health officials are finding it a challenge to pinpoint the exact cause of the mysterious vaping illness. However, Dana Meaney-Delman, CDC incident manager, made the following statement during Friday’s press conference, “We believe that; a chemical exposure is likely associated with these illnesses, but more information is needed.” In addition to the harmful substances contained in e-cigarettes, there is also concern surrounding vape products brought on the street or that have been altered by consumers.

Delivery of Illicit Substances

Some e-cigarette products are used to deliver illegal substances and may be obtained from unknown or “street” sources. The products may be modified, increasing the risk of user harm. For example:

  • Single use e-cigarette pods or cartridges can be refilled with illicit or unknown substances.
  • Some e-cigarette products are used for “dripping” or “dabbing”.
  • Dripping: dropping e-cigarette liquid directly into the hot coils of an e-cigarette resulting in high concentrations (i.e. THC and cannabinoid [CBD]).
  • Dabbing: super-heating substances that contain high concentrations of THC and other plant compounds (butane hash oil [BHO], “710” and CBD).
  • The director of the Center for Tobacco Products at the FDA, Mitch Zeller, reports particular concern is also developing around products that have been modified by vaping retailers.

Vitamin E Acetate

New York health officials have identified vitamin E acetate as a potential link between vaping and the recent severe lung illnesses. Laboratory tests conducted at the Wadsworth Center in Albany, New York, discovered very high levels of the chemical in nearly all cannabis-containing vaping products that were analyzed. Each person in New York who became ill with the lung illness and submitted a product to the state has been linked to at least one vaping product containing vitamin E acetate. Some of the vaping products containing the chemical are candy-flavored vapes. In a statement released by the New York State Health Department, a link was provided to images of some of the products found to contain vitamin E acetate (view images here). Vitamin E acetate is not an approved additive for the state’s Medical Marijuana Program-authorized vape products and was not seen in the nicotine-based products tested.

Vitamin E acetate is not known to have adverse effects when ingested as a nutritional supplement or applied to the skin. The chemical is an oil-like substance when inhaled and this is thought to be a contributing factor in the development of lung symptoms.

What is Being Done

The CDC, FDA and state health departments are continuing to investigate whether the illnesses can be linked to specific devices, ingredients or contaminants associated with e-cigarette product use. States are submitting data to the CDC about lung illnesses associated with vaping, as well as the types of e-cigarettes used.

Health providers are being asked to immediately report any possible cases of vaping associated lung illness to their local or state health department for further investigation. Providers should also provide a detailed history of the substances and devices used and when possible, any product devices and liquids should be submitted for testing.

What the Public Should Do

The CDC recommends people consider not using e-cigarettes while the investigation is continued. People who do use these products should consider the following:

  • Monitor themselves for respiratory symptoms, such as cough, shortness of breath, chest pain, nausea, vomiting, abdominal pain and fever.
  • Promptly seek medical attention for any health concerns
  • Do not buy products off the street and never modify devices or add substances not intended by the manufacturer
  • Products should never be used by youth, young adults, pregnant women or adults who don't currently use tobacco products.

If you would like more information regarding the outbreak of severe lung illness linked to vaping, visit this CDC website.

Are the lung illnesses caused by a recent change in vaping products or is it an illness that has existed under the radar? What do you think?

Additional Resources

Vitamin E Suspected in Serious Lung Problems Among People Who Vaped Cannabis

Vitamin E Key Focus in Vaping Illness, Health Officials Say

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J.Adderton

About J.Adderton, BSN, MSN

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J. Adderton MSN has over 20 years’ experience in clinical leadership, staff development, project management and nursing education

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Specializes in Medsurg.

I know as a nurse I shouldn't make judgements.....but this is like drinking a whole bottle of vodka and waking up with a killer hang over. What did these people think would happen? The potency of it is so much more than a cigarette by the looks of the smoke.

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11 hours ago, Snatchedwig said:

I know as a nurse I shouldn't make judgements.....but this is like drinking a whole bottle of vodka and waking up with a killer hang over. What did these people think would happen? The potency of it is so much more than a cigarette by the looks of the smoke.

https://slate.com/technology/2019/09/vaping-illnesses-dont-warrant-an-ecigarette-ban-philip-morris.amp?__twitter_impression=true

Understand that many “vapers” are looking for a safer alternative to smoking and our own government is looking to stifle and eliminate that as a possibility without doing any research at all.

http://www.casaa.org/

educate yourself - don’t be a tool of big tobacco.

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Specializes in Psych, Addictions, SOL (Student of Life).

It doesn't surprise me that these diagnoses are skyrocketing exponentially. The role of vaping and e-cigarette's in the development of obstructive lung disease has been pretty well documented since around 2012 (As shown by 10 evidence based articles I posted in another thread on this topic. ) The CDC after-all is involved in epidemiologic research which looks at morbidity and mortality with a population over time. Now that the CDC researchers know what they are looking for I suspect we will see far more diagnoses related to vaping.

The research that I dug up in just ten minutes of research shows that vaping affects the cognitive development of the teenage brain, contributes to DNA alterations that may cause certain cancers, increases by nearly 100% the development of obstructive lung disease (popcorn lung) in people who have never smoked and more. In fact people are developing this popcorn lung after only a few years of vaping vs development of such conditions after decades of smoking.

Honestly I don't care if people want to vape though I continue to take exception with people who need several 10 minute breaks in a workday for their "fix". Just please don't try to say it's safe.

Hppy

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15 hours ago, hppygr8ful said:

The research that I dug up in just ten minutes of research shows that vaping affects the cognitive development of the teenage brain, contributes to DNA alterations that may cause certain cancers, increases by nearly 100% the development of obstructive lung disease (popcorn lung) in people who have never smoked and more. In fact people are developing this popcorn lung after only a few years of vaping vs development of such conditions after decades of smoking

https://tobaccoanalysis.blogspot.com/2015/12/new-study-finds-that-average-diacetyl.html

"Table 1. Average inhaled daily diacetyl dose associated with smoking vs. vaping
Vaping: 9 micrograms
Smoking: 6718 micrograms."

Despite the much higher levels of diacetyl in tobacco smoke than in e-cigarette vapor, smoking has not been associated with "popcorn lung."

Thus, it is clearly misrepresenting the scientific evidence to conclude that vaping increases the risk of "popcorn lung" or that vaping causes "popcorn lung."

"The authors of the article argue that "due to the associations between diacetyl, bronchiolitis obliterans and other severe respiratory diseases among workers inhaling heated vapors containing diacetyl, urgent action is recommended...".

However, nowhere in the article do the authors recommend that "urgent action" be taken due to the presence of high levels of diacetyl in tobacco smoke (750 times higher, on average, than in e-cigarette aerosol)."

That article wasn't written by an e-cig industry hack - look his credentials over yourself - then compare the histrionics on all of the news articles regarding vaping deaths and injuries posted over the past couple of weeks.

Popcorn lung isn't new news - it's old news being pushed by those with a clear financial incentive to keep people smoking real, taxable cigarettes.

There's another side to "protecting children from vapes".

34 million (adult) Americans smoke - 15% of the population. A measurable number of people have been able to get off of "real" cigarettes with E-cigs, nearly always after trying "approved" methods of quitting. Gum, patches, lozenges & Chantix have a one-year failure rate of 93-97%.

Anything that can possibly help is something that should be thoroughly investigated and encouraged. I'm not advocating on behalf of Juul, as I'm not convinced their motives are pure - but no one needs to advocate for them, as they've done a great job of buying their way into government approval after the government bans all of their competition.

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Specializes in Short Term/Skilled.

Ugh. I'm in MA and presently the brilliant governor has banned all vaping related products for 4 months.

The research is pretty clear, and has been - that these illnesses are tied to the oil based mediums in THC vaping products - mostly iliict ones.

Vodka comes in many flavors, but it's not for kids. Cigarettes kill how many? They weren't banned.

Its better not to start either habit, of course. Certainly if you don't smoke you shouldn't start vaping but for many of us it was a means to an end.

Five years smoke free and if I'm not creative I'll have to go back to smoking if I'm not able to stop vaping. (I won't really do that because I"ll drive to maine if I have to but many will)

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Specializes in Geriatrics, Dialysis.

I think the complete banning of vaping products some municipalities are doing is an unnecessary knee jerk reaction to this issue. The vast majority of vapers that are experiencing illness are being reported as using illegal substances that are obviously not commercially prepared and contain God knows what ingredients besides THC. Dealers will of course purchase cheap equipment and combine their primary product with cheap fillers to increase their profit margin. It's these cheap fillers that are the most likely culprit for causing the health issues.

Punishing the entire industry because of those people that choose to modify the equipment and use them to vape illegal substances is a bit of overkill that is destroying many small businesses. I don't have the same concern for the big tobacco owned businesses like the extremely popular Juul, they have enough big money doctors and lawyers on their payroll to spin this story to fit their narrative. It's the small business owners that opened their vape shop with the expectation of making a living that are suffering with no recourse when local governments jump on the "shut it down" bandwagon without considering the impact.

I'm not saying there is no adverse effect to vaping commercially prepared products, what I am saying is more research and testing should have been done before the situation went this far because we just don't definitively know what those effects are. Allowing an industry to expand to this extent without fully understanding the effects of the product they are selling was never a good idea to begin with but that cat is out of the bag. Seems like the government allowed this industry to proliferate too fast and now all these local businesses are the one's left holding that bag. Definitely more research and testing still needs to be done to determine the long term effects vaping has on the body compared to the effects of smoking traditional cigarettes but in the short term what are these vape shop owners supposed to do when their business goes under and they have no income but still have to pay the rent on a building they can't operate their business out of?

I guess in retrospect it's not surprising that an industry that started as a way to offer an alternative to tobacco to adult smokers took off. I know several adult smokers that used vaping as an effective aid to to quit smoking cigarettes. I also know several adult smokers that supplement traditional tobacco use with vaping, especially when they are in a place where they can't smoke but can get away with vaping. There's even a term for it, "stealth vaping." If adults figured out stealth vaping that quickly why is anybody surprised that kids figured out that trick? I'm still not sure if big tobacco getting involved in the vaping industry is a good thing or not. They have the money and resources to drive further research, but then they also have the money and resources to drive the advertising machine that I am sure played in big part in making these products appealing to a wider audience including teens.

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

Follow the money. Big tobacco has a huge stake in making vaping products illegal. Follow the money.

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On 9/12/2019 at 8:48 AM, hppygr8ful said:

It doesn't surprise me that these diagnoses are skyrocketing exponentially. The role of vaping and e-cigarette's in the development of obstructive lung disease has been pretty well documented since around 2012 (As shown by 10 evidence based articles I posted in another thread on this topic. ) The CDC after-all is involved in epidemiologic research which looks at morbidity and mortality with a population over time. Now that the CDC researchers know what they are looking for I suspect we will see far more diagnoses related to vaping.

The research that I dug up in just ten minutes of research shows that vaping affects the cognitive development of the teenage brain, contributes to DNA alterations that may cause certain cancers, increases by nearly 100% the development of obstructive lung disease (popcorn lung) in people who have never smoked and more. In fact people are developing this popcorn lung after only a few years of vaping vs development of such conditions after decades of smoking.

Honestly I don't care if people want to vape though I continue to take exception with people who need several 10 minute breaks in a workday for their "fix". Just please don't try to say it's safe.

Hppy

5 deaths is an 'exponential skyrocket'? Cigarettes killed more people in the time it took me to type this...

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Specializes in Dialysis.

Inhaling heated gases damages your lungs? No way!

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Recently we had a presentation about these products at my job. It does surprise me how many people were surprised by the consequences of using vaping devices. What scares me is how many children have access to these products.

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Specializes in Supervisor.

I remember when this hit the headlines.

Then Covid...

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