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Posted By: Daniel Thibodeau, MHP, PA-C
October 04, 2019
Most of us have seen the recent news regarding the alarming rise of respiratory-related illnesses and deaths due to e-cigarettes, or vaping. For those not aware of the growing trend, electronic cigarettes are battery powered "cigarettes" that are used to inhale drugs—typically this drug is nicotine, but there are many varieties containing other, often unknown, chemicals. The Centers for Disease Control and Prevention (CDC) issued a statement on September 6th entitled, Initial State Findings Point to Clinical Similarities in Illnesses Among People Who Use E-cigarettes or "Vape". The piece reports that these illnesses are occurring in individuals who have used electronic cigarettes containing THC-related products, nicotine-containing chemicals, or both. More than 36 states have reported similar instances, with deaths confirmed in six patients and over 380 confirmed illnesses. The CDC's statement is directed at both the medical community and the public in an effort to raise awareness about these concerning findings despite not knowing their exact etiology. One thought is that oils that contain vitamin E could be a culprit, as several studies suggest that vitamin E may be harmful to the respiratory tissue.
The statement from the CDC should cause considerable alarm to the medical community. All states have given authority to sell these products, and only 18 have restrictions on keeping vaping activities outdoors. While research related to vaping and its effects on the human body remain limited, over the last couple of years it has caught the eye of researchers looking to determine its health effects and safety, both acutely and in the long term. As practitioners, we all must remind ourselves to ask patients not only about tobacco use, but also about electronic cigarette use. In addition, we must consider that patients may not be purchasing products that are manufactured with regulations, but are instead found on the street. This adds to the complexity of managing patients, since they are not always aware of the chemical profile of the e-cigarettes if they are purchased on the street. The potential for addiction may be high, especially for those choosing to use e-cigarettes containing nicotine.
Difficult times are ahead of us as we work to navigate the dangers of vaping. We have an obligation to protect the public and to inform our patients of these dangers.
- Centers for Disease Control and Prevention. Estimated influenza illnesses, medical visits, hospitalizations, and deaths in the United States — 2017–2018 influenza season. www.cdc.gov/flu/about/burden/2017-2018.htm. Accessed September 9, 2019.
- Miller, S. Vitamin E may worsen acute respiratory tract infections in the elderly. J Fam Pract. 2002;51:912-926.
- National Institute on Drug Abuse. Electronic cigarettes (e-cigarettes). www.drugabuse.gov/publications/drugfacts/electronic-cigarettes-e-cigarettes. Accessed October 1, 2019.