US Medical Experts Answer Six Major Questions About Vaping

On October 14, according to the Daily Herald, to help clarify the rumors and facts surrounding vaping, Dr. Adam Posner, a board-certified lung disease expert at NorthShore University HealthSystem, answered some questions for the Daily Herald.
 
When e-cigarettes first became popular, they were touted as a safer alternative to smoking. However, in recent months, 26 people have died and hundreds have fallen ill due to mysterious vaping-related lung diseases.

As of Thursday, October 10, the Centers for Disease Control and Prevention reported 1,299 cases in the U.S. Almost every state has reported vaping-related injuries, with confirmed deaths occurring in 15 states, including Illinois. More deaths are under investigation.

Anne Schuchat, the CDC's principal deputy director, stated in a briefing to reporters on October 3 that the median age of the deceased patients was about 50, ranging from people in their 20s to those in their 70s.

Dr. Adam Posner, a board-certified lung disease expert at NorthShore University HealthSystem, answered some questions about vaping for the Daily Herald.

Posner has expertise in the diagnosis and treatment of lung diseases and has treated patients who became ill after vaping. He also has extensive clinical experience regarding how smoking affects health and is board-certified in critical care and sleep medicine.

1. Q: For those who don’t know, can you explain what vaping is?

A: Vaping involves using battery-powered devices to heat liquids or oils, then inhaling the resulting vapor into the lungs. It is a way to deliver desired substances (nicotine, THC, CBD) into the user's bloodstream.

2. Q: In recent months, hundreds of people have suffered dangerous respiratory injuries due to vaping. What are the symptoms of this illness? What happens to the lungs of affected individuals? What commonalities have been found among those who have fallen ill (or even died) due to vaping?

A: Patients have exhibited symptoms such as coughing, shortness of breath, and fever, similar to pneumonia. In other cases, nausea, vomiting, or diarrhea have also been prominent.

At this point, the cause of this illness is unclear. There is suspicion that vitamin E oil added to cannabis extracts is causing lung damage. A recent letter to the New England Journal of Medicine reported a series of cases from the Mayo Clinic where this lung injury was not identified. They found damage similar to chemical burns.

Most cases seem to be associated with vaping cannabis (THC or CBD), but this is not definitive. Many patients also reported nicotine use. Some patients reported only nicotine use.

Many cases are linked to illicitly produced cartridges, but there have been reports of patients using only legally manufactured products.

3. Q: Were there any warning signs before the recent outbreak indicating that vaping could severely harm the lungs?

A: Before the recent outbreak, there were other lung diseases caused by vaping. Some of these are believed to be related to flavoring agents added to nicotine e-cigarette products.

These conditions are similar to popcorn lung, which is caused by inhaling diacetyl (a butter flavoring used in microwave popcorn). These diseases were initially found among workers in manufacturing plants. Home consumers typically do not encounter enough diacetyl to cause this disease.

Flavored e-products may contain enough diacetyl to cause this disease in some users.

4. Q: Are there any misconceptions or incorrect rumors about this vaping-related illness?

A: Currently, any claims of authoritative information are not accurate. As of now, the cause of the illness is unclear.

We do not know what products are involved. We do not know if nicotine or cannabis products are to blame. We do not know if the responsibility lies with legally or illegally produced cartridges.

The latest Mayo Clinic report raises the possibility that the heating devices themselves may release toxic chemicals during use.

5. Q: In terms of addiction and health risks, how does traditional smoking compare to vaping? Do medical experts know what the long-term effects of vaping are, or is it too early to tell?

A: Traditional smoking involves the combustion of dried plant material. This releases a large number of chemical compounds, many of which may be toxic or carcinogenic. The idea behind vaping is to extract only the desired chemicals (nicotine, THC, CBD) and deliver only those chemicals. This outbreak clearly shows that vaping cannot achieve this goal.

All addiction issues related to these substances are the same whether smoking or vaping. The accessibility of nicotine and the high concentrations of nicotine may make nicotine e-cigarettes more addictive than traditional smoking.

We already know the long-term health risks of smoking. We are now discovering the short-term health risks of vaping, and it may take years or decades to understand the long-term health risks of vaping.

6. Q: What advice do you have for those who use e-cigarettes on how to use them safely?

A: The only responsible advice is not to smoke or vape. There is no way to inhale smoke or heated vapor without the risk of lung damage.

If someone is currently smoking or addicted to nicotine, they should consult a doctor for safe smoking cessation methods. Using patches or gum to replace nicotine is a safe way to deliver nicotine without using the lungs, and there are other medications that can help reduce cravings during the quitting process.