E-cigarette for vaping. Popular vape devices

Vaping controversy has been front and center lately, with the recent news that the CEO of Juul, Kevin Burns, had resigned in September, as an increasing number of deaths related to vaping and threats of federal regulation are presenting a massive challenge for the e-cigarette company.

What was once considered a safe substitute to smoking cigarettes is now just smoke and mirrors. The Centers for Disease Control and Prevention reported that as of September 27, there have been 12 confirmed deaths from vaping in 10 states — California (two), Florida, Georgia, Illinois, Indiana, Kansas (two), Minnesota, Mississippi, Missouri and Oregon. However, the CDC hasn’t identified a particular company or vaping product as being responsible for these deaths.

Walmart also announced that it would no longer sell vaping products, and several other companies are following suit by either banning advertisements for e-cigarette makers altogether or revising their policies for e-cigarette ads. There’s still a lot of unknowns about the dangers and risks of vaping. Find out what it does to the lungs, what’s changed about the science and safety, and whether it’s still OK to take a puff of this so-called cigarette alternative.

Where there’s smoke Vaping, whether nicotine-containing or nicotine-free, can do significant damage to the lungs, according to Salem, Ohio-based family physician Dr. Mike Sevilla, who specializes in public health and environmental factors that influence a person’s health.

“It’s not only the nicotine but also the toxic chemicals in the e-cigarettes, with names like propylene glycol, vegetable glycerin, acetaldehyde and others,” Sevilla said. “I don’t think vaping was ever considered safe. Vaping was considered an alternative treatment for adults to stop cigarette smoking. The potential dangers of vaping have been discussed ever since the products were introduced on the market. What’s changed? The number of lung-related injuries and the deaths reported have definitely raised the importance of studying vaping more closely than ever before.”

The ailment that’s causing deaths in the United States is focused on the lung area, Sevilla says.

“The CDC, clinicians and researchers are frantically investigating the exact pulmonary illness that is causing these illnesses,” he says. “Current theories are now pointing to either an infection process or overwhelming inflammation of the lung which causes breathing problems, and regrettably, in some cases, death.”

Katharine Van Tassel, an expert on vaping and how it relates to the Food and Drug Administration, as well as a visiting law professor at Case Western Reserve University in Cleveland, said two different public health crises are occurring at the same time, and it is important to separate these from each other.

The first involves the hundreds of probable cases of acute respiratory distress syndrome and the numerous deaths related to this illness associated with the use of vaping products. The second involves youth vaping of nicotine products, she says.

“E-cigarette use increased from 11.7 percent to 20.8 percent among high school students and from 3.3 percent to 4.9 percent among middle school students from 2017 to 2018,” Van Tassel says, citing FDA research. “No change was found in the use of other tobacco products, including cigarettes, during this time. This use by children and teens is especially concerning because the developing adolescent brain is particularly vulnerable to nicotine addiction.”

‘Shouldn’t be used for fun’

Across the country, people who vape are experiencing illnesses that include nicotine addiction, anxiety, seizures, weight loss, nausea, vomiting, breathing problems and, of course, lung issues. Because the epidemic is new, it can be difficult to decipher the potential long-term health consequences. It typically takes decades for a cigarette smoker to develop lung cancer, so it may take decades to understand the full consequences of vaping.

“There is not even a definite list of symptoms to look out for,” Sevilla says. “At this point, there is no link between vaping and lung cancer, but more research is needed.”

To date, the FDA and the CDC have not been able to identify the cause of the illnesses, according to Van Tassel.

“Both agencies have stated that it appears likely that a contaminant is causing the illnesses,” she says.

Alex Berezow, vice president of scientific affairs at the American Council on Science and Health, a research and education nonprofit organization headquartered in New York City, said the recent concerns over illnesses and deaths linked to vaping are legitimate. But keep in mind that “most cases seem to be linked to improper use of vaping devices,” he says.

When used properly, vaping still has drawbacks, he says.

“Long-term use is probably going to cause respiratory diseases, like popcorn lung. Vaping is addictive because of the nicotine,” he says. “Really, the only pro is that vaping is 95 percent less harmful than smoking, but it’s more harmful than breathing fresh air. So it’s a good tool to help smokers quit cigarettes.”

Berezow adds some cautionary advice for skeptical vapers: “Only smokers should use e-cigarettes, which should be thought of as medical devices to help smokers quit. Nobody else should use them. They shouldn’t be used for fun,” he says.