You may have seen in the news last week that there has been an outbreak of mysterious respiratory illnesses and sudden deaths linked to vaping. Many of these cases are very serious. If you Juul, use e-cigarettes, or vape marijuana of any kind, I encourage you to keep reading this article. Your health, safety, and well-being are extremely important.

Vaping is a fairly new phenomenon that has sky-rocketed in popularity in just a few short years. Teenage use rates have increased so rapidly that the commissioners of the FDA, CDC, and health organizations across the country have been calling it a public health epidemic. There are a variety of new nicotine vaping products such as Juul, Blu, or Mojo. Additionally, the legalization of marijuana has introduced a variety of new vaping devices which can be purchased on-line and in dispensaries.

The problem with vaping is that it is new, and there is little scientific research or data to inform us about the potential impact on health. We know that both nicotine and marijuana impact the developing brain and lead to addiction. But, what are the other risks associated with inhaling heated vapors through an electronic metal device?

The caution against vaping has taken on a new urgency this week as doctors nationwide are attempting to understand a sudden spike in ER admissions for patients experiencing life threatening respiratory illnesses. Most are young, male, with a median age of 19. Most are very sick. Many require life support. In every case the patient reports having habitually vaped nicotine, marijuana, or both. As of last Friday, 450 cases of vaping illness spread among 33 states. These reports are accelerating rapidly. Currently, five individuals have died.

According to the CDC, patients experience gradual symptoms including breathing difficulties, coughing, and chest pain. Other symptoms may include nausea, vomiting, and fatigue. The symptoms and chest X-ray initially resemble pneumonia but worsen rapidly.

Officials are trying to determine what causes this illness. Although there are no definitive answers, they believe that one of the many chemicals added to vape liquids in both marijuana and nicotine might be to blame. So far, the FDA has found the same vitamin E acetate in several of the products vaped by those afflicted with the illness. Officials are researching this possibility but have not reached conclusions at this point.

Products containing cannabis are regulated by individual state’s Cannabis Control Commission. The commission requires tests for pesticides but they set no restriction on ingredients used to flavor or cut the thick marijuana extracts in vaping products. Cutting agents known as diluents are mixed with cannabis extract to create a consistent liquid that has the proper texture to be vaped. Some known additives include propylene glycol, vegetable glycerin, mineral oil, or medium-chain triglyceride (MCT) oil to name a few. Officials know that there are many other chemicals that are being added to vape oil cartridges. These additives are the center of the current investigation.

Massachusetts also does not regulate vaping cartridge hardware. Lab tests and media reports indicate the heating coils used in less expensive, cheaply made vapes come from abroad, where manufacturing practices are sub-standard. These devices, when heated, can leach heavy metals into the vapor that is inhaled by the consumer.

Similar concerns exist for nicotine-based e-cigarette liquids and devices. The FDA has yet to create regulations that test and monitor e-cigarette vape products. Most of the e-cigarette market is currently operating without official regulations. Companies can use additives, flavorants, and chemicals in e-liquids without any official oversight from a regulatory authority. It is believed that these unknown chemical additives could be contributing to the serious respiratory illnesses being reported nationwide.

Joy LaGrutta, coordinator of Alcohol & Drug Education, Framingham State University 

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