Recent research suggests nearly 11 million people vape in the U.S. alone.
s of Oct. 1, the Centers for Disease Control and Prevention had logged 805 cases of lung injury related to vaping nicotine and cannabis products, and 12 deaths.
Eight of those cases — six of which led to hospitalizations — were confirmed by the Colorado Department of Public Health and Environment as of Sept. 25. None of Colorado’s cases has resulted in death.
State and federal agencies don’t know what’s causing the mysterious illness. While 77 percent of patients reported vaping THC, the psychoactive component of cannabis, officials haven’t tied the outbreak to a specific product or substance, and urge the public to “consider not vaping” until they have answers.
Meanwhile, the governors of Massachusetts, Michigan, New York and Rhode Island have issued emergency bans on flavored e-liquid or all vaping products.
Such actions have far-reaching effects. In the U.S. alone, recent research suggests nearly 11 million people vape, many in an effort to stop smoking traditional cigarettes.
Colorado Gov. Jared Polis, a Democrat, has directed CDPHE to “fully investigate the ongoing outbreak of vaping illness,” according to a department spokesperson. The state hasn’t indicated it’s about to take any actions on the level of an outright ban.
But some local business owners worry the national vaping scare could trigger government actions that unfairly target their products, which they hold to high standards. At the same time, local health officials warn that in Colorado — where the teen vaping rate is higher than in any other state — stricter regulations of the emerging industry represent the best solution.
What happens next is anyone’s guess.
“No consistent vaping
product, substance, or additive has been identified in all cases, nor has any single product or substance been conclusively linked to the lung disease in patients,” cautions Dr. Daniel Shodell, deputy director of the Disease Control and Environmental Epidemiology Division at CDPHE, in a statement provided to the Indy
Of the people confirmed to have had vaping-related illnesses in Colorado, two reported vaping both nicotine and cannabis products. Another three reported nicotine only, and three said they only vaped cannabis.
Also of note: The median age of those who fell ill was 18 in Colorado. The vast majority of patients affected nationally — 78 percent — are younger than 35.
“While we can’t pinpoint the specific cause of these serious lung illnesses, we do know vaping products are poorly regulated and may contain or generate chemicals that are unsafe, potentially making people sick,” Shodell says. “There’s even less certainty about what’s in unregulated vaping products, regardless of whether the vapes are being used for nicotine, THC, CBD, or even just flavoring.”
Bob Wirth, director of manufacturing for Springs-based Shatter Batter LLC, has his own theory: The vaping illness is caused by products made at home or purchased off the black market.
“These are either cloned products — like people trying to make it look like a legitimate product and adulterating them — or people just trying to find a cheap way to roll something out to the public, and they’re getting sick from it,” Wirth believes.
Shatter Batter sells a flavored emulsifier product that can be added to concentrated THC or CBD (a non-psychoactive component of cannabis) to make it vapeable. According to Wirth, the company uses only ingredients that have a “Generally Recognized As Safe” or better designation from the Federal Food & Drug Administration.
Wirth says he’d never add unsafe ingredients such as Vitamin E, a component of some adulterated vape products, to Shatter Batter.
“I use the product myself and have for years. My girlfriend does, my kids do,” Wirth says. “... If there was a doubt that we were, you know, had anything to do with this [illness], I’d close my business.”
Ray Behrman owns
Hookah Emporium, which sells e-cigarettes and e-liquid along with hookahs and shisha tobacco. When he first started selling vaping products in Colorado Springs around 10 years ago, Behrman “used to be one of the only guys in town selling e-cigarettes.”
“Now there’s a guy on every corner, it seems like,” he says, and vaping products account for around 30 percent of Hookah Emporium’s sales.
Since vaping arrived on the national market, the FDA has struggled to adopt a definitive approach to regulating the swiftly growing industry.
The FDA published a rule in August of 2016 that gave its Center for Tobacco Products regulatory authority over all e-cigarettes, vapes, e-liquids, e-cigars, e-pipes and e-hookahs. That rule also made it illegal to sell any such products to customers younger than 18.
But regulation of the products themselves is still relatively new.
As of June 2019, manufacturers of e-liquid and vaping products have had to register their products with the Center for Tobacco Products and submit ingredient lists. All tobacco products (which now include e-liquid and vaping devices) must also apply for premarket authorization, but the FDA deferred enforcement of premarket review requirements for e-cigarettes and e-liquid until May 2020 to give smaller companies more time to comply — review can cost up to $466,000 per product, according to the FDA.
Behrman says he agrees with keeping e-cigarettes out of the hands of minors, and even supports raising the age limit to purchase vaping products to 21.
But he worries that banning the products altogether in the face of an outbreak is the wrong answer: “If the federal government or the FDA throws a blanket ban on e-cigarettes nationwide ... people will start going to black market outlets and backyard brewers to get their e-liquid or whatever they want, and then you have a less reputable product.”
Or, he adds, they could switch back to cigarettes.
“There’s tons of carcinogens in a regular cigarette,” he says. “So it would be a step backward into the dark ages.”
But vaping products
are far from healthy, and they aren’t recognized by the FDA as a safe alternative to cigarettes, says Dacia Hudson, program manager for El Paso County Public Health’s Tobacco Education and Prevention Partnership.
Hudson says 44 percent of children in El Paso County have tried an e-cigarette.
“We know that nicotine affects the developing brain among teenagers,” she says. “It affects their cognitive ability, their decision making, their social and emotional well-being.”
While Hudson’s program focuses on prevention strategies, she points to free resources available for adults and children dealing with nicotine addiction. The Colorado QuitLine recently lowered its age limit to 12 in an effort to combat the vaping epidemic, meaning that although minors can’t receive quitting aids like nicotine gum, they can speak to a trained quit coach by calling 1-800/QUIT-NOW (1-800/784-8669).
As for the health effects of vaping, few conclusive studies have pointed to long-term risks for adults — partly because vaping hasn’t been around very long. Public Health England released a review in 2018 saying e-cigarettes were “at least 95 percent less harmful” than cigarettes, but the FDA hasn’t approved vaping as a smoking cessation tool.
Does vaping cause cancer? The American Cancer Society has this to say about e-cigarettes:
“Scientists are still learning about how e-cigarettes affect health when they are used for long periods of time. It’s important to know that e-cigarette vapor contains some cancer-causing chemicals, although in significantly lower amounts than in cigarette smoke.”
Hudson hopes Colorado Springs will raise the smoking and vaping age to 21, or institute a ban on flavored products like Aspen and Boulder have done.
“We don’t know the lasting effects, just like we didn’t with traditional tobacco products,” she says. “...I would hope that we wouldn’t want history to repeat itself in that in 40 years, we’re seeing some serious, serious health conditions caused by these devices.”