The sudden appearance of a deadly lung disease associated with vaping is concerning, especially given the surging popularity of vaping among teenagers.
But we need to keep our wits about us. A blunt-force ban, fuelled by fear, won’t have the effect we want.
So far, 450 people in the United States have been sickened, including five who have died, owing to this mysterious vaping-related illness. By contrast, though, there are 480,000 smoking-related deaths annually and 16 million Americans living with tobacco-related illnesses. For people who smoke combustible cigarettes, switching to e-cigarettes remains a sound health move; vaping is still, by every measure, the lesser of two evils.
However, non-smokers should not take up vaping any more than they should take up smoking. Breathing unadultered air – which is 21 per cent oxygen and 78 per cent nitrogen – is of course better than inhaling smoke or vapour containing a toxic stew of chemicals.
But people inhale and consume all kinds of things they probably shouldn’t: Coke, chips, Oreos, beer, Big Macs, pot – the list goes on.
Even the air we breathe is full of toxic chemicals, particles and heavy metals because of emissions from automobiles and factories, forest fires and consumer products, such as insecticides, and hair sprays.
The role of public-health officials and regulators is to ensure the air we breathe and the products we consume are relatively safe and to help people to minimize the harm they do to themselves.
So while the yet-unnamed vaping-related illness is still an epidemiological puzzle, some clues are emerging about the source of illness.
Last week, the New England Journal of Medicine published a study of 53 patients in Wisconsin and Illinois who suffered severe lung disease that appeared to have been caused by vaping.
The most troubling aspect of the study is that the patients were young and healthy – the median age was 19 and one-third of them were under 18. They got sick quickly and violently, with acute respiratory distress, chest pain, vomiting, diarrhea, and in many cases, lipoid pneumonia, a rare condition where fat molecules accumulate in the lungs. One in three ended up on respirators.
The large majority of those studied, 84 per cent, vaped THC (a psychoactive ingredient of cannabis), and 61 per cent vaped nicotine. The most likely cause of the illnesses seems to be some sort of adulterant in vaping liquid – an organic compound or heavy metal – that is causing a dangerous immune reaction.
A common trait of those with vaping-related illness is that they purchased their e-cigarettes or vaping liquids on the black market.
More than anything else, the outbreak demonstrates the need for effective regulation. If people are going to vape, they should know the ingredients in the products they purchase. They shouldn’t be able to unwittingly buy poison. But right now, people buying THC and nicotine liquids online are guinea pigs – and some of them are paying the price with their health and their lives.
That’s why people who are calling for vaping to be banned are misguided. All that will do is send people to the black market.
The emergence of a mystery illness has focused attention anew on the meteoric rise of vaping among teens, a phenomenon that has generated a lot of concern, along with some hysteria.
A December, 2018, survey reported one in five U.S. high-school seniors had vaped nicotine in the previous month; by comparison, only one in 20 adults use e-cigarettes.
Yet, the purchase of vaping cartridges and liquids like THC is already banned for teenagers. A ban has done nothing to protect them; in fact, the data on those who are falling ill, many of whom were daily vapers, reminds us that teens are readily buying products online.
Young people who want to get their hands on alcohol, cannabis, tobacco, vaping products and any other drugs are going to do so, one way or another. What we need to do is adopt a harm-reduction mindset.
Instead of easily dismissed cries that vaping must be prohibited, we need to warn users about bootleg products from dubious sources, about using substances not intended by the manufacturer (like using butane hash oils known as “dabs” in nicotine devices), and to encourage users not to modify their devices. And when we unravel the source of the current spate of illnesses, we must add those warnings to public information.
As unsatisfying as it may be for those who want to use this outbreak to justify draconian measures, the reality is that education and regulation always work better than prohibition.
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