Outbreak of Lung Illness Associated with Using E-Cigarette Products

https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html

by colund • 7 years ago

56 64 7 years ago

newbrict• 7 years ago

Recommendation is to not use e cig until they finish investigating but I wonder if a real cig is a worse alternative still?

JohnJamesRambo• 7 years ago

It’s hard to imagine anything worse than a real cig with regard to the wide scale negative effects it has on nearly every system in the body. Maybe inhaling plutonium. :)

lightedman• 7 years ago

You already inhale polonium when you smoke a regular cigarette. :)

dtech• 7 years ago

Whelp, there go my plans of pissing off Putin

Aloha2• 7 years ago

The most harmful part about cigarettes is inhaling byproducts from something burning. I'm even mildly allergic to pretty much every vape product, and I'd acknowledge that provided there is nothing toxic in vape juice, it has to be much less harmful than smoking - simply because of the lack of combustion products.

Barrin92• 7 years ago

i said right at the beginning when people were starting to recommend e-cigarettes as a replacement for cigarettes that they should keep the good old 'unknown unknowns' in mind and that a recommendation without knowledge of long term risk is dangerous.

This should maybe be a general lesson when people advocate unproven replacements for unhealthy habits.

devoply• 7 years ago

at the same time it's entirely possible if not likely the issue is with some additive which needs to be banned and all other additives highly regulated and logged so these sorts of issues can properly be attributed to those problematic additives.

EpicEng2• 7 years ago

Yet all we know is that these people vape and many of them were vaping black market THC oil with high levels of vitamin E. An estimated 10M people vape in the US and here we have an acute health issue with a few hundred people.

https://www.nbcnews.com/health/vaping/vitamin-e-now-focus-in...

mattmanser• 7 years ago

Right now there are literally 100s of millions of people vaping.

A small percentage of Americans, who mainly smoke THC, are suffering.

Sounds like someone in America is doing something dodgy.

joezydeco• 7 years ago

To be clear, only a small percentage are showing critical damage (breathing trouble, death).

What percentage is not showing life-threatening issues yet, but are slowly building up accumulated damage?

ocdtrekkie• 7 years ago

Bear in mind their invention was, I believe, a positive. That by adjusting the nicotine in the vape you could ease off smoking. The goal was not for vaping to become a cool thing to do. (Although I'm certain once e-cig companies realized the market they were encroaching on, they capitalized as capitalists do.)

inimino3• 7 years ago

Same. Call me in 50 years when they've had as long to examine the effects of vaping as we needed to definitively establish the lung cancer link to smoking. It amazes me that people hear "no known, proven side effects" with a technology that never existed before and read that as "safe".

EpicEng2• 7 years ago

The alternative for most is cigarettes. Do you really believe that vaping is worse than that? Are you going to wait another 30 years before picking up a cell phone? What about GMO's? New medicines?

Waiting to prove a negative is a silly stance when you know the alternative will kill you and severely lower your quality of life until that day comes.

d1zzy• 7 years ago

If we replaced large increasing lung cancer rates with acute respiratory issues for some people vaping fake products I say we're much better off.

h2odragon• 7 years ago

Pretty certain I've had lipid pneumonia through vaped bad oils; but the gastrointestinal involvement and elevated heart rate and white blood cell count sound like there might be something more specific happening? Please someone educate us further?

todipa• 7 years ago

I'm not a doctor but are there any theories on how one might die from vaping?

thompo4• 7 years ago

I have asthma. Even legal dispensary bought THC cartridges put my lungs in such a bad spot that my rescue inhaler barely brings relief. If I wasn’t well aware of that and hit one a dozen times over the course of the day I would be in serious trouble.

thompo4• 7 years ago

I have asthma and have lived in Denver since before legalization.

When vape pens first came out I never had any issues. In the last few years I very well could have easily been one of those statistics.

Vape pens make my lungs hurt and I have to use my rescue inhaler for days afterwards. It’s terrible. I don’t know if they changed how they make the oil but I completely gave up on vaping. I tried one with pineapple flavoring and man... it almost was the death of me.

gtirloni• 7 years ago

Shouldn't any kind of smoking be a big no-no with ashtma? Really curious because I have rhinitis and can't stand smoke around me.

thompo4• 7 years ago

I mean, probably. Cigarettes make me hurt (haven’t smoked one in a decade at least). Vapes make me hurt. Smoking weed from a clean pipe gives me almost zero negative effects unless I smoke significantly more than usual over the course of a few days.

jcampbell1• 7 years ago

You are having a reaction to nicotine salts. Juul started the trend of using nicotine-salts rather than nicotine. It has much less throat burn so you can get a higher dose, but it makes some people wheeze.

thompo4• 7 years ago

Sorry I should have been more specific. I only vaped THC.

rconti• 7 years ago

Sorry, but I had to back up and re-read this. I guess I just assumed you were exposed to second-hand vapor, so I was very sympathetic to your plight (and quite shocked that you could detect the change in second-hand vapor!) until I got to "I completely gave up on vaping". My mis-reading of the post actually had me laughing out loud.

akira2501• 7 years ago

I've never used the pens and only use a "mod" with nicotine base mixed with 50% VG/PG at a local shop and haven't had any issues. In fact, I use my rescue inhaler far less since I've started vaping, which I only picked up after 3 years of being unable to quit the nicotine lozenges I originally used to quit cigarettes.

All the recent fear aside, I think we can form and do deserve a well regulated market for these products.

golemotron2• 7 years ago

I am not surprised at all, and I'm surprised that anyone is surprised. The idea that one can breathe particulate or droplet matter into their lungs without causing problems seems absurd on its face given everything we've known about the effects of air pollution for decades. Tobacco is not special.

brokenmachine2• 7 years ago

The more I read the comments of any discussion about e-cigarettes, the more I am convinced that there is a dedicated astroturfing campaign so any real discussion of the possible risks of e-cigarettes is derailed.

Any suggestion that e-cigarettes could be dangerous at all is instantly downvoted into oblivion or shouted down with, "you want me to smoke? It's deadly!"

Well, either a dedicated campaign or just a lot of addicts with their head firmly buried in the sand.

Is there any real chance that e-cigs could be more dangerous, or comparable to smoking? Would we even know yet? It can take decades for smokers to start developing bad symptoms, could vaping be similar?

golemotron2• 7 years ago

It's possible. I would go further and say that the idea that smoke and vapor -of any kind- might not be great for your lungs is also suppressed by people who want marijuana legalized. I'm one of them, but the idea that breathing non-gaseous things doesn't have negative health effects is just weird.

merricksb• 7 years ago

Related discussion yesterday:

https://news.ycombinator.com/item?id=20899523

aclimatt• 7 years ago

Let's fast forward a few years from now to the point where we determine that e-cigarettes contain some sort of cancer or lung disease-causing product / additive, just like we figured out with cigarettes decades ago.

What I don't understand is why the FDA will not outright ban them immediately. (Well I probably do, and the answer is lobbying.)

Regardless of your stance on whether or not the FDA _should_ ban ingredients that pose health risks (government intervention on liberties et cetera), the fact is that this is the FDA's policy. It bans harmful ingredients (usually).

So with that policy in place, what's the deal here? If and when e-cigarettes are found to contain a chemical that is directly linked to cancer or lung disease, will the FDA ban it? Or will it conspicuously let it slide, and just slap a warning on it, like it did cigarettes?

https://www.fda.gov/cosmetics/cosmetics-laws-regulations/pro...

https://www.fda.gov/food/food-additives-petitions/food-addit...

inimino3• 7 years ago

It's probably better not to create a black market for an existing, addictive product by banning it outright.

jdietrich2• 7 years ago

There's no evidence that any of the ingredients of e-cigarette vapour are significantly carcinogenic. That may well continue to be true; there is no natural law saying that a habit you dislike must be carcinogenic.

There are many possible formulations of e-cigarette liquid, with the only common factor being nicotine. We are extremely confident that nicotine isn't carcinogenic, although it may cause mild cardiovascular harm. If we find out that some of the other ingredients in e-cigarette vapour are toxic or carcinogenic, the industry will voluntarily stop using those ingredients immediately; they already did so with diacetyl.

sosilkj• 7 years ago

"We are extremely confident that nicotine isn't carcinogenic"

I would not say that's the case. This article is a good place to start:

https://tobacco.ucsf.edu/cellular-evidence-how-nicotine-and-...

algaeontoast• 7 years ago

Lungs were made for air, not smoke or atomized vapor (aside from drugs meant to be administered as a vapor).

Is this really that hard for people to figure out?

washadjeffmad• 7 years ago

air, not ...

Relevant: https://simple.wikipedia.org/wiki/Air

kyriakos• 7 years ago

Is it worse than regular smoking? or how about the new IQOS type?

Obviously not smoking is the best option but assuming smokers will continue smoking even knowing the risks - which is the case unfortunately for a big majority, i believe the best thing to do is give them a way to get their fix that poses the smallest risk.

leephillips2• 7 years ago

Surely there are several ways to deliver nicotine that are far safer than electronic cigarettes. There is mounting evidence that these are worse than tobacco.

hnarn6• 7 years ago

Disclaimer: I'm Swedish so I guess you could say I'm culturally biased, but I have no economic interest in this.

You can always try "snus". Snuff has a bad rep in the US because of the association with chewing tobacco and old westerns, but snus in a pouch under your lip is actually very hygienic, easily disposable, practically invisible and obviously spares your lungs, while still giving you a nicotine buzz.

Obviously no way of consuming nicotine is risk free, but I use it every now and then and I enjoy it, especially with beer or coffee.

I think Swedish Match is attempting to market snus in the US under the "General" brand[1], might be worth checking out if you want to try an alternate way of consuming tobacco.

[1] https://www.generalsnus.com

jdietrich2• 7 years ago

There is mounting evidence that these are worse than tobacco.

No there isn't. The evidence overwhelmingly indicates that e-cigarettes are far, far safer than any form of tobacco.

https://www.gov.uk/government/publications/e-cigarettes-an-e...

Torok• 7 years ago

As others have said this "outbreak" is likely due to dodgy thc capsules so doesn't impact anyone but a very niche group

Havoc2• 7 years ago

Bit confused how they've got 450 cases but no certainty?

Surely 1 out of 450 has a sample left that can be tested thoroughly?

dmix3• 7 years ago

Hasn't stopped them from making completely generic recommendations against vaping when most information points to specific kinds of THC pens.

Havoc2• 7 years ago

Well no. As I pointed out in another comment. All have vaping in common...only some have THC associations (with some allowance for underreporting).

So they're right to ere on the side of caution here. The CDC isn't exactly incompetent...if they could pin this down to THC pens only they would.

I do think you're right in that this is probably some dodgy THC solvent, but based on current known info I think CDC called it cautiously...but right.

mistermann• 7 years ago

The way this is being reported, I feel quite confident that this is some sort of a deliberate propaganda campaign.

The two biggest red flags for me:

1) Language used in official press releases, weasel wording like:

a) "over 450 possible cases of lung illness associated with the use of e-cigarette products"

b) "The investigation has not identified any [single - my addition] specific substance or e-cigarette product that is linked to all cases. Many [how many? do you have no statistics on that? why?] patients report using e-cigarette products with liquids that contain cannabinoid products, such as tetrahydrocannabinol (THC)".

It seems written in a manner to maximize plausible deniability, hinting at one thing strongly [but not saying it outright], and making an extremely subtle acknowledgement of alternative causes [in the spirit of professionalism and "full disclosure"], but not reporting the magnitude of the "many", which could very well be 100%.

That's the beauty (and shortcoming) of written language for communication - when something is written in a seemingly deceitful style like this, there's no way for sure of knowing whether it is accidental or not. Unnecessary vagueness from a facts based organization like the CDC and #2 (below) make me lean strongly towards the deliberately deceitful interpretation.

2) Vaping has been extremely widespread for years, with few reports like these. And then out of the blue, 450 cases (5 deaths) occur in one country. No curiosity whatsoever about why everything is fine for years and then a massive spike in a very short period of time, in one country.

I could very well be wrong, but I will make a prediction: this will play heavily in the media for a few more weeks and then subtly degrade to a "gee, we don't really know what the real issue was, but our research is ongoing", and we won't hear about it again.

EDIT: From another HN comment:

--------------------------------------------------

https://www.health.ny.gov/press/releases/2019/2019-09-05_vap...

New York State Department of Health Announces Update on Investigation into Vaping-Associated Pulmonary Illnesses

Department Warns Against Use of Black Market Vaping Products

Lab Test Results Show High Levels of Vitamin E Acetate, Now Focus of Investigation

The Department issued a health advisory in August, alerting health care providers of this emerging health threat and listing symptoms they should look for in patients. As of September 5, 2019, the Department has received 34 reports from New York State physicians of severe pulmonary illness among patients ranging from 15 to 46 years of age who were using at least one cannabis-containing vape product before they became ill. However, all patients reported recent use of various vape products.

Laboratory test results showed very high levels of vitamin E acetate in nearly all cannabis-containing samples analyzed by the Wadsworth Center as part of this investigation. At least one vitamin E acetate containing vape product has been linked to each patient who submitted a product for testing. Vitamin E acetate is not an approved additive for New York State Medical Marijuana Program-authorized vape products and was not seen in the nicotine-based products that were tested.

As a result, vitamin E acetate is now a key focus of the Department's investigation of potential causes of vaping-associated pulmonary illnesses. Vitamin E acetate is a commonly available nutritional supplement that is not known to cause harm when ingested as a vitamin supplement or applied to the skin. However, the Department continues to investigate its health effects when inhaled because its oil-like properties could be associated with the observed symptoms.

The Wadsworth Center is testing both cannabis and nicotine-containing vape products as part of this investigation and continues testing the purity of New York's approved medical marijuana products. More than a dozen product samples, in some cases multiple samples from a single product, from patients reporting symptoms have been tested. These samples have been tested for a range of substances, including THC and other cannabis-derived cannabinoids, nicotine, synthetic cannabinoids, opioids and pesticides. Products tested include a variety of labels and packaging. Many are suspected to be counterfeits of recreational cannabis-containing vape products available in other states.

--------------------------------------------------

It's rather interesting that absolutely none of these extra details, which have been available for quite some time now, appear in any official CDC reports.

doktrin• 7 years ago

I'm another person who for whatever reason was never able to adjust to vaping. It quite literally hurts, even with modest inhales, despite trying numerous models (disposables, cartridges, expensive sub ohm systems, you name it). This applies both for nicotine and thc vaping. I just wrote it off as something that was a personal eccentricity.

Honestly it was for the best - I ended up using gum and eventually just quitting, and stopped using thc for other reasons.

_Marak_• 7 years ago

I've been following this for months and New York State seems to be reporting the most accurate information.

https://www.health.ny.gov/press/releases/2019/2019-09-05_vap...

https://www.flickr.com/photos/nysdoh/sets/72157710703391248/

The sickness is suspected to be caused by blackmarket THC vape cartridges which have been cut with Vitamin E Acetate.

There is a huge problem with black market / counterfeit THC vape products.

There are two communities tracking this on Reddit:

https://www.reddit.com/r/fakecartridges/

https://www.reddit.com/r/cleancarts/

ohiovr• 7 years ago

I thc vaped for a little while. Everything seemed fine till the next batch which was a cough factory. It is unregulated and blackmarket. For all I know huffing paint is safer.

tau255• 7 years ago

In Vienna, the shop I bought my supplies had all products tested by local TÜV NORD and they mixed liquids on site. Nowadays I buy and mix myself from standard 50/50 PG/VG mix from known source. I had mixed results with imported premixed liquids (off smell, not consistent viscosity - went to bin) and that promptly stopped me from buying more of premixed stuff (along with problematic regulations of container sizes).

Anything you add to the liqiud other than nicotine and PG/VG may be problematic. You never really know what is in imported premixed liquid, what cutting agents were used, what purity of source material was.

It seems that CDC is seeing some results of cost cutting, using stuff that was not really meant to be vaped mixed to keep margins better.

Outbreak of Lung Illness Associated with Using E-Cigarette Products

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