Recent Health Concerns Associated with Vaping Products

Submitted by Kate Chestnut, PA Student at Case Western University and Corie Kovach
MD, FACOG, MBA

You can barely go anywhere without seeing clouds engulfing teens and young adults nowadays.
Vaping has been extremely popular across the country and has become the new trend. But what
exactly is it or in it?

E-cigarettes are battery-powered devices that heat a liquid producing a vapor that is inhaled by
the user. “Vaping” is the common term used amongst people to describe the act of using an e-
cigarette product. E-cigarettes can be filled with different oils containing a multitude of different
products. They commonly contain nicotine or marijuana, but other substances and drugs can be
used as well.

Recently, many have taken a step back from their clouds after learning about the harms
associated with vaping throughout the news. A lot of talk has been circulating, inciting panic
across the country.

There have been at least 39 deaths in 24 states related with e-cigarette, or vaping, associated lung
injury (EVALI) and there are more deaths currently under investigation as well as over 2,000
more people across all states with injuries related to vaping There have been reports of e-
cigarettes exploding causing countless injuries. There have even been reports of jaws being
shattered and people dying due to the blast. This is thought to be due to the lithium ion batteries
overheating and then detonating. Patients are complaining of symptoms like coughing, shortness
of breath, fatigue, diarrhea, abdominal pain, fever, nausea, vomiting and chest pain. What can be
the cause of all of these mysterious cases? How can something that seems so harmless be so
harmful?

Vitamin E is found in many foods and when ingested or applied as a topical to skin doesn’t
usually cause harm. Some manufacturers of e-cigarette and vaping products have been adding
vitamin E acetate to its products because it thickens the oil as well as resembles THC oil.
Recently, 29 patients across 10 states with EVALI had bronchoalveolar lavage fluid samples sent
to the CDC for testing. All 29 samples were found to contain vitamin E acetate. While it is
highly suspected that vitamin E is the probable culprit to these illnesses, there is insufficient
evidence to rule out other possible perpetrators.

So, what is being done about all of these EVALIs and deaths? Lawmakers have recently put
restrictions on different flavors of vapes and a few states have put temporary bans on all types of
e-cigarettes. The FDA has put restrictions on the age limit for purchase and certain companies
have made the decision to discontinue selling their products. Only time will tell if these
restrictive measures will help reduce the number of new cases until the culprit is discovered.

The CDC along with other researchers are working hard to get to the root of the cause. They
recommend refraining from using all street e-cigarette products until the investigation is closed
to assure there is no risk, but for those who choose to continue using, it is recommended that they
look for symptoms and seek medical care if any of the above symptoms arise. They also warn
not to buy THC vape products off of the street. Know what you’re putting into your e-cigarette,
but even better, your body.

The Ohio Medical Marijuana Control Program (MMCP) has been working very closely with the
CDC and the Ohio Department of Health on this matter. Currently, there are no known
connections with vape products sold within the program. The MMCP will continue to work with
the Ohio Department of Health to provide updates for patients and caregivers at the following
resource site: https://odh.ohio.gov/wps/portal/gov/odh/know-our-programs/tobacco-use-
prevention-and-cessation/news-and-events/.
Caution is again emphasized to avoid street products and black-market items.
Anyone who thinks that they may be experiencing serious breathing problems related to vaping
are advised to seek immediate medical attention.
Sources:

1. Rigotti N. Vaping and e-cigarettes. UpToDate.
https://www.uptodate.com/contents/vaping-and-e-
cigarettes?search=vaping&source=search_result&selectedTitle=1~60&usage_type=defau
lt&display_rank=1#H881599345. Published October 21, 2019. Accessed November 13,
2019.
2. Outbreak of Lung Injury Associated with the Use of E-Cigarette, or Vaping, Products.
Centers for Disease Control and Prevention.
https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html.
Published November 8, 2019. Accessed November 13, 2019.