Where There Is Vapor There Is Not Always Fire
If you’ve been paying attention to the news – or even if you haven’t – you may have heard about some serious problems going on with vaping. It seems like the news is finally catching up to the reality of the situation, but since this is the sort of thing that can persist and because the correction often doesn’t get nearly as much attention as the splashing headline, I thought I would explain what is happening and why.
A couple of months ago, emergency and urgent care centers got a rash of young admits demonstrating lung problems. In some cases, quite severe. Eventually there was a lethal case (there have since been two more). It turned out that they were vapers, and thus it became linked to vaping. The vaping industry and pro-vaping community were hit very hard with a lot of people saying “See? See?!”
There were problems with the idea that vaping as such was the culprit. Vaping has been around for a while, so why is this suddenly a problem? This isn’t a case of long-term wear. This is an acute condition so it’s not a matter of it taking until now to manifest. Something changed. But it only changed in the United States because no cases were reported elsewhere. More specifically, it changed in clusters rather than nation-wide. Since lungs don’t differ much from state to state, an inherent problem would not be so localized. Perhaps most revealingly, the afflicted were predominantly young (college age or high school). College kids’ lungs aren’t weaker than that of older people (who vape in greater numbers) including a lot of people whose lungs have been worn down by years or decades of smoking.
Where young people are weak, however, is in their judgment. They might, for instance, be vaping things they shouldn’t be vaping. Nine in ten of the afflicted reported using THC oils (something not traditionally found in market ejuice). The remaining 10%? It’s possible they’re lying (hiding it from their parents), instead of vaping THC oils they’re vaping laundry detergent or something stupid like that, or they are unrelated cases of (probably minor) lung distress lumped in with the others.
It took about a week and a half but gradually state health departments started discussing additives and contaminants as a factor. The articles had a tendency to glide over this fact, such as how this one did:
But in an ongoing state investigation among all ages of those with lung disorders who reported vaping, 89% said they inhaled THC products in the form of waxes or oils. THC is the active ingredient in marijuana.
The problem is not isolated. In Utah, Alexander Mitchell, 20, was placed in intensive care after vaping. And now his lung capacity has been diminished by 25%. “Vaping is promoted as a safer alternative when in reality it is not,” he said.
The vaping industry is blaming unlicensed retailers selling unsafe chemical mixtures and wants federal officials to clarify where the problem lies.
In three paragraphs we go from pointing out the likely source of the problem to a claim that vaping (as such) is bad to reducing the original part to a vaping industry claim.
As it turns out, federal officials have since clarified the nature of the problem, though are still suggesting that people not vape altogether (which, for a lot of people, is telling them to smoke cigarettes instead). Some of the media as well is now reporting that the problem is mostly related vitamin E.
So what happens now?
Well, some vapers are probably smoking again and others will be discouraged from using it as a method to quit. I doubt the damage here can be undone. Public health advocates will make sure of it. When a new method was found to zap e coli out of meat, nutritionist Marion Nestle commented that this was an unwelcome development because people would start thinking that meat is okay. What’s a few cases of e coli compared to a meat eating epidemic? From early on a similar decision was made by a lot of people that this is more of a tool to be used against vaping more broadly than it is an immediate health crisis for which timely and accurate information would be helpful. Even knowing what we know, there are Democrats using this as a pretext to ban flavors and condemn dominant ecigarette manufacturer Juul.
Except that Juul was not responsible, of course. Whatever the product source was, it was almost certainly not in the locked up Juul cartridges. It was not a product of their nefarious fun flavors that the governor of Michigan just banned and Dick Durbin is demanding of the FDA in response to an unrelated crisis. You can try to argue “Well it’s flavoring that drew them to it” except flavoring was supposed to draw them to nicotine and we’re talking about people who were using non-nicotine varieties. If it was flavoring they liked, they would have chosen products with more flavor (I suspect the THC subtracts rather than ads to the bubble gum flavor). This was a different user profile.
But that brings to light a big question for which there is no answer: How do you regulate against this? We have a regulation regime and this occurred outside of it. There is no reason to believe that tightening that regime would have any effect. You could try banning open systems but again this occurred outside of regulation. All you need is a device to burn them and then you can put widely available products in them. It would make devices harder (though far from impossible) to get a hold of, and would eliminate cases where the user may not have known about a product substitution. So while the cost of this policy would be immense, it could have an effect.
That would be the opposite of targeting Juul, though, the great bogeyman. In fact, as the perveyor of solely closed systems, it would benefit them greatly. You can actually tell which advocates and politicians don’t know what they’re talking about or don’t care by whether they try to rope Juul into this. Even if we consider this a vaping problem, it’s decidedly not a Juul problem. It is occupying the far other side of the industry from where they rest. I say all of this as someone who is generally critical of Juul and their effect on the vaping marketplace. But there are two companies in the vaping market that have called for more regulation of vaping products: RJ Reynolds and Juul.
As I allude to above, you can try to ban flavoring as a mechanism to get them to avoid vaping in the first place. There is likely, however, a different user profile between those attracted to bubble gum flavoring and those putting illicit products their devices. I suspect, in fact, that the THC oils disrupt the flavoring. So if it’s flavoring their attracted to, they are less rather than more at risk for this sort of experimentation. Likewise, the impetus behind the ecigarette bans is nicotine addiction. If nicotine-addiction were driving this, however, they’d be using nicotine products rather than branching out into other things. In short, these are the people who like experimenting for the sake of experimenting. That’s just a harder nut to crack.
There might be something we can do on the THC end. That’s outside of my realm.
The biggest thing I can think of that might help would be the dreaded occupational and business licensing. It’s possible that some of these were purchased at unscrupulous but traditional vape shops. Or fly-by operations that look like traditional outlets. The FDA is already regulating makers of ejuice more generally but it’s not entirely clear the best way to handle ad-hoc mixing. Some combination of required practices and a license that can be pulled from operators that don’t adhere to it may help, though.
Ultimately, though: Perspective. We are talking about three deaths and a few hundred illnesses in a nation of over 300,000. It’s unfortunate but it is not likely to scale with overall ecigarette use. Awareness may be sufficient to attack it, provided that we are giving accurate information rather than opportunistically seeing this as an opportunity to tell people Don’t Vape. Beyond that, finding a way to authorize retailers and telling people to only get their stuff from authorize retailers would probably help a lot.
Despite being an ardent advocate, I do recommend caution when it comes to vaping. There is a lot we don’t know. If your body is telling you something when you try it, you should listen. I am skeptical of Royal Health England’s “95 safer” statistic. There are almost certainly risks that we don’t know about, especially for individuals with other health problems. Eventually somebody may die from an allergic reaction to regular vaping and the vaping community needs to be prepared for that. But that’s not what is happening here.
That said, I quit vaping in April of 2017 and nothing I have learned since has lead me to be more thankful that I did or sorry that I ever took it up. I may or may not be healthier due to my vaping cessation, but most of the gains were made when I switched away from smoking. That is the anniversary I celebrate. The day may come when something truly damning does come out, but so far almost everything that does ends up – like this – being followed by clarifying additional information. My present main concern is that vaping was already struggling with a perception problem that discourages smokers from trying it or even convincing them to switch back to smoking, and this will almost certainly make that a bigger problem.
For now, though, keep on keeping on. But only with approved products, please.