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Focus on Health: The dangers of vaping

  • The medical effects of e-cigarette use are still largely unknown. Photo by Lindsey Fox

Monadnock Ledger-Transcript
Published: 2/3/2020 4:58:12 PM

Since August, the Center for Disease Control has been investigating cases of individuals hospitalized with e-cigarette, or vaping, product use associated lung injury (EVALI).

According to the CDC, as of Jan. 21, a total of 2,711 hospitalized EVALI cases or deaths have been reported from all 50 states, the District of Columbia, and two U.S. territories (Puerto Rico and U.S. Virgin Islands).

Of those hospitalizations, 60 deaths have been confirmed in 27 states and the District of Columbia. Emergency Department visits related to e-cigarette, or vaping, products continue to decline, after sharply increasing in August and peaking in September, according to the CDC, but the potential for more cases is out there, at least that’s the thought of Essy Moverman, a pulmonary program specialist and certified tobacco treatment specialist at Monadnock Community Hospital.

“People were starting to get sick, going to the hospital for respiratory illnesses,” Moverman said. “What they had in common is that they were vaping.”

Moverman said she has seen one case of hospitalization due to an e-cigarette or vaping product.

“They were incredibly sick and ended up on a respirator,” Moverman said.

While the symptoms mimic the flu, during the course of her discussion with the MCH patient, Moverman asked specifically about vaping and the answer was yes. The patient was ultimately transferred to another hospital, but Moverman stressed that there’s a good chance for a relapse. The issue, Moverman said, is that vaping related illnesses are a new problem.

“We’re treading on thin ice because we don’t know a lot,” she said. “You usually need long term studies to prove things.”

Through her work, Moverman sees a number of people who are trying to quit smoking. For those she always recommends the route of smoking cessation because she doesn’t see a switch to vaping as a practical way to quit. But she has also met with those who use a vape product.

“I consider it smoking or at the very least inhaling something,” Moverman said. “I don’t see it as something that’s far removed from smoking.”

According to Breathe New Hampshire, a nonprofit organization based in Manchester, many e-liquids contain ingredients such as nicotine, propylene glycol, benzoic acid, flavor extract and oil based substances. Flavors in vapes, have not been tested or approved by the FDA for heating, combining with other chemicals and inhaling and aerosol (vapor) from e-cigarettes may contain fine particles that are respiratory irritants.

“I’m a firm believer that nothing belongs in your lungs except air,” Moverman said.

Moverman worries about the future of those who vape.

“We don’t know what this is going to do long term health-wise,” Moverman said. “That would be the No. 1 thing I’m worried about.”

And especially teenagers that are growing up with it and don’t understand the dangers of using one. Moverman said that New Hampshire has the highest prevalence of youth usage in the country with 30 percent of high school students vaping.

“Nicotine is highly addictive and the younger you start using it the harder it is to quit,” she said. “And now we’re into something that’s hooking a whole other generation.”

Moverman said she’s done education sessions at ConVal High School and Wilton-Lyndeborough Cooperative Middle School.

At Conant High School, Biology and Chemistry teacher Margie Clark-Kevan is always looking for current health issues to bring to her anatomy and physiology class. And after the health crisis that peaked in the fall, she brought the idea of a vaping ingredient experiment to her students.

The students chose four FDA approved food ingredients found in vaping. While the ingredients – vitamin E acetate, propylene glycol, vegetable glycerin, and benzoic acid – are approved for ingesting, they are not for inhaling.

The students researched their chosen ingredient for a few days, discussed their findings and then experimented with the ingredients on pig lung and stomach tissue over the course of a number of days. The students used both a solution of their ingredients versus water on their tissue samples. 

“Stomach tissue and lung tissue are so different in their makeup and function,” Clark-Kevan said. “So my main goal was to have the kids really think about the differences as they went through this.”

Clark-Kevan didn’t have high hopes for results, but what happened when the students cut open their tissue samples – which looked normal on the outside – came as a shock. While the stomach tissue didn’t change much, the pig lung was hard and had black spots and that was only one ingredient over the course of a few days.

“It was great to get results, but on the other hand I know that people vape and that’s really scary, the impact it can have,” Clark-Kevan said. “And I do think it hit home with them.”

According to the CDC, the efforts moving forward are to identify and define the risk factors for EVALI, as well as conduct laboratory testing that can assist with identifying chemicals of concern and  communicate recommendations to health professionals and the general public.

So it is clear there is still a lot to be learned.

Monadnock Ledger-Transcript

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