Why are people getting sick from vaping now?

Source: NJ.com Editorial

Vaping is a common practice and vaping products have been available for several years before the recent nationwide outbreak of severe lung injuries. Something has clearly changed.

Patients are developing a severe, rapidly progressive lung injury that may result in ICU admission or even death. Symptoms vary, but typically include shortness of breath and coughing for several days to weeks, fever, vomiting and diarrhea. Patients have needed therapy ranging from a little oxygen and steroids to weeks on a ventilator to cardiopulmonary bypass. Deaths have occurred, and the numbers are mounting.

While information about the cause of the outbreak is limited, the majority of cases involved illicit products containing THC, the psychoactive ingredient in marijuana. This is likely not a result of the THC or nicotine itself, but the liquid in which it is extracted. Some patients reported only nicotine vaping, although patients (particularly teenagers) may be reluctant to disclose vaping THC, which is illegal in many states.

Commercially manufactured e-liquids sold legally in New Jersey contain only nicotine (or may just contain flavoring), but there is an illegal market for THC vape oil. Propylene glycol, a largely inert chemical not likely to cause severe lung injury, is the oil most often used in commercial nicotine liquids. But for THC vapes, particularly non-medical products on the black market or made in small shops and homes, the choice of liquid is anyone’s guess.

This crisis is distinct from the epidemic of teens vaping nicotine and from the legitimate use of vaping by adults as a bridge to help them quit smoking. Stopping this outbreak will require ending the use of THC vape oils and other illicit e-liquids through law enforcement and user education.

The New Jersey Poison Control Center is at the forefront of this outbreak, working closely with the N.J. Department of Health and the U.S. Centers for Disease Control and Prevention to collect case information. Anyone with concerns about vaping-induced lung injury should speak with their healthcare provider or contact us at the 1-800-222-1222 for more information. Healthcare providers seeing patients in whom vaping-associated pulmonary injury is suspected should also contact our center to aid in surveillance.

In the meantime, more information is needed to evaluate the long-term effects of nicotine vaping and to understand the causes of these illnesses associated with unregulated vaping products.

By Diane Calello, M.D., the executive and medical director of the New Jersey Poison Information and Education System at Rutgers New Jersey Medical School.
If you or a loved one want to quit smoking, call the New Jersey Quitline at 1-866-NJSTOPS.

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