I'm guessing that if this really is associated with vaping then it's likely due to the limited regulation of the ingredients. Bad batch of VG/PG/nicotine? Some problematic flavouring?
I think the best article I've found is at the BMJ: https://www.bmj.com/content/366/bmj.l5228 - sorry, paywall. Very much inconslusive at the moment completely in the public health triage stage.
Good idea to regulate it properly. I just stopped vaping after a 20 year intermittent tobacco problem + 5 years of vaping[1]. Stopping vaping is massively easier than giving up cigarettes in my experience.
[1] for almost that entire time I just went unflavoured. Less hassle and less potential for contaminants.
Similar story here. Smoked for ten years. Actually found it easy to replace smoking with vaping (strong menthol). Stopped vaping after 1 year because I was suffering from GERD and suspected that vaping was an attributing factor. Since I stopped 5 years ago, my GERD symptoms have more or less disappeared.
I really enjoyed vaping, probably more than smoking, but somehow it did not seem to have the same addictive effect on me as smoking had. I did not find it that hard to stop cold turkey.
This article has a sentence touching on it, but other sources that almost all these cases of vaping related hospitalizations are from vaping THC, so the sourcing/manufacturing of the product is highly suspect. Who knows what drug dealers are using.
So I've been saying something like this for years now. HOW do we know something is not going wrong without any long term/clinical data (ESPECIALLY around these custom flavours that people sometimes roll out themselves)?
I think it's completely presumptuous when people tout vaping as being much safer than cigarettes. We didn't all wake up one day knowing smoking was bad - it was a long road filled with politics, science and data.
Vaping is in its infancy and already people's mantras sound like old Camel commercials.
- smoking is an exceptionally harmful habit, so just by coming up with any other activity at random one is likely to end up healthier
- this also means advising smokers to switch to vaping even without knowing the health effects of vaping makes sense
- marketing vaping to non-smokers should be severely limited though
- marketing vaping to kids like juul does, should be downright illegal
Honestly, I think switching from something which WILL kill you to something which might have as-yet-undiscovered long term health implications is an absolute win.
> Vaping is in its infancy and already people's mantras sound like old Camel commercials.
I agree. I'm one of the people who managed to quit smoking using vaping and at one point I had some sort of awakening. After vaping for a couple of years I stopped and asked myself what the hell am I doing? I had countless mods, juices, RDAs, RTAs, etc.. and was a frequent contributor to the electronic_cigarette subreddit. I replaced a vice (I hated) with a hobby and was part of a cult (1). But at least I knew I was taking full responsibility for it. I knew the wattages, coil materials and what went into my juice. Most people buying stuff from gas stations or shady online retailers don't always know what they're doing (see for example the battery venting incidents).
And I stopped. I got rid of everything, vaped only unflavored juice for a while and quit altogether. After a couple of years, I ended up on the electronic_cigarette subreddit again and I was legitimately scared of what I was reading. It's a bubble. 'big tobacco' conspiracies, all doctors advising people to stop vaping are quacks, downplaying all sorts of issues (batteries venting due to shady mod soldering, hardware from China advertised as stainless steel which rusts, silica coils etc..). And nothing would change their minds. Even online vendors have these big-ass disclaimers that they won't take any responsibility for the health effects of their products but that too is classified as a plain old 'CYA' policy so you know.. nothing to worry about. Also, now they're vaping nic salts? WTF is that?
In this particular case, my personal opinion is that was definitely something seriously bad in the juice these people were vaping so I wouldn't panic just yet. Contrary to popular belief, I still believe that the CDC will get the job done and figure out the root cause. It reminds me of the time people started smoking bath salts and ended up in the ER where doctors initially didn't know what to make of it.
But I wouldn't bet any money that in a couple of years we won't find some weird/horrible side effect of vaping which appears only after prolonged use. Let's not forget that people did not get sick from cigarettes instantly...
(1) Small cult checklist:
- The group displays excessively zealous and unquestioning commitment to its ideology
- Questioning, doubt, and dissent are discouraged or even punished
- The group is elitist, claiming a special, exalted status for itself
- The group has a polarized us-versus-them mentality (see analog smokers)
- The group is preoccupied with bringing in new members (converting friends/family with starter kits)
Keep in mind that the main issue with cigarettes is what is in them: Carncinogens. Not just anything gives cancer. If something doesn't have carcinogens, like vapes, it doesn't cause cancer.
And, as far as I know, the cancer bit is what makes cigarettes so bad.
> As the mechanism is unknown, it’s unclear what the actual danger is. Is it some byproduct of the nicotine cartidges, or THC ones? Is it the vapor itself? Is it only at certain temperatures or concentrations? Is it directly affecting the lungs or entering the bloodstream? No one knows yet — all they’ve seen is an sudden uptick in respiratory or pulmonary issues where the sufferer also uses vaping products.
We've seen a few studies suggesting certain flavoring agents may cause significant problems, has this been investigated as a possible cause?
I vape - I buy only high quality liquids from a reputable manufacturer who extensively test all of their recipes. I find my lung function is 100x better than when I smoked.
I did, however, once buy a THC liquid, from a “reputable” dark web dealer. It was bloody awful - found myself retching and hacking for days after a few small tokes, and it destroyed both the coil and the tank - sticky residue, carbon, bleurgh.
So... given that the other symptoms mentioned are vomiting and diarrhoea, I think this is going to transpire to be dodgy THC liquids, as this also sounds like Cannabis Hyperemesis Syndrome.
Keep in mind that “vapor” is used to disguise that, in all cases whether nicotine or pot or etc, people are heating up a substance to its smoke point and inhaling that smoke. They use “vapor” because it sounds like “water vapor” - which is harmless - but it’s definitely not that.
Marijuana cartridges use marijuana oil or MCT oil as a base, for example. Nicotine uses glycol or other substances.
We have very little data on consuming glycol and/or MCT oil smoke. It’s possible that it clogs up the lungs in a way that takes hours to heal per inhalation, and so we’re simply seeing smoke inhalation deaths as we would from an oil factory burning for weeks or something.
(We have limited data on marijuana extract smoke - cold-processed oil is a new-ish innovation, compared to resin which is high in impurities and not easy to consume in significant quantities like marijuana oil apparently is.)
“Vaping” can often mean people filling mod boxes (not Juuls) with any sort of juice containing anything. Articles and studies often include any random juice in any random shop, so there are endless unknowns.
Juuls and many other pens contain limited ingredients, namely nicotine and propylene glycol. We already know what nicotine does.
Propylene glycol is food safe and is also used in albuterol asthma inhalers.
Vaping fumes trigger my asthma, there is all sorts of stuff in the second hand smoke. The smoking ban in the UK basically stopped me being admitted to hospital every few years and I appreciate that most bars/clubs have banned vaping inside (certainly in London).
Juuls contain a mixture of nicotine salts and presumably other alkaloids extracted from the tobacco plant. Very different in effect from pure nicotine.
I don't smoke or vape. I think the world is way better off vaping than smoking. I certainly do hope whatever caused this is discovered. I would hate to see more cigarettes light up again.
I'm guessing (and hoping) that more regulation will come down on the vaping industry to make sure whatever oils or additives are controlled so that we can prevent this from happening with future additives they discover.
We've seen it plenty of times when a product comes out and people with an agenda to make money off it say "buy this, it works" and then decades later it is discovered to have been toxic or harmful in some way.
Especially given the nature of this product, skepticism should be the default position.
The big kicker is people didn't start all types of vaping 3 months ago. My guess is this is some sort of contaminated something (with a biological agent).
Heavy metal, lead, asbestos, radium, etc. don't cause 100+ people to be hospitalized in the span of three months, they work over decades.
Completely agree. The case was clearly a result of bad ingredients -- yet it has been flogged by the media and prohibitionists as proof that vaping is just as dangerous as tobacco.
I, for one, embrace vapetopia -- the cognitive libertarian's dream of mental states on demand.
I’d worry about the excipients (e.g. PGA). Several molecular weights are deemed GRAS (“Generally Recognized As Safe”) thus their use is unregulated (of course as bulk polymers, “molecular weight” is really just the fat part of the distribution).
The problem is at point of use: the vehicle is vaporized by a simple heated nichrome wire. This fractionates and agglomerates the polymers resulting in a completely different distribution of polymer weights. The results of which aren’t being analyzed.
I’m less interested in speculation and more interested in the CDCs claims once it’s investigation has been concluded. Please do note that the claim specifically posits there exists a cluster of illnesses associated with vaping and that one person has died from it- not that only one person had ever had this disease. This makes it interesting. I hope the cause can be founds soon, given The popularity of vaping in teens.
“We do know that e-cigarettes do not emit a harmless aerosol,” he explained. “There’s a variety of harmful ingredients identified, including things like ultrafine particulates, heavy metals like lead and cancer causing chemicals. And flavoring used in e-cigarettes to give it a buttery flavor, diacetyl, it’s been related to severe respiratory illness.”
"People often assume that these e-liquids are a final product once they are mixed. But the reactions create new molecules"
I smoked cigarettes for about 25 years and switched to vaping about 5 years ago. My anecdata is it's the flavorings which are most harmful. I had a pretty consistent cough from cigarettes which got a little better after switching to vapes, but it really depended on the flavor. Some flavors were much more harsh and the cough would return. It didn't go away until I switched to completely unflavored juice.
However you look at this the take away from it all should be:
Get a vape and liquid from a large reputable supplier (keep receipts) and should we suddenly find that this is the next product to have warning and danger signs slapped all over due to health concerns, you have a large reputable supplier you can sue, ala the original tobacco scandals.
Awesome, can’t wait to replicate the resounding successes of alcohol and drug prohibition. Alcohol usage dropped to zero throughout the 1920s and there were no unintended consequences right?
Likely nobody can say with any amount of certainty.
There are vaporizers and liquids to treat very cautiously. Many materials you could make a vaporizer and especially the heating assembly would include hazardous offgassing.
Likewise you would want to be very careful about knowing the source and content of liquids. They are essentially unregulated.
Strangers on the internet selling you ingest to make a small amount of money are not particularly trustworthy.
Worth noting that the author makes a significant claim without any citation:
> That vaping works as a way to quit smoking... seems clear.
Studies have been fairly limited so far, given the recency of e-cigarettes (relative to science's timescale). And the studies that we have seem pretty mixed: some showing benefit over other accepted smoking cessation methods, some not. Some showing higher relapse rates in the e-cigarette group. Nothing about that seems clear to me.
[+] [-] singingfish|6 years ago|reply
I think the best article I've found is at the BMJ: https://www.bmj.com/content/366/bmj.l5228 - sorry, paywall. Very much inconslusive at the moment completely in the public health triage stage.
Good idea to regulate it properly. I just stopped vaping after a 20 year intermittent tobacco problem + 5 years of vaping[1]. Stopping vaping is massively easier than giving up cigarettes in my experience.
[1] for almost that entire time I just went unflavoured. Less hassle and less potential for contaminants.
[+] [-] imafish|6 years ago|reply
I really enjoyed vaping, probably more than smoking, but somehow it did not seem to have the same addictive effect on me as smoking had. I did not find it that hard to stop cold turkey.
[+] [-] noname120|6 years ago|reply
See this literature review from Gwern for more information. [2]
[1] https://en.m.wikipedia.org/wiki/Monoamine_oxidase_inhibitor
[2] https://www.gwern.net/Nicotine#addictiveness
[+] [-] chrstphrhrt|6 years ago|reply
[+] [-] EdwardDiego|6 years ago|reply
[+] [-] WillPostForFood|6 years ago|reply
[+] [-] zamalek|6 years ago|reply
[+] [-] beardedman|6 years ago|reply
I think it's completely presumptuous when people tout vaping as being much safer than cigarettes. We didn't all wake up one day knowing smoking was bad - it was a long road filled with politics, science and data.
Vaping is in its infancy and already people's mantras sound like old Camel commercials.
[+] [-] szbalint|6 years ago|reply
- smoking is an exceptionally harmful habit, so just by coming up with any other activity at random one is likely to end up healthier
- this also means advising smokers to switch to vaping even without knowing the health effects of vaping makes sense - marketing vaping to non-smokers should be severely limited though
- marketing vaping to kids like juul does, should be downright illegal
[+] [-] taneq|6 years ago|reply
[+] [-] decebalus1|6 years ago|reply
I agree. I'm one of the people who managed to quit smoking using vaping and at one point I had some sort of awakening. After vaping for a couple of years I stopped and asked myself what the hell am I doing? I had countless mods, juices, RDAs, RTAs, etc.. and was a frequent contributor to the electronic_cigarette subreddit. I replaced a vice (I hated) with a hobby and was part of a cult (1). But at least I knew I was taking full responsibility for it. I knew the wattages, coil materials and what went into my juice. Most people buying stuff from gas stations or shady online retailers don't always know what they're doing (see for example the battery venting incidents).
And I stopped. I got rid of everything, vaped only unflavored juice for a while and quit altogether. After a couple of years, I ended up on the electronic_cigarette subreddit again and I was legitimately scared of what I was reading. It's a bubble. 'big tobacco' conspiracies, all doctors advising people to stop vaping are quacks, downplaying all sorts of issues (batteries venting due to shady mod soldering, hardware from China advertised as stainless steel which rusts, silica coils etc..). And nothing would change their minds. Even online vendors have these big-ass disclaimers that they won't take any responsibility for the health effects of their products but that too is classified as a plain old 'CYA' policy so you know.. nothing to worry about. Also, now they're vaping nic salts? WTF is that?
In this particular case, my personal opinion is that was definitely something seriously bad in the juice these people were vaping so I wouldn't panic just yet. Contrary to popular belief, I still believe that the CDC will get the job done and figure out the root cause. It reminds me of the time people started smoking bath salts and ended up in the ER where doctors initially didn't know what to make of it.
But I wouldn't bet any money that in a couple of years we won't find some weird/horrible side effect of vaping which appears only after prolonged use. Let's not forget that people did not get sick from cigarettes instantly...
(1) Small cult checklist:
- The group displays excessively zealous and unquestioning commitment to its ideology
- Questioning, doubt, and dissent are discouraged or even punished
- The group is elitist, claiming a special, exalted status for itself
- The group has a polarized us-versus-them mentality (see analog smokers)
- The group is preoccupied with bringing in new members (converting friends/family with starter kits)
[+] [-] dr_dshiv|6 years ago|reply
And, as far as I know, the cancer bit is what makes cigarettes so bad.
[+] [-] buildzr|6 years ago|reply
We've seen a few studies suggesting certain flavoring agents may cause significant problems, has this been investigated as a possible cause?
[+] [-] Tharkun|6 years ago|reply
[+] [-] madaxe_again|6 years ago|reply
I did, however, once buy a THC liquid, from a “reputable” dark web dealer. It was bloody awful - found myself retching and hacking for days after a few small tokes, and it destroyed both the coil and the tank - sticky residue, carbon, bleurgh.
So... given that the other symptoms mentioned are vomiting and diarrhoea, I think this is going to transpire to be dodgy THC liquids, as this also sounds like Cannabis Hyperemesis Syndrome.
[+] [-] floatingatoll|6 years ago|reply
Keep in mind that “vapor” is used to disguise that, in all cases whether nicotine or pot or etc, people are heating up a substance to its smoke point and inhaling that smoke. They use “vapor” because it sounds like “water vapor” - which is harmless - but it’s definitely not that.
Marijuana cartridges use marijuana oil or MCT oil as a base, for example. Nicotine uses glycol or other substances.
We have very little data on consuming glycol and/or MCT oil smoke. It’s possible that it clogs up the lungs in a way that takes hours to heal per inhalation, and so we’re simply seeing smoke inhalation deaths as we would from an oil factory burning for weeks or something.
(We have limited data on marijuana extract smoke - cold-processed oil is a new-ish innovation, compared to resin which is high in impurities and not easy to consume in significant quantities like marijuana oil apparently is.)
[+] [-] magoon|6 years ago|reply
Juuls and many other pens contain limited ingredients, namely nicotine and propylene glycol. We already know what nicotine does.
Propylene glycol is food safe and is also used in albuterol asthma inhalers.
[+] [-] dazzawazza|6 years ago|reply
[+] [-] ceejayoz|6 years ago|reply
[+] [-] geggam|6 years ago|reply
A Nit : “generally recognized as safe” for use in food.
https://www.atsdr.cdc.gov/substances/toxsubstance.asp?toxid=...
[+] [-] eurasiantiger|6 years ago|reply
[+] [-] Alex3917|6 years ago|reply
[+] [-] rubidium|6 years ago|reply
[+] [-] refurb|6 years ago|reply
If you cut that in half, that’s a win.
This is what harm reduction is all about.
[+] [-] sk5t|6 years ago|reply
[+] [-] rhacker|6 years ago|reply
I'm guessing (and hoping) that more regulation will come down on the vaping industry to make sure whatever oils or additives are controlled so that we can prevent this from happening with future additives they discover.
[+] [-] stjohnswarts|6 years ago|reply
[+] [-] bsder|6 years ago|reply
There is something going on. It may even turn out to be unrelated to vaping.
However, incidents like these are why the CDC exists.
[+] [-] james_s_tayler|6 years ago|reply
We've seen it plenty of times when a product comes out and people with an agenda to make money off it say "buy this, it works" and then decades later it is discovered to have been toxic or harmful in some way.
Especially given the nature of this product, skepticism should be the default position.
[+] [-] sgent|6 years ago|reply
Heavy metal, lead, asbestos, radium, etc. don't cause 100+ people to be hospitalized in the span of three months, they work over decades.
[+] [-] jahewson|6 years ago|reply
1) which people? 2) what agenda?
[+] [-] dr_dshiv|6 years ago|reply
I, for one, embrace vapetopia -- the cognitive libertarian's dream of mental states on demand.
[+] [-] dmead|6 years ago|reply
[+] [-] gumby|6 years ago|reply
The problem is at point of use: the vehicle is vaporized by a simple heated nichrome wire. This fractionates and agglomerates the polymers resulting in a completely different distribution of polymer weights. The results of which aren’t being analyzed.
[+] [-] SolaceQuantum|6 years ago|reply
[+] [-] innovateee|6 years ago|reply
"People often assume that these e-liquids are a final product once they are mixed. But the reactions create new molecules"
[+] [-] snarfy|6 years ago|reply
[+] [-] Zenst|6 years ago|reply
[+] [-] jimhefferon|6 years ago|reply
[+] [-] wellpast|6 years ago|reply
[+] [-] apta|6 years ago|reply
[+] [-] stallmanite|6 years ago|reply
[+] [-] mikevm|6 years ago|reply
[+] [-] colechristensen|6 years ago|reply
There are vaporizers and liquids to treat very cautiously. Many materials you could make a vaporizer and especially the heating assembly would include hazardous offgassing.
Likewise you would want to be very careful about knowing the source and content of liquids. They are essentially unregulated.
Strangers on the internet selling you ingest to make a small amount of money are not particularly trustworthy.
[+] [-] Proven|6 years ago|reply
[deleted]
[+] [-] javadocmd|6 years ago|reply
> That vaping works as a way to quit smoking... seems clear.
Studies have been fairly limited so far, given the recency of e-cigarettes (relative to science's timescale). And the studies that we have seem pretty mixed: some showing benefit over other accepted smoking cessation methods, some not. Some showing higher relapse rates in the e-cigarette group. Nothing about that seems clear to me.