Vaping health crisis: the latest on lung injuries, exploding e-cigs, and seizures

THC-containing vaping products sold under the name Dank Vapes are the most common brand associated with vaping-related injuries, according to a new update from the Centers for Disease Control (CDC). However, there are regional differences in the brands associated with injury and hospitalization, and officials say that one single brand is likely not responsible for the outbreak of injuries. 

As of December 3rd, 2,291 patients were hospitalized with vaping-related injuries, now known as EVALI (e-cigarette, or vaping, product use-associated lung injury), in the United States. Only 1,782 of those patients provided information on the products that they used, and of that group, 80 percent reported using vaping products that contained THC at some point in the three months before symptoms began. The number of cases reported each week has declined since the middle of September, according to the updated data, published today in the CDC’s Morbidity and Mortality Weekly Report.

On Tuesday, New York Attorney General Letitia James announced a new lawsuit against e-cigarette company Juul, alleging that the company misled consumers about the risks of vaping through deceptive advertising.

In its lawsuit, New York alleges that Juul’s marketing of its products downplayed their health risks and used “colorful images of attractive, young models” to appeal to minors.

The past year has seen a skyrocketing rate of teen vaping, an outbreak of lung injuries, some serious regulatory shake-ups in the e-cigarette industry, and a whole lot of panic. With so many different vaping crises going on right now, we thought we’d provide a vaping roundup.

This post will be updated as new information emerges. 

Apple has removed all apps relating to vaping from the App Store, citing warnings from health experts that the spread of vaping products and e-cigarettes constitutes a “public health crisis and a youth epidemic.”

“[We’ve] updated our App Store Review Guidelines to reflect that apps encouraging or facilitating the use of these products are not permitted,” said Apple in a press statement. “As of today, these apps are no longer available to download.”

Samples of lung fluid from 29 lung injury patients in 10 states all contained the same chemical, the Centers for Disease Control and Prevention said today. The discovery is a huge step forward for the ongoing investigation into the severe and mysterious lung injuries that have affected e-cigarette users across the country.

The chemical, called vitamin E acetate is now considered a “chemical of concern” by the CDC, which is investigating the outbreak. As of November 5th, 2019, 39 people have died of the injury, and 2,051 cases are being investigated.

San Francisco will ban the sale of e-cigarettes entirely starting in 2020, after the resounding defeat of a proposition designed to thwart the restrictions. The ballot measure was the last hurdle for the proposed ban, which was passed into law in June.

Early results from the city’s Department of Elections show that slightly more than 80 percent of voters opposed Proposition C, which would have overturned the ban and paved the way for looser regulations. Initially, Proposition C was heavily supported by Juul Labs, which poured an estimated $18 million into promoting the measure. Efforts to defeat the proposition were spearheaded by former New York mayor Michael Bloomberg, who spent about $6.6 million to oppose the proposition.

One in four high schoolers and one in ten middle schoolers have tried vaping in the last 30 days, according to the 2019 National Youth Tobacco Survey released today. The survey results come as both states and the federal government have called for stricter regulations to stem the rising number of young people who use e-cigarettes. But current efforts may be falling short by continuing to allow mint and menthol flavors to be easily accessible. Another study, published today in the same journal, found that mint was the most popular flavor for Juul users in eighth through 12th grade. 

The numbers, published in the Journal of the American Medical Association suggest that there are now 4.1 million high schoolers using electronic cigarettes, about a half million more than the year before. And it’s a gigantic leap from five years ago, when just 4.5 percent of high school students reported vaping. Vaping became more popular than smoking cigarettes among students for the first time in 2014. There’s also been an uptick in how often the students are vaping. More than one in three of those who vape said that they’ve done so at least 20 days out of the past 30 days. That number was closer to one in four last year. The study authors note, however, that it’s more difficult to compare this year’s numbers to previous years because of changes to the questionnaire that reflect the changing brands on the market. And this was the first year that the survey was conducted electronically instead of using paper and pencil, which likewise makes the results tricky to compare to other years.

On Thursday, e-cigarette manufacturer Juul Labs announced that it would be suspending the sale of all fruity flavored vape pods until the products are fully reviewed by the Food and Drug Administration. 

“We must reset the vapor category by earning the trust of society and working cooperatively with regulators, policymakers, and stakeholders to combat underage use while providing an alternative to adult smokers,” Juul CEO K.C. Crosthwaite said in a statement Thursday. 

Nearly 1,300 people have come down with a serious lung injury related to vaping, as government researchers continue to investigate the cause of the outbreak. That’s an increase of over 200 reported cases since last week.

“We are concerned — with hundreds of new cases reported each week — that we’re looking at a very concerning outbreak, very difficult to control,” Anne Schuchat, principal deputy director of the Centers for Disease Control and Prevention (CDC), said in a press call today. “The data that we’re getting does not suggest this has peaked. It doesn’t suggest this is declining.”

Consumers should stay away from vapes that contain THC, the US Food and Drug Administration said today. People should also avoid all illicit vaporizers, regardless of whether they contain nicotine salts, tobacco, or THC.

As of today, more than 1,000 cases of the vaping-related lung injuries have been identified by the US Centers for Disease Control and Prevention, along with 18 deaths across 15 states. Almost three-quarters of patients have been men, and 80 percent of the patients have been under the age of 35.

Embattled e-cigarette heavyweight Juul is shaking up its leadership and marketing practices as the company faces increasing regulatory scrutiny. Juul announced on Wednesday that CEO Kevin Burns is being replaced by K.C. Crosthwaite, an executive at tobacco company Altria, which bought 35 percent of Juul in December.

In the same announcement, Juul declared that it is “suspending all broadcast, print and digital product advertising in the U.S.” The move comes a week after media companies CBS, Viacom, and WarnerMedia decided to follow CNN’s lead and ban e-cigarette advertising, including Juul, from their networks.

In California, federal prosecutors have launched a criminal probe into Juul Labs, the immensely popular e-cigarette manufacturer, according to The Wall Street Journal. The focus of the probe is unclear, but the investigation is being led by the US Attorney’s Office for the Northern District of California, according to the Journal.

Juul has faced a number of legal challenges in recent months, as government outrage grows over hundreds of illnesses linked to e-cigarette use, including seven deaths.

Walmart will stop selling e-cigarettes because of “regulatory complexity and uncertainty” surrounding the products. CNBC reported on an internal company memo about the change, and Walmart confirmed the news in a statement to The Verge.

“Given the growing federal, state and local regulatory complexity and uncertainty regarding e-cigarettes, we plan to discontinue the sale of electronic nicotine delivery products at all Walmart and Sam’s Club U.S. locations,” says the statement. “We will complete our exit after selling through current inventory.”

As the number of respiratory illnesses linked to e-cigarettes continues to rise, lawmakers and governors in states across the country are pushing for regulations on the products — including bans on flavors and increased oversight of counterfeit cartridges. But well-intentioned as they may be, it’s not clear that the proposals are targeting the source of the problem, or what kind of public health benefits they’ll have in the future.  

“I think the best regulations are those that are informed by science. That isn’t the case here,” says Thomas Eissenberg, co-director of the Center for the Study of Tobacco Products at Virginia Commonwealth University. 

India has banned e-cigarettes as US health inspectors investigate a series of deaths linked to vaping. Reuters reports that an executive order prohibits selling, producing, importing, or advertising e-cigarettes. First offenders could receive up to one year in prison and a 100,000 rupee ($1,400) fine; later violations could cost up to three years and 500,000 rupees. The ban doesn’t apply to actually using e-cigarettes — but it means users can’t legally buy refills for their vapes.

Traditional cigarettes are legal in India, although they’re highly taxed. E-cigarettes, however, have held a less certain position. The government has been weighing a ban for years, despite concerns over the legality of stopping imports, and Reuters reported on a draft of this week’s order back in August. “These novel products come with attractive appearances and multiple flavours and their use has increased exponentially and acquired epidemic proportions in developed countries, especially among youth and children,” said a spokesperson from India’s health ministry.

A group of senators is expected to demand that eBay, Alibaba, and Craiglist explain how they plan to counter the illegal sale of vaping products on their platforms in letters they will send to the companies on Monday.

In June, The Verge reported that e-commerce platforms like eBay were littered with e-cigarette listings. Some of these listings appeared to be authentic, brand-name products like Juul pods, while others were counterfeit. These items violate eBay’s policies, and while the company uses a variety of tools to remove the listings, it’s still fairly easy to purchase tobacco products and e-cigarettes on the platform. In addition to violating platform rules, there’s no method to verify that the purchaser is of legal smoking age either.

CNN will no longer run ads for Juul or other e-cigarettes, following reports of a deadly lung illness linked to them. The Daily Beast reports that CNN Worldwide president Jeff Zucker announced the news at an employee meeting; the network also confirmed it in a statement to the outlet. However, it says the policy may change in the future as health agencies continue to investigate the disease.

“Given the recent news reports of serious illnesses and deaths linked to the product category and the subsequent warnings ... CNN has revised its policies regarding e-cigarette advertising, and will not air ads in this category effective immediately,” a spokesperson told The Daily Beast. The ban might be lifted if “new facts come to light” during the investigations.

Henry Korman is exactly who Juul wants using its e-cigarettes. He’s not a teen, and he’s a former smoker, so he thought substituting a vape for cigarettes was a healthy decision when he switched two years ago. But then, he wanted to quit the Juul, too. He tried multiple times, cold turkey, to no avail. The Juul addiction stuck around, at least until he found sugar snap peas. 

“I carry around this big bag of sugar snap peas to keep me occupied and replace the Juul,” he says. “I used to say ‘phone, keys, wallet, Juul’ — that’s what I needed to have before I left the house. But now it’s ‘phone, keys, wallet, peas.’”

In a surprise meeting on Wednesday, President Donald Trump pushed to ban all non-tobacco-flavored e-cigarettes from the market. Trump discussed the proposal during a meeting at the White House after discussing the move with advisers like Health and Human Services Secretary Alex Azar and acting Food and Drug Administration Commissioner Norman Sharpless, Bloomberg reported.  

“Not only is it a problem overall, but really specifically with respect for children,” Trump told reporters. He continued, “We may very well have to do something very, very strong about it.” Secretary Azar said the FDA would soon issue regulatory guidance to remove flavored vaping products from the market. The secretary cited statistics showing five million children using e-cigarettes of some kind, a number he found “alarming.”

Federal officials announced today that over 450 people across 33 states and the US Virgin Islands have come down with a deadly lung illness that has been linked to e-cigarette use. That more than doubles the total number of reported cases nationwide — last week, the total stood at 215 possible cases in 25 states.

Officials in Indiana also announced today that a person in their state has died of the disease, bringing the nationwide death toll from the illness to three. The outbreak of the mysterious lung disease is one of two ongoing public health investigations related to e-cigarettes. In addition to trying to uncover the cause of the lung disease, the Food and Drug Administration is also collecting reports on possible seizures related to e-cigarette use.

US officials are working to track down a chemical contaminant that is potentially behind a rash of lung illnesses connected to vaping.

The Washington Post reported that while the investigation was ongoing, some state investigators had identified a potential lead: oil derived from vitamin E. Vitamin E can be found in almonds and avocados, and the oil is commonly used in beauty products and nutritional supplements. But inhaling it could pose risks. It acts like a grease coating a vaper’s lungs, Bryn Mawr College chemistry professor Michelle Francl told the Post.