Electronic cigarettes (e-cigarettes, or e-cigs)first lit up the smoking scene in 2016.They were promoted as a means to help recalcitrant tobacco smokers to quit. Eventually, youngsters and even non-smokers gravitated toward e-cigs and the fad grew.Marketingsoon followed with labels and flavours like “Fruity Pebbles”, “Cherry Rush”, and “Apple Jacks. Within months of the flavours-induced success of e-cigs, counterfeitersemerged with “flavours” that contained addictive additives that launched a new condition now coined EVALI disease. The EVALI condition exhibits pneumonia-like symptoms and can lead to severe illness and even death.  Medical experts are trying to answer the question: Why is vaping so harmful?

A condition in search of an identity

The EVALI disease is new and remains ill-defined. It’s an acronym for: “E-cigaretteVaping Associated with Lung Injury”. Note that the official term for the condition refers to it as an “injury” versus a “disease”. Vaping is the act of inhaling substances in an aerosol form via a battery-powered electronic cigarette.

EVALI is potent and its effects are immediate. Regular tobacco smokers may go years or even decades before exhibiting symptoms of inhaling nicotine, butmany vapers seek medical help within a few weeks of using e-cigs.Vaping was declared an epidemic in April 2019,and by September much of the public had been dissuaded from the harmful practice. Yet almost 2300 people in the US now suffer from the new lung disease linked to vaping, and 48 people have died. Sixty-seven percent of those affected by EVALI are white maleswhose average age is just 24. The ages of those who died range from 17 to 75.  Symptoms of the disease are coughing, shortness of breath, fever,hypoxia, and diarrhea.

Not all e-cigarettes are to blame for the disease. It is assumed that some makers of e-cigarettes produce safe products. The culprits that cause the disease seem, so far, to be the bootleg, black market e-cigarettes that contain THC (tetrahydrocannabinol) — the psychoactive component of marijuana — and the highly addictive substance vitamin E acetate, which is a sticky substance that attaches to the walls of the lungs. These bootleg e-cigs are sold undervarious fake brand names like “DANK Vapes”, according to the CDC. The CDC suspects such bogus products to be the root cause of the more than 2,000 illnesses and dozens of deaths across the 50 US states.Fifty-six percent of the sufferers used bootleg brands, reports the CDC. Eighty percent of the pulmonary illnesses have been contributed to vapes containing THC, according to the statistics announced by the Centers for Disease Control. In comparison, however, 38 million persons continue to smoke tobacco in the United States.

Raids and the media to the rescue

Because of concentrated media attention, the epidemic seems to have peaked in mid-September. Also, since the rapidly expanding epidemic mostly affected youngsters, teens, and twenty-somethings, law enforcement spurred into action. Much of the information helping experts formulate premises for their medical and scientific research was gathered as a result of aggressive police raids nationwide.A police raid in Los Angeles seized at least 7,200 adulterated and therefore illegal Dank Vapes, while Minnesota authorities discovered about 75,000 counterfeit Dank vaping products and other e-cigarette paraphernalia. Numerous similar seizures have occurred during the last several months and the evidence has been shared with the CDC and other appropriate agencies.

Still a mystery

Despite intense media attention and aggressive law enforcement, the definitive cause of the illnesses and deaths remains unsolved. Even though the overwhelming circumstantial evidence points to the Dank Vapes and other bootleg brands as the guilty parties causing the EVALIhealth crisis, Dank Vape and others are merely lowly suspects. Likewise, despite the fact that vitamin E acetate has been determined to be in the vapes used by many people with EVALI, that compound is still not considered what the CDC calls a “strong culprit” for causing the pulmonary illnesses. Moreover, unlike pneumonia, EVALI does not respond to antibiotics, which would be expected if the condition is an “infection” similar to pneumonia rather than an “injury”. Basic nicotine vapes have also not been ruled out. Forbes recently reported that President Trump is under pressure from a recent poll conducted by McLaughlin & Associates for the Vapor Technology Association (VTA), an industry trade group, not to ban all vape flavours. The investigation and research are continuing.

Vitamin E acetate is not safe to inhale into the lungs because it adheres to lung tissues. Doctors are still not sure, but hypothesize that when vitamin E acetate sticks to the lungs,that phenomenon triggers a still unknown secondary reaction that causes damagesto the lungs, resulting in a build-upof fluids.

Conclusion

While it is clear that e-cigarettes and vaping of aerosolized dilatory and addictive substances are a precursor to the EVALI condition, researchers are not yet clear on the cause. The cure, however, may be as simple as abstaining from the practice of vaping. Until the cause is known, it may be wise to refrain from vaping e-cigarettes even if your purpose is to quit smoking tobacco cigarettes. Both are dangerous and potentially deadly, but the effects of one appear to be much more immediate.