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News recently broke that an Ontario teen was put on life support due to what public health officials are calling the first-reported case of illness linked to vaping in Canada. At the time of publishing, there have been seven deaths already linked to similar lung-related illnesses in the U.S.
Now, the Canadian Medical Association wants to tighten the rules around federal laws that pertain to the selling of e-cigarettes.
Dr Yoni Freedhoff gives us a crash course on everything we need to know about vaping and related lung illnesses.
Is vaping safe?
According to Freedhoff, vaping is not risk-free, meaning he doesn’t deem it to be safe. There are already risks in terms of nicotine addiction, as well as the danger in the inhalation of chemicals, which was around even before the recent mysterious lung disease that has led to lung damage. It’s important to consider the factor of unknown in which vaping just hasn’t been around for long enough for science and medicine to have a sense of risks over time.
It’s also important to be aware that in rare cases, defective vaping products (especially batteries) may catch fire or explode, leading to burns and injuries.
Can it help with quitting smoking?
For those thinking of quitting smoking, switching to vaping is a form of harm reduction. The scientific consensus does acknowledge that vaping is a better substitute to smoking. Combustion by-products from smoking are absent when it comes to vaping with the risks of smoking being on a large scale. Around half of long term smokers die as a consequence of smoking.
Second hand vapour
Second hand vaping is not harmless compared to second hand smoking, but it does contain far fewer chemicals. Bystanders can still be exposed to vapour that is exhaled by users. It’s still unknown of the health effects from exposure to second-hand vapour. However, compared to smoke from a tobacco product, the risks are expected to be much lower.
The biggest risk of second hand vapour is of children and teens seeing their peers vaping and wanting to try it themselves.
A recent survey of high school seniors found that the number who have vaped nicotine in the past 30 days has doubled since 2017, which is the largest increase ever recorded for any substance in that survey’s 43 year history.
How much nicotine?
E-cigarettes contain as much nicotine as traditional cigarettes, and in some cases, more. It was reported that a 21-year-old turned back to cigarettes to help himself quit vaping after finishing a pod in three hours, because one e-cigarette pod of a certain brand contains just as much nicotine as a pack of cigarettes.
There’s still potential for addiction based on the amount of nicotine exposure. Nicotine, however, is not known to cause cancer. It’s approved for use in nicotine replacement therapies, such as the patch or nicotine gum, but there are still nicotine-related risks. Nicotine can raise blood pressure from increasing circulating adrenaline which speeds up the heart rate and causes the arteries to narrow.
In 2018, a report by the National Academies of Sciences, Engineering, and Medicine found that there’s conclusive evidence most e-cigarette products contain and emit numerous potentially toxic substances in addition to nicotine. This includes chemicals that can damage cells or cause lung disease or cardiovascular disease. E-cigarettes produce ultrafine particles, which are connected to lung and cardiovascular issues. Compared to tobacco products, vaping substances have fewer and different chemicals.
The main liquids in vaping products are vegetable glycerine and propylene glycol. These are considered safe for use in many products like cosmetics and sweeteners. However, the long-term safety of inhaling the substances in vaping products is unknown and studies are still being assessed.
Food manufacturers use chemicals to add flavour to their product which are also being used in vaping products. Though these ingredients are safe to eat, they ingredients have not been tested to see if they are safe to breathe in.
The vaping process needs the liquid to be heated but there is no burning during this. It can create new chemicals, like formaldehydes. Some contaminants such as nickel, tin and aluminum might also get into the vaping products and then into the vapour.
Though the number of chemicals added to vaping liquids may be low, they often interact with one another forming new compounds which can indeed carry risks.
Symptoms of lung illness
There are a number of early symptoms that patients who have been diagnosed with severe lung illness linked to vaping. These include fatigue, nausea, vomiting, coughing and fever, escalating to shortness of breath, which can become so extreme it can lead to an emergency room visit or require immediate hospitalization. In as many as a third of cases analyzed in The New England Journal of Medicine, some patients have needed supplementary oxygen, including a ventilator.
Compared to teens who never vaped, researchers found that e-cigarette users were twice as likely to experience a chronic cough, phlegm, or bronchitis.
Health investigators believe that these illnesses are linked to vaping for a number of key reasons: The patients have vaped either nicotine, marijuana extracts, or both, and don’t have an infection or any other condition that would explain the lung disease.
Patients are now characterized as having the illness only If patients have reported vaping within 90 days, they are now characterized as having the illness. Some patients have vaped more recently in some of these cases.
For more information, you can watch our interview with Dr. Yoni in the video clip above.