Vaping and lung disease in the US: PHE’s advice

Posted on 1st November 2019

What’s happening in the US?

Since mid-September, headlines around the world have warned about an outbreak of serious lung disease across the US, said to be associated with vaping. As of October 22, 1,604 cases have been reported to the Center for Disease Control (CDC) from 49 US states, including 34 deaths.

The US has an estimated 9 million e-cigarette users in the country, but weekly updates on the CDC website make it clear that the group of people affected is very specific. The outbreak appears to be largely among young men: 70% of patients are male and the average age is 24. Almost half (46%) are under 21.

Dr Dana Meaney-Delman, head of the CDC team investigating the outbreak has reported that “We’ve narrowed this clearly to THC-containing products that are associated with most patients who are experiencing lung injury. The specific substance or substances we have not identified yet”. THC is the main psychoactive component of cannabis and the CDC has said that the products identified are being obtained off the street or from other informal sources (e.g. friends, family members or illicit dealers).

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The specific chemical or chemicals that are causing the illness and deaths have not yet been identified and it is not clear that all cases are the same kind of injury. The outbreak does not appear to be associated with long term use of nicotine e-cigarettes, which have been used in the US for over 10 years. The first case was reported at the end of March this year and along with all the other cases appears to be linked with very recent use causing a rapid harmful effect.

Because of what’s happened, several US states have banned the use of flavourings in e-cigarettes and have called for urgent action.

Our concern is that the responses we have seen to the problem in the US and in other countries may increase the already widespread misunderstanding about the relative safety of nicotine e-cigarettes, deterring smokers from switching and risk driving vapers who have switched back to smoking. There is a real risk therefore that such a reaction will mean people continue to smoke, which will undoubtedly put lives at risk.

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