Vaping

Blaming Breathing Problems on 'Vaping' Is Like Blaming Food Poisoning on Eating

Two dozen patients hospitalized in the Midwest all reportedly had vaped something at some point, but we don't know what it was or whether it caused their symptoms.

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Health says the recent hospitalization of about two dozen people in the Midwest who had breathing problems after vaping shows "why e-cigarettes are so dangerous." Since we don't know what these patients were vaping or whether it was actually the cause of their symptoms, that conclusion is quite a leap.

So far 15 cases have been reported in Wisconsin, at least six in Illinois, and at least four in Minnesota. In addition to shortness of breath, the patients' symptoms have included coughing, fever, vomiting, diarrhea, headache, dizziness, and chest pain. "It's unclear exactly what the patients—many of whom are young adults—had been inhaling or what type of devices they were using," NBC News reports. "Nor do doctors know where they had purchased the devices or e-liquids." The New York Times notes that "officials are not yet clear whether vaping caused the injuries, and if so, what ingredient in the e-cigarette or vaping systems was responsible."

The assumption that vaping caused the breathing problems seems to be based on little more than supposition. "We are continuing to interview patients so we can identify a possible cause," Andrea Palm, secretary-designee of the Wisconsin Department of Health Services, said in a press release. "All patients reported vaping prior to their hospitalization, but we don't know all the products they used at this time. The products used could include a number of substances, including nicotine, THC, synthetic cannabinoids, or a combination of these."

Emily Chapman, the chief medical officer for Children's Minnesota, a pediatric health system based in Minneapolis, told NBC, "We know there are certain characteristics in common with these cases, but we have not been able to get to the bottom of exactly what aspect of the vaping habit or product or solvent or oil is causing the injury." David Gummin, the medical director of the Wisconsin Poison Center, likewise told the Times: "We don't yet know the causative agent. We have no leads pointing to a specific substance other than those that are associated with smoking or vaping."

The Times says "one hypothesis" is that "the teenagers had purchased a nicotine or cannabis-derived vaping product that had been used once, and then refilled with dangerous substances that would be hard to detect." The paper notes that "patients reported using open-tank systems and devices with interchangeable cartridges," meaning they were not necessarily using commercially produced e-liquids.

At least some of the patients were vaping not nicotine but a cannabis extract, or what they thought was a cannabis extract. "People will buy them from the states where it is legal and they'll bring them back to states such as Wisconsin where it's not legal," the brother of one patient told NBC. "You don't know if you're buying something from a middleman that picked it up from a dispensary or if you're buying it from somebody who has tampered with it and made their own mixture. You literally don't know what you're inhaling into your body."

In this context, linking these cases to Juul, the leading e-cigarette company, seems like a non sequitur. Yet that is what both NBC and the Times did, citing a 2018 study that found some flavoring agents used in e-cigarettes, when mixed with solvents, produce acetyl compounds that can irritate the lungs. It's not clear what that has to do with breathing problems people experience after vaping black-market cannabis extracts or synthetic cannabinoids.

"There are still many unanswered questions, but the health harms emerging from the current epidemic of youth vaping in Minnesota continue to increase," Ruth Lynfield, medical director at the Minnesota Department of Health, said in a press release. Since the "unanswered questions" include which products the patients used and what drugs they delivered, tying these cases to the "epidemic of youth vaping," a phrase associated with the use of commercially produced nicotine delivery devices such as Juul, makes little sense.

Lynfield added that "we are encouraging providers and parents to be on the look-out for vaping as a cause for unexplained breathing problems and lung injury and disease," which pretty much guarantees that we will hear about more cases supposedly caused by e-cigarettes. "Could it be that these particular patients were smoking something in common?" Christy Sadreameli, a pediatric pulmonologist at the Johns Hopkins Hospital in Baltimore, said in an interview with NBC News. "Definitely possible. It's also possible that as clusters become evident to physicians, we start to look out for things more."

In other words, once people hear that "vaping"—of what exactly, we're not sure—causes breathing problems, they are more likely to attribute breathing problems to vaping, reinforcing the impression that a causal relationship has been established, which in turn encourages more such reports, and so on. Even when symptoms actually are related to vaping, the specific agent and causal mechanism, which may differ from case to case, are lost in a sea of anecdotes. Without that information, blaming these cases on "vaping" in general, implying that all forms of it are equally dangerous, is about as helpful as blaming food poisoning on eating.

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  2. Maybe they all had Zika infections!

  3. Of the 21 patients in WI and MN, how many had asthma or some other underlying malady?

    1. The symptoms don’t even overlap well. Vomiting, diarrhea, stomach pain, fever, and difficulty breathing is not the same set of symptoms as headache, dizziness, chest pain, and difficulty breathing despite the one commonality.

  4. I’ve always wondered about inhaling all that vapor. kind of like slowly drowning oneself

    1. It’s certainly not great for your lungs. I’ve been trying to switch from smoking to vaping and while it’s a hell of a lot better than smoking you still feel it. Haven’t drowned yet, though!
      I don’t know what happens to the little bit of propylene glycol that gets deposited in your lungs. Gets coughed out or absorbed somehow I imagine.

      1. It’s certainly not great for your lungs.

        Depends on the lungs. As long as you’re not someone suffering from chronic infection or COPD, it’s not terrible (assuming it’s clean). I can’t imagine it’s phenomenally worse than breathing normally in FL, LA, S. MS, S. AL, or S. GA 24/7. Certainly not worse than a hour of automotive exhaust every morning and evening.

        1. I agree. All I mean is that not vaping is better for your lungs than vaping, all else being equal.

          1. Not 100% disagreed, just unable to confirm or distinguish from noise.

            My wife and son both have asthma. While not used daily, nebulizers and vaporizers absolutely do enhance their lung health or, at least, significantly improve quality of living.

            1. Oh, yeah, I’m sure those things are beneficial. I’m thinking nicotine e-cig kind of vaping.

      2. Propylene glycol is water soluble and commonly used as a solvent in food additives. Vaping in general is like sniffing perfume.

    2. Sure, in the same way that smoking is like being buried alive…

  5. I was in California a few weeks ago for work and saw some pretty ridiculous anti-teen-vaping ads on TV. It was like the anti-drug ads of the 80s. You’d think they were talking about heroin or something the way they portrayed the dangers of nicotine.
    Always need something to freak out about.

  6. Maybe some types of vaping aren’t as dangerous as others.

  7. There’s a big problem with fake cannabis cartridges.

  8. People don’t need to deal in the black market if the product is legal. Could these people actually be so ignorant to basic economics or is there a malicious intent?

    1. The malicious intent is from a bunch of health panic purveyors and anti-tobacco marketers (and the often ill-defined “health professionals”) whose careers have been funded by the big tobacco settlement, wanting to carry on in the upper-middle-class semi-professional style to which they’ve become accustomed.

      That’s why the tone of anti-vaping commercials looks like the anti-heroin or anti-cigarette ads of yesteryear: it’s the same agencies writing the same grant requests of the same government agencies…and they don’t give a fuck if vaping is 95% safer than smoking, they want them jerbs!!

      1. sigh. The first “agencies” above, should, of course, be “AD agencies”.

        1. Someday we may have the technology to change, or ‘edit’ our comments after they’ve been submitted. Perhaps in the far future after we’ve been to the Moon, and developed ‘thinking machines’ of some sort.

          1. I agree that there must be some special interests with deep pockets somewhere but is the Wisconsin Department of Health really getting a kick back? They act more like ideologues than frauds, just using the teen vaping “epidemic” to grand stand. I just don’t understand why the anti-vaping notion is so pervasive. Maybe you’re right and they are just looking for something to do.

          2. I think edit is actually a bad idea. Unless there is no editing after a reply has been made, and replies not being allowed to be submitted if there was an edit between view and reply.

            That’s more logic than the average web lackey is willing or able to do.

  9. Perhaps they all vacationed in the Dominican Republic recently…

  10. If someone runs a red light and hits someone who has been drinking, but otherwise following all traffic laws, the accident will be deemed “alcohol related,” the guy who was drinking will get a DUI, and have to fix the car that hit them.

    I suppose it’s a similar rationale here. If someone has breathing problems, and vaped at some point in their life, vaping was the cause. Not the two packs of Camels a day they smoked before vaping got them off the tobacco.

    Nope. It was the vape.

    1. TRust me, it will be blamed on the camels first.

      1. I don’t trust you.

  11. Call me old fashioned, but a bowl is a bowl, a joint is a joint, and a cig is a cig. These vape things make it difficult to manage quantity.

    But as I’m enjoying the fruits of legalization in the form of destroying my life via edibles, perhaps that’s just a personal problem.

    1. Mmmmmm…. Edibles….

    2. As someone with asthma, I love the edibles!

  12. Well, SOMETHING has to be blamed for a person’s inability to breathe easily.
    It might as well be vaping.
    Either that or global warming.

  13. Juul has taken over the market because of delivery system using disposable cartridges and because they figured out how to use nicotine salts rather that freebase nicotine. The salts deliver a more satisfying “hit” and absorb faster. The solvent uses propylene glycol and glycerin, both are used as food additives.

    People who use those refillable things with some juice somebody cooked up in their basement are taking their own risks.

    And the symptoms listed are completely nonspecific and likely unrelated.

    1. I wonder if none of the patients with problems vaped from Juuls. If none of them had, would these health professionals (or journalists) report that fact, to divert vapers from likely more dangerous sources, or would they keep mum, to avoid debunking a good bit of anti-vaping propaganda?

      I doubt that these cases represent a big general problem with vaping, because if there were one, it would have been noticed much earlier and unmistakably.

  14. When he was in the Navy in WWII, my father had the opportunity to start smoking, and military policy at the time encouraged it. He said it just didn’t “seem” like it was a healthy thing to do so he never started. We now know, of course, that smoking tobacco is potentially deadly. Vaping doesn’t seem to me to be all that good for you. We definitely need more science before coming to any definitive conclusions, but those who claim vaping is harmless are as foolish as those who know for a fact that it is dangerous. I’d err on thee side of caution, but that’s just me.

  15. OMG!! 0.000024% of the Midwest population got sick enough to be admitted to the hospital and when asked admitted to having vaped at some point in their lives.

    The other 2% that were sick in the exact same way never vaped or admitted they did. Its a plague – call in the red cross!!!

    Smoking is the perfect example of parrots parroting — How many smokers die of old age again? Oh, yeah, like 100% of them. Lung cancer kills more non-smokers than smokers. The oldest living person smoked her whole life.

    Beware of the propaganda.

  16. VAPING IS KILLING OUR YOUTH!! Oh, wait, that was pot…..

  17. You’ll die if you don’t eat but there’s no physiological requirement that you vape.

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  19. While I question vaping as a healthy activity, I also question the results from the recent reports. Seems to me its geographically limited. Surely, there is far more vaping in California, Texas, and Florida than these other states, yet no reports there.

  20. People have been vaping for more than 10 years now. If this were a common side effect, we would have heard about it several years ago, especially when you consider all the scrutiny vaping has gotten, even before Juul came on the scene. One of these people reported vaping THC extract, so my guess is this is the culprit. But the media will use every opportunity to malign vaping without ever fact checking. It’s like refer madness and the 1970s angel dust scare all over again

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