Cravings for a Reality Check

A surge in respiratory illness and death associated with vaping and electronic-cigarette use calls on health agencies and departments to prevent new cases.

a map of the united states

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Over the past few months, the nation has been alarmed by a surge in respiratory illness and death associated with vaping and electronic-cigarette use. As of December 3, over 2,200 cases of hospitalized lung injury and 48 deaths related to e-cigarettes and vaping have been reported. Patients suffering from the illness, which resembles lipoid pneumonia and other respiratory diseases, experience cough, shortness of breath, chest pain, nausea, gastrointestinal pain, and fever among other symptoms.

As the map shows, the states marked with the darkest colors have been hardest hit. Texas has had over 200 cases; California and Illinois 150-199 cases; New York, Pennsylvania, Indiana, and Utah 100-149 cases. Nineteen states have suffered from 10-49 cases, and ten others have been afflicted with 50-100. Thirteen states and the District of Columbia have had less than 10 cases of lung injury.

At the start of the outbreak, health agencies and departments issued unclear warnings about vaping and e-cigarettes and advised the public to refrain from using the devices altogether. These early alerts ignored that there are a variety of different types of vaping devices. Failing to differentiate between retail and counterfeit products and between nicotine and THC devices put the public’s health at risk. Many initial warnings also failed to mention that oil-based additives in counterfeit THC (the psychoactive compound in marijuana) vape cartridges are the key suspect responsible in the lung disease epidemic.

Massachusetts, which has had 46 cases, temporarily outlawed the sale of all vaping products from September through December 11. Other states have issued executive orders and regulations related to vaping products.

For now, according to the CDC, we know Vitamin E acetate has been found within the lungs of most cases and most patients disclosed using THC products. States are continuing to report new cases of lung injury and death on a weekly basis, and other substances continue to be investigated as the cause of injury.

Databyte via Outbreak of Lung Injury Associated with the Use of E-Cigarette, or Vaping, Products. Centers for Disease Control and Prevention, December 31, 2019. Data visualization by Jamal Yearwood.