November 30, 2019

You have likely heard recently about some people experiencing breathing problems, lung injury, and even death following vaping, or use of electronic cigarettes. Although not all of the details are clear at this time, we want you to be aware of the latest information and warnings from the Centers for Disease Control and Prevention (CDC).

The CDC has not yet identified the definite cause or causes of the lung injuries in these cases, although Vitamin E acetate is a “chemical of concern”. The only commonality among all cases is that patients report the use of e-cigarette, or vaping, products. Most, but not all, people who have experienced these problems reported using THC-containing products. (Note that THC is the component in marijuana that results in a “high”.)

According to the CDC, “…the only way to assure that you are not at risk while the investigation continues is to consider refraining from use of all e-cigarette, or vaping, products.” Please talk to your children about vaping and follow this timely and potentially life-saving advice.

From the CDC:
As of November 20, 2019, 2,290 cases of e-cigarette, or vaping, product use associated lung injury (EVALI) have been reported to CDC from 49 states (all except Alaska), the District of Columbia, and 2 U.S. territories (Puerto Rico and U.S. Virgin Islands). Forty-seven deaths have been confirmed in 25 states and the District of Columbia.

Recommendations:
• CDC recommends that people should not:
• Use THC-containing e-cigarette, or vaping, products.
• Buy any type of e-cigarette, or vaping, products, particularly those containing THC, from informal sources, such as friends, or family, or in-person or online dealers.
• Modify or add any substances to e-cigarette, or vaping, products that are not intended by the manufacturer, including products purchased through retail establishments.
• While the investigation is ongoing, vitamin E acetate should not be added to e-cigarette, or vaping, products.
• While it appears that vitamin E acetate is associated with EVALI, evidence is not yet sufficient to rule out contribution of other chemicals of concern to EVALI. Many different substances and product sources are still under investigation, and it may be that there is more than one cause of this outbreak.
• Adults using e-cigarettes to quit smoking should not go back to smoking; they should weigh all risks and benefits and consider utilizing FDA-approved nicotine replacement therapiesexternal icon.
• Adults who continue to use an e-cigarette, or vaping, product should carefully monitor themselves for symptoms and see a healthcare provider immediately if they develop symptoms like those reported in this outbreak.

If trying to quit smoking:
• Contact a healthcare provider for help quitting tobacco products, including e-cigarettes.
• Use evidence-based treatments, including counseling and FDA-approved medicationsexternal icon.

For youth or adults addicted to marijuana:
• Effective treatments are available and recovery is possible.
• People who have significant impairment or distress from ongoing problematic use of THC-containing e-cigarette, or vaping, products should seek evidence-based behavioral treatment and recovery services for cannabis use disorder.
• Visit Substance Abuse and Mental Health Services Administration’s Treatment Locatorexternal icon to locate treatment in your area, or call 1-800-662-HELP (4357).

If you are concerned about your health after using an e-cigarette, or vaping, product, contact your health care provider, or local poison control center at 1-800-222-1222.

Irrespective of the Ongoing Investigation:
• E-cigarette, or vaping, products should never be used by youths, young adults, or women who are pregnant.
• Adults who do not currently use tobacco products should not start using e-cigarette, or vaping, products. There is no safe tobacco product. All tobacco products, including e-cigarettes, carry a risk.
• THC use has been associated with a wide range of health effects, particularly with prolonged frequent use. The best way to avoid potentially harmful effects is to not use THC-containing e-cigarette, or vaping, products.

For further information, please consult the CDC website: https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease/need-to-know/index.html

This article was submitted by Ed Kraemer, M.D. and Steve Salanski, M.D., Co-Chairs, Lee’s Summit Health Education Advisory Board, a Mayor-appointed, volunteer board that promotes and advocates community health by assessing health issues, educating the public and government agencies, developing plans to address health issues, encouraging partnerships and evaluating the outcomes.