Confused vaping stories that cost lives
This week has seen a number of sensational headlines appear in US media, warning that “vaping” has been the cause of some clusters of illnesses, and in one distressing case, a death.
The US authorities have issued statements and warnings about ‘’e-cigarettes’’ and ‘’vaping’’, but what is the real story?
The real story is that all the evidence is currently suggesting that these illnesses have been caused by the use of black market cannabis products, not by vaping nicotine e-liquid.
Yet the exaggeration, obfuscation, and misinformation at play have linked vaping e-liquid to serious respiratory illnesses. This link has been repeated by media and opponents of harm reduction and vaping, and is likely to have a detrimental and long term effect on public health by encouraging smoking instead of vaping.
The following are statements made by health and public health professionals in areas that have seen these outbreaks of illnesses.
Four cases of respiratory illness in young adults with a history of vaping have been reported to the Iowa dept of health (IDPH). The patients are young adults (early to mid 20’s ) from across Iowa who reported vaping prior to becoming ill. These cases are still being investigated, but three patients have reported use of vaping products that contain THC. – Iowa Dept of Public Health – 22nd August
The first several cases we had, the patients were inhaling marijuana oil in some form’’ Harris said. ‘’We’re seeing this association with marijuana oil, definitely, in every case. Many of these patients are also doing e-cigarettes”
– Dixie Harris, a pulmonology and critical care specialist at Intermountain Healthcare, 19th August
All cases still under investigation have been hospitalised with severe breathing problems after vaping, including cough, shortness of breath, and fatigue. NMDOH, other states, and the Centres for Disease Control and prevention (CDC) are still investigating the possible causes of these illnesses. Cases have been reported vaping or dabbing (vaping marijuana oils, extracts, or concentrates) in the weeks prior to hospital admission. – New Mexico Department of Health, 21st August
According to the Indiana State Department of Health people are suffering from severe acute respiratory illnesses caused by substances used to vape. Indiana is investigating 11 cases. Dr Estes said vaping isn’t necessary the problem. ‘’Probably not directly correlated to the vaping itself opposed to what these individuals are vaping’’ Said Estes. The Health Department said these cases are a result of dabbing. A new way many people are smoking marijuana, using oils, extracts or concentrates. – Dr Marc Estes, Indiana State Department of Health, 19th August
After their health further deteriorated, doctors determined that patients instead had a condition called acute respiratory distress syndrome, and the cause was something surprising, said Kings County public health officer Dr Milton Teske. ‘’The only connecting factor that tied them all together was a history of vaping THC or CBD or some combination of that’’, Teske Said, referring to compounds in marijuana. – Dr Milton Teske, Kings County Public Health Department, California 21st August
Each mentions the use of THC or other cannabidiols. THC is a cannabinoid which gives the user the ‘’high’’ associated with marijuana use. In the US, in states which have legalised cannabis and indeed in others where it remains illegal, some people engage in ‘’dabbing’’, a slang term for using marijuana oils in vape-like devices specially designed for the purpose.
This is not the same activity as using an e-cigarette with liquids made from alcohol-based diluents like propylene glycol, glycol and nicotine – the ingredients in a commercially available vaping product.
Moreover, in US states that have legalised cannabis, once a product is sold through a dispensary or other regulated outlet, the product will have been subject to tight controls. In contrast, products which have been manufactured and sold illegally may be adulterated or contain processing contaminants.
It is paramount for public health, and for the millions of people who smoke or vape, that there should be proper communication which adequately informs the public.
Health authorities at Federal level in the US such as the Centres for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) have not done this. Their public statements on these illnesses continued to confuse over the past number of days.
The CDC have even gone as far as to evade direct questioning from journalists as to why these health issues have emerged just now, and not over the ten years since e-cigarettes emerged. Instead of making the difference between the use of black market cannabis oil and vaping nicotine clear, the CDC’s representative repeats some of the most blatant mistruths about e-cigarettes. These that have been shown to be such through many years of independent studies, and through evidence reviews by Public Health England, the Royal College of Physicians, and even the US’s own Academy of Science.
The US authorities are taking an entire category term ‘’vaping’’ and repeating concerns around ‘’e-cigarettes’’ without making it crystal clear that it is what is being vaped that is of concern.
Dr Michael Siegel posed the question ‘’why are the CDC and other health groups being so broad in their statements”, warning broadly against “vaping” or using “e-cigarettes” but failing to warn against the use of THC oil.
The answer, he believes, is that these organisations have such a preconceived conclusion that vaping is hazardous and such a bias against the use of e-cigarettes for smoking cessation that they are hoping to be able to attribute these cases to traditional nicotine vaping.
These reports from the USA do not change available evidence that vaping is significantly less harmful than smoking when the devices are used as intended (to deliver nicotine to smokers trying to quit). – Professor Linda Bauld
So how have the British media been getting the reporting so wrong?
The headlines have included:
First vape death as concerns grow about safety of e-cigarettes – Metro, 24th August
193 e-cigarette smokers in 22 US states suffering respiratory issues – The Independent (online), 24th August
Man ‘dies from vaping in world first’ as expert warns e-cigarettes are ‘harmful’ – The Sun, 24th August
Vaping death raises fears for 3m Britons – The Times, 25th August
Man becomes ‘first person in the world’ to ‘die from vaping’ – The Mirror, 24th August
World’s first vaping death recorded amid spike in respiratory illnesses linked to e-cigarettes – Daily Record, 24th August
None of these headlines can be considered factually correct. They all confuse the delivery method (vaping) with what is contained in the product being used.
The BBC even ran a news item on the Radio 4 Today Programme broadcast on the 24th of August, during which in the headline and the piece from their BBC America and Canada correspondent solely referenced ‘’e-cigarettes’’.
Where is the journalistic integrity evident here, if the reports of a link to THC/ backstreet cannabis oils were already in the public domain?
The IBVTA takes a dim view of this level of misreporting by British media, and we have have lodged complaints to the relevant bodies and editors.
Millions of vapers have used e-cigarettes as an alternative to smoking, for over ten years. If, suddenly after a publicised outbreak of illness from vaping illegal or illicit cannabis, a death is reported where the relevant Department of Health’s own website mentions the use of THC or other illicit products, are editors in this country doing the right thing in terms of factual correctness? The above headlines in the UK came after all of the statements by US health departments were made public. Should the link not have been made, and reported on?
As Louise Ross, former Stop Smoking Service manager and Vice Chair of the New Nicotine Alliance has said, ‘This is NOT science or medicine, this is a witch-hunt’.
Dr Aaron Scott, from the University of Birmingham, quoted in the Metro Newspaper, mistakenly makes a link between this case and the products available for purchase in the UK, and erroneously states that these are largely unregulated products here.
The facts are that vaping products are heavily regulated in the UK.
Manufacturers wishing to make a product available for sale in the UK must abide by a lengthy set of rules, where there is a list of banned ingredients in place, a set of toxicological risk assessments and product testing must be conducted, and products must be notified to the MHRA.
Furthermore, a list of the notified products is published on the MHRA’s website, and updated regularly as new products come onto the market.
To give an example of how out of control this new vaping panic has become, there are millions of people worldwide who use syringes to self-administer things for a range of reasons, from diabetes to fertility. Because a smaller number of people use syringes to administer drugs bought off the street, we would not see media reports that a syringe caused someone to overdose from a drug. Neither would we consider it justified to call for a ban on syringes.
Or, as others have stated in relation to the erroneous reports on vaping causing death and illnesses, we would not see bans on eating after an outbreak of food poisoning.
Vaping and e-cigarettes, via reputable products which comply with regulations are a viable, cost effective and proven route away from smoking. Should the UK’s 3.3 million vapers be concerned?
No. If you vape, continue to buy your vaping supplies from reputable retailers who can demonstrate due diligence in their product stewardship. If you are among the 7 million smokers who may be thinking about switching to vaping, you can be assured that if you visit a good quality high street vape shop, you will not befall the same fate as those who use illegally produced cannabis oils bought from backstreet dealers.
According to Deborah Arnott, Chief Executive of Action on Smoking and Health (ASH), “If you’re a smoker using e-cigarettes to help you quit or prevent relapse back to smoking and are having no problems with the e-cigarettes you are using, it would not be a good idea to stop vaping and revert to smoking. When you smoke you inhale toxic tar and carbon monoxide not present in e-cigarettes, so while vaping is not risk-free it is widely acknowledged by UK health authorities to be significantly less harmful than smoking.”
Lucy Eden, Scientific Lead of the IBVTA’s Steering Committee said: ‘’These recent media stories highlight the wider issue of reporting incidents without sufficient scientific scrutiny.
When people are choosing to improve their own lives by switching to vaping to get away from smoking, we cannot afford to be careless with the facts. Misleading reports risk sending people back to smoking, or stopping them from trying an e-cigarette in the first place.’’.