The United States of America is suffering a growing public health crisis that shows no signs of slowing down. The only thing all victims have in common is that they vape. At press time, thirteen people have died in the US and there are 805 known cases of a mysterious, severe lung illness occurring in e-cigarette users, according to US health officials. Hundreds more cases than the first cited 530 were reported in the past week alone.
All patients with the unknown lung disease are being monitored as part of an investigation to determine the cause of the illness. There is one reported case in Canada and the teenager is now on life support.
The first demographic provided by the US Centers of Disease Control, according to The New York Times, shows that nearly three-quarters are male, with two-thirds between 18 and 34 years of age. Sixteen per cent are 18 or younger. More than half of cases involve those under 25 years of age. The sudden spate of illnesses still spans a wide age range.
E-cigarettes (vapes) are battery-powered devices which vaporise liquids that often are flavoured and contain nicotine. E-cigarette liquids contain less carcinogenic toxins than cigarettes and they have no tobacco, and many people use them to wean off cigarettes.
But although some people consider vaping as a safer alternative, laws in some countries prohibit e-cigarettes from being marketed in that way. Refinery 29 reports: “There may be higher concentrations of nicotine in e-cigarettes than in cigarettes . . . for example, one Juul pod delivers the same amount of nicotine as a pack of 20 cigarettes.” Some health agencies argue that although less, toxins are still present in e-cigarettes.
Patients have reported using nicotine, THC (the psychoactive ingredient in marijuana) or both in their e-cigarettes, and some use neither. Vaping liquids are meant to contain vegetable glycerin, propylene glycol and other ingredients for flavouring. Tests have found in more than half of the THC samples tested, vitamin e acetate, which should not be consumed through the lungs.
Many of the mysterious illness’ victims have admitted to using black market vapes. But still, no single ingredient or vaping product can yet be identified as the cause for the illnesses and hospitalization. The US Federal Drug Administration is preparing to implement a full ban on the sale of all flavoured e-cigarette products until approved, but some states, including Michigan, New York, Massachusetts and Rhode Island, have already acted on their own by implementing temporary bans.
Juul, the largest e-cigarette promoter, was cited as the biggest player in US under-age vaping. This week its CEO stepped down in the midst of the pressure and was replaced by Big Tobacco tycoon, Kevin Burns. The e-cigarette supporters speculate that the ongoing health crisis can create a loophole for the tobacco industry to regain the control it lost under growing vaping numbers worldwide.
As for Saint Lucia, along with the rest of the world, we only know what’s available in the US media about the growing health crisis. Health ministry permanent secretary Felix St Hill says there are no local concerns that have made it to his desk. Senior medical officer Dr Sharon Belmar-George alluded that there might be some worries within the ministry but referred this reporter to Charmaine Hippolyte, Director of the Substance Abuse Advisory Council Secretariat. Several attempts to contact the director proved fruitless.
Currently, there are at least two local e-cigarette retailers. Exhale Vapes and Island Vapes both believe the e-cigarette black market is the possible perpetrator of the US crisis. Island Vapes seems to be leaning towards the tobacco-rule theory. Exhale Vapes’ owner told this reporter that concern is growing locally but his products have been approved by respective health agencies in the countries where he sources his products. He said they contain all required certification to come through Saint Lucia’s Customs and Excise Department, and there are no health regulations to follow. “We did not have to go through the extra process here,” he said. “It would have already been screened. The receipts will have all the information Customs would need.”
He also vouches that his products are safe: “We will not have an issue. 95 per cent of our juices are from the UK, and the UK does not have that issue.” To Exhale Vapes, it would be “a bit of a stretch to ban everything, especially when we have measures in place.” The owner argues that the US has a federal issue with under-age use of e-cigarettes which threatens growing children’s health. “But we don’t allow anyone under 18 years into our store. We’re even thinking of bringing it up to 21.”
Exhale Vapes’ owner knows, however, that it might not take much for young people to order their own e-cigarettes off the online black market. “There can be more regulations, they can put a cap on persons ordering—you need to upload your ID, the credit card needs to match the ID photo and so on. There are ways to crack down on age limit. We should have some sort of order in place so people cannot just pick it up from Customs.”
For his part, the owner of Exhale Vapes thinks there should be more control and better effort by the health ministry in his industry.
