A Look at the Threat of Vaping-Related Illness

Have you heard of EVALI? It’s one of the hottest things hitting TV screens near you. 

Grey’s Anatomy Season 16, Episode 11; Chicago Med Season 5, Episode 12; and New Amsterdam Season 2, Episode 12; all featured medical cases related to the negative effects of vaping, or the inhaling of heated liquid (an aerosol) generated by a battery-operated smoking accessory.

What can I say? I like medical dramas for entertainment value and these three are my current favorites, and they can sometimes be educational. However, it’s important to remember that almost all fictional television shows are written for dramatic effect — they are called dramas, after all — so watch whatever you like while being mindful of its intended purpose.

This all brings up a bigger, more important question: Is all that’s being presented in prime time just fear-mongering or indicative of a legitimate concern? Let’s dig deeper. 

In the New Amsterdam episode Dr. Floyd Reynolds, played by Jocko Sims, tells the parents of a young male patient, “Jackson has extensive damage to both of his lungs. We’re going to have to perform what is called a bronchoalveolar lavage [BAL] to determine the extent of his injuries.”

Dr. Max Goodwin, played by Ryan Eggold, walks in just in time to hear the parents ask, “So, it’s not a heart attack?” He replies, “No. CDC is calling it EVALI.”

EVALI is an acronym for Electronic Cigarette or Vaping Product Use-Associated Lung Injury, and it’s not only showing up on television dramas.

The Centers for Disease Control and Prevention (CDC) is currently in the midst of a multi-state investigation into what’s been called a “national outbreak” of EVALI, in partnership with state, local and federal health-focused organizations.

On September 27, 2019, Mecklenburg County Health Director Gibbie Harris held a press conference after one person was pronounced dead of a vaping-related illness at a Greensboro hospital. Harris announced that two people in Mecklenburg County had been hospitalized with vaping related illnesses at that time, and 40 around the state.

She added that Mecklenburg County is participating in CDC’s ongoing investigation.

“We know what cigarettes do to the body, we’re learning what this does,” Harris told reporters.

More often than not, an individual suffering from EVALI has smoked a liquid that contained nicotine or THC, some sort of flavoring, and other chemicals. This is where we all should focus our attention, because some television programs, radio shows or even news articles forget to mention or elaborate on what it is that people are vaping.

A month after the Mecklenburg County press conference, Politico posted an article titled “The hazy science around vaping safety” in which Arthur Allen wrote, “The ongoing epidemic, which is mostly but not entirely tied to black market vapes containing the marijuana component THC, has killed at least 27 people and sickened nearly 1,300 as of Friday.”

His mention of black-market vape devices is key, as many retail stores have strict policies to guard against selling toxic products. 

Kim DeLaney-Surratt, owner of My Green House CBD in Concord, says she always requests third-party lab testing results for products to ensure they are free of pesticides and heavy metals. Her store is “now receiving notice of our brands becoming certified Good Manufacturing Practices (cGMP) and/or FDA compliant,” she said. “You will not find that happening on the black market. We have always been particular of what vape products we carry, even before the industry issues; scaling back to a [medium chain triglyceride]-free, vegetable-glycerine- & propylene-glycol-free cartridge. The difference is a cleaner experience and better overall product.”

CDC’s latest numbers, released on February 4th, state that a total of 2,758 e-cigarette, or vaping, product use-associated lung injury (EVALI) cases or deaths involving hospitalization have been reported to CDC from 50 states, and 64 deaths have been confirmed in 28 states, though North Carolina was not on the list.

Also this month, the CDC updated its website’s “What We Know” section in regards to EVALI specifically, stating that its lab data shows that “vitamin E acetate, an additive in some THC-containing e-cigarette, or vaping products, is strongly linked to the EVALI outbreak.”

The website also explains that “vitamin E acetate was identified in bronchoalveolar lavage (BAL) fluid samples (fluid samples collected from the lungs),” which flashed me back to New Amsterdam.

Here’s the kicker with all of this EVALI talk. The CDC isn’t ready to write off vaping just yet. In fact, the organization still sees a potential benefit for adults trying to kick a cigarette and/or nicotine habit, as long as they’re not pregnant and not using other smokable tobacco products on the side.

The U.S. Food & Drug Administration discourages use of e-cigarettes and vaping products by young people up to age 25 due to brain development, pregnant women for obvious fetal reasons, and non-smokers because of the unknown long-term health-related effects.

It’s that fear of the unknown that inspires my final thought: As with any time you put something into your body, do your own homework and make sure you’re comfortable with what you find. Perhaps most importantly, as with the journalism you consume, consider the source.

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