Amid rising use of e-cigarettes among teenagers and college students — and the first death linked to vaping in Illinois — health officials around the nation are warning how little information there is about the consequences of long-term e-cigarette use.
The Illinois Department of Public Health (IDPH) released a statement Aug. 23 announcing the death of an Illinois resident who had recently vaped, and then died after being admitted to the hospital with a “severe respiratory illness.” To protect the anonymity of the person, there are no further details available.
“The number of cases of people reported to IDPH who have used e-cigarettes or vaped and have been hospitalized with respiratory symptoms has doubled in the past week,” the statement read. “A total of 22 people, ranging in age from 17-38 years, have experienced respiratory illness after using e-cigarettes or vaping.”
E-cigarettes are small devices used to inhale aerosols that typically hold nicotine, flavoring and other chemicals, according to the National Institute on Drug Abuse. Vaping refers to when a person inhales the vapor created when the device heats up and vaporizes the chemical liquid inside the device.
Another form of vaping is an e-cigarette device that contains tetrahydrocannabinol (THC) — the main ingredient in cannabis — and is commonly referred to as a dab pen. Some patients in Illinois admitted to using THC products as well before being admitted to the hospital.
The IDPH said symptoms of these vaping-related illnesses included coughing, shortness of breath, fatigue, vomiting and diarrhea in some cases. However, the statement also said no specific vaping product was conclusively linked to all the cases.
Some popular vaping products companies include Juul, Blu, Vuse and MarkTen. Juul is the most popular e-cigarette brand — especially among high schoolers and minors, despite the legal age to buy being 21 years old — due to its variety of tasty flavors and its easily concealable size, The Phoenix reported last year.
Last year, Loyola updated it’s on-campus smoking policy to prohibit the use of vapes inside buildings and within 15 feet of entrances, The Phoenix reported.
Mary Duckett, the health educator at Loyola’s Lake Shore Campus Wellness Center, said when she first started at Loyola in 2015, the university didn’t talk too much with students about vaping or its health risks because not many of the products had been developed or popularized yet.
Duckett said in 2018, a College Health survey among Loyola undergraduates revealed a seven percent increase in use of e-cigarettes at least once in the last 30 days compared to 2016. Because of such a big jump, she said the Wellness Center started to focus on vaping more.
For confidentiality reasons, specific numbers of patients who came to the Wellness Center with symptoms associated with a possible vaping illness couldn’t be given.
In 2016, the National College Health Assessment (NCHA) found 4.3 percent of college students reported “any use [of e-cigarettes] within the last 30 days.” Three years later, the number jumped to 14.3 percent.
Emma, a student at Loyola who requested her last name not be included, said she started vaping when she was 19 years old, but would just use her best friend’s. The 21-year-old said she bought her own a year ago, but recently stopped.
“I just got over it, like it was a phase,” said. “I was addicted, I think so … but it wasn’t like I had withdrawal symptoms or anything trying to stop, like I just threw it away one day, and I was like, ‘Okay, I’m over this.’”
Emma said her biggest reason for quitting was because of the affect it was having on her lungs.
“As I got into running, it would be frustrating that my lungs would wheeze, and I knew that was part of [vaping],” Emma said.
Joan Holden, the director of Loyola’s Wellness Center and a nurse practitioner, said the goal of the Wellness Center is to educate students both on what they know and what they don’t know about e-cigarettes.
Holden said the Wellness Center is hoping to launch a new initiative by the end of this academic year, which would consist of an e-cigarette screening and intervention protocol for medical staff to work with students. Students who come to the Wellness Center for a medical appointment would be asked a screening question about if they use e-cigarettes. If the student answers yes, they would be given information about potential health risks to vaping and resources to quit by a staff member.
A 19-year-old sophomore at Loyola, who requested to remain anonymous, said she doesn’t use nicotine vapes — such as Juul — but started using a dab pen this past summer. She said she used to use her friend’s pen, but then got one as a birthday present from a friend.
“It was always sort of a social thing for me … I’ll usually just do it if I’m hanging out with friends,” the student said.
The 19-year-old student said one of the big reasons she has a dab pen is because of its convenience.
“Having a dab pen means I don’t have to find a weed dealer, I don’t have to go out and buy however many grams of weed every month or whatever, and I don’t have to hide it, it doesn’t smell,” the sophomore said.
Duckett said she’s aware of the fact that some people vape with marijuana, but can’t specifically say what effects that might have.
“I think part of the issue with [vaping marijuana] is that you’re inhaling it straight into your lungs … and since that is a newer way to smoke it, we don’t really know exactly what those effects,” Duckett said.
Duckett said she thinks students may not know how dangerous it is to vape with nicotine — an addictive chemical — even if it doesn’t have tobacco, a dried-up plant used in cigarettes.
“I think with e-cigarettes, that students don’t always think about, is that they don’t contain tobacco, but they do contain nicotine, and so they are addictive because nicotine affects your brain as an addictive substance … so, you’re body’s becoming dependent on the e-cigarette vapor,” she said.
Even e-cigarettes without nicotine can have health risks, according to a study done by researchers at the Laboratory for Structural, Physiologic, and Functional Imaging at the University of Pennsylvania School of Medicine.
The study found healthy adults who smoked nicotine-free e-cigarettes experienced temporary inflammation of their heart and blood vessels.
The 19-year-old student said since she only uses her dab pen socially — and doesn’t use any vapes that have nicotine — she doesn’t worry too much about any health risks to her body.
“I’m sure there are health consequences, and I don’t want to be naive in saying, ‘Oh, I don’t really notice anything,’ like, of course there’s health consequences, it’s a drug,” the sophomore said. “I think that out of all the things I could be doing, and just taking in other factors in my life, I really don’t think that it’s going to affect me that much.”
Duckett said in addition to nicotine, e-cigarettes also contain many unknown and potentially unregulated chemicals.
“I think part of the thing with e-cigarettes is that they’re just starting to get regulated by the FDA [Food and Drug Administration], so people really don’t actually know what’s in them, and we don’t really know the long term effects,” she said.
Emma said even though she’s cut back her vaping, she still notices how it affects her lungs when she runs.
“That’s one of the reasons why … I’m like, ‘It’s clearly not worth it,’” Emma said.
In response to the death in Illinois, Dr. Robert Redfield, director of the Center for Disease Control and Prevention (CDC), issued a statement Aug. 23 saying the CDC is investigating with state and local health departments and the FDA to determine if the cause of death is related to vaping.
“This tragic death in Illinois reinforces the serious risks associated with e-cigarette products,” Redfield said in his statement. “Vaping exposes users to many different substances for which we have little information about related harms. … CDC has been warning about the identified and potential dangers of e-cigarettes and vaping since these devices first appeared. E-cigarettes are not safe for youth, young adults, pregnant women, or adults who do not currently use tobacco products.”