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While federal health officials are continuing to investigate reports of severe respiratory illnesses among users of e-cigarettes, a growing number of doctors are voicing concerns that they have seen vaping problems from JUUL and other products for years, suggesting that federal regulators have missed warning signs.
The U.S. Centers for Disease Control and Prevention (CDC) announced last month that it has identified at least 215 cases of vaping respiratory illnesses reported between June 28 and August 20. The problems come from 25 different states, and are part of a multi-state outbreak investigation launched only weeks earlier, which involves at least two deaths.
According to an NBC News report, doctors nationwide are now speaking out, saying these illnesses are nothing new, but regulators have not started to put all the pieces together until now.
When they were first introduced electronic cigarettes had very little regulatory oversight, meaning no one in the government was responsible for ensuring they were safe, there were no required clinical trials or testing, and they were not even considered tobacco products.
The U.S. Food and Drug Administration (FDA) began regulating the products in 2009, but has faced harsh criticism over its failure to prevent manufacturers like JUUL from aggressively marketing their products to teens and prior non-smokers, featuring flavors like bubblegum and cotton candy, and designs that are intended to hide vaping from adults.
In recent years, a growing number of studies and safety reviews have highlighted serious health effects associated with the widespread use, including a JUUL vaping addiction epidemic among teens and young adults with no prior history of smoking.
In addition to JUUL, there is a massive variety of liquid nicotine products, cartridges and pods that contain chemical cocktails designed to simulate a wide variety of flavors, deliver nicotine at various levels, and even designed to either generate lots of visible vapor or none at all. Many of these are imported from other countries, with very little oversight or indication of what is actually in them.
Many doctors say it was a problem waiting to happen, and that they have been seeing individual cases of respiratory illnesses from JUUL and other vaping products for years.
One example was highlighted in a case report was published in the medical journal Diffuse Lung Disease in 2015, involving a 31-year-old woman who fell ill after vaping, leading the authors to warn that vaping could cause acute lipoid pneumonia.
Nearly five years later, the CDC and FDA report they are now aware of hundreds of cases involving severe lung disease linked to vaping nationwide, including deaths in Illinois and Oregon. Illinois Department of Public Health (IDPH) officials requested help from the CDC just days before the death was reported. The other death in Oregon is awaiting confirmation of a link to vaping, but has been reported by multiple media outlets.
CDC Seeks More Information From Doctors
The CDC has not indicated whether the JUUL and other vaping lung disease cases are the same as doctors have been reporting for years, or even that the illnesses are all connected to a common product. However, both the FDA and CDC have issued public health warnings over e-cigarette respiratory illnesses this week, calling for consumers to avoid using JUUL and othe re-cigarettes if they do not already use the products.
The CDC has also released a clinical action alert, calling on doctors to report any possible cases of vaping lung illnesses to their state health department.
Federal health officials indicate that it is important to collect as much information about the vaping products used. Doctors should try to find out if they were using commercially available devices or liquids, if they were sharing e-cigarette products with other people, if they were reusing old cartridges or pods, or if they were heating a drug to concentrate it, then using a specific type of device to inhale it, which is known as dabbing.
In addition to the cases of lung disease, the U.S. Food and Drug Administration (FDA) has received at least 127 reports of seizures and other neurological symptoms believed to be linked to e-cigarette use. The agency is investigating whether there is a direct relationship between vaping and seizures, or other adverse neurological events.
A stream of additional studies published over the last few years have linked e-cigarette use to seizures, pneumonia, fungal infections of the lungs, and respiratory health risks, among many other adverse health effects.
In the coming weeks, Michigan will become the first state to ban the use of flavored e-cigarette products, as a law signed in June (PDF) goes into effect.
This new information comes amid a growing number of JUUL vaping lawsuits filed by young adults, teenagers and parents, claiming that the manufacturer of the most popular form of e-cigarette targeted their addictive product toward teens and withheld important safety warnings.