Newell: Louisiana's first vaping-related death should give vapers pause

Experts suspect black-market products to blame, but science is far from settled

Newell Normand
November 19, 2019 - 5:59 pm

Louisiana has recently joined a number of other states around the country that are experiencing fatalities that medical examiners determined to be caused by vaping. Vapers might want to do a little bit more research before determining whether or not they’re willing to accept the risk that vaping might make you seriously ill. Newell invited Assistant State Medical Director Dr. Joe Kanter to the program Tuesday morning to discuss.

“This seems to be an imminent threat,” Newell began. “Many confirmed cases of lung injury so far, and a number of deaths as well. What is the root cause of all this?”

“It is very unclear,” Dr. Kanter replied, “2,000 national cases right now, 42 deaths nationwide. The challenge is, while there are some strong leading theories, the experts at the CDC are not ready to say exactly what is causing this outbreak. They believe it's likely to be some sort of adulterant that’s added to vaping substances, perhaps to dilute it down. Vitamin E acetate has been mentioned many times, and there’s strong evidence pointing to that, but not conclusive evidence, so the jury is still out on what exactly is causing this.”

“Have we determined if the substances at the root of this problem are after-market products, as opposed to those produced by the leading vaping product manufacturers?” Newell asked.

“That is the suspicion,” came the answer. “That a large driver for this is substances being produced on the black market, then being diluted down. The challenge in Louisiana and most every other state is that people have gotten sick from vaping both legitimate and illicit products, so it’s difficult to narrow it down.”

“There was a similar occurrence when you think back to the synthetic marijuana challenges we faced as a country… the State of Louisiana took a very proactive approach to that by prohibiting substances through the regulatory scheme. Is that something up for consideration when it comes to these vaping products?”

“Well, there’s really two issues going on at the same time, and they get confused,” Dr. Kanter said. “There’s an outbreak of lung-associated injuries like we’re talking about here, we don’t know exactly what’s causing it. Separate from that, but connected is the dramatic rise in the rates of teen vaping. Many teens are being turned onto nicotine addiction through vaping, and it threatens to eliminate the gains we’ve seen in teen smoking rates. You’ve heard both the Governor and the Secretary of Health say they are highly concerned about that. Up until a week ago it looked like the Trump administration was going to ban flavored e-cigarettes - now there’s some backtracking on that, but we’re following that closely and discussions are ongoing.”

Later in the program, Heather Hutton called the talk line from the Louisiana Vaping Association.

“The vaping products you purchase in stores are regulated by the FDA,” Hutton said. “We have to submit ingredients list and they come and do regular site inspections of our manufacturers. And no contaminants have been found in any legal products that they’ve tested. All the contaminants have been found in the black market THC products… there’s this hysteria we’ve been lumped into, and it’s harmful to the public health when you have a product that has dramatically reduced the smoking rate and can help improve people’s quality of life. It’s a shame the public is getting scared away from using these safer alternatives.”

“I go to the FDA website, and it says no vaping product has been approved by the FDA for therapeutic uses, or authorized for marketing,” Newell said.

“They’ve not been approved, but they are regulated by the FDA. The approval process has been in the court system and the goalposts have been moved quite a few times - we’re regulated more strictly than the cigarette industry ever was… the cost of the regulations means that each product, each variation, each flavor, is subject to up to one million dollars of fees to get that approval. It’s so costly that most small businesses can’t afford it.”

“I guess in the end, you’re going to have to decide for yourself,” Newell concluded. “There’s just not a big body of science out there on this. As the number of cases of chronic lung disease increase, you’re not necessarily sure what you’re getting, when, where, why or how!” 

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