EVALI
The most recent news cycles have focused on the Coronavirus pandemic and the social upheaval going on across the country. But many of the concerns that we were having before have not gone away. One of these significant pulmonary concerns has to do with “e-cigarette vaping associated lung injury” (EVALI). As of February of 2020 there have been 2807 cases of EVALI requiring hospitalization and 68 deaths.
I think it is important to remind everyone that vaping devices were designed to optimize the delivery of an addictive substance (nicotine) through the use of an extremely high concentration of nicotine salts. One such device (JUUL) contains 40 mg of nicotine (@59mg/ml) which is greater than the amount of nicotine inhaled or absorbed when smoking an entire pack of cigarettes. This is interesting since the FDA has been trying to reduce the amount of nicotine in combustible cigarettes to help prevent addiction. Addiction specialists believe it takes only one to three vaping sessions to become addicted to nicotine.
The majority of EVALI cases were in young men and 30% had asthma. The initial culprit for this problem was suspected to be Vitamin E used as one of the stabilizing agents in e-juice. There are many other chemical associations, e.g. a significant number of EVALI patients also vaped THC, along with nicotine.
Controlling the vaping epidemic is as complicated as any other epidemic. There are not only medical, but also political, issues to be addressed. Hopefully, the current news cycle will not erase our concern.
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