Bill Monahan: Graceful Health: Health aid gone wrong


E-cigarettes - have you heard of them? Originally created to help adults stop nicotine use and smoking, e-cigarettes have instead become an alarming health story we all need to take seriously.

Electronic-cigarettes, also known as "e-cigarettes," are devices with a battery inside that heats liquid into an aerosol (vapor). Vaping is the term for use of this device because of the vapor that is inhaled. The user inhales the vapor in an activity similar to smoking.

EVALI causes injuries, deaths

The e-cigarette was first patented in 1963, and the use of e-cigarettes has ballooned since 2007, leading to a lung injury disease that can damage and kill. E-cigarette Vaping Associated Lung Injury (EVALI) is the term for this disease.

Statistics for this disease change on a daily basis, but recent reports from the U.S. Centers for Disease Control (CDC) indicate that more than 1,600 Americans have been affected by EVALI, and at least 34 have died.

The three most common uses of e-cigarettes are for ingesting nicotine, THC (the chemical compound in marijuana that creates the feeling of being "high"), and hash oil or Dabs (illicitly produced products which also contain THC). THC products obtained off the street or from informal sources (e.g. friends, family members, or illicit dealers) are linked to most of the cases and thus play a major role in the outbreak.

Young people most affected

The data also indicates that this is primarily a young person's disease.

Among EVALI patients for whom we have data, 79 percent were under age 35; 78 percent were non-Hispanic white; and 70 percent were male.

Also, recent data shows that 20 percent of high school students have used e-cigarettes (compared to 3 percent of adults), adding to concerns that the incidence of this disease has not yet peaked.

THC and Vitamin E Acetate

No single ingredient or compound has emerged as the definite cause of EVALI, and more than one substance may be involved. But recent studies point to two major culprits: THC and Vitamin E Acetate, a substance added to vaping products that contain THC.

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Among the EVALI patients who have died and for whom the CDC has data, 84 percent used THC-containing products.

THC and Vitamin E Acetate are also implicated in non-lethal cases of EVALI. THC is present in most of the samples tested, and most EVALI patients report use of THC-containing products. One study showed that among EVALI patients who used e-cigarettes for at least three months preceding symptoms, 86 percent used THC products, 64 percent used nicotine products, and 52 percent used both.

Also, a CDC analysis found Vitamin E Acetate in all lung fluid samples taken from 29 hospitalized EVALI patients.

We recommend that you do not use e-cigarette or vaping products, especially those that contain THC. Also, please remember that nicotine inhaled by vaping is also implicated in EVALI.

Adults addicted to nicotine who are using e-cigarettes should weigh all risks and benefits, and should consider using FDA-approved nicotine replacement therapies instead of vaping or combustible tobacco. There is no safe tobacco product. All tobacco products, including e-cigarettes, carry a risk.

Free quit support

The state of Vermont is now offering an e-cigarette quit support program specifically for teens and young adults. Teens and young adults sign up to receive free text messages aimed at building confidence and skills to quit vaping. The messages show the real side of quitting, both the good and the bad, to help young people feel motivated, inspired and supported during the quitting process.

Vermont teens and young adults aged 13-24 can text "VtVapeFree" to 88709 to enroll.

Since this program launched nationally in January 2019, over 50,000 young people have enrolled in the free program. Data published in Nicotine & Tobacco Research journal showed that the 30-day quit rate for those using the program was 15.5 percent.

Great American Smokeout

Any day is a good day to stop smoking and vaping, but why not use the American Cancer Society's Great American Smokeout next week, Thursday, November 21, as your day?

I'm a certified Tobacco Cessation Specialist, and I can consult for free with anyone dealing with smoking, EVALI or vaping. Call me at 802-365-3715 to talk.

Bill Monahan, RN, is Grace Cottage's Community Health Team Outreach Coordinator. He received his Associate's degree in liberal studies from Berkshire Community College, his Associate's in nursing from Greenfield Community College, and his bachelor's in health advocacy from UMass-Amherst.


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