As students across the commonwealth head back to school, the Virginia Department of Health issued a warning this week about the dangers of e-cigarette use, or “vaping.” On Aug. 23, the first death of an individual with severe respiratory illness associated with vaping was reported in an Illinois resident.

According to the Centers for Disease Control and Prevention, as of Aug. 22, 193 potential cases of severe lung illness associated with e-cigarette use had been found in 22 states. Virginia is already reporting three cases and is investigating additional potential cases. All patients have reported vaping in the weeks or months prior to illness.

Symptoms of the respiratory illness associated with vaping have included gradual onset of cough, shortness of breath and/or fatigue that gets worse over a period of days or weeks until the patient has to be admitted to the hospital for treatment. Some patients have also reported vomiting and diarrhea. Anyone who has these symptoms and a history of e-cigarette use is advised to seek medical attention immediately. 

EVMS researchers are concerned as well, especially based on the results of a study published Aug. 19, “Vaping Expectancies: A Qualitative Study among Young Adult Nonusers, Smokers, Vapers, and Dual Users,” co-authored by Paul Harrell, PhD, Assistant Professor of Pediatrics, and Kelli England, PhD, Professor of Pediatrics and Director of the Community Health and Research division of EVMS Pediatrics.  

“The study found that young adults reported general uncertainty about the health risks associated with vaping,” Dr. Harrell says. “This uncertainty is justified as e-cigarettes are considered tobacco products under federal law and are not subject to the extensive testing for adverse effects that is involved with drug approval, such as for FDA-approved treatments for nicotine dependence. By comparison, our understanding of short-term and long-term effects for e-cigarettes is highly deficient.” 

Since 2014, e-cigarettes have been the most commonly used tobacco product among U.S. middle and high school students. Between 2017 and 2018 alone, the number of youth who used e-cigarettes went up by 1.5 million nationwide. 

Amy Paulson, MPH, Instructor of Pediatrics, is Director of the Consortium for Infant and Child Health (CINCH) based at EVMS. “Because vaping is a fairly new behavior,” Ms. Paulson says, “it may be years before we fully understand vaping safety and risks. But what we do know is that there are absolutely serious risks and potential harms for children, teens and anyone who doesn’t already use tobacco products. Because of these risks, we unequivocally recommend against children and teens using vaping devices or being exposed to secondhand vapor.” 

Dr. England says that her research division has been focused on working with the community to understand and intervene in the issue of youth vaping. “With input from teens and experts in the field,” she says, “we created and launched our RethinkVape campaign and website last year. We continue to work with community stakeholders to educate and provide resources on the issue.” 

Parents and health professionals should be aware of this warning from the Virginia Department of Health, Dr. Harrell adds. “It is not clear,” he says, “if this recent surge in reports of adverse effects is due to some novel substance recently added to the oils and liquids, increased awareness of the issue or some combination of the two. Investigators are attempting to understand if the ailments are caused by legal nicotine e-cigarettes, marijuana-type products, some type of street concoction or perhaps a contaminant or defective device. Anyone who reports similar symptoms should be asked about all legal and illegal substances inhaled.” 

Information on this illness is available at the Virginia Department of Health’s vaping web page. The number of confirmed Virginia cases will be posted each Thursday at that site. 

For help quitting any tobacco or nicotine product, consider using FDA-approved treatments, talk with your primary-care provider, call 1.800.Quit.Now or visit Quit Now Virginia.