TOPEKA, Kan. (KSNT) – The recent increase in vaping illnesses has sparked a national conversation on vaping and the side effects that come with it.

Tuesday, it was confirmed that the sixth person in the United States to die from a vaping related illness was from Kansas.

Because of this, KSNT News is breaking down all you need to know about vaping, the illnesses associated with it, and what officials are saying.

What is vaping?

The Center on Addiction describes vaping as the act of inhaling and exhaling the vapor produced by e-cigarettes.

What do you use to vape?

E-cigarettes work by heating a liquid that contains nicotine, flavorings or other chemicals to make the vapor.

The juice that the e-cigarettes contain is called vape juice or e-liquid, according to the CDC. There are flavored options as well, such as watermelon, coffee, and apple pie, just to name a few. Users can also smoke marijuana and other drugs from the device.

E-cigarettes come in all shapes and sizes, such as USB drives, pipes, cigarettes, and cigars, among others.

Source: Center for Disease Control

One of the most popular brands in the U.S. is Juul; a USB shaped e-cigarette that has a high level of nicotine. According to the manufacturer, one Juul pod contains as much nicotine as a pack of 20 regular cigarettes.

What is in the vapors?

Besides nicotine, the American Cancer Society said e-cigarettes and e-cigarette vapor contain propylene glycol and/or vegetable glycerin. These are substances used to produce stage or theatrical fog which have been found to increase lung and airway irritation after concentrated exposure.

The aerosols include additives, heavy metals, ultrafine particles, and other toxic and carcinogenic ingredients that pose second and third-hand health risks.

In addition, e-cigarettes and e-cigarette vapor may contain the chemicals or substances listed below.

  • Volatile organic compounds (VOCs): At certain levels, VOCs can cause eye, nose and throat irritation, headaches and nausea, and can damage the liver, kidney and nervous system.
  • Flavoring chemicals: Some flavorings are more toxic than others. Studies have shown that flavors contain different levels of a chemical called diacetyl that has been linked to a serious lung disease called bronchiolitis obliterans.
  • Formaldehyde: This is a cancer-causing substance that may form if e-liquid overheats or not enough liquid is reaching the heating element.
Source: Center for Disease Control

Is vaping addictive?

The e-liquid in all Juuls and most e-cigarettes contain nicotine, which the American Cancer Society noted is highly addictive in any form.

What are the health effects?

Dr. Michael Blaha, director of clinical research at the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease reported, “Nicotine is the primary agent in both regular cigarettes and e-cigarettes, and it is highly addictive. It causes you to crave a smoke and suffer withdrawal symptoms if you ignore the craving. Nicotine is also a toxic substance. It raises your blood pressure and spikes your adrenaline, which increases your heart rate and the likelihood of having a heart attack.”

According to the U.S. Food and Drug Administration, inhaling the chemicals found in most flavored e-cigarettes is associated with respiratory disease.

Is it safer than smoking?

The CDC reported that e-cigarettes are less harmful than regular cigarettes, as they contain fewer toxic chemicals regular cigarette smoke. The e-cigarette aerosol is not harmless though; it contains harmful substances including nicotine, heavy metals like lead, organic compounds and cancer-causing substances. So while they are reported to be less harmful, they are not safe.

NBC News reported that currently, no vaping product has been reviewed federally to be determined to be safer than smoking. They also noted that while most experts agree that the aerosol from e-cigarettes is less harmful than cigarette smoke, there has been no research on the long-term effects of vaping.

Does it help people quit smoking?

Dr. Blaha also noted that e-cigarettes have not received Food and Drug Administration approval as quit smoking aid. He said a study found that most people who intended to use e-cigarettes to stop smoking cigarettes ended up continuing to smoke both traditional and e-cigarettes.

Are there harmful effects of secondhand e-cigarette smoke?

The American Cancer Society reported that while e-cigarettes don’t give off smoke like regular cigarettes, they do expose people to secondhand vapor that may contain harmful substances.

Research is still being done about the secondhand effects, but it has been determined to be less harmful than secondhand cigarette smoke.

How common is it among teens and adults?

There has been a sharp increase in e-cigarette use in teens and adults in recent years.

Source: U.S. Food and Drug Administration

E-cigarettes are the most commonly used tobacco product among youth. In 2018, over 3.6 million U.S. middle and high school students used e-cigarettes.

The FDA has taken action to combat this increase in youth vaping, as they launched a Youth Tobacco Prevention Plan.

“What I find most concerning about the rise of vaping is that people who would’ve never smoked otherwise, especially youth, are taking up the habit,” Dr. Blaha said. “It’s one thing if you convert from cigarette smoking to vaping. It’s quite another thing to start up nicotine use with vaping. And, it often leads to using traditional tobacco products down the road.”

A study reported by Reuters Health said that in 2018, around 10.8 million American adults were using e-cigarettes with over half of them under the age of 35.

What are the illnesses associated with vaping?

As of September 10, there are around 450 cases of chronic lung disease linked to vaping across 33 states and the Virgin Islands.

The DCD, FDA, and state health departments are conducting an investigation into the link between the widespread lung illness and the use of e-cigarette products.

While they have not found a cause, all reported cases of the severe pulmonary disease have a history of using e-cigarettes.

The CDC said that no evidence of infectious diseases has been identified; therefore lung illnesses are likely associated with chemical exposure.

Another commonality among the cases was the use of e-cigarette products containing tetrahydrocannabinol, or THC.

Map of reported cases
Source: Center for Disease Control

What are the symptoms of vaping illnesses?

According to the CDC, symptoms of Severe Pulmonary Disease include shortness of breath or chest pain, fever, dizziness or headache, cough, nausea, vomiting, diarrhea, fatigue, and weight loss.

It is recommended that anyone who uses e-cigarette products and is experiencing these symptoms seek medical care.

Have people died from vaping?

There have been six confirmed deaths caused by vaping related illnesses. They have occurred in Kansas, California, Illinois, Indiana, Minnesota, and Oregon.

The death of the woman in Kansas was announced on Tuesday. NBC News reported that she was over 50 and had a history of health problems before she passed away from acute respiratory distress syndrome.

A number of the people who have died from the vaping related illnesses used their e-cigarettes to smoke THC.

Where are e-cigarettes sold?

E-cigarettes can be purchased at standalone stores, as well as in gas stations, Walmart, and Amazon, among other stores.

Are there any regulations on e-cigarettes or the vapors that are used?

The FDA does not currently require e-cigarette manufacturers to stop using potentially harmful substances. It is also not required for manufacturers to list all of the harmful or potentially harmful substances contained in them.

To combat the surge in underage vaping, 17 states have raised the minimum age required to purchase tobacco. In Kansas, 22 cities and counties, including Topeka, restrict the sale of tobacco and e-cigarette products to those 21 and older.

On May 8, 2019, Walmart also raised the age to purchase tobacco to 21 and discontinued the sale of fruit and dessert nicotine flavors.

Are there any warnings?

The CDC issued a health advisory for using e-cigarette products. The advisory included the following recommendations for the public:

  • Anyone who uses e-cigarette products should not buy these products off the street (e.g., e-cigarette products with THC, other cannabinoids) and should not modify e-cigarette products or add any substances to these products that are not intended by the manufacturer.
  • Regardless of the ongoing investigation, e-cigarette products should not be used by youth, young adults, pregnant women, as well as adults who do not currently use tobacco products. If you use e-cigarette products, monitor yourself for symptoms (e.g., cough, shortness of breath, chest pain) and promptly seek medical attention if you have concerns about your health. CDC and FDA will continue to advise and alert the public as more information becomes available.
  • If you are concerned about harmful effects from e-cigarette products, call your local poison control center at: 1-800-222-1222.

Where can I go for more information?

Website about the facts and risks of e-cigarette use.

The Surgeon General’s report of e-cigarette use among youth and young adults.

The FDA’s Youth Tobacco Prevention Plan.

Get the facts on e-cigarettes, their effects, and risks on the CDC e-cigarette website.

CDC’s guide for quitting smoking, including free resources and a mobile app.