Feb 24, 2020

FHSU's Duffy addresses vaping-related lung injury

Posted Feb 24, 2020 12:01 PM
CDC, the U.S. Food and Drug Administration, state and local health departments, and other clinical and public health partners are investigating a multistate outbreak of lung injury associated with e-cigarette product use, or vaping. Graphic courtesy of the CDC
CDC, the U.S. Food and Drug Administration, state and local health departments, and other clinical and public health partners are investigating a multistate outbreak of lung injury associated with e-cigarette product use, or vaping. Graphic courtesy of the CDC

By CRISTINA JANNEY
Hays Post

The Centers for Disease Control and Prevention is now tracking lung injury associated with vaping, but much is still unknown about the long-term affects of the practice.

FHSU's Bob Duffy, coordinator of the Drug and Alcohol Wellness Network, presented "The Latest on the Vaping Injury Outbreak" as part of the American Democracy Project lecture series on Feb. 12 at the Forsyth Library.

Duffy relayed reports from the CDC on EVALI, which is an acronym that stands for e-cigarette or vaping product use-associated lung injury.

Bob Duffy
Bob Duffy

EVALI did not become a public concern until September. 

Many of the symptoms of EVALI are similar to the flu.
• Cough
• Shortness of breath
• Chest pain
• Nausea, vomiting, stomach pain
• Diarrhea
• Fever
• Chiils
• Weight loss

"It is not some kind of virus or infection. It is some kind of chemical reaction," Duffy said.

Duffy began giving presentations to classes about the second week of classes in the fall, and there were no real numbers to give on vaping-related illnesses. Within a month, the number of reported cases of EVALI had jumped to more than 1,000 with 18 vaping-related deaths in 48 states.

As the nation entered flu season in November, the CDC stopped looking at any cases unless the patient was hospitalized

Duffy's latests reports from the CDC indicated 2,758 people  have been hospitalized for EVALI with 64 deaths. Of the vaping-related deaths, two have been in Kansas as of Feb. 4.

"My worry is because these signs and symptoms imitate the flu, how many cases are going undiagnosed? How many people are doing this on an out-patient basis?" Duffy said.

Although current information is leaning to EVALI being caused by vaping of THC, some cases involving solely nicotine products have been reported, Duffy said.

Vitamin E acetate is strongly linked to the EVALI outbreak, according to the CDC website. Vitamin E acetate has been found in product samples tested by FDA and state laboratories and in patient lung fluid samples tested by CDC from geographically diverse states. Vitamin E acetate has not been found in the lung fluid of people that do not have EVALI.

Research is indicating 78 percent of the THC vaping injuries are being caused by vape juices from what the CDC calls "informal sources," non-name brand products that could be from the black market.

Sixty-nine percent of people using nicotine vaping products are using commercial brands, Duffy said.

In the most recent survey of FHSU students, 38 percent of students reported they had tried vaping at least once in the last year. Just over 5 percent of students surveyed reported using vaping devices daily.

The survey did not distinguish between vaping devices used for nicotine verses THC, but Duffy said he will consider adding that question in the future.

A single JUUL pod, the leader in vaping devices, is equivalent to a pack of cigarettes. That will give the users about 200 puffs. YouTube videos may show users taking in long inhales from a pod, but Duffy said that is likely not common use of the devices.

He is seeing users taking short puffs because they are trying to hide the devices and their use.

FHSU is a nicotine-free campus, which includes vaping. Duffy helped create that policy.

"When this happened I started asking myself, 'Am I going to tell people to go back to smoking cigarettes?' As a drug and alcohol counselor, that is advice I never want to give anybody because of the long-term health consequences," he said. "But I don't want someone taking on something that has such drastic short-term consequences."

Duffy noted there is no medical evidence vaping is a good means of quitting smoking; however, nicotine patches are. Although smoking cessation programs can be expensive, Duffy said student health will help students get started on a smoking cessation plan as inexpensively as possible.

New legislation has limited the sale of flavored vaping juices with the exception of menthol and has pushed the age to buy the products to 21. However, Duffy said the law has a loophole. It does not regulate disposable vaping devices. One of the brands is Puff Bars.

"Kids are already using it," he said.

Duffy said Puff Bars and other disposable devices are less expensive than refillable devices, such as JUUL, (about $30) which mean it is easier for middle school and high school students to purchase the products.

Resident halls on campus are starting to talk more about vaping as the age to purchase vaping products has gone up to 21. Duffy said the mandate has not made it clear if people younger than the age of 21 possessing vape products is also illegal.

Duffy said the university is also considering adding education models to its University 101 class on vaping and THC use.

Members of the lecture audience expressed concern for their peers.

"It actually makes me really upset of thinking about using vaping because, as a generation, we had stopped smoking cigarettes more and more each year," said Cynthia Jimenez, 24, a senior art history from Salina, "Now vaping is out."

For more information on this issues, see the CDC website.