When doctors at the Wisconsin Children’s Hospital checked the lungs of a teenager admitted last June, they first thought of cancer. They were actually dealing with unusually large interstitial pneumonia. Since then, seven patients have died in the United States and several hundred have been hospitalized for serious lung diseases. All had vaping – mostly THC oils, the active substance of cannabis, but not only. Faced with this “health emergency” that Europe seems to be missing for the moment, New York State decided Tuesday to ban flavored electronic cigarettes and Donald Trump wants to do the same at the federal level. On Wednesday, a first hospitalization was reported in Canada.
Are electronic cigarettes dangerous in their entirety? Should we only avoid THC oils and flavored liquids? What do we know about long-term effects? 20 minutes Take stock with Anne Melzer, a pulmonologist and tobaccologist at the University of Minnesota. She is adamant: “Until we have more information about the safety of e-liquids and electronic cigarettes, it is highly recommended to stop vaping. “
What is happening in the United States?
The first case seems to go back to 2015, but it had not been reported to the authorities. The health crisis has exploded in the last six months, with seven deaths and nearly 400 hospitalizations in 36 states. Doctors have identified several types of pneumonia that led, in the most severe cases, to acute respiratory distress syndrome, a state of inflammation of the lungs often fatal. With the exception of the seven dead, “most patients have seen their condition improve with corticosteroid treatment. But some may have permanent lung damage, “warns Anne Melzer.
What is the main suspect?
In Wisconsin and Illinois, four of the five dead had been vaping THC oil. At this stage, the CDC (Center for Disease Control) continues to investigate to determine the factor (s) involved. But in New York, the authorities are particularly interested in a compound, vitamin E acetate, present in these oils of THC but absent electronic cigarettes with nicotine. According to Anne Melzer, it is “a logical suspect” but not necessarily the only one: several patients have said they did not have THC vaping. “Even before this crisis, we have seen cases of acute eosinophilic pneumonia with lungs filled with allergic inflammation in nicotine vapors. I myself treated such a patient last year, who used only nicotine e-cigarettes to stop smoking, “says Melzer.
If the phenomenon is recent, are established brands safer?
New York authorities have reported colored packaging marketed under the name of Dank Vapes. But this “brand” does not correspond to any legitimate business and seems to be distributed on the street and on the Internet. There is indeed a vast underground market in the United States, to which the miners often turn. “The recent nature of the phenomenon seems to suggest that older brands (like the leader of the electronic cigarette Juul) are probably less concerned,” concedes the expert. But according to her, it is possible that there were older cases that were not identified.
What is in the “steam”?
Although the term – and marketing – makes some people believe that they are ingesting water vapor, they are not. Fats, heavy metals, artificial flavors, nicotine or THC … This “vapor” is a cocktail of chemicals. “Propylene glycol is used in cosmetics, food and as an antifreeze base. Vegetable glycerin to make soap, toothpaste or explosives, “says Anne Melzer. These compounds “are not supposed to be inhaled because they are toxic to the lungs. “
What’s going on in the lungs?
The body has immune cells macrophages responsible for cleaning what we breathe, including lipids. But for “reasons still poorly understood, this mechanism can cause massive inflammation” of the lungs, details the researcher. The alveoli of the lungs are filled with secretions and the lungs can no longer ensure the oxygenation of the blood. This can lead to acute respiratory distress syndrome.
What does the WHO say?
The consensus among scientists is that for a smoker, vaping is probably less harmful than burning a cigarette because it avoids ingesting carcinogens. But less dangerous does not mean without danger. At this stage, “there is not enough evidence to quantify the precise level of risk,” said a WHO report last June. Which ended like this: electronic cigarettes “are undeniably harmful and will have to be regulated”.
Is Vapoter safer in France?
For now, the crisis seems to mainly affect the United States. The composition of e-liquids is much more regulated in France – where THC oils are not allowed. Liquids must be registered with the National Health Security Agency six months prior to marketing. Nevertheless, Anne Melzer calls for the utmost caution: “Some studies suggest that there is an increased risk of stroke and heart attack. There is increased exposure to chemicals known to be linked to certain cancers, not to mention the effects on the lungs. The reality, she says, is that “we have almost no information about the long-term effects of vaping. It is imperative according to her that the youngest do not play guinea pigs.