Directions: Answer the prompt in 2 well-developed pparagraphs(no less than 7 sentences each). An effective response will incorporate information from the two attached handouts. You are also welcome to incorporate any independent knowledge you may have on the subject into your response.
Prompt: According to the CDC in 2018, more than 3.6 million US middle and high school students used e-cigarettes in the past 30 days. Does this statistic alarm you? Why or why not? What facts, arguments and/or perspectives would you present to these students in order to make them understand that the health consequences of e-cigarette use are highly detrimental to their development and Health Triangle?
11/5/2021
The Mysterious Vaping Illness That’s ‘Becoming an Epidemic’ – The New York Times
https://www.nytimes.com/2019/08/31/health/vaping-marijuana-ecigarettes-sickness.html
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The Mysterious Vaping Illness Thatʼs ʻBecoming an Epidemicʼ
A surge of severe lung ailments has baffled doctors and public health experts.
John Tan
jtan@millenniumhs.org
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By Sheila Kaplan and Matt Richtel
Published Aug. 31, 2019 Updated Oct. 12, 2021
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An 18-year-old showed up in a Long Island emergency room, gasping for breath, vomiting and dizzy. When a doctor asked if the
teenager had been vaping, he said no.
The patient’s older brother, a police officer, was suspicious. He rummaged through the youth’s room and found hidden vials of
marijuana for vaping.
“I don’t know where he purchased it. He doesn’t know,” said Dr. Melodi Pirzada, chief pediatric pulmonologist at NYU Winthrop
Hospital in Mineola, N.Y., who treated the young man. “Luckily, he survived.”
Dr. Pirzada is one of the many physicians across the country treating patients — now totaling more than 215 — with mysterious
and life-threatening vaping-related illnesses this summer. The outbreak is “becoming an epidemic,” she said. “Something is
very wrong.”
Patients, mostly otherwise healthy and in their late teens and 20s, are showing up with severe shortness of breath, often after
suffering for several days with vomiting, fever and fatigue. Some have wound up in the intensive care unit or on a ventilator for
weeks. Treatment has been complicated by patients’ lack of knowledge — and sometimes outright denial — about the actual
substances they might have used or inhaled.
Health investigators are now trying to determine whether a particular toxin or substance has sneaked into the supply of
vaping products, whether some people reused cartridges containing contaminants, or whether the risk stems from a broader
behavior, like heavy e-cigarette use, vaping marijuana or a combination.
On Friday, the Centers for Disease Control and Prevention issued a warning to teenagers and other consumers, telling them to
stop buying bootleg and street cannabis and e-cigarette products, and to stop modifying devices to vape adulterated
substances.
[Read more: The Trump administration is weighing a ban on some flavored e-cigarettes.]
The illnesses have focused attention on a trend that has been overshadowed by the intense public concern about soaring
teenage use of e-cigarettes, with its potential for hooking a new generation on nicotine: the rise of the vaping device itself. It
has introduced a wholesale change in how people consume nicotine or marijuana, by inhaling vaporized ingredients.
Vaping works by heating liquid and turning it into steam to be inhaled. Broadly speaking, e-cigarettes are considered less
harmful than traditional cigarettes, which work through the combustion of tobacco that sends thousands of chemicals, many
carcinogenic, into the lungs.
But vaping has its own problems: Nicotine or THC, the high-inducing chemical in marijuana, is mixed with solvents that
dissolve and deliver the drugs. The solvents, or oils, heat up during aerosolization to become vapor. But some oil droplets may
be left over as the liquid cools back down, and inhaling those drops may cause breathing problems and lung inflammation.
“Inhaling oil into your lungs is extremely dangerous behavior that could result in death,” said Thomas Eissenberg, who studies
vaping at Virginia Commonwealth University. “That is probably the biggest message we can get out of this.”
Many vaping ingredients are not listed on the products. Vitamin E oil appears to have been a common substance associated
with the severe and sudden respiratory problems in some of the New York cases, according to state health officials. It is not
known how it was used. Vitamin E is sometimes advertised as a supplement in cannabidiol oil, which is not designed for vaping
but has been used that way.
1/5
11/5/2021
The Mysterious Vaping Illness That’s ‘Becoming an Epidemic’ – The New York Times
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Dr. Scott Gottlieb, the former commissioner of the Food and Drug Administration, said he suspected a link to illicit products —
perhaps related to ingredients including THC — because the main manufacturers of e-cigarettes had not suddenly altered their
ingredients on a wide scale. “It’s probably something new that has been introduced into the market by an illegal manufacturer,
either a new flavor or a new way to emulsify THC that is causing these injuries,” he said.
2/5
11/5/2021
The Mysterious Vaping Illness That’s ‘Becoming an Epidemic’ – The New York Times
Vaping, said Dr. Melodi Pirzada, a pediatric pulmonologist on Long Island, “is very, very
dangerous. We already have one death in Illinois and we don’t need more.”
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The outbreaks have created a crisis for two emerging industries — e-cigarettes and legal
cannabis
— that have pitched
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themselves as beneficial to public health. E-cigarette supporters consider the technology a safer alternative to smoking, while
cannabis has been sold politically as “medical marijuana” and as a substitute for tobacco growers.
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Now some subset of these products is causing a serious lung disease that even cigarettes,
while
lethalGoogle
in thewill
long
run,
don’t
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cause in young people. Lobbyists and company officials in both industries are scrambling
to address,
blame unregulated
products.
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of service.
The spate of illnesses has made news again of Juul Labs, maker of the blockbusterpolicy
e-cigarette
blamed for the surge in
teenage vaping. In a television interview, Kevin Burns, the company’s chief executive, said he did not know of evidence linking
the recent cases to Juul’s products.
On lung scans, the illnesses look at first like a serious viral or bacterial pneumonia, but tests show no infection. “We’ve run all
these tests looking for bacteria, looking for viruses and coming up negative,” said Dr. Dixie Harris, a critical care pulmonologist
in Salt Lake City, who has consulted on four such patients and reviewed case files of nine others in the state.
On Aug. 6, Dr. Harris was working in a Salt Lake City-area hospital — she declined to provide more detail in order to protect
patient privacy rights — when she was called to the intensive care unit to consult on a patient with the severe lung ailment.
The patient was in his 20s and a heavy e-cigarette user who also vaped THC.
She later consulted with two dozen hospitals around the state on patients with difficult pulmonary or critical care issues. “I saw
a second case,” she said. “I’m like, ‘Wait a second, this is weird — two hospitals, two young people, almost identical story.’”
The next morning, she called Dr. Joseph Miner, the chief medical officer for the Utah state health department, who told her he
would try to figure out what was going on.
In the ensuing weeks, Dr. Harris saw two other patients firsthand and reviewed nine other cases for the hospital group where
she works, Intermountain Healthcare, which has 24 hospitals in Utah and Idaho. She said the first 10 cases were from eight
different hospitals; over all, the state of Utah reported 21 cases.
Dr. Harris said that the four patients she had been directly involved with “have been doing e-cigarettes with nicotine
constantly, like round the clock. Maybe there’s some sort of accelerant effect causing inflammation in the lung caused by the
THC oil.” She added that her interviews with patients suggested they were getting the marijuana liquid from friends in states
with legal supplies of the drug, like California and Colorado.
Some patients are suffering from another condition known as lipoid pneumonia, doctors said. When vaped oils get into the
lungs, the lungs treat them as a foreign object and mount an immune response, resulting in inflammation and the buildup of
liquids, which can cause lipoid pneumonia.
3/5
11/5/2021
The Mysterious Vaping Illness That’s ‘Becoming an Epidemic’ – The New York Times
A CT scan of a vaping injury patient, looking up from the patient’s feet, with
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areas in the lungs showing damage. Intermountain Healthcare
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John Tan
The surge in these illnesses comes at the start of a school year, one in which parents, teachers
and administrators had already
jtan@millenniumhs.org
braced for the challenge of educating in the age of the vape pen, which is easy to conceal.
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While educator and parental concern has focused on Juul, the reality is that the market for vaping devices and the liquids that
create
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fill them is vast and filled with counterfeiters and do-it-yourselfers, making it hardTofor
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The Vapor Technology Association, an e-cigarette and vaping industry trade group,
asked
officials to thoroughly
investigate the circumstances which might have led to each reported hospitalization before making statements to the public as
to whether certain products are implicated in these incidents.”
The regulation and study of the marijuana industry is particularly complex. Even though the federal government still considers
cannabis a controlled substance, 33 states now allow it to be sold for either recreational or medicinal purposes or both.
Hundreds of cannabis products are sold, legally and illegally, such as THC oil, or cannabis oil with THC.
The Food and Drug Administration has warned some sellers of cannabis product supplements not to make health claims, but
more are doing so than the agency can keep up with. The F.D.A. oversees CBD products sold as dietary supplements, but does
not regulate THC, which is illegal under federal law. Liquid nicotine and THC, sometimes sold in cartridges for use in vaping
devices, can each contain oils that may be safe to swallow but can damage the lung when vaporized into a mix of unknown
chemicals.
Vaping devices confiscated from students at a middle school in Boulder, Colo. Nick Cote for
The New York Times
E-cigarettes accessories for sale in a store in Manhattan. Jeenah Moon for The New York
Times
While e-cigarettes have been presumed less harmful over the long run than cigarettes, the ultimate impact from years of
vaping is simply not yet known.
Mr. Eissenberg, director of the Center for the Study of Tobacco Products at Virginia Commonwealth University, said seven
cases of similar lung injuries from e-cigarette vaping had been reported in previous years.
“A common ingredient was vegetable glycerin, which is made from vegetable oil,” he said. “If there is some incomplete process,
there can be oil left in the vegetable glycerin when that person is using it, and inhaling oil and getting oil into your lungs is what
is causing some of the lung injuries we see.”
4/5
11/5/2021
The Mysterious Vaping Illness That’s ‘Becoming an Epidemic’ – The New York Times
“Basically what the F.D.A. should be doing is testing every one of these liquids to see if they have any oil at all and making a
in to The
New Yorksaid
TimesMr.
with
regulation that would ban oil in any of these products, whether it is a THC product or aSign
nicotine
product,”
Eissenberg,
Google
who is researching vaping with a grant from the agency.
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A Juul user in San Francisco. Jason Henry for The New York Times
Dr. Nora D. Volkow, director of the National Institute on Drug Abuse, a part of the National Institutes of Health, said she was
surprised at the severity of the lung disease involved in this summer’s cases, but not by the possibility that vaping products
were causing such illnesses.
“There is no oversight,” Dr. Volkow said. “No one is actually evaluating the products to see whether they are pure, or if they
contain toxic substances. There has to be some way of regulating them.”
The Long Island teenager, who was on a ventilator at one point, has a long road to recovery and doctors still haven’t identified
the cause of his illness.
“They tested for infectious diseases. They tested for bacteria. They tested for a host of issues. It all came back negative,” his
father said. He requested anonymity to protect the identity of his son. “We were helpless. We didn’t know what to do. The
doctors didn’t know what to do. They would treat the symptoms first and figure out what was killing him later.”
In Illinois, a woman in her 30s who had recently vaped was hospitalized and died, health officials said on Aug. 23.
Another recent case involves a 31-year-old Queens resident named Kevin Corrales, who in late July was in the back seat of a
car heading to a Long Island beach when he started gasping for air.
“It was terrifying,” he said. “I was really gasping. I should have been rushed to the hospital. They thought I was exaggerating.”
He called an Uber to take him home. Too tired to climb the stairs of the home he shares with his parents, he stayed in a
basement room for several days, until he felt better.
That day, in the car, he had been vaping a Juul, the popular e-cigarette. But he also occasionally vapes THC oil in a separate
device. “I can buy these oils like a bag of potato chips,” Mr. Corrales said.
“It’s hard to say whether it was the THC or nicotine,” said Mr. Corrales, who used e-cigarettes to quit smoking.
Mitch Smith contributed reporting from Chicago.
5/5
ELECTRONIC CIGARETTES WHAT’S THE BOTTOM LINE?
» E-cigarettes have the potential to benefit adult smokers who are not
pregnant if used as a complete substitute for regular cigarettes and
other smoked tobacco products.
» E-cigarettes are not safe for youth, young adults, pregnant women, or
adults who do not currently use tobacco products.
» While e-cigarettes have the potential to benefit some people and harm
others, scientists still have a lot to learn about whether e-cigarettes are
effective for quitting smoking.
» If you’ve never smoked or used other tobacco products or e-cigarettes,
don’t start.
WHAT ARE E-CIGARETTES?
» E-cigarettes are known by many different names. They are sometimes called “e-cigs,” “e-hookahs,”
“mods,” “vape pens,” “vapes,” “tank systems,” and “electronic nicotine delivery systems.”
» Some e-cigarettes are made to look like regular cigarettes, cigars, or pipes. Some resemble pens,
USB sticks, and other everyday items.
» E-cigarettes produce an aerosol by heating a liquid that usually contains nicotine—the addictive
drug in regular cigarettes, cigars, and other tobacco products—flavorings, and other chemicals
that help to make the aerosol. Users inhale this aerosol into their lungs. Bystanders can also
breathe in this aerosol when the user exhales into the air.
» E-cigarettes can be used to deliver marijuana and other drugs.
Rechargeable
e-cigarette
Disposable
e-cigarette
CS298852-A
Tanks & Mods
For Print Only
WHAT IS IN E-CIGARETTE AEROSOL?
THE E-CIGARETTE AEROSOL THAT USERS BREATHE FROM THE DEVICE AND
EXHALE CAN CONTAIN HARMFUL AND POTENTIALLY HARMFUL SUBSTANCES:
CANCER-CAUSING
CHEMICALS
VOLATILE
ORGANIC
COMPOUNDS
ULTRAFINE
PARTICLES
NICOTINE
HEAVY METALS SUCH AS
NICKEL, TIN, AND LEAD
FLAVORING SUCH AS
DIACETYL, A CHEMICAL
LINKED TO A SERIOUS
LUNG DISEASE
It is difficult for consumers to know what e-cigarette products contain. For example,
some e-cigarettes marketed as containing zero percent nicotine have been found to
contain nicotine.
ARE E-CIGARETTES LESS HARMFUL THAN REGULAR CIGARETTES?
VS
YES, but that doesn’t
E-cigarette aerosol generally contains fewer toxic
chemicals than the deadly mix of 7,000 chemicals in
smoke from regular cigarettes. However, e-cigarette
aerosol is not harmless. It can contain harmful and
potentially harmful substances, including nicotine,
heavy metals like lead, volatile organic compounds,
and cancer-causing agents.
mean e-cigarettes are safe.
For Print Only
WHAT ARE THE HEALTH EFFECTS OF USING E-CIGARETTES?
SCIENTISTS ARE STILL LEARNING ABOUT THE LONG-TERM HEALTH EFFECTS
OF E-CIGARETTES. HERE IS WHAT WE KNOW NOW.
1
Most e-cigarettes contain nicotine, which has
known health effects
» Nicotine is highly addictive.
» Nicotine is toxic to developing fetuses.
» Nicotine can harm adolescent brain development,
which continues into the early to mid-20s.
» Nicotine is a health danger for pregnant women
and their developing babies.
2
Besides nicotine, e-cigarette aerosol can contain
substances that harm the body.
» This includes cancer-causing chemicals and tiny particles
that reach deep into lungs. However, e-cigarette aerosol
generally contains fewer harmful chemicals than smoke
from burned tobacco products.
3
E-cigarettes can cause unintended injuries.
» Defective e-cigarette batteries have caused fires and
explosions, some of which have resulted in serious
injuries.
» In addition, acute nicotine exposure can be toxic.
Children and adults have been poisoned by swallowing,
breathing, or absorbing e-cigarette liquid.
For Print Only
CAN E-CIGARETTES HELP ADULTS QUIT SMOKING CIGARETTES?
E-CIGARETTES ARE NOT CURRENTLY APPROVED BY THE
FDA AS A QUIT SMOKING AID.
The U.S. Preventive Services Task Force, a group of health experts that makes recommendations
about preventive health care, concluded that the evidence is insufficient to recommend e-cigarettes
for smoking cessation in adults, including pregnant women.
HOWEVER, e-cigarettes
may help non-pregnant adult
smokers if used as a complete
substitute for all cigarettes and
other smoked tobacco products.
TO DATE, THE FEW STUDIES ON THE ISSUE ARE MIXED.
Evidence from two randomized controlled trials found that e-cigarettes with nicotine can help smokers
stop smoking in the long term compared with placebo (non-nicotine) e-cigarettes.
A recent CDC study found that many adults are using e-cigarettes in an attempt to quit smoking.
However, most adult e-cigarette users do not stop smoking cigarettes and are instead continuing
to use both products (“dual use”). Because smoking even a few cigarettes a day can be
dangerous, quitting smoking completely is very important to protect your health.
For Print Only
WHO IS USING E-CIGARETTES?
E-CIGARETTES ARE THE MOST COMMONLY USED
TOBACCO PRODUCT AMONG YOUTH.
In 2018, more than
3.6 MILLION
U.S. middle and high school
students used e-cigarettes in
the past 30 days, including:
4.9%
MIDDLE SCHOOL
STUDENTS
IN THE U.S.,
YOUTH ARE
MORE LIKELY
THAN ADULTS
TO USE
E-CIGARETTE
20.8%
HIGH SCHOOL
STUDENTS
AMONG CURRENT E-CIGARETTE USERS AGED 45 YEARS AND OLDER
in 2015, most were either current or former regular cigarette smokers, and
1.3% had never been cigarette smokers.
IN CONTRAST, AMONG CURRENT E-CIGARETTE USERS AGED 18–24 YEARS,
40.0% had NEVER BEEN regular cigarette smokers
In 2017,
IN 2015, AMONG ADULT E-CIGARETTE
USERS OVERALL:
29.8%
were former
regular cigarette
smokers
2.8%
of U.S. adults were current
e-cigarette users
58.8%
were current regular
cigarette smokers
11.4%
had never been
regular cigarette
smokers
For Print Only