If any positive side to the vaping-related illnesses and deaths that have been reported in recent months exists, it’s that the connection to vaping is clear and emerged so quickly.
After all, it took people almost 400 years before they accepted that smoking causes cancer.
We likely won’t wait nearly that long to realize that vaping isn’t a completely benign alternative to older nicotine-delivery methods.
The recent epidemic of vaping-related lung illnesses demonstrates that. In mid-December, the U.S. Centers for Disease Control reported that more than 2,500 people had been hospitalized for vaping-related illness in the U.S., and confirmed 55 deaths. British Columbia confirmed its first probable case in October, while Health Canada reported 15 cases across the country as of January.
Vaping-related illness is an inflammation of the lungs. Symptoms include coughing, shortness of breath, chest pain, fatigue and vomiting. People who had used e-cigarettes and other vaping devices, whose illnesses have not been attributed to another cause, and whose X-rays show substances such as pus or blood in the lungs, are likely cases.
Researchers have detected one chemical — vitamin E acetate, a sticky, oily compound used in supplements, cosmetics and vaping products — in all tissue samples taken from the lungs of 51 patients with the illness. However, officials warn that many substances and even e-cigarette devices themselves could be at fault.
Vaping products contain dozens of chemicals. Some — including a suspected carcinogen banned in food in the U.S. — are known to be potentially harmful. None of the compounds have been proven safe for the lungs.
Heating vape solutions can cause additional toxic chemicals to form, too.
One 2019 study shows that inhaling a vapourized liquid solution through an e-cigarette immediately decreases blood-vessel function throughout the body — even when the solution does not include nicotine. Other research shows that inhaling unflavoured e-cigarette vapour causes inflammation and stress in the heart, airways and brain.
Canada restricts the sale of e-cigarettes and vape products that contain nicotine to people 19 years of age or older, and bans lifestyle promotions and advertising that appeals to youth.
Because e-cigarettes and vape products have been on the market for only about a decade, long-term studies haven’t been possible, and the long-term public health effects haven’t emerged.
Whereas smoking had centuries to affect public health.
Indigenous North Americans have used tobacco in ceremonies for thousands of years. Chemical analysis of residues in a dozen clay pipe artifacts found along the Snake River in Washington state show that First Nations tribes in the region were smoking — and likely farming — native tobacco at least 1,200 years ago.
Although Columbus encountered tobacco and smoking in the Americas in 1492, it took until the 1570s for tobacco smoking to become common practice across Europe among those who could afford it.
Some people believed it cured many illnesses. One 1595 treatise accused physicians of keeping tobacco use secret for fear it would put them out of business.
But in possibly the earliest published example linking smoking to ill health — a 1602 English essay called Worke of Chimney Sweepers — the author stated that illnesses often seen in chimney sweeps were caused by soot and that tobacco might have similar effects.
Medical science finally began furnishing measurable, repeatable proof in the 20th century. The first U.S. medical study to link tobacco smoke to lung cancer was published in 1912, followed by other medical reports from Germany and elsewhere.
Health researchers also recognized tobacco smoke’s contributions to other cancers. For example, when doctors diagnosed Sigmund Freud, father of modern psychoanalysis, with mouth cancer in 1923, they identified his longtime 20-cigar-a-day habit as a contributing factor. He underwent 34 operations to remove tumours, stop hemorrhaging and cut away infected tissues — and still he refused to quit. In the months before he died in 1939, he had to pry his jaw open manually to insert the cigar, and eat and drink.
Beginning in the 1940s, evidence was piling up. A clear relationship between smoking and cancer was demonstrated in the ’50s, and by the ’80s, governments were enacting laws and policy to limit the practice and its public health consequences.
Tobacco smoke is now known to be associated with at least 50 cancer-causing compounds.
Let’s hope public health officials and governments act more quickly to identify and contain the problems with vape products.
