this person, rest in peace had COPD
People with COPD are more likely to develop pneumonia. Pneumonia is particularly dangerous for people with COPD because it causes an increased risk of respiratory failure. This is when your body is either not getting enough oxygen or isn’t successfully removing carbon dioxide.
he died from pneumonia.
The man smoked for decades, and was already suffering from several diseases. As far as the vaping disease diagnosis, the CDC criteria is pretty general. For example, ground glass appearance in the lung can be caused by many different illnesses including pneumonia:
https://www.reference.com/health/ground-glass-lung-result-ct-scan-mean-9e6d0bf96c56cd3b
This was a very irresponsible article because it suggests that smoking is safer than vaping.
1
I wonder what brand vape killed this man. Why wouldn't the story include this important information as a matter of public health. Are they absolutely positive it was not from an illicit THC vape? It's estimated that 40 million people worldwide are regular user of nicotine vapor, where are the other dead bodies?
2
@Sean Thanks for your comment. Mr. Steffen's family told me that he used the brands Mistic, blu and Juul, and they are as sure as they can be that he wasn't secretly vaping THC.
1
@juliebosman just curious. Why wasn’t the information about the brands included in the story?
Thanks for helping us all smoke and vape again!
When researching my industry book, Cigarette Seduction, I learned that psychoanalysts have been hired by the industry since 1922 to find out why people smoke.
We should learn from them.
Smoking and vaping is a complex issue - something like culturally-accepted psychological folk medicine that profoundly defies simple banning. Changes in pricing and advertising in the past 30 years simply shifted smokers to pill poppers and now, vapers. When smoking declined from about 44% of the adult population to 24%, prescription mood-altering drugs increased in mirror fashion.
The current vaping hysteria will probably accomplish the following:
- More vaping, since smokers aren’t actually looking for safety. Unconsciously, they "consume the safety factor" with new abuses
- Teens will still take risks to prove they are real adults
- More mood-altering prescription and non-prescription will appear thanks to all this attention
- Vapes will be regulated, taxed and arguably, safer
Bottom line: We need to understand why people do this and manage it, not ban it.
As for teenagers, this is a coming-of-age issue and they have a profound need for a social rituals, testing and identity-giving. Most tribal societies knew this but we forgot it. We need meaningful 21st Century versions of this and it's not about advertising since every adult user is also their billboard. or the tobacco, vaping, drug and alcohol industries fill that vacuum.
4
I have never smoked - ok, a cigarette here or there- but definitely never vaped.
To me, anything foreign like that to put it into lungs - which are some of the most delicate lungs - you would think would be damaging.
And while tobacco smoke was supposed to be hot as in burning - hard for me to believe that temperature and carbon material are any different from vaping.
Either way, we must stop promoting vaping as an alternative - and safer - to tobacco.
It's just another bad habit.
3
My partner (we are in our 60’s) would be dead without e-cigarettes. Several years ago he smoked himself into an 8 day stay in the UCLA cardiac wing. Edema and an eventual diagnosis of COPD. All he wanted when he got out of the hospital was a cigarette. But vaping allowed him to quit. He vapes as much as he ever smoked, buys products from reputable sellers and no longer needs oxygen. He is no longer frightened of stairs and can walk without worrying that he’ll run out of air. While this is in no way intended to be a blanket statement about it being a product for everyone (especially children) I believe the e-cigarettes saved his life. As with so many things, this is not a simple issue.
3
The real problem is that it is incredibly difficult to recover from a nicotine addiction. No one should be smoking or vaping. One is not a good solution for quitting the other. Vaping is less obnoxious and dangerous to bystanders, but involved inhaling liquids along with toxic chemicals, and apparently, in some cases, kills you quicker than smoking. It certainly deserves some more extensive regulation and restrictions with regards to people under the age of 18. Understanding what is happening with these vaping related deaths is critical to making better regulations and safer products.
2
@Louise Cavanaugh I quit 35 years ago. It's not that hard really, but if you delude yourself into believing that smoking isn't that bad for you and that it couldn't possibly effect others around you, then it becomes easy enough to fail. This guy chose to believe that smoking wasn't so bad and that vaping was safe, despite the evidence that smoking is terrible and the obvious fact that vaping is a leap in the dark. He chose poorly, but maybe his family can cash in. I wish them the best.
@krw, thank you, Julie Creswell, for reporting on the questions I raised. (I read this newspaper on my phone, and found the article Ms. Creswell contributed to as the next article after this one.) It's all about the money, once again. Lobbying and small businesses that sell death in a flavored package win out - again. I thank you, NYT, and Julie Creswell, for your reportage.
He is equally dead, regardless of what he smoked. Why so much fuss related to vaping, with much less concerning smoking tobacco.
2
@turbot People have know about the dangers of cigarettes for decades. People have been aware of the dangers of the lithium ion batteries in vaping devices for years. It's only recently that people have become aware that the vapor itself can be dangerous. This is quite alarming when you consider the number of teenagers who vape in spite of being underage.
This is an unfortunate article that shouldn't have made it past the editorial stage, or at least ought to have covered the weakness of its premise.
A 68 year old man has a 40-odd year history of such heavy smoking "he had smoked a cigarette several times an hour." As a result of this heavy smoking habit he developed chronic obstructive pulmonary disease (COPD), had heart disease (associated with smoking), and non-hodgkins lymphoma (at least one form is associated with smoking.) These were pre-existing conditions that caused him to give up cigarettes and substitute vaping. Neither COPD nor heart disease brought on by smoking are reversible. He contracts pneumonia, not uncommon in those with COPD - and dies of it. There was no autopsy after his death.
Months later another doctor examines his chest X-rays, but never examine the patient, had no tissue samples, no other materials, and based on that examination of an x-ray and what he sees as patterns, concludes that the patient dies because he vaped - despite all the smoking related disease he presented. That's hardly a credible diagnosis.
Next, you have an epidemic of Lipoid Pneumonia, credibly believed to be caused by vapers (often young adults) making up illicit CBD and THC liquids to vape, using various oils (including vitamin E oil.) A diagnostic issue is that many deny using the illicit liquid (for obvious reasons.) Yet 30 of the illnesses are attributed to regular vapes based on those denials.
Editors please.....
2
The anti-vaping hysteria is so helpful to the tobacco industry.
These money-motivated crazies remind me of the alleged moralists who opposed needle exchanges during the height of the AIDS crisis.
Smoking killed for many, many years before we formally attributed the deaths to smoking. I still know people today who don’t believe smoking will kill them because they have an uncle who smoked two packs a day and lived to a ripe old age, etc. We don’t know for sure how harmful vaping is, but to argue “if it were harmful, it would be obvious by now,” seems specious at best.
17
Coach a high school sport and this summer during our summer workouts one of the players had difficulty completing laps and kept having to stop and rest. One day, he felt nauseous and so we took him to the hospital to see about any heat related illness--the summer had been unusually hot with multiple 90 degree days here. His breathing was rapid and he felt real bad. Doctors examined him and said his core temperature was normal. They were puzzled. They watched him and he recovered and went home. But throughout the summer and fall he struggled physically in what should have been easy exercise for a teen. Kept my eye on him. Then a few weeks ago he got busted for vaping at a school event. School rules saw him leave the team. After some questioning he confessed he had been vaping every day during the summer--waking up late, vaping and then thinking he could run like an athlete after. We put two and two together and concluded his poor physical performance was due to his vaping. He cost his family an ER visit, time, money, and may have hurt his lungs. He's given up vaping and is trying to clean up his act. He had no idea that vaping could hurt his lungs. He had not heard that some people were getting sick and dying. He had no idea what was actually in these carts or pods. This is why the FDA needed to regulate these products ten years ago. A failure on our government. Teens think they are invincible and they need to be protected from new products that seek to exploit them.
37
Your school did the right thing.
Hopefully that was a lesson for more of the kids to quit vaping.
5
Vaping was scary from the beginning, which is why I wonder why it has taken this long for the information to reach the country. I was a long time smoker that reached for a vape when I first tried to quit. My father, still alive, said he had a “bad feeling” about the vaping and it’s long term impact on the lungs, so I opted for the gum. I have been a non smoker for some time now, but I feel for children who are marketing targets, and I thank my lucky stars my father saw the writing on the wall. We have a friend who’s son got an embolus from vaping in his twenties. He is fine now, but I worry for the young people in this country. I hope they heed the warnings.
26
@Anitakey Please provide evidence for the embolus that your friend's son got from vaping in his 20s. For example, how long ago was it? At this time, scientists are still researching and haven't been able to make a definite diagnosis for vaping related diseases. That's why reliable sources (unlike this article) always use the words "probable cause" before vaping related type diseases.
2
Translated: Smoking or vaping? You might as well plunge your head into a bucket of sand and inhale it deeply. And repeat. What goes into the lunge stays in the lunge.
4
Needlessly sucking anything into your lungs, whether unadulterated smoke or nicotine laced steam, is obviously a terrible idea. Our bodies are a fragile miracle allowing us to live on this earth for awhile, and breathing addictive toxins for some perceived pleasure will never be consequence free.
4
Wouldn't common sense tell you that sticking a mechanical device in your mouth that injects liquid whatever into your lungs is just not a good idea?
6
@Amanda Jones Teenagers aren't known for having a lot of common sense. Nicotine addicts are often in denial about the consequences of their addiction. If you think that deliberate smoke inhalation is a good idea, you lack common sense and you have a substance abuse problem.
3
Nothing here passes the smell test - a dude who smoked from Reagan to Obama, had COPD, lymphoma, and god knows what else.... But it was the vaping. Sure. Whatever.
4
The heck with vaping. "They" should make them things illegal! I'm heading over to the supermarket to buy some totally-legal, easily-available, real live ciggies. I like my death drugs to be all-natural!
3
@Miss Anne Thrope Nothing beats locally sourced, organic, fair trade, free range tobacco!
1
The vaping illness thing needs to be sorted out, but did you need to pick a 68 year old, life-long militant smoker as your poster child?
6
Cigarette package labels have been required since 1969.
Tobacco television ads have been banned since the 1970s.
The 1998 Tobacco Master Settlement Agreement was enacted against major tobacco firms as a result of nationwide Attorney Generals' suit against the firms to recover costs associated with smoker's healthcare expenses. This was the largest settlement in history!
In 2009, the Family Smoking Prevention and Tobacco Control Act was signed and gave the U.S. Food & Drug Administration (FDA) the authority to regulate the manufacturing, marketing, and sale of tobacco products, authority with a 1996 law failed to convey.
The obvious questions ask themselves.
What has the FDA been doing to regulate smoking products since 1998?
Why were e-Cigarettes ever allowed to advertise on television?
Why were e-Cigarettes ever allowed to develop names making deadly products attractive to children?
Where was the FTC during the evolution of e-Cigarettes and their advertising tactics?
It's clear the Federal agencies have failed us, yet again.
4
This man smoked for decades and suffered from COPD and other conditions before he started vaping. No firm conclusions can be drawn from this case.
It is irresponsible to suggest he would have been better off with tobacco which we know for sure kills 500,000 per year and destroys the health of many more, even those only exposed to second and third hand smoke.
3
A self made "opioid" crisis. Don't put anything in your lungs, the dirty air we breath now is bad enough.
2
Isn’t it obvious that putting anything in your lungs except oxygen is a bad idea?
3
Why are there no vaping related deaths in Europe and especially Asia where vaping is and has been extremely popular for years? (It’s because they aren’t smoking bootleg thc products imitating legitimate products that are tested and safe and legal in some parts of their country but not others)
13
@Mat
How do you know there are no vaping related deaths in other countries? I'm not saying that's false, but I'd like to know the source of this statement. Also, in this case Mr. Steffen apparently never smoked cannabis products.
2
Who is paying for the investigative work into the causes of death and injury in these vaping related cases?
Whether it’s at the CDC or in state health agencies.
If not already, it’s time the e-cig industry foot the bill for this important medical detective work.
@Andrew B , maybe, but we still have no definitive evidence that unadulterated, un-altered e-cigs like Juul are actually causing the problem. Of course, if they are, they should pay dearly. But I'm not convinced.
I don't want anyone to die. By the same token, there needs to be more accountability for one's actions. A vaping "crisis"? A vaping "epidemic"? These are human beings making their own decisions, and need to take responsibility for them.
Our society is much too keen to gang up on industries when people who were indulging start feeling the effects and it's never made any sense to me. Who thought this was "good"? Is this the same logic that tells people Diet Soda is okay because it's not "Regular" Soda?
I've never smoked in my life and still wouldn't sue the tobacco industry because I got lung cancer for smoking for decades. Same with suing McDonald's because you ate Big Macs every single week. Take responsibility. This was a luxury, this is not the drinking water in Michigan! THAT is an epidemic.
4
How is it possible to see images of people vaping, obscured in a cloud of . . . something, and not suspect that it probably won't end well for them?
1
Sorry, I'm not buying this one. This gentleman was very ill before he began vaping. Let's get off the bus that has gone out of control and focus on the real thing.
13
What a sad and tragic story. My sincere condolences to the family.
Let’s be clear, smoking kills. Period.
1
My sincere condolences to the family.
However, just going on my gut (I hope I do that with better results than the Gut-Person-in-Chief), I still strongly believe that most, if not all, of the vaping-related deaths are related to substances found in bootleg THC vape carts. The people making and selling those things are not, I imagine, Walt and Jesse-types who are obsessive about the purity of their product.
In the past few weeks, during all of this coverage (still with very nebulous "facts" about what, EXACTLY, is causing the illnesses and deaths), I've noticed something I haven't seen in a very long time--people smoking actual cigarettes on the streets.
I assume they're doing it because of all these scary (but, again, nebulous) warnings about vaping in general.
If it turns out that products like Juul are really the issue, then my bad. But if all this fear-mongering gets people back to smoking cigarettes when the real problem is THC vape carts filled with God-knows-what, then the fear-spreading without factual evidence is going to get us right back to the good ole Marlboro Man days, and that will be an egregious miscalculation.
How can they not have been able to pinpoint the cause yet? It seems that it should be fairly straightforward testing that could give us the answer, no? Something just seems off here, and I'm not one for conspiracy theories.
4
@NGB a quick search for chemicals in cigarettes reveals:There are approximately 600 ingredients in cigarettes. When burned, cigarettes create more than 7,000 chemicals. At least 69 of these chemicals are known to cause cancer, and many are toxic.
I was a moderate smoker for many years. I switched to vaping 6+ years ago. No THC. Standard mix: PG/VG (propelyne glycol/vegetable glycerine), nicotene (a reduced amount), light flavor.
That's 600 chemicals in cigarettes (conservatively) vs. 4 in vaping. I buy my vape juice from a private, small business that has been around since I started; same with my vape device- no big box or over-the-counter sources
Many former smokers will tell you how radically different they feel, making the switch: greater resistance to colds, no more (or less) coughing, weight gain (dang), significant difference in breathing easier, dramatically less smell (that doesn't cling), no ashes or butts. There are more, but these are the obvious and immediate.
That they are unable to identify, through analysis of the products used, the cause of this new problem... it's suspicious.
That a doctor would recommend smoking tobacco over vaping, is both suspicious and ridiculous.
I am following this situation with interest, and have the same questions as everyone else: why now, all of the sudden, and what is in the cartridges of the deceased and ill?
There is no "safe" way to "smoke", but up until recently, there has been a better alternative to cigarettes.
2
He quit one to quit the other. What did he think would happen? It’s nicotine. The most addictive substance on earth.
Hard to imagine what is more lethal than smoking cigarettes.
THe press has been irresponsible concerning the recent mystery concerning vaping. Tens of millions of people have safely vaped for over a decade now and most of them do so to quit smoking cigarrettes. Whatever this mysterious illness is it has nothing to do with vaping but rather they are ingesting a dangerous chemical with vaping used as the delivery system. The logic that vaping is causing these deaths is like blaming a heroin addicts death on the syringe instead of the heroin. Cigarettes kill thousands of people every single day. The press says nothing about that. The press has an odd fixation on vaping and they do not report the truth. I am starting to understand the phrase “fake news.”
7
Whatever happened to those commercials that touted vaping as an aid to reduce/stop smoking?
Any lie, no matter, how great, all in the name of making a buck or two.
I know that any common sense comment here will be attacked as preposterous, that vaping couldn't possibly be the cause, sounds a lot like the old tobacco disclaimer, now by trolls any time that a voice comes out to say something against some product.
Young people, you will NOT die from NOT smoking/inhaling any of these products. If you still decide to put this stuff in your system, please do not ask others for sympathy & help. If you really want help, give it to yourself & tell all the smoke & smokers goodbye. That is your only sure chance.
Resistance to smoke is growing in every civilized area; I do not allow it in my residence or near me as I go places, don't invite known smokers to get togethers. The only people who try to get you on it want to get you hooked so they can leech off you. Don't go for it. Save your money and your life.
Please remember, “More Trees & Less Fossil Fuel is The Solution Going Forward. Plant & water some trees each week. Trees are a Proven Climate Change Solution.” Thank you & Vote Blue in 2020.
1
I really hope that the needed research is being ramped up to bring more clarity to this issue, because I'm worried that anti-vaping hysteria is also going to harm smokers struggling to find an alternative to cigarettes -- people like a family member of mine who, like Mr. Steffen, failed for decades to quit before she tried vaping. She just went back to cigarettes, unfortunately, since her state banned vape liquids. And if Dr. Safranek could have examined this person a month ago -- when she visited my home and to my startled surprise had developed something I've never known her to have before, a SENSE OF SMELL -- and then examined her again today when she's back on cigarettes and reports that she feels lousy, I wonder if he'd think that there's more than one possibility here. (Are we also completely forgetting the harm of second- and third-hand smoke, which vaping eliminates?)
17
@gmg22 I'm not aware of hysteria. Health professionals are rightly concerned about a product which appears to be causing death and injury to many. It will take years before we know exactly what the health effects of this activity are, and until that point caution is warranted. Your family member may have her smell back, but she is still damaging her respiratory system.
2
While I certainly do not have all the data about the deceased individual, it would appear from the article that the doctors could not figure out what caused the pneumonia. Since he had vaped and his lungs had the appearance of at least some of the folks who have had this lung condition, they chose vaping as a cause. In fact, they have no real evidence that this is the cause.
Two data suggest that vaping per se is not the cause of these illnesses. First, why has this only occurred in the United States? If it were simply vaping, you would expect to have many cases in other countries since vaping is a world-wide phenomenon. Second, why has it appeared so acutely? Again, if it were simply vaping you would have expected a gradual onset of the disease, not it appearing all of a sudden.
19
The CDC refuses to provide basic information that would allow people to make evidence-based decisions. Of those who have been sickened or died, how many vaped THC vs. nicotine, and how many bought commercial vaping products vs. street products? Yes, I understand that there may be some uncertainty where there is overlap, but sickened users could be asked to make estimates of their usage patterns. it appears that the CDC has data it is not releasing. I have no idea why, but people who buy name brand THC vaping products at Med Men and people who buy Juul and similar products to stop smoking have a right to know.
14
@ShenBowen We don't know. The disease is lipoid pneumonia - it is known to be caused by inhaling oils - oils are used to dissolve non-water soluble CBD and THC. It seems that some if not many users are "fibbing" when asked what they vaped, for obvious reasons. But it makes the issue tricky to assess.
9
@MacK: It would be valuable to know, for example, how many subjects were sickened by name-brand commercial THC vaping products purchased in states where THC is legal (where people are less likely to fib about their usage). Similarly, it is useful to know the numbers for nicotine users (who might also use some THC but consume much larger amounts of nicotine because of their addiction). I believe the CDC has collected this data. They are using it to understand the cause of the outbreaks, but in the meantime, they are not making this data public.
2
@ShenBowen It's something like 80% were smoking THC pods (unclear is legal or not) and only 13% said they smoked exclusively nicotine (with the others smoking a combination). Regardless of legality in each state, I think it's pretty safe to make the assumption that this is caused by THC in some capacity.
As a now 68 years old "ex" if I were to ever once again take up the nicotine habit I'd opt for traditional cigarettes rather than vaping. The former take a lot longer to kill you.
Fortunately I gave up on tobacco and nicotine some 38+ years ago!
7
@George - We are so lucky. Now that I'm 68 I want to live forever.
1
Good for you!
1
The evidence connecting his death to vaping seems tenuous at best.
16
@Camille - I think the evidence that connects his death to vaping is his chest X-ray.
Typical pneumonia doesn't have the 'ground glass' appearance on chest xray that doctors are finding with these vaping related cases.
2
so many comments in here from people who are almost assuredly not doctors but almost certainly avid vapers
we get it, you like vaping, and you won't be convinced or scared off until the evidence buries us like an avalanche
14
@Pat Miller The truth is subjective for these folks. If they like something, it's automatically benign. These are the same folks who shop at Whole Foods and wouldn't dream of eating non-organic kale or cleaning their house with non-natural products. I see them all over the place. Most of these vaping folks also carry yoga mats with their other hand. My father in law is a well known doctor who would be the first to tell you that the lungs were not meant to inhale anything except air. Everything else is poison.
7
@Pat Miller The only avalanche is implicating illegal THC carts. And the CDC is unscrupulously trying to hide it.
NY 34/34
https://www.health.ny.gov/press/releases/2019/2019-09-05_vaping.htm
CA 21/21; NM 8/8; WI 24/27; MN 8/8.
http://tobaccoanalysis.blogspot.com/2019/09/health-officials-continue-to-warn.html
OR 5/5; IA 18/23 78%; TX 75%; IN 1 death.
http://tobaccoanalysis.blogspot.com/2019/09/in-response-to-two-deaths-due-to.html
DE 10/11
http://tobaccoanalysis.blogspot.com/2019/10/cdcs-communications-are-likely-making.html
NC 5/5
https://www.northcarolinahealthnews.org/2019/10/04/nc-hospital-spotted-mystery-vaping-injury-patterns-early-on/
UT 34/36
http://tobaccoanalysis.blogspot.com/2019/10/utah-department-of-health-concludes.html
2
@Pat Miller - I neither smoke nor vape. However, there are millions of people vaping safely, who have been vaping for years without incident. So until the real culprit involved in tiny number of illnesses and deaths "related" to vaping is determined, some of us choose to recognize the media frenzy over this, the typical ignorance of governmental reactions to something they know little about, and the likewise multitudes of readers who choose to exercise critical thought about any of it, and wait for actual evidence.
12
Did this patient have a Do Not Intubate order? Otherwise it is unexplainable that in a hospital they watched him turn blue and then die.
7
@Panagiotaropoulos
He didn't turn blue. Pale and cold. Yes, he had a DNR due to his COPD and age.
Vaping IS smoking, period. You are inhaling a chemical substance into your lungs for "pleasure." I am completely bewildered that this is seen as a new health crisis. Your lungs are meant to supply your body with oxygen. Anything else you inhale will eventually cause harm. How is this difficult to understand?
29
@Southlandish Not to be semantic, but if you're not burning anything, it can't be smoking.
4
@Southlandish That's a stirring proclamation for those who don't have an addiction to nicotine. In the real world, it means nothing. It's a matter of degree in those of us who are addicts. Which is less bad, cigarettes or vapes? My doctor recommended that I vape as a less-damaging alternative to my smoking habit.
4
@Southlandish "Vaping IS smoking, period" Uh, no. Smoking requires combustion and there is no combustion in vaping. And no, anything else you inhale will not cause harm. Ignoring all of the other gases that we routinely inhale, including nitrogen, argon, CO2, carbon monoxide, etc., our lungs are also designed for occasionally inhaling smoke, droplets of liquid, etc. We evolved doing these things and if something is damaging, there will be a selection for genes that prevent that damage.
4
We have a problem, a problem that is crippling people for life, and killing others outright. We do know that it is confined to a small subgroup, those who Vape, and possibly those who Vape THC, but we are not sure. It as if we had some sort of Demon who was going "You, and You, Not you, Not you, You, but you are dead." Yet people are still going to the Vape shops and buying this stuff off the street. There are even some who, when released from the hospital, go back to the street and start Vaping again. Then they are surprised when they wind up back in the hospital.
We have a very strange culture, we have a group who it seems will use a drug even when they know it is deadly, and after having survived a near death experience will go back to that same drug. Vaping seems to tap into the same culture as Heroin, I hate to call people stupid, but it seems to fit the behavior.
5
“Better off sticking with tobacco...”
Big pharma (patches and pills) and big tobacco won’t stop until e-cigs are made illegal.
The media loves this “crisis.”
20
@trblmkr This is where you are very wrong. First, big tobacco is very, very heavily involved in vaping and making money and big pharma will make a fortune off of sickly vapers.
3
My sympathies to this family that has suffered such a grievous loss. The issue of vaping and whether it should be curtailed or banned raises another question for me: Why doesn't the government ban cigarettes that kill thousands, millions of people?
Vaping deaths are awful; so too are the deaths and disabilities caused by cigarettes. Get them off the market! They're disgusting.
8
@hotGumption
In another news piece I share my thoughts on this. I don't think vaping should be banned because many other addictive substances aren't banned. I believe we need more research on vaping and better warnings. Vaping originated as a safe alternative to smoking. However it may not be as safe as it seems.
1
This is not a very balanced article. Vaping associated lipoid pneumonia is pretty rare considering the number of people who vape and don’t experience any disease. Most pulmonologists believe that harm may arise in flavored vape liquid and THC oil, but nicotine in solvent is likely not harmful. Anyone currently smoking should absolutely switch to vaping.
16
@Local Labrat he didn't have lipoid pneumonia that we know of. It's not the pneumonia on CTs and xrays. It's the ground glass as appearance that we know little about.
Lipoid pneumonia tends to be from inhaling other oils from THC and refills. This wasn't the case here.
5
@Local Labrat
What part of Nicotine is an addictive poison, don't you understand?
Go to the CDC website look up Nicotine.
@Local Labrat - Surely you meant "Anyone currently smoking should quit and NOT switch to vaping".
1
It'll be interesting now that there is more information out there what the actual case rate it. My guess is much higher than currently reported.
2
I smoked cigarettes for 43 years. Six years ago I switched to vaping and never looked back. The health benefits were immediate. There is no other smoking cessation method that satisfies the ritualistic elements of the smoking addiction, I tried them all multiple times. Even if the government wrecks the flavored juice industry I’ll either vape pure vegetable glycerin (tastes slightly sweet) or mix my own flavored juices.
12
@Steve B Same. Ten years vaping this year. No hacking, roaring cough on waking up. No loss of my sense of taste. No reek of cigarette smoke.
Man, the factory I work in has more dangerous stuff in the air than what vaping puts into it. The difference is, one is for a 'noble' cause and one is something people can attack based on their own morals. This is the one way that both the left and right fail: Their need to dictate to others what we do with our own bodies.
2
I have a suggested solution to the vaping caused illness epidemic.
I am appealing to the same money seeking law firms that pay for the many television advertisements seeking people who may have been injured by 1) asbestos, 2) talcum powder, 3) prosthetic mesh, 4) Roundup herbicide or 5) low testosterone supplements to now seek those injured by vaping to develop a class action law suit against the manufacturers and distributors of vaping products.
The fear of a significant legal and deserved legal judgement against the vaping industry should help rid us of an unsafe product.
The FDA can also mandate warning messages on all vaping products stating that usage of this product can lead to lung damage and death.
1
I suspect that one of the many problems with vaping is the minute particle size delivering plastic vapour and toxic chemicals into the depths of the human body. A friend picked my husband up after a trip and drove him—in a convertible—about an hour’s drive. His sealed suitcase had been in the trunk and we had to air the contents out for a week. I still get a whif of it from that suitcase even one year later.
4
Could it be that cigarettes are safer than vaping?
Neither are 'safe'. One may be less harmful than the other. The media should not use the word safe when describing either method of inhaling nicotine.
The comments for this article are excellent as a whole. It’s true smoking is a tragic social disease for which our government has utterly failed us. Our entire lives have been turned upside down because of 9/11 and the death of 3 to 5 thousand directly and indirectly. Yet, tobacco kills over 500,000 people a year. Digest that. We don’t have to ban it, as that would be like failed prohibition, but we could do lots more to tax, regulate and educate it out of existence. Also, vaping never had to be allowed and never would have caught on. Teen smoking was plummeting before vaping. Nobody in my family smokes, so I really don’t focus on it but it really is a travesty.
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What is puzzling me about this whole mess is how come, after years of existence, is caping now causing deaths? Did the companies change a formula? Was this happening before and not caught? Is it just hysteria? Seems like it can’t be inherent to vaping or it would have happened earlier and in Europe as well.
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If people want to vape or do anything that might be harmful to them, they can and will find “evidence” to support their choices.
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As one who successfully quit smoking many years ago, I can endorse a method that worked for me. I admitted to myself truthfully that I had been duped into smoking, at jeopardy to my health, by the uncaring management of an evil industry. My anger and hatred of them strengthened my determination to escape their clutches. I doubt that anything else could have worked. Hatred can be powerful weapon well applied.
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This is the closest any journalist has came to naming brands and actual items inhaled. I have emailed the CDC myself telling them that until they call out actual brands nobody is going to quit vaping.
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In my experience, people who vape do so far more often then they would light up and smoke a cigarette. Much higher rate of consumption with vaping. I write this having watched friends make the switch from real cigs to vapes.
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@Tony I agree. I did and that made the addiction to nicotine even more than when I smoked cigarettes. 6 weeks vape free now though.
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At least from reading the article, I don't see any particular evidence that this man died as a result of vaping. Even ground-glass opacities are a nonspecific and relatively common diagnostic finding that appear in, among other things, many pneumonias.
This is the wrenching story of an aging man with 30+ pack years under his belt and a history of atrial fibrillation, non-Hodgkin's lymphoma, and chronic obstructive pulmonary disease, who sadly passed this year, likely from cigarette related illness.
About 500,000 Americans die every year from cigarettes. This year, about 30 patient deaths have been linked to vaping, and almost all of those patients were vaping tainted blackmarket THC products.
The reason to regulate e-cigarettes is to prevent teenagers from picking up the habit under intense marketing pressure from industry. But they must continue to be made available to the 40 million Americans who smoke cigarettes, which all available evidence shows WILL kill them.
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@Local - For the 40 million Americans who smoke cigarettes, the options are not just to vape or to continue smoking. There is another option - quit nicotine entirely.
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@Local,
These are the early stages of this outbreak investigation. At this stage, with precise pathophysiology unclear, case definitions are often somewhat non-specific.
Also, at this stage, usually a hefty percentage of cases have yet to be identified.
Zero of the identified cases have evidence of an active pulmonary infection. I suspect part of the reason this patient was identified is that he had no evidence of an infection.
CDC's website has info on the current status of the investigation, including the case definition:
https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html
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@Local
The article doesn't go into the details of the lengthy investigation the NE health department went into. However, part of it is ruling out everything else like the flu etc. The state follows guidelines from the CDC on how to CV classify it as a vaping death.
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Why haven't we heard about whether this vaping health crisis/incident is endemic to the U.S only or whether other large vaping markets such as Europe and Asia are seeing similar effects and casualties affecting their vapers?
Is there any communication and sharing of data etc between the U.S and other Countries on this issue or is the U.S just assuming it is a case of American Vaping Exceptionalism...like so many other things that others do or don't and that in and on many of them ...America can't...or won't?
This is especially pertinent given the fact that the U.S authorities have been very lax in all areas of regulation, research, safety strategies and protocols as the market is allowed to run rampant with a minimal of oversight in this era of Corporate Hegemony and power over Citizen rights and standards.
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@Loomy I suspect we're not hearing about (the absence of widespread vaping illnesses in) Europe because the U.S. media is enjoying this "crisis" and doesn't want to report on data that might undermine the crisis story.
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@Loomy I'm not aware of any country that has adopted vaping on the same scale as the United States. In Australia, for example, electronic cigarettes containing nicotine are banned entirely.
My brother in law travels a lot to Europe because of his job. He said A LOT of people vape there. Why isn’t Europe experiencing the same problems?
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@Kb No black market THC vaping pods, because it is legal to smoke marijuana there.
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@Gusting
Marijuana is not legal in Europe.
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@Camille , in Amsterdam, when I visited about ten years ago, it was served openly in lovely little "coffee shops." Has that changed?
An elderly man’s death from vaping is hardly going to help convince young people to stay away from vaping.
Not trying to be overly critical, but young people are in grave danger from vaping. We have to find a way to reach out before it’s way too late.
Nevertheless, this family is saddened by the terrible effects of smoking, physically and mentally. They tried to help Mr. Steffen help himself. That in itself is a very sad story that so many others have also endured. Condolences.
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Vaping IS smoking. The only differences are the nicotine delivery mechanism and the higher risk of abuse. Period. End of story.
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@ArtM - You're wrong. E-cigarettes do not contain the carcinogens that cigarettes contain. Vaping IS NOT smoking. I'm a former cigarette smoker and have been vaping for over two years.
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@ArtM
Simply not true. Carcinogens are created by burning the tobacco leaf material in the cigarette .
Nicotine as a pure chemical is akin to, and no arguably more dangerous than, caffeine.
Dependencies on both can be managed. Starbucks, anyone?
It is disheartening to see public health "reformers" adopt the anti-science genus of arguments familiar from climate change denial.
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@ArtM
Smoking is inhaling smoke. Vaping is inhaling vapor. They are different, and they do not necessarily involve nicotine. Or abuse.
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It's a bit laughable to think the doctors did not know that their patient used E-Cigarettes and they needed a "tip" to find out.
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@Jeff
He died in May. He was 68, had COPD and pneumonia. The vaping epidemic didn't hit until August. We assumed it was the COPD and pneumonia and not vaping. Only recently had vaping come into light and now it makes sense looking back.
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@Dulcia there's certainly nothing laughable about it. Your reply makes sense with respect to context -- until recently, a lot of people though of vaping as just "water vapor," which is understandable given the term "vaping."
Explanations notwithstanding, I'm very sorry for your loss. It had to have been hard to watch; I hope you and your family shortly receive lasting peace.
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The gentleman had COPD, the disease from which a dear friend of mine who had given up her four pack a day habit did die around age 60. Pneumonia used to be called the old man's friend-- ironically -- now we have the vaccine and flu vaccines... but all that said. it seems that vaping indeed is a cause of death unexpectedly (like fentanyl) and it beats me why anyone in this day and age would take up smoking or opioids/heroin. We do know! It's not a maybe... and people have told me they were addicted from cigarette no. 1. Elton John (60 Minutes?) on the topic of cocaine addiction... kept going even tho no. 1 made him sick, no2. got him for the next 20 years and supposedly the coke habit is easier to kick than ciggies. Maybe it's time for society in general to slow down.. starting with Sesame Street... and onward with all the ads, news shows, Wall Street hype etc. Marianne Williamson may have something there, but I still go with Warren, who seems to have common sense and compassion and logic... and not be too beholden. Being bored is not a terrible thing. One doesn't always have to do. Why do we do what we do??
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More hysteria and madness. Once again I ask: why are other countries not having this problem? Because they regulate the e-cig system and are far more open minded than Americans. They see e-cigs as a way to quit smoking cigarettes and I for one agree as a smoker myself. People are dying from smoking THC black market cartridges, period. The small amount of those who claim it wasn’t THC are most likely lying to protect themselves from parents, authorities, etc. America’s lack of a federal marijuana legalization law has led to a huge black market of THC cartridges. These are the problem but don’t tell the anti-smoking crowd that. They don’t care. They see this as an opportunity to push their smoke free agenda on the rest of us.
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@Mike L Other countries do have this problem, it just gets less press.
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@KarenAnne Got any sources for that claim?
The media is so, so desperately trying to push this narrative that e cigarettes are an imminent threat to American public health and it just is not the case. This has been a concerted disinformation campaign to fear monger the public. Articles like this never mention how statistically insignificant and minuscule these occurrences are. Fail to mention or attribute these illnesses to any other underlying medical problems with a patient (like perhaps smoking for decades would cause!). Have for weeks said “we don’t know what is causing these illnesses”. Really? The US medical and scientific community can’t definitively say when there has been a nothing short of a medical moral panic over this for the past 6 weeks? The fact is, out of these few hundred cases, the cause has been tainted THC cartridges, homemade and unregulated and sold illegally. Yes that has been said, but has been substantially downplayed, willful ignorance and misinformation by the entire media landscape to push a story that all e cigarettes are dangerous and evil. That nicotine is going to kill you. One must ask why these ultra rare illnesses among the tens of millions of American vape product consumers is being so, so heavily feature and reported on... someone must think they’re going to win the Pulitzer on this nonsense.
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It’s “nonsense” to care about people dying, or getting extremely sick & almost dying?? There are over 1000 now. This is all just hype???
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@F. Jozef K. I'm a cynic. Who stands to profit by pushing stories like these in the media. Always follow the money.
NYT's Writer, Ms. Bosman deserves much credit, I'd heard about these deaths, yet it was her words, that put a human face on this situation.
Loss is always sad, and family loss that comes from a company's greed, needs prosecuted.
My sincere condolences to the Steffen Family. Please know, this could have been anyone's family.
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After cigarette manufacturers were finally forced to admit publicly that their product was addictive and caused preventable fatal diseases, why were they permitted to develop and market a new and similar product? After smoking became socially unacceptable, why was vaping seen as a reasonable alternative and a path to quit smoking? And why hasn't this product, a drug and a drug delivery system, been rigorously regulated?
It would be instructive and helpful to see reporting devoted to these questions. NYT, can you inform us, please?
10/14/19, krw
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“E-Cigarettes Went Unchecked in 10 Years of F.D.A. “ is another article in today’s NYTimes.
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While I share the caution against vaping, whether nicotine or THC, I read the article regarding Mr. Steffen's condition and history. He was really living on borrowed time even if he stopped smoking and never vaped.
Were it not for the search for a root cause in vaping illnesses and deaths, this case would have never been judged as vaping related and I continue to think the researchers are pulling a fact from what would normally be speculation.
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The case of Mr. Steffen is very similar to the case of Terry Miller in the UK who died in 2010 of vaping. He also was a former heavy smoker and his health rapidly deteriorated after switching to e-cigarettes, at the age of 57. Is it possible that some ex-smokers with beginning COPD and other complications from smoking are much more sensitive to e-cigarette toxicants ? Professional societies of lung doctors, the European Respiratory Society, American Lung Association and others, have strongly come out against vaping, stating that nothing should enter our lungs but clean air. That anyone would recommend that ex-smokers should again fill their lungs with chemicals, and we know now that e-cigarettes contain toxic exposures, is beyond the pale.
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@Eric Sorkin
An important question: is it better to fill your lungs with cigarette smoke, or e-cigarette vapor?
Like the patient described in the story, many smokers try a thousand ways to quit without success, before switching to vaping.
All evidence shows that cigarettes are deadly. Ecigarettes have been around for ~8 years, and until the rash of THC associated complaints, there were maybe a dozen case studies of possible vape related illness
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@Eric Sorkin I literally read this story thinking it was the UK case too. Then I kept reading it to see if they actually named brands or products.
Mr. Sorkin comes closest to pointing out the chemicals that are present in vaping formulations. I am amazed that not one article I have read, over weeks and months now, has mentioned that propylene glycol, a major component of antifreeze, is a harsh chemical that I would never breathe into my lungs. Imagine vaping antifreeze?!?! To me there is no mystery.
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This patient had a history of COPD and lymphoma, and from the story may have had prolonged infectious symptoms which may have precipitated his respiratory failure. To blame nicotine vaporizers for his death when the typical cases involve black market THC, and when he had multiple other potential causes of ARDS, seems highly speculative.
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@Joshua F
I wonder if it's really true that the typical cases involve black market THC. I've seen a lot of speculation that young folks who get sick must have used black market THC, since that's the typical case. There may be some circular reasoning going on here.
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@Joshua F He had not infection since he did not respond to antibiotics, pointing to the typical sterile inflammation seen in vapers. E-cigarettes are not just nicotine vaporizers, the "vapor" aerosol contains many other chemicals, many of them found to be toxic now.
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@Joshua F
He was cancer free when he died. Yes his health didn't help matters, but the doctors can distinguish vaping damage on lungs and his were solid signs of it.
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Sad story, but it’s an anecdote and not data, especially given the lack of any conclusive evidence that vaping caused his death. The CDC suspects that 1,300 people MAY have been sickened by vaping, in total, when 1,300 people ACTUALLY DIE every single day in the US from smoking-related causes. We need careful studies, but until I see them I would prefer the product that might have some risks over the one that is the guaranteed #1 cause of preventable deaths.
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@Mike Mac You're ignoring the unusual and characteristic ground glass appearance of the rays of the lungs that is characteristic of a vaping injury.
But then anyone who continues smoking or vaping is not good at recognizing reality.
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@KarenAnne Loons get to write opinion pieces too. Ground glass appearance is a constant in the emphysema portion of what is now called COPD. Also indicator of both infectious and non infectious pneumonia. https://en.wikipedia.org/wiki/Ground-glass_opacity
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Excuse me? A 60-something man with a whole host of health problems dies from a respiratory illness after decades of smoking... and this article blames vaping? Going so far as to quote his widow’s characterization of his vape pen as a “bullet and a gun”. This is absolutely outrageous.
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@Andrew Clark Note the characteristic vaping injury on the lung x-rays.
Yes, the individual had a host of health problems but that doesn't excuse a more premature death from vaping.
(Why the article mentions atrial fibrillation, when it has no effect on life expectancy if treated, is, however, puzzling.)
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Ground glass infiltrates on chest x-ray are not exclusive to vaping related lung injury. They can occur from pneumonia, pulmonary edema, or chronic inflammatory lung disease.
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@Andrew Clark
Another way to look at it is to see what is vaping doing to the lungs of otherwise robust healthy young people. Then ask what it could have done to .. as you said .. a 60-something man with a whole host of health problems ... after decades of smoking?
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If these deaths are the result of American made e-cigarette products, I can only wonder how many more countless deaths will occur once the United States starts importing vaping products that are made in countries like China. 
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@David H
I won’t even buy dog toys that are made in China!
@David H Most of our vaping hardware is made in China and has been for ten years. It's the liquid that's made here, and it's specifically the black market liquid that's causing problems.
I'm all for American made, but let's be real on facts here.
@David H - Yesiree Bob - them Chinese purveyors of death are way worse than our own home-grown 'Murican death dealers!
Don’t many e-cigarette cartridges contain diacetyl - the additive that caused lung injury to those who worked around butter-flavored popcorn?
If so, wouldn’t that cause or contribute to these lung injuries?
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@JM Popcorn lung, or bronchiolitis obliterans, is a severe lung disease. Damage to lung tissue traps air inside the lungs and makes breathing difficult. The name stems from incidents of the disease occurring in workers at a microwave popcorn factory. The CDC determined that the cause was breathing in the fumes of the diacetyl used for the butter flavoring.
The analysis showed that the popcorn factory workers were spending an entire shift in an area where the diacetyl in the air was measured at 18 parts per million. The constant, long-term exposure at that level was deemed to be a health hazard.
As a result of the CDC diacetyl analysis, OSHA instituted provisions for popcorn factory workers to wear protective equipment to avoid inhaling diacetyl.
In a seperate univeristy study, researchers did not conclude that a diacetyl vape will cause respiratory illness. What they did suggest was that their discovery indicated a need for further study. That is a reasonable position that makes sense. We do need more study on this issue. As a vaper, this is something you certainly deserve to be aware of.
To add some perspective here, studies have shown that when diacetyl has been detected in vapor, it was measured at a high 9.0 micrograms. The diacetyl level found in tobacco smoke has been measured at 335.9 micrograms. Cigarette smoke exposes tobacco users to 85x higher diacetyl levels than e-cigarette vapor that contains diacetyl.
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@Andrew Clark --
1. Thanks -- I really did pose this as a question, because I've heard people mention the diacetyl in vaping solutions, but didn't know why it wasn't being talked about.
2. I don't smoke, nor do I vape. I do, however, work in the insurance industry. One of the things we do is keep up-to-date on emerging sources of litigation, so it's helpful to understand what might cause these conditions.
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@Andrew Clark
In your last paragraph, micrograms doesn't make sense as a unit. Micrograms per what? Liters? Cubic meters? Unless you give the whole unit you don't know if you are comparing like numbers.
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