Surgeons are not squeamish people, so when one of them says, "This is an evil that I haven't faced before" it gets your attention. The doctor is Hassan Nemeh, surgical director of thoracic organ transplant at Detroit's Henry Ford Hospital. The evil is the stunning wreck that vaping made of a 17-year-old double-lung transplant patient's lungs.
"What I saw in his lungs was nothing that I've ever seen before, and I've been doing lung transplants for 20 years," says Nemeh. That vaping, particularly of cannabis products using THC oils, has become a major public health crisis is indisputable: Since March, vaping-related illness has landed over 2,000 individuals in hospitals nationwide, and at least 39 of those people have died.
The patient in Detroit
mage source: James R. Martin/Shutterstock
Not much information regarding the individual described by Nemeh has been released, since he's a minor. What we do know is that his family has described him as an otherwise-healthy young athlete.
The teen was admitted to the first of three hospitals, St. John Hospital, September 5 with what seemed to be pneumonia. His breathing, however, became increasingly difficult until he was put on a ventilator September 12. He was soon transferred to Children's Hospital of Michigan to be connected to an extracorporeal membrane oxygenation device (ECMO) in order to maintain heart and lung functioning. Still failing, he was transferred to Henry Ford for a six-hour, double-lung transplant on October 15, without which, doctors say, he would certainly have died.
"There was an enormous amount of inflammation and scarring in addition to multiple spots of dead tissue. And the lung itself was so firm and scarred, literally we had to deliver it out of the chest," recalls Nemeh.
THC and vitamin E acetate
Vitamin E acetete
Image source: ibreakstock/Shutterstock
When the medical community first became aware of the pulmonary problems, it was unclear what aspect of vaping was causing them. Likewise, it was unclear whether it was tobacco or THC vaping that was causing the problems, or both.
Scientists from the CDC tested for the presence of potential culprits in victims' lung fluid, looking for plant oils, petroleum distillates including mineral oils, or any other suspicious contaminants common to the individuals' cases.
What they found — though there could still be additional substances involved — was vitamin E acetate, or tocopheryl acetate. Collecting 29 lung-fluid samples from 29 people who had been sickened or who had died of lung issues, all 29 contained vitamin E acetate. The CDC's Dr. Jim Pirkle says that's "pretty much unheard of," and constitutes a "very strong signal" that vitamin E acetate is at the very least part of the reason for vapers' pulmonary damage.
CDC officials have concluded that most of the patients had vaped cannabis-based products. This is supported by state testing — New York's reports finding "very high levels of vitamin E acetate in nearly all" of the samples from cannabis vapers they tested. While the federal FDA remains cautious about putting all the blame on vitamin E acetate, they, too, have found it to be prevalent in afflicted vapers' lungs. Medical authorities are continuing to test for other possible factors in the frequency of pulmonary illnesses among vapers.
Legitimately manufactured and sold cannabis-based vaping products don't necessarily contain vitamin E acetate. However, the sticky, honey-like substance is commonly used as a thickener in black-market THC products. Unlike THC itself, vitamin E acetate lingers in users' lungs. These unregulated, illicit cannabis-based vaping products, say experts, have indeed been linked to most of the cases medical professionals are seeing.
"This is a preventable tragedy," says Nemeh. While vaping is presumed by many to be safer than smoking, this current public health crisis makes clear that caution is advised, especially when buying vaping products off the street.
Cigarette smoking has had a bad name since the first Surgeon General's warnings in the 1960s, and a lot of erstwhile buttheads consider themselves more health-conscious by smoking cigars instead. Tobacco smoke, though, regardless of its source, contains dangerous toxins that pose a danger to others via their exposure to secondhand smoke. Thirdhand exposure is also an issue, from contact with clothing and surfaces on which smoke lands. Though marijuana is generally believed to be safer than tobacco — and to have medicinal value — that's not entirely certain yet. Vaping with tobacco or grass also exposes the vaper to toxins.
The home improvement company Porch recently polled 1,009 people — 570 men and 490 women — on their feelings about smoking, especially cigarette smoking. The recently published the results as infographics.
The high cost of cigarette smoking
When it comes to good-old tobacco smoking, it's a habit that requires a serious commitment of cash, not to mention health. The average smoker spends $96.22 per month for the privilege of lighting up 8.9 times a day. And that's without the local cigarette taxes imposed in some areas as a disincentive for the habit.
If that seems like a lot of scratch, Porch found smokers would be willing to spend even more if certain perks were included. They'd pony up another $43.01 to smoke in their homes without getting any flack — not sure who exactly they'd be paying — and tack on another $29.24 per night to hotel bills to be able to smoke in their rooms.
Significant (cough, cough) others
Smokers, nonsmokers and reformed smokers have feelings about hooking up with smokers.
While about 80 percent of nonsmokers find the habit a turnoff, the remainder wouldn't necessarily spurn a smoker's attention.
Ex-smokers are iffy, perhaps for fear of backsliding. A little over a third of the male ex-smokers polled said maybe, while only 19.8 percent of women would be okay with dating a puffer.
At the bottom right below sits the most icky pie chart we've seen in a while, and appropriately so: that ashtray reveals that 19.2 percent of nonsmokers would rather date a convicted felon!
Porch throws in an extra amusing political tidbit here: A majority of both parties would rather go out with a member of the opposing party than someone with a nicotine habit.
The malady lingers on
Three out of four nonsmokers won't put a deposit down on a house whose smell reveals that a smoker was a previous inhabitant.
Likewise, remember how smokers would pay extra to be able to smoke in their hotel rooms? Well, nonsmokers staying at those spaces would not be too happy about that. Almost 90 percent of nonsmokers would demand a room switch if their temporary abode smelled like smoke.
But let's say you're a nonsmoker and you've moved in and have company over: about 43 percent of you don't want guests smoking anything in Chez Vous. Vaping would be sort of okay, getting high a little less, and 22.6 percent of nonsmokers would find themselves having to awkwardly request their guests put those death sticks away. Of course, famously stinky cigars are the least welcome of all.
A smoker’s home is her/his ashtray
Almost 80 percent of smokers light up in their own domiciles. Question: Is lighting a cigarette on the stove cool or ridiculous? Discuss. How about lighting a match on your teeth (not part of the survey).
Pot smokers are even more likely to smoke at home, which makes sense considering that herbally recreating in public may pose problems, and in some places arrest. Once again, cigar smokers, presumably many of whom live with people who have noses, only smoke at home about half the time.
The dangers of different types of smoking
In general, women consider all forms of smoking slightly more dangerous than men do. Beyond that, the survey's respondents have the relative dangers in about the right order according to current research. However, it's likely we have more to learn about thirdhand-cigarette smoke, marijuana, and vaping various varieties of plant matter.
Smoking around children
So playing the odds with one's own health is one thing, but what about rolling the dice with the well-being of the children who happen to be around when you smoke coffin nails? About two thirds of nonsmoking parents would speak up if you tried it, and about 40 percent of smoking parents.
Of those smoking parents, about two thirds do smoke around their own children, and a third of them in the car — obviously, that's close exposure, and when the weather is such that the windows are closed, a car is nasty place for a kid who wants to breathe.
Native Americans’ revenge?
Smoking is something that just doesn't seem to ever want to go away, and that's been true since ever the early colonists were exposed to tobacco by the locals. Each generation has its own relationship to it, finding it alternately fashionable/cool or repulsive/unhealthy — smoking is currently on the decline. But for many, the oral appeal is undeniable. If you're a smoker, we'd of course like you to be around as long as possible, and hope you'll consider quitting — there are lots of ways to making it happen once you can cough up sufficient determination.
