An outbreak of severe lung illness related to vaping has affected more than 450 people and killed five in the United States in the past few weeks. The Centers for Disease Control and Prevention has advised people to avoid all e-cigarette products while it investigates. Symptoms for many of the victims quickly escalated from coughing and shortness of breath to a life-threatening condition known as acute respiratory distress syndrome.
The cause of the illness is unknown, but there's evidence to suggest it's connected to vaping THC, the psychoactive chemical in marijuana, that may have been purchased on the street or modified by users.
E-cigarettes are small devices that heat liquid into vapor that is then inhaled. They're classified as tobacco products because most contain nicotine. While they have been available for about a decade, e-cigarettes exploded in popularity with the release of more discreet handheld vaporizers.
Why there's debate:
The recent spate of serious illnesses linked to vaping has highlighted how little is known about what’s in the products and the potential effects of long-term use. E-cigarettes can contain ultrafine particles, harmful chemicals and heavy metals. Beyond the risk that these ingredients may result in an acute illness, the lasting effects of regular use are largely unknown.
Among the most vocal anti-vaping campaigners are survivors of the recent outbreak. "It's going to attack your lungs," an 18-year-old patient from Illinois warned.
Vaping products are marketed as antismoking tools, but there's concern they may cause users to develop a nicotine addiction that ultimately drives them to cigarettes. Though selling e-cigarettes to minors is prohibited in the U.S., e-cigarette manufacturers have also been accused of using marketing tactics and creating candy-like flavors to appeal to teenagers. Tobacco use among youths had reduced dramatically in decent decades, but the introduction of e-cigarettes has "erased" that decline, and the Food and Drug Administration said in 2018 that vaping among teens had reached "epidemic" levels.
Vaping advocates say the recent outbreak of illness is caused by black-market "street vapes" containing THC, not store-bought tobacco products. When purchased from a reliable seller, e-cigarettes have tremendous value as an antismoking aid, they argue. One study showed them to be twice as effective at helping people give up cigarettes as other products like nicotine patches and gums. The governments of Canada and the United Kingdom even formally recommend vaping for adults addicted to smoking.
Smoking-related illnesses are responsible for 7 million deaths globally every year. A panic over a handful of vaping-related deaths, some argue, could backfire by limiting the number of people who use the products to get off cigarettes.
Just because vaping is better than smoking doesn't mean it's safe
"Many people, including health professionals, have assumed that e-cigarettes are safer than traditional cigarettes. … But 'safer' doesn’t mean 'risk-free.'" — editorial, Los Angeles Times
There's no evidence legal e-cigarettes are related to recent illnesses
"The common denominator is that the people suffering from these illnesses were using illegal and unregulated products, most containing cannabis oil and other unknown ingredients. Not a single one of these cases has been attributed to the use of a legal nicotine product." — Guy Bentley, Washington Examiner
Vaping can be deadly
"Young people are inhaling what they think are innocuous vaping liquids when, in fact, they could be killing themselves." — editorial, St. Louis Post-Dispatch
Overreacting to the risks of vaping may result in more smoking deaths
"Vaping is harmful. But since vaping restriction might lead millions to switch to the number one cause of preventable death in the country, we must exercise caution so as not to make an epidemic exponentially worse." — Raymond March, the Hill
Vaping leads to addiction that means prolonged exposure to dangerous chemicals
"The real problem of vaping isn’t all that different from the one presented by cigarettes: Nicotine is a highly addictive chemical, and feeding that addiction requires repeated long-term contact with all kinds of solvents, emulsifiers, and by-products that have either harmful or unknown consequences for those who inhale them." — Amanda Mull, the Atlantic
A lack of oversight has allowed a dangerous black market to emerge
"A Wild West culture emerged rife with black-market or unlicensed 'pop-up shop' sales of Chinese-made vape pens and marijuana ingredients … all breeding the risk of toxic contaminants." — editorial, USA Today
E-cigarettes may lead some people to take up smoking
"Mysterious illnesses aside, many have accused e-cigarette manufacturers of exposing young people to addictive nicotine and luring them toward smoking." — Hannah Knowels, Washington Post
The risks of vaping are exaggerated
"The current wave of legislation is a predictably panicked response to a rise in teen vaping — a rise that the FDA has portrayed in inflammatory terms as an 'epidemic.'" — Jacob Grier, Slate
New laws are needed to protect children
"The government should enact the regulations now — before one more kid becomes addicted to nicotine, or ends up in the emergency ward gasping for a breath that may not come." — editorial, Toronto Star
We simply don't know how safe or dangerous vaping is"Based on existing evidence, most doctors and scientists think that e-cigarettes are probably safer than regular cigarettes. But exactly how much safer is still anybody’s guess. The only way to know for certain is with a thorough and impartial vetting of these products."