Ian Sane / Flickr
Preliminary data from the Centers for Disease Control showed a larger number of young people coming down with COVID-19 than first expected, with patients under the age of 45 comprising more than a third of all cases, and one in five of those patients requiring hospitalization. That also tends to be the group most likely to use e-cigarettes.
<p>While there is not yet a clear answer as to why so many young people are experiencing severe symptoms, some experts say vaping could be making things worse, according to <a href="https://abcnews.go.com/Health/vaping-cigarettes-adding-fuel-coronavirus-fire/story?id=69782735" target="_blank">ABC News</a>.</p><p>If you vape, "you're going to make lungs more vulnerable to severe infection," said Dr. Panagis Galiatsatos, an American Lung Association spokesman who is also director of the tobacco treatment clinic at Johns Hopkins Hospital, to <a href="https://www.webmd.com/lung/news/20200325/covid-19-likely-worse-for-vapers-smokers#1" target="_blank">WebMD</a>.</p>
<p>According to information released by <a href="https://www.massgeneral.org/children/vaping/smoking-vaping-and-covid-19" target="_blank">MassGeneral</a> in Boston, smoking and vaping weaken the body's immune system by damaging parts of the immune system that keep illnesses at bay and by strengthening an enzyme that allows viruses to attach and replicate in the immune system.</p><p>"If a person who smokes catches COVID-19, they are more than twice as likely to develop a severe case of COVID-19 than those with no smoking history," according to <a href="https://www.massgeneral.org/children/vaping/smoking-vaping-and-covid-19" target="_blank">MassGeneral</a>. "This means if a person smokes and catches COVID-19, they are more likely to be admitted to the Intensive Care Unit, placed on a ventilator or die from the illness. Menthol and other flavorings in tobacco products (including e-cigarettes) can also make lung infections, such as COVID-19, worse."</p>
<p>Dr. David Beuther, chief medical information officer at National Jewish Health in Denver, echoed that sentiment to <a href="https://www.thedenverchannel.com/news/national/coronavirus/vaping-smoking-might-increase-risks-from-covid-19" target="_blank">Scripps International</a>.</p><p>"I'd be more worried about you more than normal, but I think anybody that vapes, that inhales anything toxic into their lungs, is putting their lungs at risk, because it probably alters the immune system," said Dr. Beuther. "It probably causes some irritation. It probably reduces your own lung's ability to defend itself against this virus."</p><p>While we are advised to stay six feet away from each other, Beuther said somebody vaping may blow a cloud beyond the recommended distance and possibly spread the virus, as <a href="https://www.thedenverchannel.com/news/national/coronavirus/vaping-smoking-might-increase-risks-from-covid-19" target="_blank">Scripps</a> reported.</p>
<p>Doctor J. Taylor Hays, an internist with Mayo Clinic in Rochester, told a Wisconsin-based <a href="https://wqow.com/2020/03/31/smoking-and-vaping-leads-to-increase-of-getting-sharing-covid-19/" target="_blank">ABC News affiliate</a> that coronavirus particles get stuck in the mucus in bronchial tubes, which can trap the virus. Then virus particles are exhaled in a puff of smoke that can infect others nearby.</p><p>However, Dr. Hays said that quitting smoking and vaping can have an immediate impact in reducing the severity of COVID-19 symptoms.</p><p>"There is an immediate benefit in stopping smoking. It's not something that you won't notice for the next few weeks. It will happen right away. Less coughing, less shortness of breath, less mucus production. And probably those all mean lower risk of complications of a viral infection like COVID," Hays said, as <a href="https://wqow.com/2020/03/31/smoking-and-vaping-leads-to-increase-of-getting-sharing-covid-19/" target="_blank">WQOW</a> in Eau Claire reported.</p>
<p>While there is not a long enough history of vaping and COVID-19 exposure to say for sure if it increases susceptibility to the virus, medical professionals know that vaping can lead to serious lung and respiratory problems so it is logical that the habit could exacerbate symptoms, according to <a href="https://abcnews.go.com/Health/vaping-cigarettes-adding-fuel-coronavirus-fire/story?id=69782735" target="_blank">ABC News</a>.</p><p>"We know that e-cigarettes include chemicals such as propylene glycol, glycerol, and flavorings, and that these chemicals have the ability to go deep into your lungs and cause damage," said Dr. Alok Patel, a Columbia University pediatrician, to <a href="https://abcnews.go.com/Health/vaping-cigarettes-adding-fuel-coronavirus-fire/story?id=69782735" target="_blank">ABC News</a>. "When people become critically ill from COVID-19, this also involves the deep pockets of their lungs. It's really scary to think about what could be happening in those that have both of these going on together."</p>
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School students and activists gather at Fridays for Future school climate strike on Jan. 17, 2020 in Lausanne, Switzerland. Dominika Zarzycka / NurPhoto via Getty Images
No country on Earth is doing what is necessary to protect the health and future of the world's children, a major new report has found.
<p>The report, published in <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)32540-1/fulltext" target="_blank">The Lancet Tuesday</a>, is the work of a more than 40-expert commission convened by The Lancet, the <a href="https://www.who.int/" target="_blank">World Health Organization</a> (WHO) and the <a href="https://www.unicef.org/" target="_blank">United Nations Children's Fund</a> (UNICEF). It found that children around the world were at risk from the ecological and <a href="https://www.ecowatch.com/climate-change/" target="_self">climate crises</a>, as well as from advertising that markets unhealthy items like processed <a href="https://www.ecowatch.com/food/" target="_self">foods</a>, alcohol and tobacco products directly to children.</p><p>"[E]very child worldwide now faces existential threats from climate change and commercial pressures," former New Zealand Prime Minister and commission co-chair Helen Clark said in a <a href="https://www.who.int/news-room/detail/19-02-2020-world-failing-to-provide-children-with-a-healthy-life-and-a-climate-fit-for-their-future-who-unicef-lancet" target="_blank">WHO press release</a>.</p>
<div id="6f5fd" class="rm-shortcode" data-rm-shortcode-id="E48AC51582124395"><blockquote class="twitter-tweet twitter-custom-tweet" data-twitter-tweet-id="1230052726316421125" data-partner="rebelmouse"><div style="margin:1em 0">No country is adequately protecting children’s
•health
•their environment, and
•their futures
We must build a f… https://t.co/3ZHNbVRyic</div> — World Health Organization (WHO) (@World Health Organization (WHO))<a href="https://twitter.com/WHO/statuses/1230052726316421125">1582102397.0</a></blockquote></div>
<p>The report ranked 180 countries based both on "child flourishing" — how well they could feed, care for and educate children now— and "<a href="https://www.ecowatch.com/tag/sustainability" target="_self">sustainability</a>" — assessed based on greenhouse gas emissions and economic equality. It found that, while less developed countries had a hard time providing healthy lives for their children currently, developed countries threatened the future of all children with their higher greenhouse gas emissions.</p><p>For example, when it came to child flourishing, Norway, the Republic of Korea and the Netherlands performed the best, while the Central African Republic, Chad, Somalia, Niger and Mali fared the worst. However, when per capita carbon dioxide emissions were taken into consideration, Norway fell to number 156, the Republic of Korea to 166 and the Netherlands to 160. The U.S. ranked with Australia and Saudi Arabia as one of the 10 worst emitters. It was number 173 in terms of sustainability and number 39 in terms of child flourishing.</p><p>Only Albania, Armenia, Grenada, Jordan, Moldova, Sri Lanka, Tunisia, Uruguay and Viet Nam were both on track to meet 2030 per capita carbon dioxide targets and ranked in the top 70 for child flourishing.</p>
<p>"Climate change threatens our children's future so we must stop carbon emissions as soon as possible," University College London professor of global health and sustainable development Anthony Costello told <a href="https://www.theguardian.com/global-development/2020/feb/19/the-world-is-failing-to-ensure-children-have-a-liveable-planet-report-finds" target="_blank">The Guardian</a>. "Our new index shows that not a single country performed well on both child development and emissions indicators."</p><p>The report's authors warned that if emissions rise past four degrees Celsius by 2100, which they are currently on track to do, this would have serious consequences for <a href="https://www.ecowatch.com/tag/childrens-health" target="_self">children's health</a> because of <a href="https://www.ecowatch.com/tag/sea-level-rise" target="_self">sea level rise</a>, <a href="https://www.ecowatch.com/tag/heat-wave" target="_self">heat waves</a>, the spread of diseases like malaria and dengue and malnutrition.</p>
<div id="fad35" class="rm-shortcode" data-rm-shortcode-id="E0XA2I1582124395"><blockquote class="twitter-tweet twitter-custom-tweet" data-twitter-tweet-id="1230067702141771782" data-partner="rebelmouse"><div style="margin:1em 0">@UNICEF @TheLancet @WHOSEARO @WHOEMRO @WHO_Europe @pahowho @WHOAFRO @WHOWPRO Children are among the most vulnerable… https://t.co/0dYl2dUT0a</div> — World Health Organization (WHO) (@World Health Organization (WHO))<a href="https://twitter.com/WHO/statuses/1230067702141771782">1582105968.0</a></blockquote></div>
<p>The report also warned about the consequences of advertising. Currently, children in some countries see as many as 30,000 television commercials every year, including ads for alcohol, junk food and sugary drinks, <a href="https://www.bbc.co.uk/news/health-51547441?intlink_from_url=https://www.bbc.co.uk/news/science_and_environment&link_location=live-reporting-story" target="_blank">BBC News reported</a>.</p><p>One new threat in this department is <a href="https://www.ecowatch.com/tag/vaping" target="_self">vaping</a>. The number of children in the U.S. exposed to e-cigarette commercials rose more than 250 percent over a two-year period, WHO said.</p><p>Another emerging problem is the spread of advertising on social media, Costello told BBC News, though it is still insufficiently understood.</p><p>"We have few facts and figures about the huge expansion of social-media advertising and algorithms aimed at our children," he told BBC News.</p><p>In response to their findings, the commission called for "the birth of a new era for child and adolescent health," Lancet editor-in-chief Dr. Richard Horton told WHO. According to WHO, the commission recommended five specific actions:</p><blockquote>1. Stop CO2 emissions with the utmost urgency, to ensure children have a future on this planet;<br>2. Place children and adolescents at the centre of our efforts to achieve sustainable development;<br>3. New policies and investment in all sectors to work towards child health and rights;<br>4. Incorporate children's voices into policy decisions;<br>5. Tighten national regulation of harmful commercial marketing, supported by a new Optional Protocol to the UN Convention on the Rights of the Child.</blockquote><p>"It will take courage and commitment to deliver," Horton said. "It is the supreme test of our generation."</p>
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Vagengeym_Elena / iStock / Getty Images Plus
By Shawn Radcliffe
The Food and Drug Administration (FDA) announced Thursday that it will take action to remove most unauthorized flavored e-cigarette cartridges from the market.
<p>This would apply to mint, fruit, and dessert flavors, but not menthol or tobacco-flavored products. Also, it would apply only to flavored cartridges, not open tank systems.</p><p>This action is intended to strike a balance between protecting youth from the health risks of vaping — including nicotine addiction — and allowing adult smokers to use e-cigarettes as a way to quit combustible cigarettes.</p><p>"The enforcement policy we're issuing today confirms our commitment to dramatically limit children's access to certain flavored e-cigarette products we know are so appealing to them — so-called cartridge-based products that are both easy to use and easily concealable," said FDA Commissioner <a href="https://www.fda.gov/about-fda/fda-organization/stephen-hahn" target="_blank">Dr. Stephen M. Hahn</a> in the <a href="https://www.fda.gov/news-events/press-announcements/fda-finalizes-enforcement-policy-unauthorized-flavored-cartridge-based-e-cigarettes-appeal-children" target="_blank">news release</a>.</p>
<h2>FDA Targets Most Popular Vape Products</h2><p>Cartridge-based e-cigarettes have long been popular among minors, as have non-tobacco flavors.</p><p>Data from the <a href="https://jamanetwork.com/journals/jama/article-abstract/2755265" target="_blank">2019 National Youth Tobacco Survey</a> show that more than 5 million U.S. middle and high school students reported using an e-cigarette within the last 30 days. Nearly 60 percent of high school students who vaped used cartridge-based JUUL products.</p><p>Other <a href="https://www.drugabuse.gov/news-events/news-releases/2019/11/nih-funded-study-finds-teens-prefer-mint-mango-vaping-flavors" target="_blank">research</a> shows that the most popular e-cigarette flavor among high school students was mint, followed by mango and fruit.</p><p>Last fall, in anticipation of an FDA crackdown on flavored e-cigarette products, <a href="https://www.npr.org/sections/health-shots/2019/10/17/771098368/juul-suspends-sales-of-flavored-vapes-and-signs-settlement-to-stop-marketing-to-" target="_blank">JUUL took most of its flavors off the market</a>, although it continued to sell mint and menthol products.</p><p>The FDA emphasized that this week's action is not a "ban" on these products. Instead, the agency is enforcing its existing authority to regulate e-cigarettes.</p><p>Since 2016, all e-cigarettes have been required to seek "premarket authorization" from the FDA before being sold in the U.S.</p><p>So far, no e-cigarettes have this approval — so all products on the market "are considered illegally marketed and are subject to enforcement, at any time, in the FDA's discretion," the agency wrote in its release.</p><p>The FDA, though, is currently reviewing several premarket applications for flavored e-cigarette products. If any of those applications are approved, the products could be legally sold in the U.S.</p>
<h2>E-Cigarette Restrictions 'Better Than Nothing'</h2><p>The FDA's current effort falls short of the <a href="https://www.fda.gov/news-events/press-announcements/trump-administration-combating-epidemic-youth-e-cigarette-use-plan-clear-market-unauthorized-non" target="_blank">commitment</a> the <a href="http://www.ecowatch.com/trump-watch/">Trump</a> administration made in September to remove all unauthorized nontobacco-flavored e-cigarettes from the market, including mint and menthol.</p><p>According to The New York Times, this "partial retreat" is in response to the intense <a href="https://www.nytimes.com/2019/12/31/health/e-cigarettes-flavor-ban-trump.html" target="_blank">lobbying efforts of the vaping industry</a>, as well as a desire to avoid a legal battle with the tobacco industry.</p><p>President Trump's advisers have also warned him that, with the 2020 election looming, a complete flavor ban would hurt him with his base, The New York Times reports.</p><p><a href="https://www.houstonmethodist.org/doctor/timothy-connolly/" target="_blank">Dr. Timothy Connolly</a>, a pulmonologist and medical director of Respiratory Care Services at Houston Methodist Hospital in Texas, said the approach announced by the FDA is "certainly better than nothing," although he would prefer the agency target all types of e-cigarettes.</p><p>"The decision by the Trump administration to ban flavored e-cigarette cartridges is definitely an excellent step to discourage American youth from beginning to vape," said Connolly.</p><p>Patricia Folan, RN, DNP, director of Northwell Health's <a href="https://www.northwell.edu/doctors-offices/northwell-health-center-for-tobacco-control" target="_blank">Center for Tobacco Control</a> in Great Neck, New York, said because e-cigarette flavors like mint and fruit are so popular among youth, restricting the sale of these products may keep teens from starting to vape, and "could also motivate some youth to seek help to quit using these products."</p><p>However, she is concerned that youth may simply switch to menthol, which is <a href="https://www.cdc.gov/tobacco/basic_information/tobacco_industry/menthol-cigarettes/index.html" target="_blank">made from mint</a>.</p><p>"Since the FDA will not be restricting the manufacture of menthol-flavored e-cigarettes, many of our youth may continue to use e-cigarettes," said Folan.</p>
<h2>How to Reduce Youth Vaping</h2><p>The current debate over a flavor ban was prompted last year by a sharp increase in <a href="https://www.fda.gov/tobacco-products/youth-and-tobacco/youth-tobacco-use-results-national-youth-tobacco-survey" target="_blank">rates of youth vaping</a> and the recent outbreak of vaping-related lung injuries.</p><p>As of Dec. 27, 2019, <a href="https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html" target="_blank">2,561 people have been hospitalized</a> with severe lung injuries due to vaping, with 55 confirmed deaths, reports the Centers for Disease Control and Prevention (CDC). Most of these are related to vaping tetrahydrocannabinol (THC), the high-inducing compound in marijuana.</p><p>A growing body of <a href="https://www.bmj.com/content/366/bmj.l5275.abstract" target="_blank">research</a>, though, shows that even nicotine e-cigarettes can damage the heart, lungs, and immune system.</p><p>The FDA's actions will also not apply to THC-vaping products, which are regulated by states that have legalized marijuana.</p><p>Health officials and legislators have made other efforts to protect youth from vaping.</p><p>In December, Trump signed a new minimum age law. "It is now illegal for a retailer to sell any tobacco product — including cigarettes, cigars, and e-cigarettes — to anyone under 21," the FDA said on its <a href="https://www.fda.gov/tobacco-products/retail-sales-tobacco-products/selling-tobacco-products-retail-stores" target="_blank">website</a>.</p><p>These regulatory efforts may help slow the rise in youth vaping, but are only part of the solution.</p><p>"Although a ban on flavored vaping products makes it more difficult to purchase legally," said Connolly, "individuals interested in smoking via this mechanism will still find ways to procure novel devices and abuse nicotine."</p><p>Folan said more must also be done to help current young vapers break free of the nicotine addiction that occurs when using these products.</p><p>"Parents, school officials, and healthcare providers should not underestimate the discomfort and unpleasant symptoms associated with withdrawal from e-cigarette use," said Folan.</p>
<p><em>Reposted with permission from <a href="https://www.healthline.com/health-news/e-cig-flavor-ban-what-to-know#How-to-reduce-youth-vaping">Healthline</a>.</em></p>From Your Site Articles
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Medicare, Obamacare, vaping, vaccines and virtual healthcare are expected to be among the top health-related issues in 2020. Ani Kolleshi / Unsplash
By Roz Plater
It's 2020 and another year of health-related topics awaits us.
<p>What health issues will take priority? What buzzwords will we all be talking about? How might technology change healthcare?</p>
<p><em>Reposted with permission from </em><a href="https://www.healthline.com/" target="_blank"><em>Healthline</em></a><em>. For detailed source information, please view the original article on <a href="https://www.healthline.com/health-news/what-will-be-the-top-health-issues-for-2020#Vaping" target="_blank">Healthline</a></em><em>.</em></p>
<p>We asked some experts to peek into their crystal balls and make a few predictions.</p><p>They tell us that how you get access to healthcare and how you pay for it will both be hot topics this presidential election year.</p><p>In fact, one expert says healthcare could help decide political winners and losers.</p><p>"Whoever comes up with a plan that will work, is affordable, and something people can understand, that will push them ahead," said <a href="https://www.merritthawkins.com/why-merritt-hawkins/who-we-are/leadership/" target="_blank">Kurt Mosley</a>, vice president of strategic alliances for Merritt Hawkins, a physician search, consulting, and research firm.</p>
Medicare
<p>Medicare is front and center as we kick off 2020.</p><p>That's in part because "<a href="https://www.healthline.com/health/what-medicare-for-all-would-look-like-in-america" target="_blank">Medicare for All</a>" is the single payer option health plan being touted by two of the top Democratic presidential candidates.</p><p><a href="https://www.forrester.com/Jeff-Becker" target="_blank">Jeff Becker</a>, the senior analyst for healthcare strategy at Forrester Research says there are also a number of bills in Congress looking to expand access to Medicare as a public option.</p><p>"When you look at the polling numbers, our call is that Medicare for All will die in the court of public opinion and become Medicare Advantage for more," Becker told Healthline.</p>Affordable Care Act
<p>The <a href="https://www.healthline.com/health/consumer-healthcare-guide/pros-and-cons-obamacare" target="_blank">Affordable Care Act (ACA)</a>, often referred to as Obamacare, will be in the courts again this year.</p><p>In December, a federal appeals court <a href="https://www.cnbc.com/2019/12/18/-.html" target="_blank">ruled</a> that the health insurance law's individual mandate provision was unconstitutional.</p><p>However, the justices sent back to a federal district court in Texas the issue of whether other parts of the law could continue to exist without the mandate that requires everyone to have health insurance.</p><p>Look for some sort of Obamacare case to wind up in the U.S. Supreme Court this year.</p><p>"Our call is whether or not it goes to the Supreme Court, the ACA will survive because the individual mandate is severable," Becker told Healthline.</p>Price Transparency
<p>Experts say you'll hear a lot of debate about price transparency, a move designed to increase competition and lower costs.</p><p>President Trump <a href="https://www.hhs.gov/about/news/2019/11/15/trump-administration-announces-historic-price-transparency-and-lower-healthcare-costs-for-all-americans.html?amp" target="_blank">signed an executive order</a> in November that requires hospitals and insurers to publish their confidential, negotiated rates for treatments.</p><p>"The reason this would be important is you'd be able to figure out what your out-of-pocket expenses would be" said Becker.</p><p>But a coalition of hospital groups has <a href="https://www.reuters.com/article/us-us-hospitals/hospital-groups-file-lawsuit-to-block-trumps-price-transparency-rule-idUSKBN1Y81YY" target="_blank">filed a lawsuit</a> to block the rule. They argue that the public disclosure of negotiated charges would create confusion about consumers' out-of-pocket costs.</p><p>The order is scheduled to go into effect January 1, 2021.</p>Lower Prescription Drug Prices
<p>"The thing about pharmaceuticals is, if you can't afford them, they don't work," Mosley said.</p><p>He predicts the move to lower the costs of prescription drugs will again be on the front burner of the healthcare debate in 2020.</p><p>"The problem is Medicare and Medicaid can't negotiate prices with these drug companies," Mosley told Healthline.</p><p>The House of Representatives has <a href="https://www.aarp.org/politics-society/advocacy/info-2019/house-passes-drug-price-bill.html" target="_blank">approved a bill</a> that would do just that. The legislation also caps out-of-pocket expenses for people enrolled in Medicare Part D.</p><p>However, the prognosis for this bill becoming law isn't good.</p><p>Political observers say the legislation won't go anywhere in the Senate, and the White House has indicated the president would veto it.</p><p>Republicans in the Senate have <a href="https://www.usatoday.com/story/news/health/2019/11/11/mcconnell-pelosi-clash-over-drug-price-bill-congress-act/2558426001/" target="_blank">crafted</a> their own prescription drug price plan. The president has indicated he would sign this bill, but it would need to be approved by the Democrat-controlled House.</p>Access to Health Services
<p>"One of the cross-cutting issues we see as a priority in 2020 is the social determinants in health disparities in our patients," said <a href="https://www.aafp.org/media-center/releases-statements/all/2013/amy-mullins-medical-director.html" target="_blank">Amy Mullins</a>, MD, FAAFP, medical director for quality improvement for the American Academy of Family Physicians.</p><p>"Patients need more than just access to a physician," she told Healthline. "They need access to good food, safe places to live, to exercise, transportation, community resources, access to medication."</p><p>"If you don't address those, it's really difficult to treat your patients effectively," she added.</p><p>Mullins says her group has an internal division called the Center for Diversity and Health Equity whose mission is to look at healthcare through that lens.</p>Vaccine Hesitancy
<p>Mullins also says the issue of vaccine myths is one you'll continue to hear about in 2020.</p><p>"We want to do more to counter the misinformation that's out there around vaccines that may be holding some people back from getting what they need," said Mullins.</p><p>A <a href="https://www.sciencedirect.com/science/article/pii/S0264410X1931446X?via%3Dihub" target="_blank">recent study</a> concluded that a lot of the false information is being spread on social media by a handful of anti-vaccine ad buyers.</p><p>"We're promoting vaccine education to physicians, their healthcare teams, patients, and communities" Mullins said.</p><p>A <a href="https://www.healthaffairs.org/do/10.1377/hblog20191212.484779/full/" target="_blank">2020 National Vaccine Plan</a> is currently being developed by the Department of Health and Human Services' Office of Infectious Disease and HIV/AIDS Policy.</p>Vaping
<p>"Another of the big priorities for health providers in 2020 is vaping and e-cigarettes," Mullins said.</p><p>"We really applaud and support the work the Centers for Disease Control and Prevention and the Food and Drug Administration is doing to try and get a handle on this crisis," she said. "But these products target adolescents and we think the marketing needs more regulation."</p><p>A <a href="https://www.drugabuse.gov/news-events/news-releases/2019/12/vaping-marijuana-rise-among-teens" target="_blank">study</a> released last month from the National Institute on Drug Abuse reported that more teens are vaping marijuana.</p><p>That's despite a lung illness linked to vaping that's killed <a href="https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html" target="_blank">more than 50 people</a> nationwide.</p>Virtual Care Visits
<p>On the digital front, Becker predicts there will be aggressive growth in virtual care visits.</p><p>That's where you interact with your doctor via text, video, or phone call.</p><p>Becker's group crunched the numbers after looking at outpatient visit data as well as talking to virtual vendors and tracking healthcare investments.</p><p>"The result was 36 million net new virtual care visits in 2020," he said.</p><p>He points to how employers and insurers are already embracing the concept. Amazon recently launched a pilot program called "<a href="https://www.cnbc.com/amp/2019/09/24/amazon-launches-employee-health-clinic-amazon-care.html" target="_blank">Amazon Care</a>," a virtual clinic for its employees in Seattle.</p><p>Walmart recently expanded its <a href="https://mhealthintelligence.com/news/walmart-expands-telehealth-services-for-employees-in-3-states" target="_blank">telehealth services</a> to workers in Colorado, Minnesota, and Wisconsin with $4 online or video care visits.</p><p>Humana has <a href="https://medcitynews.com/2019/04/humana-and-doctor-on-demand-launch-new-virtual-primary-care-health-plan/" target="_blank">teamed up</a> with "Doctor on Demand" to offer a virtual primary care plan at significantly lower monthly premiums.</p><p>"Everybody is moving toward a model where we're not using high-cost care centers like emergency rooms," Becker said.</p><p>"And consumers are demanding more cost effective services, too," he added. "In 2018, consumers took out <a href="http://nymag.com/intelligencer/2019/04/americans-borrowed-usd88-billion-for-health-expenses-in-2018.html" target="_blank">$88 billion</a> in personal loans just to pay for out-of-pocket medical costs."</p>From Your Site Articles
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Congress has taken action to put a stop to the soaring popularity of vaping amongst teenagers. Tucked into a spending bill that passed the House and the Senate on Tuesday is a provision that raises the legal age to buy e-cigarette products and tobacco products from 18 to 21, as the New York Times reported.
<p>President Donald Trump, who had said he would ban flavored e-cigarettes and then backtracked from that statement, is expected to sign the bill, as the <a href="https://www.nytimes.com/2019/12/19/health/cigarette-sales-age-21.html" target="_blank">New York Times</a> reported.</p>
<p>"Raising the tobacco age to 21 is a positive step, but it is not a substitute for prohibiting the flavored e-cigarettes that are luring and addicting our kids," said Campaign For Tobacco-Free Kids media director Dave Lemmon in an emailed statement to <a href="https://www.forbes.com/sites/lisettevoytko/2019/12/19/congress-raises-tobacco-e-cigarette-purchasing-age-to-21/#13ed7530534d" target="_blank">Forbes</a>.</p>
<p>The Senate majority leader, Mitch McConnell, a Republican from Kentucky, <a href="https://twitter.com/senatemajldr/status/1207742536007200768" target="_blank">tweeted</a> yesterday, "The Tobacco-Free Youth Act I introduced with Senator Kaine, is headed to @POTUS' desk and will help address this urgent crisis and keep tobacco products, including e-cigarettes and vaping devices, away from children."</p>
<div id="fec11" class="rm-shortcode" data-rm-shortcode-id="L3D5HC1576874827"><blockquote class="twitter-tweet twitter-custom-tweet" data-twitter-tweet-id="1207742536007200768" data-partner="rebelmouse"><div style="margin:1em 0">🚨The Tobacco-Free Youth Act I introduced with Senator Kaine, is headed to @POTUS' desk and will help address this u… https://t.co/B45OgFcTeV</div> — Leader McConnell (@Leader McConnell)<a href="https://twitter.com/senatemajldr/statuses/1207742536007200768">1576783234.0</a></blockquote></div><p>The legislation has bipartisan support after recent data has shown e-cigarettes growing in popularity amongst teens. As of yesterday, the Centers for Disease Control identified 54 deaths and over 2,500 lung related injuries attributed to vaping. <a href="https://gizmodo.com/congress-passes-law-to-raise-smoking-and-vaping-age-to-1840541553" target="_blank">Gizmodo</a> reported that the 2019 <a href="https://www.fda.gov/tobacco-products/youth-and-tobacco/youth-tobacco-use-results-national-youth-tobacco-survey" target="_blank">National Youth Tobacco Survey</a> found that more than 5 million youth are currently using e-cigarettes, with 1 million using it daily. The report also found that just 5.8 percent of high school students use traditional cigarettes, but 27.5 percent were using vaping products.</p><p>"This is a big win for public health," said Senator Brian Schatz, Democrat of Hawaii, who had proposed the higher national age limit to buy tobacco in 2015 after his state adopted it, as the <a href="https://www.nytimes.com/2019/12/19/health/cigarette-sales-age-21.html" target="_blank">New York Times</a> reported. "Raising the minimum smoking and vaping age to 21 will protect our kids and save lives." </p><p>Hawaii is far from the only state to raise the legal age limit. So far, 19 states and more than 500 municipalities have already raised the purchasing age to 21, according to the <a href="https://www.nytimes.com/2019/12/19/health/cigarette-sales-age-21.html" target="_blank">New York Times</a>.</p><p>Many in the tobacco and e-cigarette industry approved of the measure, seeing it as a way to cushion the criticism the industry faces for marketing to youth. Sen. Dick Durbin is in favor of raising the age limit, but he was disappointed that the provision did not include an outright ban on flavored e-cigarettes. </p><p>"Any serious solution to skyrocketing rates of youth e-cigarette use must include the removal of kid-friendly flavors, not just the tobacco industry's preferred policy," Senator Durbin said in a statement, according to the <a href="https://www.nytimes.com/2019/12/19/health/cigarette-sales-age-21.html" target="_blank">New York Times</a>.</p>
<p>The backlash to the marketing to kids recently forced Facebook to change its policies on its site and on Instagram. While Facebook's ad policies have banned vaping and tobacco-products, it does allow influencers to post about smoking and accept sponsorship from advertisers, according to <a href="https://www.cnbc.com/2019/12/18/instagram-to-ban-influencers-from-promoting-vaping-and-guns.html" target="_blank">CNBC</a>.</p><p>The company announced Wednesday that it will no longer allow influencers to post branded content on any of its platforms that promote e-cigarettes or tobacco products, effectively closing the loophole in private posts that advertisers exploited, as <a href="https://www.cnbc.com/2019/12/18/instagram-to-ban-influencers-from-promoting-vaping-and-guns.html" target="_blank">CNBC</a> reported. </p>
<p>The National Academy of Medicine has estimated that 90 percent of smokers developed their addiction before turning 19, when developing brains are most vulnerable to nicotine addiction. That has led some to believe that raising the legal age limit will reduce long-term addiction. </p>
<p>"I think that you would be able to see lots of improvements in reduction of tobacco use among teens, all of which is good because the longer you delay any kind of initiation, the less likelihood there is to develop addiction and the less likely it is that use will escalate," said Robin Mermelstein, professor of psychology at the University of Illinois at Chicago, as the <a href="https://www.nytimes.com/2019/12/19/health/cigarette-sales-age-21.html" target="_blank">New York Times</a> reported.</p>
<p>Critics, however, contend that the bill makes no mention of how to implement raising the age-limit, and it will be toothless if retailers continue to sell to youth. Furthermore, most public health advocates argue that a ban on flavored e-cigarette products and an excise tax are more effective in reducing youth smoking, according to the <a href="https://www.nytimes.com/2019/12/19/health/cigarette-sales-age-21.html" target="_blank">New York Times</a>.</p>
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Apple has removed all 181 vaping-related apps from its App Store. VioletaStoimenova / E+ / Getty Images
Apple has removed all 181 vaping-related apps from its App Store, the company announced on Friday. The removal of the apps comes after thousands of people across the country have developed lung illnesses from vaping and 42 people have died.
<p>"Recently, experts ranging from the CDC to the American Heart Association have attributed a variety of lung injuries and fatalities to e-cigarette and vaping products, going so far as to call the spread of these devices a public health crisis and a youth epidemic. We agree, and we've updated our App Store Review Guidelines to reflect that apps encouraging or facilitating the use of these products are not permitted," the company said in a statement, as <a href="https://www.cnn.com/2019/11/15/health/apple-vaping-apps-bn/index.html" target="_blank">CNN</a> reported.</p><p>The App Store also updated its <a href="https://developer.apple.com/app-store/review/guidelines/#safety" target="_blank">Review Guidelines</a> for developers looking to place their products in the App Store.</p><p>"Apps that encourage consumption of tobacco and vape products, illegal drugs, or excessive amounts of alcohol are not permitted on the App Store," says the company's guidelines, as <a href="https://vaping360.com/vape-news/86676/apple-removes-vaping-apps-from-the-app-store/" target="_blank">Vaping360</a> reported. "Apps that encourage minors to consume any of these substances will be rejected. Facilitating the sale of marijuana, tobacco, or controlled substances (except for licensed pharmacies) isn't allowed."</p><p>The App Store has never allowed the sale of tobacco or vaping cartridges. The banned apps are a menagerie of apps, games, and hardware companion apps that allows users to regulate variables in the vaping process like the lighting and heating of vaping pens, according to <a href="https://www.cnbc.com/2019/11/15/apple-removes-vaping-related-apps-from-app-store-amid-lung-illness-crisis.html" target="_blank">CNBC</a>.</p><p>However, iOS users who already own and use any of those 181 apps will be allowed to keep them and to continue using them, even if they transfer their information to a new device, <a href="https://www.cnbc.com/2019/11/15/apple-removes-vaping-related-apps-from-app-store-amid-lung-illness-crisis.html" target="_blank">CNBC</a> reported.</p><p>The move is largely symbolic since vapers do not seem to depend on iOS apps and the apps removed only represent 0.00010 percent of the 1.8 million apps available, according to Apple, as <a href="https://www.cnn.com/2019/11/15/health/apple-vaping-apps-bn/index.html" target="_blank">CNN</a> reported.</p><p>"We take great care to curate the App Store as a trusted place for customers, particularly youth, to download apps. We're constantly evaluating apps, and consulting the latest evidence, to determine risks to users' health and well-being," Apple said in a statement emailed to <a href="https://www.axios.com/exclusive-apple-to-remove-vaping-apps-from-store-8669fd94-e92a-4ce4-a9e2-ce5afa598b67.html" target="_blank">Axios</a>.</p><p>Advocacy groups applauded the move.</p><p>"By taking e-cigarette related apps off the App Store, Apple will help reduce youth exposure to e-cigarette marketing and discourage youth use of these products," said Matthew L. Myers, president of the Campaign for Tobacco-Free Kids. "Apple is setting a welcome example of corporate responsibility in protecting our kids."</p><p>The move comes as the CDC officials confirmed <a href="https://www.ecowatch.com/marijuana-vaping-lung-disease-2640236131.html" target="_self">what New York Department of Health officials found</a> — vitamin E acetate is a possible cause of the epidemic of vape-related lung illnesses. The CDC found the compound present in 29 tissue samples that it tested from all around the country. They called the compound a "potential toxin of concern," as <a href="https://www.cnbc.com/2019/11/15/apple-removes-vaping-related-apps-from-app-store-amid-lung-illness-crisis.html" target="_blank">CNBC</a> reported.</p><p>While the CDC says it is a breakthrough, it has not yet declared the compound the official cause of the outbreak.</p>
<p>"Recently, experts ranging from the CDC to the American Heart Association have attributed a variety of lung injuries and fatalities to e-cigarette and vaping products, going so far as to call the spread of these devices a public health crisis and a youth epidemic. We agree, and we've updated our App Store Review Guidelines to reflect that apps encouraging or facilitating the use of these products are not permitted," the company said in a statement, as <a href="https://www.cnn.com/2019/11/15/health/apple-vaping-apps-bn/index.html" target="_blank">CNN</a> reported.</p><p>The App Store also updated its <a href="https://developer.apple.com/app-store/review/guidelines/#safety" target="_blank">Review Guidelines</a> for developers looking to place their products in the App Store.</p><p>"Apps that encourage consumption of tobacco and vape products, illegal drugs, or excessive amounts of alcohol are not permitted on the App Store," says the company's guidelines, as <a href="https://vaping360.com/vape-news/86676/apple-removes-vaping-apps-from-the-app-store/" target="_blank">Vaping360</a> reported. "Apps that encourage minors to consume any of these substances will be rejected. Facilitating the sale of marijuana, tobacco, or controlled substances (except for licensed pharmacies) isn't allowed."</p><p>The App Store has never allowed the sale of tobacco or vaping cartridges. The banned apps are a menagerie of apps, games, and hardware companion apps that allows users to regulate variables in the vaping process like the lighting and heating of vaping pens, according to <a href="https://www.cnbc.com/2019/11/15/apple-removes-vaping-related-apps-from-app-store-amid-lung-illness-crisis.html" target="_blank">CNBC</a>.</p><p>However, iOS users who already own and use any of those 181 apps will be allowed to keep them and to continue using them, even if they transfer their information to a new device, <a href="https://www.cnbc.com/2019/11/15/apple-removes-vaping-related-apps-from-app-store-amid-lung-illness-crisis.html" target="_blank">CNBC</a> reported.</p><p>The move is largely symbolic since vapers do not seem to depend on iOS apps and the apps removed only represent 0.00010 percent of the 1.8 million apps available, according to Apple, as <a href="https://www.cnn.com/2019/11/15/health/apple-vaping-apps-bn/index.html" target="_blank">CNN</a> reported.</p><p>"We take great care to curate the App Store as a trusted place for customers, particularly youth, to download apps. We're constantly evaluating apps, and consulting the latest evidence, to determine risks to users' health and well-being," Apple said in a statement emailed to <a href="https://www.axios.com/exclusive-apple-to-remove-vaping-apps-from-store-8669fd94-e92a-4ce4-a9e2-ce5afa598b67.html" target="_blank">Axios</a>.</p><p>Advocacy groups applauded the move.</p><p>"By taking e-cigarette related apps off the App Store, Apple will help reduce youth exposure to e-cigarette marketing and discourage youth use of these products," said Matthew L. Myers, president of the Campaign for Tobacco-Free Kids. "Apple is setting a welcome example of corporate responsibility in protecting our kids."</p><p>The move comes as the CDC officials confirmed <a href="https://www.ecowatch.com/marijuana-vaping-lung-disease-2640236131.html" target="_self">what New York Department of Health officials found</a> — vitamin E acetate is a possible cause of the epidemic of vape-related lung illnesses. The CDC found the compound present in 29 tissue samples that it tested from all around the country. They called the compound a "potential toxin of concern," as <a href="https://www.cnbc.com/2019/11/15/apple-removes-vaping-related-apps-from-app-store-amid-lung-illness-crisis.html" target="_blank">CNBC</a> reported.</p><p>While the CDC says it is a break through, it has not yet declared the compound the official cause of the outbreak, as <a href="https://www.cnn.com/2019/11/15/health/apple-vaping-apps-bn/index.html" target="_blank">CNN</a> reported. </p>
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The Centers for Disease Control (CDC) released new numbers that show vaping-related lung illnesses are continuing to grow across the country, as the number of fatalities has climbed to 33 and hospitalizations have reached 1,479 cases, according to a CDC update.
<p>Those numbers, which come from 49 states (not Alaska) plus DC and the U.S. Virgin Islands, represent nearly 200 more cases and 7 more deaths than last week when the number of report vaping-related illnesses tallied 1,299 and 26 fatalities, as <a href="https://www.cnn.com/2019/10/17/health/vaping-lung-injury-new-cases-cdc-bn/index.html" target="_blank">CNN</a> reported.</p>
<p><br>"This is extremely complicated and difficult. It's fatal or potentially fatal with half of the cases requiring intensive care," said CDC Principal Deputy Director Anne Schuchat to House lawmakers at a hearing Wednesday, as <a href="https://www.cnbc.com/2019/10/17/vaping-illness-deaths-climb-to-33-as-outbreak-spreads-and-doctors-worry-flu-season-could-make-it-worse.html" target="_blank">CNBC</a> reported.</p><p>The CDC has warned in the past that almost all patients who get sick end up hospitalized, and the overwhelming number are young people. In cases where the CDC had age and gender data, 79 percent were under 35, with the median age of 23, as <a href="https://www.cnbc.com/2019/10/17/vaping-illness-deaths-climb-to-33-as-outbreak-spreads-and-doctors-worry-flu-season-could-make-it-worse.html" target="_blank">CNBC</a> reported. The youngest was 13.</p><p>The CDC was able to identify the products used in 849 of the 1,479 confirmed EVALI (e-cigarette or vaping product use associated lung injury) cases, according to <a href="https://www.foxnews.com/health/33-dead-vape-epidemic-cdc-black-market-thc-products-major-role" target="_blank">Fox News</a>. From that sample, 78 percent reported using some sort of marijuana product containing THC within the three months prior to developing symptoms.</p><p>While the CDC confirmed that there are 33 vaping-related deaths, it said it is investigating other deaths to see if EVALI was the cause. The patients who died range in age from 17 to 75, as <a href="https://www.cnn.com/2019/10/17/health/vaping-lung-injury-new-cases-cdc-bn/index.html" target="_blank">CNN</a> reported.</p><p>Last month, New York State pinpointed vitamin E in marijuana vaping products as a possible culprit causing lung irritation, as <a href="https://www.ecowatch.com/marijuana-vaping-lung-disease-2640236131.html" target="_self">EcoWatch</a> reported. The CDC, however, has not adopted that stance, insisting that it still does not know the cause. "No one compound or ingredient has emerged as the cause of these illnesses to date; and it may be that there is more than one cause of this outbreak," the <a href="https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html" target="_blank">CDC's update</a> reads.</p><p>In the meantime, the CDC recommends that smokers avoid THC-related products, not buy any vape material illegally, and not alter a legal product in any way. It also emphasized that smokers "consider refraining from use of all e-cigarette and vaping products," and <a href="https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html" target="_blank" rel="noopener noreferrer">recommended</a> that "there is no safe tobacco product. All tobacco products, including e-cigarettes, carry a risk."</p>
<p>The CDC warned that the impending flu season could exacerbate symptoms. The CDC said patients who develop EVALI might increase their risk of developing severe flu complications or other respiratory illnesses circulating during the winter, as <a href="https://www.cnbc.com/2019/10/17/vaping-illness-deaths-climb-to-33-as-outbreak-spreads-and-doctors-worry-flu-season-could-make-it-worse.html" target="_blank">CNBC</a> reported.</p><p>"It's going to be a very challenging winter," Schuchat said at the House hearing.</p><p>Anticipating a ban on its product due to the young age of most EVALI patients, e-cigarette giant Juul announced that it will immediately suspend all sales of it popular fruity e-cigarette flavors—crème, mango, fruit, cucumber—that are often blamed for appealing to and addicting teenage customers to its products, as <a href="https://www.cnbc.com/2019/10/17/e-cigarette-giant-juul-suspends-sales-of-fruity-flavors-ahead-of-looming-ban.html" target="_blank">CNBC</a> reported. However, the company will continue to sell its mint and menthol flavors on its website.</p><p>Juul's sales have soared over the past few years alongside a spike of middle school and high school students who report using e-cigarettes.</p><p>"We must reset the vapor category by earning the trust of society and working cooperatively with regulators, policymakers, and stakeholders to combat underage use while providing an alternative to adult smokers," said Juul CEO KC Crosthwaite said in a statement, according to <a href="https://www.cnbc.com/2019/10/17/e-cigarette-giant-juul-suspends-sales-of-fruity-flavors-ahead-of-looming-ban.html" target="_blank">CNBC</a>.</p><p>The move did not pass muster with the company's critics though.</p><p>"Juul's announcement today that it is leaving mint and menthol flavors on the market shows that it hasn't changed one bit under its new leadership and isn't serious about preventing youth use," said Matthew Myers, president of Campaign for Tobacco-Free Kids in a statement, as <a href="https://www.cnbc.com/2019/10/17/e-cigarette-giant-juul-suspends-sales-of-fruity-flavors-ahead-of-looming-ban.html" target="_blank">CNBC</a> reported.</p>
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E-Cig Vaping Led to Lung Cancer in Mice: What Does This Mean for Humans?
14 October 2019
Health + Wellness
Pexels
- Mice exposed to nicotine-containing e-cigarette vapor developed lung cancer within a year.
- More research is needed to know what this means for people who vape.
- Other research has shown that vaping can cause damage to lung tissue.
A new study found that long-term exposure to nicotine-containing e-cigarette vapor increases the risk of cancer in mice.
<p>This study adds to a growing body of research highlighting the potential negative health effects of vaping.</p><p>The researchers caution in a <a href="https://nyulangone.org/news/e-cigarette-smoke-causes-lung-cancer-mice" target="_blank">statement</a> that, because this is a mouse study, the results are not meant to show directly what happens in people who vape.</p><p>But they argue that the results are concerning enough that, "E-cigarette smoke must be more thoroughly studied before it is deemed safe or marketed that way."</p><p>And it comes as the number of <a href="https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html" target="_blank">vaping-related lung injuries</a> in the U.S. has grown to 1,299 cases, with 26 confirmed deaths. In those cases, federal officials believe cartridges containing THC may be to blame.</p>
<p class=""><em>Reposted with permission from our media associate <a href="https://www.healthline.com/health-news/e-cig-vaping-led-to-lung-cancer-in-mice-what-does-this-mean-for-humans#Experts-caution-against-vaping" rel="noopener noreferrer">Healthline</a>.</em></p>
E-Liquid Vapor Linked to Cancer in Mice
<p>In the new <a href="https://www.pnas.org/content/early/2019/10/01/1911321116" target="_blank">study</a>, one group of mice were exposed to nicotine-containing e-cigarette vapor for 20 hours per week for 54 weeks.</p><p>After this time, 22.5 percent of the mice developed a type of lung cancer called an adenocarcinoma.</p><p>Also, 57.5 percent of these mice developed a rapid growth of cells in the bladder, known as urothelial hyperplasia. This is a type of abnormal tissue growth seen in cancer.</p><p>Another group of mice breathed nicotine-free e-cigarette vapor for the same duration. None of these mice developed lung cancer, while 6.3 percent (one mouse) developed bladder hyperplasia.</p><p>The researchers also had a control group of mice who breathed only filtered air. One of these mice (5.6 percent of the total) developed a lung tumor after 54 weeks. None showed signs of abnormal cell growth in the bladder.</p><p>Their findings were published this month in the journal Proceedings of the National Academy of Sciences of the United States of America.</p><p>The researchers think that nicotine is responsible for the increased risk of cancer in the mice.</p><p>They published <a href="https://www.pnas.org/content/115/7/E1560.long" target="_blank">research</a> last year in the same journal showing that nicotine in human lung and bladder cells can form other chemicals called nitrosamines. These chemicals are <a href="https://ntp.niehs.nih.gov/ntp/roc/content/profiles/nitrosamines.pdf" target="_blank">potential carcinogens</a>, or cancer-causing agents, in people.</p><p>Dr. Margarita Oks, a pulmonologist at <a href="https://www.northwell.edu/find-care/find-a-doctor/pulmonary-disease/dr-margarita-oks-md-11363448" target="_blank">Lenox Hill Hospital</a> in New York City, said this study shows that e-cigarettes may also carry some of the same health risks as combustible cigarettes.</p><p>"The reason that the vaping industry has been so successful is because of the claim that vaping is safer than smoking cigarettes," said Oks, who was not involved in the new research. "This study is showing otherwise, albeit in a mouse model."</p><p>While this is a mouse study, and it's unclear what will happen in humans with long-term e-cigarette use, the devices are so new that researchers will have to wait decades to get a long-term study on humans using e-cigarettes at this point.</p>Nicotine Suspected in Mice Cancers
<p>Dr. Nima Majlesi, director of toxicology at <a href="https://www.northwell.edu/find-care/find-a-doctor/emergency-medicine/dr-nima-majlesi-do-11317913" target="_blank">Staten Island University Hospital</a> in Staten Island, New York, who was not involved in the new study, said it's difficult to apply the new results to people because potentially carcinogenic chemicals may affect mice and people differently.<br></p><p>But Oks said this research still warrants attention even though it was done in mice.</p><p>"All mouse research is done with the purpose of eventually being translated to clinical research as it pertains to humans," she said.</p><p>Majlesi said the new study also raises questions because, "Nicotine itself is not considered a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5020336/" target="_blank">carcinogen</a>. It is the other components in tobacco that cause cancer."</p><p>Nicotine-replacement gums and patches have not been linked to an increased risk of cancer, he said.</p><p>The authors of the paper point out that chemicals added during the curing of combustible tobacco are known to cause carcinogenic nitrosamines to form.</p><p>Scientists believe that inhaling nitrosamines in tobacco smoke is partially responsible for how cigarettes cause cancer.</p><p>However, the <a href="https://www.pnas.org/content/115/7/E1560.long" target="_blank">2018 study</a> found that human cells contain chemicals that can react with nicotine to form nitrosamines and other harmful compounds.</p><p>The authors point out that more research is needed to determine whether nicotine-containing e-cigarette vapor poses a cancer risk in people, and how frequently someone would need to vape to increase their risk.</p>Harmful Effects of Vaping
<p>A recent <a href="https://www.bmj.com/content/366/bmj.l5275.full" target="_blank">review</a> in The BMJ of previous research shows that vaping has a number of harmful effects in people, even if it isn't cancer. These effects include respiratory symptoms such as difficulty breathing, increased asthma and bronchitis-like symptoms — especially in adolescents.<br></p><p>Studies also show that vaping can damage lung tissue, increase the risk of bacterial or viral infections in the lungs, and cause the type of lipoid pneumonia seen in some of the recent vaping-related illnesses.</p><p>Research has also found that the components of e-liquids — including nicotine, propylene glycol and vegetable glycerin, and flavors — may have negative health effects.</p><p>One of the challenges in studying vaping is that e-liquids and e-cigarette devices vary from product to product.</p><p>"I am not sure we can re-create all the components of vaping liquid and say that it is universal to all brands," said Majlesi.</p><p>What's missing from all this research are long-term studies in people on the safety and toxicity of vaping.</p><p>Without those, "Saying with certainty that e-cigarettes are safer than combustible cigarettes is impossible," write the authors of The BMJ review.</p>Experts Caution Against Vaping
<p>However, there's enough evidence that vaping isn't completely safe to raise concerns among health professionals. The recent outbreak of severe lung disease linked to vaping has highlighted how little researchers know about the long term effects of e-cigarettes.<br></p><p>In the outbreak of lung disease linked to vaping, which has sickened over <a href="https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html" target="_blank">1,299 and led to 26 deaths</a>, the Centers for Disease Control and Prevention (CDC) believes much of the damage may be from people who were vaping products with THC. But researchers are still investigating.</p><p>"Vaping is a major public health issue at this time, and we should discourage vaping of any kind," said Majlesi. "Although it appears that THC-containing products are most responsible for the recent issues with lung injury."</p><p>Last week, the Food and Drug Administration warned consumers to <a href="https://www.fda.gov/news-events/press-announcements/statement-consumer-warning-stop-using-thc-vaping-products-amid-ongoing-investigation-lung-illnesses" target="_blank">stop using THC vaping products</a>. The CDC, though, <a href="https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease/need-to-know/index.html" target="_blank">recommends against</a> the use of any vaping product.</p><p>Oks said people who currently vape should stop, and those who are considering it should not start.</p><p>"There have been so many severe respiratory illnesses — and now deaths — related to vaping that it is not worth the risk," said Oks, "whether or not this new link to possible cancer is validated in the future."</p>From Your Site Articles
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Histopathology of Acute Lung Injury Associated with Vaping. New England Journal of Medicine
People who develop respiratory illnesses after using e-cigarettes to vape nicotine and marijuana are showing symptoms akin to chemical burns in their lungs, according to new research by Mayo Clinic doctors.
<p>The illness is causing lung damage that resembles injuries from chemical weapons used in World War I such as mustard gas and those found in industrial workers after a toxic chemical spill, Dr. Brandon Larsen, an Arizona-based surgical pathologist at the Mayo Clinic and senior author of the <a href="https://www.nejm.org/doi/full/10.1056/NEJMc1913069?query=featured_home" rel="noopener noreferrer" target="_blank">study</a>, told the <a href="https://www.nytimes.com/2019/10/02/health/vaping-illnesses.html" target="_blank">New York Times</a>.</p><p>The doctors, who published their findings this week in the <a href="https://www.nejm.org/doi/full/10.1056/NEJMc1913069?query=featured_home" target="_blank">New England Journal of Medicine</a>, examined biopsies from 17 of the <a href="https://www.webmd.com/smoking-cessation/news/20191002/getting-to-the-bottom-of-vaping-illnesses-outbreak" target="_blank">more than 800 people</a> around the country since April who have developed a deadly respiratory illness from <a href="https://www.ecowatch.com/tag/vaping" rel="noopener noreferrer">vaping</a> — including two who died from the illness.</p>
<div id="d829d" class="rm-shortcode" data-rm-shortcode-id="SYQNVL1576661362"><blockquote class="twitter-tweet twitter-custom-tweet" data-twitter-tweet-id="1179774356051726336" data-partner="rebelmouse"><div style="margin:1em 0">New resource for physicians and health care professionals — on a new page, NEJM presents a collection of recently-p… https://t.co/Y3YssY9hfb</div> — NEJM (@NEJM)<a href="https://twitter.com/NEJM/statuses/1179774356051726336">1570115100.0</a></blockquote></div><p>"All 17 of our cases show a pattern of injury in the lung that looks like a toxic chemical exposure, a toxic chemical fume exposure, or a chemical burn injury," Larsen told the Times.<br></p><p>The study marks the first formal research using lung tissue samples of patients with the mystery illness, and the first time toxic chemicals have been considered as the primary culprit. </p><p>Previously, the prevailing theory was that oil additives in vape juice had been causing fatty acid to build up in the lungs,<a href="https://www.cnbc.com/2019/10/02/toxic-chemical-fumes-not-oils-may-be-causing-vaping-illness-mayo-clinic.html" target="_blank"> CNBC reported</a>, but no cases in the Mayo Clinic study showed any evidence to that effect.</p><p>Instead, the doctors observed tissue damage and cell death in the airways and lungs suggestive of pneumonia from inhaling "noxious chemical fumes." According to the New York Times, when the body tries to heal the damage, swelling tissue and fluid build up can make breathing even more difficult.</p><p>"Based on what we have seen in our study, we suspect that most cases involve chemical contaminants, toxic byproducts or other noxious agents within vape liquids," Larsen said in a <a href="https://newsnetwork.mayoclinic.org/discussion/vaping-associated-lung-injury-may-be-caused-by-toxic-chemical-fumes-study-fines/" target="_blank">press release</a>.</p><p>Finding out exactly which chemicals are causing the illness will require additional research, Larsen told <a href="https://www.cnn.com/2019/10/03/health/vaping-lung-disease-chemicals/index.html" target="_blank">CNN</a>, but researchers have begun to hone in on patterns across the cases that could eventually point to the cause.</p>
<div id="fc48f" class="rm-shortcode" data-rm-shortcode-id="BQ8O2N1576661363"><blockquote class="twitter-tweet twitter-custom-tweet" data-twitter-tweet-id="1179502770589708288" data-partner="rebelmouse"><div style="margin:1em 0">"Everyone should recognize that #vaping is not a wise thing to be doing, and I think our research supports that," s… https://t.co/aVz6WjPaHj</div> — Mayo Clinic (@Mayo Clinic)<a href="https://twitter.com/MayoClinic/statuses/1179502770589708288">1570050349.0</a></blockquote></div><p>For instance, the Mayo Clinic researchers said that more than 70 percent of the cases involved people who vaped marijuana or cannabis oils, <a href="https://www.cnn.com/2019/10/03/health/vaping-lung-disease-chemicals/index.html" target="_blank">CNN reported</a>.</p><p>This supports <a href="https://www.webmd.com/smoking-cessation/news/20191002/getting-to-the-bottom-of-vaping-illnesses-outbreak" target="_blank">previous reports</a> from the Centers for Disease Control and Prevention, which noted that 77 percent of patients who reported having the illness had used vape products that were acquired illicitly and often contained THC, the primary psychoactive ingredient in marijuana.</p><p>As of Thursday, respiratory illnesses from vaping were linked to <a href="https://www.cnn.com/2019/10/01/health/virginia-vaping-lung-death-bn/index.html" target="_blank">17 deaths</a> in Alabama, Virginia, New Jersey, California, Oregon, Kansas, Illinois, Indiana, Minnesota, Missouri, Mississippi, Nebraska, Florida and Georgia.</p><p>In response to the outbreak, a number of states have <a href="https://time.com/5685936/state-vaping-bans/" target="_blank">issued bans</a> on vapes and the CDC has <a href="https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html" target="_blank">warned against</a> using e-cigarettes and buying vape products off the street. The agency also urged users to avoid adding any substances to vaping products that were not intended by the manufacturer.</p><p>"Everyone should recognize that vaping is not without potential risks, including life-threatening risks, and I think our research supports that," Larsen said in the <a href="https://newsnetwork.mayoclinic.org/discussion/vaping-associated-lung-injury-may-be-caused-by-toxic-chemical-fumes-study-fines/" target="_blank">press release</a>. "It would seem prudent based on our observations to explore ways to better regulate the industry and better educate the public, especially our youth, about the risks associated with vaping."</p>
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Inhaling from an electronic cigarette. 6okean / iStock / Getty Images Plus
By Shawn Radcliffe
- As illnesses and deaths linked to vaping continue to rise, health officials urge people to stop using e-cigarettes.
- Officials report 8 deaths have been linked to lung illnesses related to vaping.
- Vitamin E acetate is one compound officials are investigating as a potential cause for the outbreak.
The number of vaping-related illnesses has grown to 530 cases in 38 states and 1 U.S. territory, federal health officials reported.
<p><br></p>
<p class=""><em>Reposted with permission from our media associate <a href="https://www.healthline.com/health-news/vaping-illness-top-400#Even-licensed-vape-products-carry-risks" rel="noopener noreferrer" target="_blank">Healthline</a>.</em></p>
<p>This number is up significantly from the 380 cases reported last week.</p><p>The Centers for Disease Control and Prevention (CDC) announced last week that they were only including probable and confirmed cases. They're no longer including possible cases that are under investigation.</p><p>Eight deaths linked to vaping have been confirmed in 7 states — California, Illinois, Indiana, Kansas, Minnesota, Missouri, and Oregon. The latest death was <a href="https://health.mo.gov/news/newsitem/uuid/6aa00c1e-504f-43a0-ad83-7b01390cfe8b/dhss-announces-first-vaping-associated-death-in-missouri-eighth-nationally" target="_blank">reported</a> in Missouri on Monday.</p><p>In the case, a man in his mid 40s came down with a vaping-related lung illness that rendered his lungs unable to provide gas exchange. He had normal lung function before he started vaping last May.</p><p>Many of the people affected required supplemental oxygen, and some had to be put on a ventilator to help them breathe.</p><p>"These developments are extremely concerning, especially because most victims are teenagers or young adults," said <a href="https://www.uofmhealth.org/profile/31740/wassim-walid-labaki-md" target="_blank">Dr. Wassim Labaki</a>, a pulmonary disease physician at the University of Michigan.</p><p><a href="https://www.healthline.com/health/smoking/electronic-cigarettes" target="_blank">E-cigarettes</a> — battery-powered devices that heat liquids with substances such as nicotine and marijuana — have been around for more than a decade.</p><p>But reports of vaping-related illnesses started showing up in <a href="https://www.dhs.wisconsin.gov/dph/memos/beoh/2019-02.pdf" target="_blank">July</a>. Since then, the number of cases has grown steadily.</p><p>Patients report experiencing symptoms such as coughing and shortness of breath, as well as nausea, fatigue, and weight loss. Symptoms may develop over a few days or several weeks.</p>
Cdc and FDA Narrow Investigation
<p>The CDC and the Food and Drug Administration (FDA) are coordinating with state health officials in testing samples of vape products and monitoring illnesses.</p><p>The focus of the investigation is narrowing, but "complex questions" remain, <a href="https://www.cdc.gov/about/leadership/leaders/ondieh.html" target="_blank">Ileana Arias</a>, PhD, the CDC's acting deputy director for noninfectious diseases, said in a <a href="https://www.cdc.gov/media/releases/2019/a0906-vaping-disease.html" target="_blank">briefing</a> on Friday.</p><p>"Until we have a cause and while this investigation is ongoing… we're recommending individuals consider not using e-cigarettes," she said.</p><p>The FDA, though, has focused its <a href="https://www.fda.gov/consumers/consumer-updates/vaping-illnesses-consumers-can-help-protect-themselves-avoiding-tetrahydrocannabinol-thc-containing?utm_campaign=CU_Vaping%20Illnesses_9/6/2019&utm_medium=email&utm_source=Eloqua" target="_blank">warnings</a> on vaping products containing THC, the psychoactive compound in cannabis.</p><p>Many people affected reported recently <a href="https://www.cdc.gov/media/releases/2019/p0906-vaping-related-illness.html" target="_blank">vaping cannabis products</a>. But some said they had used e-cigarettes containing both THC and nicotine, or only nicotine.</p><p>Given the number of questions that remain about these cases — and that e-cigarettes are largely <a href="https://www.salon.com/2019/09/03/experts-say-a-lack-of-regulation-caused-mysterious-vaping-illness/" target="_blank">unregulated</a> — many health officials are urging caution.</p><p>"There is no guarantee that vaping is safe, especially if 'black market' products are used," said <a href="http://www.lenhorovitz.com/_index.php" target="_blank">Dr. Len Horovitz</a>, a pulmonary specialist at Lenox Hill Hospital in New York City.</p><p><a href="https://www.fda.gov/tobacco-products/about-center-tobacco-products-ctp/mitch-zeller" target="_blank">Mitch Zeller</a>, JD, director of the FDA's Center for Tobacco Products, echoed this in Friday's briefing.</p><p>"If you're thinking of purchasing one of these products off the street, out of the back of a car, out of a trunk, in an alley… think twice," he said.</p><p>He also warned against adding compounds to vaping products, even those purchased at licensed retailers.</p>Vitamin E Compound Is Possible Culprit
<p>CDC officials currently believe that these cases involve chemical exposure, rather than an infection. Laboratory testing has identified one possible culprit — vitamin E acetate.</p><p>The <a href="https://www.health.ny.gov/press/releases/2019/2019-09-05_vaping.htm" target="_blank">New York State Department of Health</a> said this month that nearly all cannabis-containing samples tested as part of the state's investigation contained "very high" levels of this compound. This wasn't found in nicotine-based products that were tested.</p><p>Vitamin E acetate is a common nutritional supplement that is "not known to cause harm when ingested as a vitamin supplement or applied to the skin," said the Department.</p><p>But if the compound is aerosolized and then inhaled through the lungs, it's not clear what kind of damage it can do.</p><p>Vitamin E acetate isn't approved as a vape product additive by the New York State Medical Marijuana Program.</p><p>The Department is continuing to investigate whether inhaling this oil-like compound could be responsible for the symptoms seen in patients.</p><p>Although health officials are keeping an eye on vitamin E acetate, some of the <a href="https://www.cdc.gov/media/releases/2019/p0906-vaping-related-illness.html" target="_blank">more than 120 samples</a> being tested by the FDA have not contained this compound.</p><p>"No one substance or compound, including vitamin E acetate, has been identified in all of the samples tested," said Zeller.</p><p>During Friday's briefing, health officials emphasized that the number of cases is definitely rising, rather than more of them being diagnosed by doctors.</p><p>States are also reviewing earlier medical records using <a href="https://www.cdc.gov/mmwr/volumes/68/wr/mm6836e2.htm" target="_blank">guidelines</a> developed by the CDC to see if the illnesses extend further back than the first cases reported in July.</p><p><a href="https://www.linkedin.com/in/jen-layden-8aa35311a/" target="_blank">Dr. Jennifer Layden,</a> chief medical officer and state epidemiologist with the Illinois Department of Public Health, said during the briefing that so far they've identified cases as early as mid-April.</p>Even Licensed Vape Products Carry Risks
<p>While the current investigation focuses in part on black market vaping products, even those purchased from licensed retailers <a href="https://ehjournal.biomedcentral.com/articles/10.1186/s12940-017-0249-x" target="_blank">contain</a> potentially harmful ingredients.</p><p>"People should remember that these devices are still not regulated," said Labaki. "Therefore, consumers of e-cigarettes are constantly at risk of exposure to potentially toxic inhaled compounds."</p><p>With the number of vaping-related illnesses continuing to rise, Labaki recommends that people stop vaping immediately.</p><p>"This is a still growing public health crisis and the consequences are very serious, including respiratory failure and death," he said. "Continuing to vape is certainly not worth the risks."</p><p><a href="https://www.northwell.edu/find-care/find-a-doctor/emergency-medicine/dr-teresa-murray-amato-md-11354025" target="_blank">Dr. Teresa Murray Amato</a>, director of emergency medicine at Long Island Jewish Forest Hills in Queens, New York, said there's a shortage of good-quality research on the short- and long-term effects of vaping on health.</p><p>But she said given the recent concerns about vaping, people should consider the risks before choosing to vape.</p><p>The CDC says that people who use e-cigarettes should seek medical care promptly if they experience any <a href="https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html#symptoms-severe-pulmonary-disease" target="_blank">symptoms</a> seen in these cases.</p><p>A growing number of recent studies show that e-cigarettes have a number of potential health risks independent of this recent outbreak. These dangers include damaging <a href="https://www.ncbi.nlm.nih.gov/pubmed/31390877" target="_blank">lung tissue</a> and <a href="https://www.ncbi.nlm.nih.gov/pubmed/31429679" target="_blank">blood vessels</a>.</p><p>Nicotine addiction is another issue that concerns experts. <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0193328" target="_blank">Studies</a> show that e-cigarettes could get a new generation of young people hooked on nicotine and combustible cigarettes.</p><p>"Vaping in any form is smoking, and we know now that smoking destroys lungs and leads to chronic breathing problems," said <a href="https://www.houstonmethodist.org/doctor/zeenat-safdar/" target="_blank">Dr. Zeenat Safdar</a>, pulmonary critical care physician at Houston Methodist, in Houston, Texas.</p>From Your Site Articles
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Vaping360 / Flickr / CC BY-ND 2.0
The Trump administration will ban flavored e-cigarettes. It comes in response to a surge in youth vaping and health concerns following a handful of mysterious deaths and hundreds of lung illnesses linked to the product.
<p>The U.S. federal government plans to ban flavored e-cigarettes amid rising concern over youth vaping and lung illness and deaths linked to the products, President Donald Trump said Wednesday.</p><p>The president and top U.S. officials expressed concern that flavored vaping products ranging from mint to mango were drawing millions of youth into nicotine addiction.</p><p>"We have a problem in our country, it's a new problem ... and it's called vaping, especially vaping as it pertains to innocent children," Trump said in the Oval Office. "There have been deaths and there have been a lot of other problems."</p>
Fda Approval Required
<p>U.S. Health and Human Services Secretary Alex Azar made the announcement at the White House alongside acting Food and Drug Administration Commissioner Ned Sharpless, the president and First Lady Melania Trump.</p><p>Azar said the FDA would create guidelines over the next couple of weeks to remove all flavored e-cigarettes from the market.</p><p>"We simply have to remove these attractive flavored products from the marketplace until they can secure FDA approval, if they can," Azar said, adding that tobacco flavored products would remain on the market for adult consumers.</p><p>But he said that if <a href="https://www.ecowatch.com/tag/childrens-health">children</a> use tobacco flavored products, "we will take enforcement action there also."</p><p>Flavored products may apply for FDA approval, but they would only be granted clearance if they prove to show a net benefit to public health, he said. </p>New Generation of Vaping Addicts
<p>The announcement comes after parents, health officials and politicians have called for federal action to stem a surge in vaping.</p><p>Preliminary federal health data for 2019 shows a quarter of high school students had used e-cigarettes in the past 30 days. The vast majority of underage teens consumed fruit, menthol or mint flavors.</p><p>E-cigarette advocates argue <a href="https://www.ecowatch.com/tag/vaping">vaping</a> is safer than cigarettes and can help users stop smoking, but there is little evidence nicotine-containing e-cigarettes are effective in dropping the habit.</p><p>Critics say companies such as Juul have marketed their products to youths and created a new generation of addicts to feed a multi-billion dollar market. </p><p>"It has taken far too long to stop Juul and other e-cigarettes companies from targeting our nation's kids with sweet-flavored, nicotine-loaded products," said Matthew Myers, of the Campaign for Tobacco-Free Kids, in a statement.</p>Growing Questions Over Safety
<p>Most health experts agree that e-cigarettes are safer than smoking tobacco products that contain thousands of chemicals and lead to the death of nearly a half-million people a year in the United States.</p><p>However, there is scant research on the long-term effects of vaping.</p><p>The administration's announcement comes as e-cigarettes and other vaping devices have been linked to six deaths and nearly 450 cases of possible vaping-related lung illness.</p><p>The exact cause of the deaths and illnesses have not been determined, but most are initially believed to be related to vaping counterfeit <a href="https://www.ecowatch.com/tag/marijuana">marijuana</a> products containing vitamin E oil, which is dangerous if inhaled.</p>From Your Site Articles
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