According to the recent warning issued by CDC (Center for Disease Control and Prevention) using E-cigarette products leads to severe pulmonary disease.

On August 30^th 2019 CDC has released caution regarding use of any type of Electronic cigarettes. In its emergency preparedness and response CDC has provided:

1. Background information on the forms of e-cigarettes products
2. Information on the multistate outbreak of severe pulmonary lung disease associated with devices, liquids, refill pods, cartridges – all types of e-cigarettes
3. Clinical features of patients with severe pulmonary disease.

CDC health advisory also gives recommendation to public health officials, clinicians and to public the information that is related to use of e-cigarettes that leads to severe lung disease.

Reason for warning:

All E-cigarettes contain nicotine the substance that gives a kick for cigarette smokers. It also contain flavoring and other types of chemicals. According to CDC it might also contain marijuana or other substances. These are known by many other different names and come in different shapes, device types and sizes. E-cigs, vapes, e-hookahs, vape pens, mods, tanks or ENDS or Electronic Nicotine Delivery systems. Some of the e-cigarettes devices resemble tobacco products such as common cigarettes or USB flash drives, pens and flashlights. Some have unique shapes. The vaping and juuling is common problem among youths. The dabbing E-cigarettes are referred as dab pens.

Apart from nicotine, heavy metals like lead, volatile organic compounds and cancer causing compounds are also present in E-cigarettes. In addition, e-cigarettes are according to CDC are, used for delivering illicit substances acquired from unauthorized an unknown vendors or sources.

These products could have been modified that can only cause severe harm to users. For example e-cigarette pods or cartridges marketed for single use can be refilled with illicit substances. Some e-cigarette products are used for dripping that involves dropping e- cigarette liquid directly on hot coils of an e-cigarette that results  in high concentration of cannabinoid or/and, tetrahydrocannabinol compounds. Dabbing involves superheating substances like butane hash oil or budder and 710 that contain high concentration of THC and other plant compounds like cannabidiol or CBD.

E-cigarettes are not approved from FDA as an aid to quit smoking. Adults, young adults and pregnant women who do not use tobacco products must not use e-cigarettes as an alternative to start smoking. E-cigarettes also contain nicotine and have might be useful to reduce smoking habits but still are not approved as an aid to quit smoking.

According to CDC, as of August 27^th 2019, 2015 cases are reported in US alone from 25 states for pulmonary illness. One causality has been reported due to severe pulmonary condition. Epidemiologic investigations is still undergoing to understand the characterize of the exposure, demographic, clinical and laboratory features including patients behavior. All those patients have reported to smoke e-cigarette products and many were using the e-cigarettes containing cannabinoid products such as CBD and THC.

Patients will pulmonary conditions have experiences symptoms like cough, shortness of breath, chest pain, severe respiratory problems, gastrointestinal symptoms – nausea, vomiting or diarrhea, fatgue, fever, weight loss over the period of few weeks. In addition, elevated white blood cell count, fever, tachycardia has been reported. Several patients were reported to have lipid pneumonia and many patients required supplemental oxygen. All these patients reported to use e-cigarettes and inhalation of cannabinoid products, THC or cannabidiol in many patients.

CDC is working with state departments to facilitate collecting specimens for further testing at US FDA Forensic Chemistry Center.

CDC has issued following instructions for public:

Recommendations for the Public

• While this investigation is ongoing, if you are concerned about these specific health risks, consider refraining from using e-cigarette products.
• Regardless of the ongoing investigation, anyone who uses e-cigarette products should not buy these products off the street (e.g., e-cigarette products with THC, other cannabinoids) and should not modify e-cigarette products or add any substances to these products that are not intended by the manufacturer.
• Regardless of the ongoing investigation, e-cigarette products should not be used by youth, young adults, pregnant women, as well as adults who do not currently use tobacco products. If you use e-cigarette products, monitor yourself for symptoms (e.g., cough, shortness of breath, chest pain) and promptly seek medical attention if you have concerns about your health. CDC and FDA will continue to advise and alert the public as more information becomes available.
• Adult smokers who are attempting to quit should use evidence-based treatments, including counseling and FDA-approved medications. If you who need help quitting tobacco products, including e-cigarettes, contact your doctor.
• If you are concerned about harmful effects from e-cigarette products, call your local poison control center at: 1-800-222-1222.
• We encourage the public to submit detailed reports of any unexpected tobacco or e-cigarette-related health or product issues to the FDA via the online Safety Reporting Portal: https://www.safetyreporting.hhs.govexternal icon.

If you are a E-Cigarette user please visit https://emergency.cdc.gov/han/han00421.asp for further information.

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