Today, the Evidence Based Health Policy Project of UW-Madison brought experts to speak at the Wisconsin Capitol. The project aims to “provide policymakers with timely, non-partisan, high-quality information for evidence-based decision-making.”
Megan Piper is a researcher for the UW Center for Tobacco Research. She argues that new vaping devices such as JUUL products offer a quicker hit. She says that teens aren’t expecting to become addicted when they start vaping.
“But they’re dependent. Why? Because there’s been an up-regulation and increase in the number of nicotine receptors in their brain, and those don’t go away. And when those receptors are empty, they’re screaming for nicotine, and you get what the kids call “fiending” now. They are fiending, they are desperate for a hit off of any source of nicotine.”
The popular e-cigarette company JUUL has stopped manufacturing flavored pods, but flavors such as mango, strawberry milk, and watermelon can be purchased from third party sellers. Disposable e-cigarettes come even more flavors like green apple, pink lemonade, and lush ice.
Piper says that 80 percent of Wisconsin high-schoolers who use e-cigarettes and 95 percent of middle-schoolers wouldn’t use them if they weren’t flavored. She says that these flavors are specifically marketed to teens.
While e-cigarettes offer an alternative to traditional cigarettes, Piper says they are leading to nicotine addiction in young people.
“It’s important for us to recognize that tobacco use, specifically combusted tobacco, cigarettes primarily, is the leading preventable cause of death and disease in this country and in this country.”
Piper cites some of the problematic effects of nicotine among young people. Among them: altering neuropathways, impulsivity, increased the risk of mood disorders, learning and memory problems.
“Why can’t they quit even after they’ve been hospitalized? They might like the flavor, but it’s the addiction. It’s the dependence [and] it’s the rewired brain that makes it so hard for them to quit.”
Earlier this year, a mysterious lung injury broke out among young adults and teens who vaped. Pediatricians at Children’s Hospital of Wisconsin were among the first in the nation to start identifying the illness.
Jon Meiman, Chief Medical Officer at the state health department, says that what started as a few patients at Children’s Hospital of Wisconsin in July has grown to over two-thousand similar cases nationwide.
“Those patterns we identified held true even when we looked at more patients. These were still very young people, these were people in their teens and adolescence. And, more importantly, what came out of this analysis, we found that about eighty percent endorse vaping THC.”
Psychoactive THC is not legal in Wisconsin. While some of these products may have been bought in states where they are legal, law enforcement busted a large-scale operation in Kenosha that was producing vapable THC for the black market. Law enforcement later determined the producers were refilling empty e-cigarette cartridges with THC concentrate.
Meiman says that his investigation took three routes: patient interviews, analyzing and testing the products, and testing bodily fluids The FDA is currently testing the products for toxins.
“Initially, from at least what they’ve been able to tell us, they haven’t identified any obvious levels of known toxins, but in the THC products that they’ve tested, almost sixty percent had Vitamin E Acetate, which is kind of a clue as to what may be going on in this particular outbreak.”
Vitamin E Acetate is used as a thickening agent in some black market vapes. Meiman says that early in the investigation, DHS collected and stored bodily fluids from patients.
“Well, [the] CDC just several weeks ago offered to test those, and so we shipped those down [and] we have more that are being tested currently. And, of those samples that CDC received, all 29 had Vitamin E Acetate. Although we can’t confirm in fact that Vitamin Acetate is causing these illnesses, it certainly is a potential toxin and is probably the most promising lead we’ve had thus far in the investigation.”
Michael Gutzeit is a chief Medical Officer for Children’s Hospital of Wisconsin. He says that because vaping is new, the long term health effects are unknown. The future of patients affected by the lung illness is unknown.
“What we’re finding is that although many of them have returned to some of their activities, a lot of them are still continuing to have lung-function issues. Their lung functions have not returned to normal [and] we don’t know if they will ever return to normal.”
Gutzeit says that physicians are facing new challenges because of their patients’ addictions to nicotine.
“This patient was doing two pods of vaping a day, and that’s the equivalent of two packs of cigarettes per day. What happened is as the patient was admitted to the hospital, obviously there was an abrupt cessation of that habit, which created tobacco withdrawal symptoms in the patient, so for the first time in his career, our provider needed to think about [a] tobacco cessation product and how we would be using that and using a nicotine patch, but that is not something that we as pediatricians do on a regular basis.”
As an attempt to address teen addiction, President Trump said he would ban flavors. U.S. Senator Ron Johnson urged Trump not to take away the flavors, and now Trump has backed off the proposal.
The state legislature is currently considering a package of bills to make 21 the minimum age to buy vaping devices.