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Nov 18, 2019

E-cigarette use has spiked in recent years – especially among teens. But vaping-related lung illnesses and deaths have health officials concerned about these devices.

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The Story

Millions of people use e-cigarettes. And that has federal regulators very worried.

The Background

First, a brief history of traditional cigarettes. They first became popular in the early 20th century, and were seen as a symbol of sophistication and glamour. That started to change in the mid-1900s. Doctors started to find links between cigarette smoking and diseases like lung cancer. In 1964, the Surgeon General issued its first report on the issue and said ‘yup, these doctors are right.’ Since then, more than 20 million Americans have died from smoking.

But people quit too, right?

They did. Congress implemented laws to try to keep Americans safe, like requiring cigarette packs to have a health warning on them and banning smoking on flights. That Surgeon General report we just mentioned is estimated to have prevented premature death for 8 million people. 


Yup. Meanwhile, scientists have tried to come up with healthier alternatives to smoking. Like, yes, e-cigarettes. The e-cigarettes we have now seem to stem from 1963, when an inventor created a “smokeless non-tobacco cigarette.” Instead of burning tobacco and paper, it heated up liquid that turned into “flavored air” vapor. But manufacturers weren’t interested in making it at the time.

What changed?

Fast forward to 2003, when a Chinese pharmacist created the modern-day e-cigarette. They became popular in China because they were seen as a way to help quit smoking. Over the next few years, it hit the market in Europe and the US. As more e-cig makers came on the scene, their products sold like crazy. They were heavily marketed, especially to teenagers. And Americans took up the habit thinking it was healthier than regular cigarettes, since e-cigarettes don’t contain tobacco, which has carcinogens (aka chemicals that can cause cancer). Today, there are e-cigarettes for nicotine, THC (a component in weed that can get you high), and CBD (a component in weed that doesn’t get you high).

We have a Skimm Notes on marijuana. You’ll learn…

✷ The history of marijuana: it wasn’t always about getting high

✷ How recreational weed became a thing in the US

✷ What the controversy looks like today

And how do these devices actually work?

There are a few different types, but there are four major components: a cartridge that holds liquid (which contains nicotine, THC, or other chemicals), an atomizer that heats the liquid into a vapor that you inhale, a power source (like a battery), and a mouthpiece. 

The Big Issue

E-cig devices are causing serious health problems. They may not have tobacco, but they are still extremely addictive, and some contain as much nicotine as an entire pack of cigarettes. Then there’s the fact that since the CDC started tracking deaths this summer, it has reported that 42 people have died from vaping-related lung illnesses – and more than 2,000 have gotten sick from vaping. 

What’s causing all this?

CDC officials are pointing to vitamin E acetate as one of the culprits. The chemical is typically safe in things like skin products or supplements. But when you breathe it in, it can become sticky and sit in your lungs. It’s unclear how exactly the vitamin is harmful to the lungs, but patients have had symptoms including chest pain, shortness of breath, and fever. 

Does this mean all vaping products are dangerous?

Health officials found the vitamin in the lungs of dozens of patients who used THC vapes, although it can also be found in nicotine vaping products. The acetate is sometimes added to vapes to dilute the amount of THC. The CDC is urging people not to buy e-cigs off the street. But health officials still don’t know the overall long-term effects of vaping. And since there may be other causes of these lung diseases, the CDC says to avoid e-cigarettes altogether while they’re investigating.

So what’s being done about all this?

Bans on bans on bans. Officials are especially worried about the teen vaping epidemic. Just like cigarettes before them, vape pens have become cool among young people. They look high tech (like USB drives) and can come in flavors like mango and mint. In 2016, the feds banned e-cig sales to people under 18. Some states have made moves to ban flavored e-cigs. Skimm Notes gets into how the gov is trying to crack down on vaping. You'll learn:

✸ How vaping and e-cigarettes first got on the gov's radar

✸ Why so many people have been getting sick

✸ How the gov is taking action

The Debate

The Impact

On health…studies show that e-cig use among teens has skyrocketed in recent years. Concerning, and not just because of the mysterious lung illnesses linked to THC. But because teens are also vaping nicotine. That can have negative effects on developing brains, like on the ability to focus, and can make you more susceptible to substance abuse later in life. Some health researchers are also worried that teens who vape could eventually take up smoking cigarettes, which still kills at least 480,000 people a year in the US.

On the industry...e-cigs have turned into a multi-billion dollar industry that doesn’t have a ton of federal regulation. And e-cigarette and tobacco companies have lobbied hard to keep it that way, arguing that their products are safer than cigarettes. To address the teen vaping epidemic, President Trump previously said he was going to issue a nationwide ban on most flavored e-cigarettes. But this week, reports came out about him backing off that plan, after lobbying from the vaping industry and after advisers told him it could cost Trump supporters in the upcoming 2020 election.


E-cigarettes have gone from a seemingly promising concept to a potential health liability for the millions of people that use them. While officials are starting to understand what’s causing the illnesses, there’s still a lot we don’t know about these products.

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