A multi-state vaping health scare includes at least one probable or confirmed case in Williams County, according to the North Dakota Department of Health.
Williams County is among four counties highlighted on a map showing the locations of 12 probable or confirmed vaping illnesses in the state. The other counties include Cass, Grand Forks, and Morton counties.
Rajean Backman, a Respiratory Therapy Care Manager at CHI St. Alexius Health in Bismarck, said recent clarity on symptoms has helped clinicians identify more cases of vaping-related lung disease. She herself has already identified a handful of cases.
What stands out to her is the severity of symptoms compared to the ages of the patients.
“We have all seen elderly people who smoked cigarettes regularly all their lives,” she said. “We can see the lung disease and how short of breath they are. It’s very difficult to see those kind of symptoms on someone very young, in their teens, 20s, and 30s, and yet they are so short of breath.”
Backman, who has been trained by the Mayo clinic in smoking cessation, said many people start vaping with the idea of quitting smoking. In fact, that’s how the industry itself markets the devices.
But that’s not generally what happens.
“We counseled 1,600 patients in the hospital on smoking cessation,” she said. “Of those, I know of one person who was able to use an electronic device to help them quit.”
The devices are not approved by the FDA for smoking cessation, Backman pointed out. And perceptions that the devices are “healthier” than smoking remain to be seen.
“Ejuice usually has a vegetable glycerin to help get the flavoring in there,” she said. “And it is also mixed with propylene glycol. What we know about that is you can use that on food as a preservative and you can ingest or eat it and it doesn’t hurt anything. But we don’t know about when it is inhaled.”
Propylene glycol is not water soluble, and that could be behind the recent vaping illnesses that are emerging.
“The lungs don’t tend to absorb anything that is not water soluble, so they can’t get rid of it,” Backman said. “So those patients we are hearing about in the news who come into an ER or hospital are the ones heavily using these devices.”
THC oil, too, is not water soluble Backman added.
At this point, the exact mechanism behind the 1,299 cases of vaping-related lung diseases nationally is not well understood.
While a majority of patients did report THC use, a substantial number of patients denied using any THC products. Nicotine use thus cannot be ruled out as a potential pathway for the vaping-related illnesses, which have so far killed 26 people in 21 states.
Kodi Pinks, with the North Dakota Department of Health, said the vaping illnesses in North Dakota are being treated as an emerging critical illness in the state. As a result, medical providers are required to report incidents to the health department, which is in turn sharing that data with the Centers for Disease Control.
“As more data and investigations are being conducted, we are seeing common symptoms and signs that make this easier to identify,” Pinks said.
In the meantime, the CDC and the North Dakota Department of Health are recommending that individuals stop using vaping products, particularly if they are using any that contain THC.
The agencies have also warned against using vaping devices that have been modified or ejuices that have been altered in any way.
As far as returning to smoking, this is not recommended, Pinks said.
Instead, she recommended individuals access the 1-800-QUIT-NOW hotline, to connect with an evidence-based smoking cessation program, as did Backman.
“If people need help quitting, the best way so far is a combination of being counseled and using medications that are FDA-approved for quitting,” Backman said.