Had another day passed without medical intervention, 18-year-old Piper Johnson might have been unresponsive on a ventilator, her lungs under attack from a vaping-related illness. It was an event her parents, Ruby and Tim Johnson of New Lenox, won’t easily forget.
Piper spent a week in a Greeley, Colorado, hospital this past August, including a few days in the intensive care unit. She had been about to start her freshman year at the University of Northern Colorado, Ruby says.
But in the days leading up to school, Piper was coughing, ran a 102-degree fever and told her parents that it hurt to take a deep breath, Ruby says, adding that her daughter does not have asthma. Piper had, however, been vaping. She mainly used e-cigarettes containing nicotine but also vaped with some THC products, Ruby says.
The long-term effects of vaping are not known, due in part to e-cigarettes being introduced in the United States relatively recently — in about 2007 — and the fact that users tend to be teens and young adults.
The Illinois Department of Public Health says 88 cases of vaping-related illnesses and one death have been reported in the state. An additional 17 cases are being further investigated.
Nationwide, 805 people have experienced lung injuries associated with the use of e-cigarettes or vaping products, as of September 24, 2019, according to the Centers for Disease Control and Prevention (CDC). Twelve people, including a resident of Illinois, have died. Of the cases with complete data, 62% were 18 to 34 years old, while 16% were younger than 18. Males comprised 69% of the cases.
Similar to Piper, another 18-year-old Illinois teen, Adam Hergenreder, of Gurnee, was told he could have died from a vaping-related illness. Hergenreder is suing e-cigarette company Juul Labs, claiming he was a victim of deceptive marketing and that he suffered severe lung disease as a result of using the product, the Chicago Sun-Times reported in September. The suit was filed in Lake County Circuit Court.
Stephen Amesbury, MD, a pulmonologist and critical care physician, treated Hergenreder at Advocate Condell Medical Center in Libertyville. Amesbury says he’s seen increasing numbers of teens and young adults with vaping-related illnesses. Treatment includes oxygen, antibiotics and steroids, he says.
Symptoms include coughing, shortness of breath, chest pain, vomiting and fever. When patients show such symptoms, Amesbury says, “The first question I ask is if [they] vape.”
Both Piper and Hergenreder have told news media they began using flavored e-cigarettes in high school and developed an addiction to the nicotine.
They’re far from alone. Some 25% of high school seniors in 2019 reported using an e-cigarette within the last month, compared to 21% in 2018 and 11% in 2017, according to data released in September by the National Institute on Drug Abuse. The National Youth Tobacco Study found more than 3.6 million middle and high school students currently use e-cigarettes.
Kristen Young, executive director of the American Lung Association, Greater Chicago, says youth may wrongly believe “it is just water vapor being inhaled.”
However, “That is not true. There are many harmful substances,” she says. E-cigarette vapors can contain formaldehyde, which is known to cause cancer, and acrolein, which is used as a weed killer and can cause irreversible lung damage.
When some flavors and additives are heated, it creates new compounds that can trigger irritation and inflammation. In addition, many users vape THC oil that contains vitamin E acetate, which may be implicated in some vaping illnesses, as it can be dangerous when heated and inhaled.
In its analysis of vaping-related cases to date, the CDC found that most of the cases reported using THC or both THC and nicotine. Some of the cases have reported using only nicotine.
While e-cigarettes with fruity flavors have been marketed to teens, regular e-cigarettes have been marketed to adult smokers as a smoking cessation tool.
“E-cigarettes are not safe and can cause irreversible lung damage and lung disease. No one should use e-cigarettes or any other tobacco product,” says Harold Wimmer, national president and CEO of the American Lung Association, in a statement on the ALA’s website. Wimmer adds that the Food and Drug Administration “has not found any e-cigarette to be safe and effective in helping smokers quit.”
Young notes that one e-cigarette pod, or cartridge, delivers the same amount of nicotine as 20 tobacco cigarettes. It’s a powerful punch from a device that can be as small as a thumb drive.
Nicotine can affect teens’ developing brains, says Kevin Germino, MD, a DuPage Medical Group pediatrician.
“Nicotine is an addictive stimulant drug that is especially harmful to teens, as the brain is still developing until the age of 25,” Germino says. “Not only does nicotine affect neurotransmitters, it can have serious effects on a developing brain. It can also make teens more prone to mood disorders and attention issues.”
Germino says part of the problem is that e-cigarette ads found through social media, YouTube and elsewhere “make it look cool to vape.”
“According to the CDC, there is a link between our youth’s exposure to e-cigarette advertising and the likelihood that they will give it a try,” Germino says. Teen vaping has also increased, he says, because “there are thousands of flavors, many of which would appeal to their less sophisticated palates.”
Illinois lawmakers are expected to take up a proposed ban of flavored e-cigarettes in the fall session of the Illinois General Assembly. Chicago Mayor Lori Lightfoot has proposed banning flavored e-cigarettes citywide, while 15th Ward Alderman Raymond Lopez has called for a ban of all e-cigarettes in Chicago.
The IDPH has launched an anonymous online survey to gather more data about vaping. It’s working with the Illinois State Board of Education to make sure youth are aware of the dangers of vaping and e-cigarette use, says Melaney Arnold, state public information officer for the IDPH.
Congressional Democrats and Republicans are pressing for a ban on flavored e-cigarettes, and the Trump administration says it is preparing such a ban. Ruby Johnson testified before a Congressional committee in September as an Illinois advocate with the national organization of Parents Against Vaping E-cigarettes.
Ruby and her husband Tim say schools must do more to educate children and teens about the hazards of e-cigarettes. Elected leaders in Illinois and across the country, they say, should permanently ban all flavored e-cigarettes.
Permanently banning flavored e-cigarettes could help reduce the number of teens who vape, says Ruby, noting, “They’re attracted to the flavors, including mint and menthol.”
Tim adds, “I don’t think kids have a clue as to what they may be inhaling or that it includes nicotine.” Of a permanent, nationwide ban on all flavored e-cigarettes, he says, “It is not a Republican issue or a Democrat issue. It’s bipartisan.”
Now out of the hospital and back in college, Piper has sworn off e-cigarettes and says she wants to teach others about the dangers of vaping. Acknowledging that the long-term effects of vaping are not known, her mother, Ruby, adds, “We are praying for a full recovery.”