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September 27, 2019

As vaping illnesses spike to 805 cases, Congress launches hearings

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    Congress this week held public hearings on the risks of vaping following a surge in cases of a mysterious illness that is linked to e-cigarettes and vaping products and has killed at least 12 people.

    Cases of a mysterious vaping illness jump by 52%, CDC says

    CDC on Thursday said officials from 46 states and one U.S. territory have reported 805 confirmed and probable cases of lung illness linked to e-cigarettes and vaping products, that's up 52% from last week when the agency was tracking 530 such cases. CDC also reported 12 deaths believed to be tied to the illness in 10 states. The Associated Press reports that Mississippi on Thursday reported a 13th death tied to the illness.

    Anne Schuchat, CDC's principal deputy director who is overseeing the agency's investigation into the matter, said she expects the number of cases to increase further as state officials report new cases in the ongoing outbreak.

    FDA officials last month said they have found vitamin E acetate in many of the tested tetrahydrocannabinol (THC) vaping samples, and researchers have noted that the chemicals in vaping liquids "undergo thermal degradation" when they are heated, producing new, potentially harmful compounds.

    However, FDA on Thursday said it has yet to identify a single common factor linking the cases and deaths. According to the Washington Post, FDA's tests have shown the deaths involved patients who used e-cigarettes with just nicotine; just THC, which is the high-inducing chemical found in marijuana; and a combination of the two.

    CDC warns against e-cigarette use at congressional hearing

    During the House Oversight and Reform Committee's Economic and Consumer Policy Subcommittee hearing on Tuesday lawmakers heard testimony from Schuchat, as well as representatives from the American Lung Association, Illinois Department of Public Health, and parents of children affected by the vaping illness.

    Schuchat in her testimony reiterated that CDC still does not know which compound, including THC or Vitamin E acetate or others, may be linked to the illness.

    CDC at the hearing told lawmakers that consumers should avoid all vaping products until health officials identify the cause of the vaping illness, which Schuchat said has probably sickened "hundreds more" people since the updated numbers were released last week.

    "At this point I think caution in all products is recommended," Schuchat told the House Oversight and Reform Committee. "The identification of the cause or causes for the outbreak may take substantial time and continuing effort," she continued. "It may not even be the THC or the nicotine. It may be the additives or substances that may be common. It may be the material is not labeled appropriately."

    But telling consumers to avoid vaping might be easier said than done, according to Schuchat. She added that some e-cigarette makers are producing products that contain nicotine salts, which increase the amount of the addictive substance that reaches the brain, making the products "even more addictive" to younger consumers whose brains are still developing.

    Ruby Johnson, the mother of a student who was hospitalized last month with severe respiratory problems linked to vaping, alleged that e-cigarette companies have treated teens like "guinea pigs," adding that the products should be banned to prevent further cases of the illness, NPR reports.

    "These products flooded the market without anyone knowing how they would cause damage, and now we're trying to clean up a mess," Johnson said. "If this was romaine lettuce, the shelves would be empty."

    But some lawmakers argued that e-cigarettes should still be available as a "harm reduction" approach for adults who are trying to quit smoking combustible cigarettes.

    "We can both prevent children from using e-cigarettes, while also ensuring that they remain available for those adults who are choosing to quit smoking," Rep. Carol Miller (R-W.Va.) said.

    However, Albert Rizzo, chief medical officer of the American Lung Association, at the hearing said "FDA has not found any e-cigarette to be safe and effective in helping smokers quit." Additionally, the agency has not approved e-cigarettes for smoking-cessation, he added.

    FDA warns against e-cigarette use at second hearing

    During the House Committee on Energy and Commerce's Subcommittee on Oversight and Investigations hearing Wednesday lawmakers heard from acting FDA Commissioner Ned Sharpless, as well as several state public health department officials.

    Sharpless during the hearing said, "E-cigarette products are not safe," and warned that FDA has not approved any e-cigarette product for use. Sharpless said FDA is finalizing a compliance plan to evaluate e-cigarettes, and told lawmakers that implementing a new user fee program for e-cigarette makers could help the agency's enforcement actions (LaVito, CNBC, 9/24; Aubrey, "Shots," NPR, 9/24; Cornwell, Reuters, 9/24; Ayesh/Rummler, Axios, 9/26; Stobbe, Associated Press, 9/26; Wang, Inside Health Policy, 9/25 [subscription required]).

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