Address crisis now

Need to understand vaping effects

This week, the total number of reported deaths from vaping-related illnesses in the United States increased to 12. Across the country, there have been more than 800 reported cases of confirmed or potential lung injuries related to the use of e-cigarettes, nine of those in Arkansas. That’s a dramatic increase from the 530 cases reported nationally a week ago.

In recent testimony before the Arkansas General Assembly’s Joint Public Health, Welfare and Labor Committee, state Sen. Jim Hendren, R-Gravette, called for action on this problem, adding, “there are devastating health consequences every single day that we wait.” Hendren said the time to “find a solution to this problem is today.” He’s absolutely right.

People are suffering serious health consequences and dying from vaping, just as they have for years from lung cancer and tobacco-related illnesses caused by smoking cigarettes. The Centers for Disease Control and Prevention, the American Medical Association, and health departments across the United States advise Americans to stop vaping until this epidemic of lung disease and its relationship to e-cigarettes is investigated. We must do our due diligence to understand the shortterm and long-term effects of vaping.

Dr. Matthew Steliga, a lung cancer surgeon at the UAMS Winthrop P. Rockefeller Cancer Institute, and Dr. Pebbles Fagan, director of the Center for the Study of Tobacco at the UAMS Fay W. Boozman College of Public Health, also spoke to the joint legislative committee on the same day as Hendren. Dr. Fagan noted that none of the vaping devices currently on the market have been approved as smoking-cessation tools by the Food and Drug Administration, and research shows that the majority of those who gave up cigarettes and started vaping are still vaping after a year. They simply gave up one nicotine delivery method for another.

According to Acting FDA Commissioner Ned Sharpless, no electronic nicotine delivery system product in the United States is on the market legally. “To be legally marketed as a tobacco product, the product would need to undergo FDA scientific review, and the agency would have to find that the marketing of the product is appropriate for the protection of the public health.” That hasn’t happened.

We need to better understand the effects of e-cigarettes on health and other potential effects, not just today but 20 or 30 years down the road. Imagine if we had done this sort of investigation decades ago when manufactured tobacco products were first introduced. Just think of how much trouble we could have saved ourselves. Just think of all the lives that could have been saved.

One could argue that vaping is a personal choice and those who choose to vape bear personal responsibility. That is true—vaping is a personal choice—but the longterm effects are much broader. This is a problem that affects all of society and all of our pocketbooks.

In his testimony, Dr. Steliga spoke of the patients he sees every day with lung disease. Many suffer lifelong consequences like a patient he saw recently, a 40-year-old father of two children who can no longer work and must now rely on state and federal assistance to help support his family. Dr. Steliga said that even if a patient hospitalized with vaping-related illnesses is able to be weaned off a ventilator, be released from the hospital and go home, that patient may still have longterm pulmonary damage. The disabilities, Dr. Steliga warned, will outweigh the deaths.

The CDC estimates the cost of tobacco-related illness in the U.S. to be more than $300 billion each year. Nearly $170 billion of that is spent on direct medical costs. E-cigarettes are relatively new, so we don’t yet know what the cost will be. However, if the cost of lung-related illness from vaping is even one-tenth that of smoking, how will we pay for that?

As the state’s only academic medical center, UAMS is committed to working with providers and state and federal policymakers to address disease and improve health. That includes vaping-related illnesses. Our specialists will treat as many patients as possible, and we can lead the discussion and share expert advice with rural providers and others across Arkansas.

However, if the problem of vaping-related illnesses is left unchecked, the health-care community cannot bear the cost without adequate resources. More research and investigation is needed and, as Senator Hendren said, the time to act is now.