FDA launches criminal probe into vaping deaths

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The US Food and Drug Administration (FDA) has launched a criminal probe into the recent spike in vaping-related illnesses, which has jumped to 530, health authorities are quoted in a USA Today report as saying. The confirmed cases were reported by 38 states and one territory as of 17 September, the US Centres for Disease Control and Prevention (CDC) said.

CDC reported that seven deaths resulting from vaping-related illness have been confirmed in six states, and that more were likely to occur. By Thursday evening of last week, the Missouri Health Department confirmed that a man in his mid-40s died due to a vaping-related illness – the first in Missouri and the eighth nationwide.

“We are in desperate need of facts,” said Mitch Zeller, director of the FDA’s Centre for Tobacco Products.

Zeller said the criminal probe will not look into personal use of vaping-related products. Instead, the investigation will focus on the products, where they were purchased and how they are being used.

The report says the cause of the outbreak remains a frustrating mystery to health authorities. No consistent product, substance or brand has been identified in all cases, CDC said. Most, but not all, patients reported a history of using e-cigarette products containing THC, a psychoactive chemical found in cannabis.

The FDA has collected more than 150 vaping product samples for forensic analysis, and the agency is testing them for traces of nicotine, THC, and other cannabinoids, opioids, cutting agents, additives, pesticides, poisons, toxins and more. “We are leaving no stones unturned,” Zeller said.

The report quotes Zeller as saying while vitamin E acetate has shown up in some of the FDA’s lab samples, no singular compound has shown up in all the samples.

India has announced a ban on electronic cigarettes, as a backlash gathers pace worldwide about a technology promoted as less harmful than smoking tobacco. The Guardian reports that the announcement by India came a day after New York became the second US state to ban flavoured e-cigarettes following a string of vaping-linked deaths.

The emergency legislation in New York, the second US state to ban flavoured e-cigarettes, followed a mysterious outbreak of severe pulmonary disease that has killed seven people and left hundreds unwell. The report says Donald Trump’s administration announced last week it would soon ban flavoured e-cigarette products to stem a rising tide of youth users.

Legislation is also being tightened elsewhere, and in Singapore e-cigarettes are already outlawed. In Japan, vaping and alternatives such as “heat not burn” tobacco vaporisers are allowed but e-juices with nicotine are not. And, the report says, China, home to almost a third of the world’s smokers, indicated in July that it wanted the “supervision of electronic cigarettes” to be “severely strengthened”.

The Indian ban covers the production, manufacture, import, export, transport, sale, distribution, storage of e-cigarettes, as well as advertisements.

In South Africa, the national government’s proposed Control of Tobacco Products and Electronic Nicotine Delivery Systems Bill seeks to regulate e-cigarettes in the same way as traditional cigarettes. According to a Cape Argus report, if passed into law, the Bill seeks to control the sale and advertising of e-cigarettes, to provide standards for their manufacture and export and – most importantly for the anti-smoking lobby – to prohibit their sale to and by persons under the age of 18.

But medical expert Tony Westwood, head of the general and community paediatrics School of Child and Adolescent Health at the Faculty of Health Sciences at the University of Cape Town (UCT), said the Bill didn’t go far enough. “We worry that e-cigarettes are a nicotine delivery device and should only be used, if at all, as prescribed medication to assist nicotine addicts. While they may seem very cool, especially to young people, they’re actually very cruel,” said Westwood.

Lucy Balona, head of marketing and communication at the Cancer Association of SA, said: “The safety of e-cigarettes has not yet been scientifically shown. Testing has highlighted that e-cigarettes vary widely in the amount of nicotine and other chemicals they deliver, and this is not communicated to buyers.”

Johnny Moloto, head of external affairs at British American Tobacco Southern Africa, said: “Preventing the development of a market for these products would deny smokers the possibility of benefiting from these advanced vaping technologies. There are many studies that indicate that products such as e-cigarettes can be an effective tool for smokers looking for an alternative to reduce or quit smoking.”

Local vapers don’t need to panic as long as they stick to reputable products. A Cape Argus report says this is according to the Vapour Product Association of SA’s Kabir Kaleechurn who said: “It appears that the products responsible for the current reported illnesses are illicit products containing THC (tetrahydrocannabinol), which is the principal psychoactive constituent of cannabis. It was reported that the THC was cut with Vitamin E acetate, which has no place in a vaping product.”

Professor Elvis Irusen, head of pulmonology at Tygerberg Hospital and Stellenbosch University’s division of medicine, agreed that cannabis oil was the culprit for the deaths so far. “The recent deaths in the US are due to vaping cannabis oil,” he said. “This is fatty and clogs up the lungs leading to lung failure, needing ICU, and is extremely dangerous as there is no definitive treatment.”

Dr Richard van Zyl-Smit, head of the Lung Clinical Research Unit at UCT’s Lung Institute, said the levels of vape-related illness may be less locally than in the US because of different usage patterns. But van Zyl-Smit said there was a potential danger to the flavourings. “It is important to note that the flavours used are commercial food flavours generally – tested safe to put in the oven, cook and eat, or alternatively to flavour a drink,” he said. “They have not been tested or approved to be heated to over 200 °C and then inhaled.”

USA Today report The Guardian report Cape Argus report Cape Argus report

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