Vaping has become increasingly popular within the last few years. In fact, there were just seven million people vaping in 2011, and there were 41 million in 2018. As the number of adults who vape are estimated to reach almost 55 million by 2021, the health concerns arising from vaping injuries — including respiratory illnesses and deaths — are cause for concern and potential legislative action. 

There have been 17 cases of vaping injuries and vaping-related respiratory illness in Arizona, and there have been no reported deaths in the state as of Nov. 19, according to the Arizona Department of Health Services. 

The Arizona Capitol will see more efforts in changing tobacco and vaping laws next year as Sen. Heather Carter (R) from North Phoenix, recently said her new legislation will seek to raise the age to buy tobacco or vaping products to 21 from 18. It also would classify vaping products as tobacco, making them subject to the same restrictions in place for smoking such as a ban on use indoors, and require retailers to get a license to sell them.

As of Nov. 20, the Centers for Disease Control and Prevention has confirmed 2,290 lung injury cases associated to e-cigarettes or vaping across the country. There have been cases reported in 49 states — all except Alaska — in the District of Columbia, and in Puerto Rico and the U.S. Virgin Islands. 

There have been 47 deaths confirmed in 25 states and the District of Columbia, the CDC reports as of Nov. 20. The ages of these patients ranged from 17 to 75 years old, and the median age was 53. As of Nov. 5, among the 2,016 vaping or e-cigarette-associated lung injuries reported to the CDC, 68 percent were male and 77 percent were under 35 years old, with a median age of 24 and ranged from 13 to 78 years old (among 1,906 patients with data on age.)

CDC reports that the symptoms of lung injury that patients have had include coughing, shortness of breath, chest pain, nausea, vomiting, abdominal pain, diarrhea, fever, chills, and weight loss. According to the CDC, some patients’ symptoms developed over a few days, but others’ developed over several weeks.

Eddie Espinoza, the lead respiratory therapist at Pulmonary Associates, explained that complications occur in the lungs once they’ve been damaged from inhaling anything. The main problem with vaping is that it is diminishing patients’ ability to absorb oxygen, meaning they have shortness of breath. Espinoza said there’s a difference between ventilation and oxygenation. 

“Just because you can take a deep breath in and fully inflate your lungs doesn’t necessarily mean that you are absorbing all of the oxygen per breath,” he said. “Normally [the bronchioles] are wide open, when you inhale and exhale air flows right through those little branches [bronchioles] inside your lungs, but when you constantly inhale stuff… those branches tend to swell up a little bit. They get inflamed, and that’s where people start to have trouble breathing,” he said.

Vitamin E acetate has been identified as a “chemical of concern” by the CDC because 29 patients with vaping related lung injury had this chemical in fluid samples collected from their lungs. This chemical is sometimes used as a thickening agent or to dilute THC oil in vape cartridges to make it go further. Tetrahydrocannabinol, known as THC, is the ingredient in cannabis that creates the ‘high.’ The CDC also reports that although vitamin E acetate appears to be associated with most of the cases, they are not yet ruling out other chemicals of concern that are still under investigation. 

Many vaping companies — especially JUUL Labs, the e-cigarette company that holds the most market share — have received backlash concerning their marketing campaigns and has been accused of targeting high schoolers and young adults.

The FDA has found a surge in youth e-cigarette use. In 2017, 11.7 percent of American high school students were using e-cigarettes, but that number jumped to 20.8 percent in 2018 — an increase of 78 percent, according to a survey funded by the FDA and CDC.

Jace Hirano, a sophomore at Arizona State University, started vaping in high school and has continued to for the past three years. He started mainly because his friends were vaping and he was always around it, which seems to be how most high schoolers and college students become addicted.

Hirano continues to vape even after all of the recent reports of illnesses and deaths because he hasn’t experienced any negative health effects yet: “Almost all the cases [of illness and death] deal with people that are vaping excessive amounts, way more than what I, and most other people, do.” However, he has already decreased his usage and has plans to quit, but he’s not in a “rush” to do so quite yet.