The Safety of E-cigarettes

Safety of E-cigarettes

Susan Schmunk, CSTR, CAISS

On May 5, 2018, a St. Petersburg, Florida man died after his vape pen exploded, firing pieces of the device into his brain and setting his house on fire. This is the first recorded U.S. fatality linked to an e-cigarette. The autopsy in this case notes that the explosion sent two pieces of the vape pen into his cranium with the official cause of death listed as “projectile wound of head.” The victim also suffered “thermal injuries” with burns to approximately 80% of his body.

These gadgets have been on the market about 10 years and were promoted as safer than smoking cigarettes. They are lithium-ion battery-powered, rechargeable, and work by heating, not burning, a liquid containing nicotine and sometimes flavoring to a level where it turns to vapor. They have many different shapes and configurations and encompass devices known as e-cigarettes, e-cigs, personal vaporizers (PVs), electronic nicotine delivery systems (ENDS), mods, or similar devices. It is interesting to note that while they were initially marketed as a smoking alternative, there are a growing number of consumers who have never been smokers who now use these devices.

While death is certainly not a common outcome, a report entitled “Electronic Cigarette Fires and Explosions” published by the U.S. Fire Administration (USFA) focuses on incidents that occurred in the U.S. between January 2009 and December 31, 2016. This data was pulled from U.S. media reports and describes a previously unrecognized hazardous condition – electronic cigarette and battery explosions in pockets.

The latest fad seems to center around “juuling.” A Juul is a type of e-cigarette that looks like a USB drive. Its use has exploded among teens. This device was originally manufactured for adults but appeals to children. School-age children have been found charging their Juul devices with school-issued laptops and some schools have banned USB memory sticks as a result. Other school interventions have included taking the bathroom doors off lavatory stalls. Some of the nicotine pods have flavors that include “fruit medley”, “cool cucumber” and “crème brulee” that leave an odor that can be mistaken for candy or gum. The company counters that the shape and flavors are targeted to adults who want to quit smoking but don’t want to be reminded of the shape of a cigarette or the smell of tobacco. School administrators, law enforcement officials, and health workers say the increase in underage use became particularly marked this year with the advent of students openly posting and sharing photos of juuling on social media.

Parents have concerns about this practice leading to drug use as children get older, but the practice is so new there is no “hard” data to support this fear. School-age children share “juuling” hits and this fuels the potential that students may be inhaling mystery substances. But the ultimate concern is that this is getting a whole new generation hooked on nicotine. The company has countered by announcing it would dedicate $30 million to research, education and prevention efforts to keep its devices away from young people.