On April 3, 2019, the U.S. Food & Drug Administration (FDA) issued a press release statement (https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm635157.htm) from Commissioner Scott Gottlieb, M.D. and Principal Deputy Commissioner Amy Abernethy, M.D., Ph.D. about a serious safety concern related to e-cigarette use.
The FDA's statement came after the agency received reports of seizures in some e-cigarette users – especially youth and young adults. Seizures and convulsions are known side effects of nicotine poisoning (https://www.medicalnewstoday.com/articles/319627.php), especially in intentional or accidental swallowing of e-liquids that contain the drug.
Between 2010 and the first part of 2019, the FDA received reports of 35 cases of seizures following e-cigarette use. In most cases, the seizures occurred within a day after using the e-cigarette, with some individuals experiencing seizures after the first few puffs. The FDA acknowledged that the number is not significantly high considering the number of e-cig users, but also stated that there could be cases that have gone unreported.
The statement acknowledges that the group of individuals experiencing seizures is diverse, with both first-time users and experienced users experiencing seizures. In addition, some users admitted to having a prior history of seizures, while other users were also using amphetamines or marijuana (https://pediatrics.aappublications.org/content/141/5/e20173787) around the same time.
The FDA also makes it clear that whether a direct relationship exists between e-cig use and seizures is yet unknown, but the number of cases reported does warrant further investigation. Future research should investigate whether there are common risk factors amongst those that experience seizures and if a particular brand, nicotine concentration, or product formulation that is associated with the issue.
As of the time of the FDA's statement, no specific brand was implicated as leading to an increased risk of developing a seizure disorder.
Credit: https://pixabay.com/vectors/vaping-cigarette-electronic-3630389/
A Growing Epidemic
This announcement comes at a time where there is growing concern about the number of youth using vaping and e-cigarette devices (https://www.cdc.gov/tobacco/basic_information/e-cigarettes/index.htm). FDA Commissioner Gottlieb called the rate of e-cig use by teens and youth a growing epidemic.
While e-cigarettes are commonly used by adult smokers that want to switch to a less harmful nicotine-containing product, many youths are using vape pens and e-cigarettes as their initial introduction to nicotine use.
As the FDA and other agencies are determining how to handle the increase in teen e-cig use, schools and other youth programs are dealing with incidents related to vaping and e-cigarettes. For example, in Pataskala, Ohio, the Licking Heights school district (https://www.dispatch.com/news/20190402/licking-heights-schools-dealing-with-third-vaping-incident-since-february) recently had three major incidents related to e-cigarettes. In February 2019, two high school students were transported from school to the hospital after vaping THC wax and becoming ill. Three other students were also treated on the scene. In March 2019, two middle school employees required medical treatment after developing a rash from a vape pen they confiscated from a student. Then in April, a 12-year-old student from the district was vaping on the school bus when several students became sick, resulting in several police officers and first responders being called to the bus.
To help stop this growing problem, the FDA has begun drafting a formal plan (https://truthinitiative.org/news/6-key-takeaways-new-fda-plan-e-cigarettes-flavored-tobacco-products) to curb the sale of flavored e-cigarettes and reduce the number of youth that has access to e-cigarettes and vape pens. This plan now has growing urgency with the possibility that these devices may also be linked to seizures in the youth population.
As I continue to write for Sunshine Behavioral Health (https://www.facebook.com/SunshineBehavi1
), my goal is to talk about health-related issues.
- Charles Watson
@charleswatson00