Cases of severe lung illnesses related to vaping are spreading across the country — and Madison is not exempt from the epidemic.
Vaping is the use of an e-cigarette, according to the Center for Disease Control. There’s no difference between an e-cigarette, vape or Juul — they’re all electronic nicotine delivery systems — though it is common to hear them used in different contexts.
Vaping has become a staple of college culture at UW-Madison, said Christian Cole, a junior studying Communication Arts at UW-Madison, who started vaping going into his freshman year.
“It’s 100 percent apart of the college party scene,” he said. “You can’t really go anywhere without someone asking for a Juul. It’s become something that you don’t even think about when you go out, you just know you’re going to see it.”
Diagnosing the issue
As of last week, there have been 380 confirmed cases of vaping-related illnesses across the United States.
As of Tuesday, there have been seven deaths.
It was only last week that the CDC created a case definition for vaping-related lung illness. The early symptoms include fatigue, nausea, vomiting, coughing and fever and can escalate to shortness of breath, which can require immediate medical attention or hospitalization.
UHS hasn’t diagnosed any cases yet, but they have seen several that demonstrate the identified symptoms, according to the Director of Medical Services at University Health Services, Bill Kinsey.
“We certainly have students who have had similar symptoms and who also vape,” Kinsey said. “It’s likely that we have seen some but we haven't officially diagnosed it.”
Kinsey stated that the scientific community is trying to catch up with what is relatively a new phenomenon of illness and death from vaping.
“I am absolutely worried about the trends right now,” he said. “It’s a perfect storm for raising the possibility of severe lung disease, and even death, for students on this campus. I don’t want to see that happen.”
Ryan Sheahan, Program Coordinator for Public Health Madison & Dane County’s Tobacco-Free Living Program, hopes that the outpouring of national cases will make young adults second guess trying e-cigarettes.
“What we're hearing is that it’s these black market liquids causing harm,” Sheahan said. “You have no idea what’s in them.”
So what’s in e-cigarette cartridges?
They contain high amounts of nicotine, which by itself can exacerbate heart conditions and breathing issues. They also have other volatile organic compounds and toxins that are known to cause cancer, Sheahan said.
The national crisis seen across the U.S. stems from the fact that e-cigarettes are not regulated by the FDA, he explained.
Close to 90 percent of the national cases of vaping-related illnesses have involved THC in the e-cigarette cartridges, which is illegal in the state, according to Wisconsin’s Department of Health Services.
Making local change
Sheahan’s goal is to change local policies — in schools and throughout the city — by educating policymakers and local schools on the benefits of updating e-cigarette regulations.
“We're not out there trying to fight kids into not smoking — that doesn't work,” he said. “It's about how can we help these kids that are extremely addicted to nicotine quit successfully.”
Assistant Principal at Edgewood High School Shannah McDonough believes changing the behavior of students is the responsibility of both parents and teachers.
“This problem is all of our problems... they’re vaping or Juuling in a bathroom where we don’t have cameras or a supervisor there at all times, they’re doing it at home too,” McDonough said.
Public Health Madison & Dane County’s Tobacco-Free Living Program has a multi-layered strategy to spread information, locally and statewide: youth prevention and advocacy, community education, coalition building and policy building.
The program works to educate the community, mainly parents, school administrators and residents, about tobacco — and now vaping devices.
One of their initiatives, Wisconsin Wins, hires youth between the ages of 16 and 17 to conduct tobacco compliance checks throughout Columbia and Dane County. Through the program, teens go into smoke shops and ensure retailers aren't selling tobacco products — and e-cigarettes — to minors.
New regulation in the city and the nation
Earlier this year, a new bill was proposed to amend the previous smoke-free laws created in 2009, which prohibited smoking tobacco products indoors. With the recent uprise of e-cigarette use, the bill redefines "smoking" in order to tackle this issue.
Not just city officials have gotten involved.
Last week, U.S. Sen. Tammy Baldwin, D-Wis., urged the CDC to activate its Emergency Operations Center to expand its investigation into vaping-linked diseases. The CDC took that step on Monday in a statement announcing its commitment to finding out the cause of the current outbreak of these issues.
Both the CDC and Public Health Madison & Dane County are recommending youth, young adults, pregnant women, as well as adults who don’t currently use tobacco products to not use e-cigarettes or vaping devices no matter what the substance is inside of it.
“THC, nicotine and CBD are all unregulated at this point and we don’t know what the user is using,” Sheahan said. “At any one point, you can be exposed and put your health, and even your life, at risk.”
Kinsey said that these efforts aren’t enough.
“There are formal statements at the state and national level warning people not to use e-cigarettes at this time,” he said. “Merely making a statement is not going to be sufficient for some students.”
There are a handful of smoke shops on State Street alone that sell e-cigarettes. However, Knuckleheads Tobacco and Vapes and Pipefitter were not available to comment. Azara on State Street declined.
A threatening trend on the rise
Public Health Dane County and Madison saw a significant rise in e-cigarette rates in 2016. Sheahan said that it was mainly Juul’s doing — and it was revolutionary.
“It’s pretty amazing,” Sheahan stated. “Juul is a term that is used now. It’s its own verb essentially.”
From 2016-2017, Juul sales jumped 641 percent — from 2.2 million devices sold in 2016 to 16.2 million devices sold in 2017. Much of the product’s appeal came from the variety of flavors it marketed: watermelon, cappuccino and even strawberry milk.
The Trump administration called for banning most flavored e-cigarettes to combat lung illnesses and keep the products away from teenagers.
“For the first time in a while, we’re seeing our cigarette smoking rate stagnate,” Sheahan said. “Those might go back up because so many youth and young adults are getting hooked on nicotine through a Juul.”
Alex Budke, a junior at UW-Madison, got addicted to Juul his sophomore year. He would even go home in between classes to smoke.
“I realized I was addicted and I didn’t actually enjoy it,” Budkey said. “Not vaping made me feel healthier and more aware and present. It took a little while to get over it, though.”
Cole has utilized a different tactic.
“Every time a story comes out, I brush it by the way-side,” he said. “A lot of people, including myself, try to be negligent to it and act as if they don’t need to worry because it hasn’t affected anyone they know. But if it can happen to them, then it can happen to you.”