A look at vaping and the making of a health crisis that’s only just begun
Jonas Bardin recently photographed New Yorkers age 18 to 23 who were vaping nicotine. Here, Bella, on the corner of 9th Street and Avenue C. Photo: Jonas Bardin Dr. Lynn D’Andrea was standing in a small consultation room on one of the upper floors of the Children’s Wisconsin hospital this past Fourth of July weekend when a younger colleague on the pulmonary team, Dr. Brian J. Carroll, told her she needed to see a teenager who was having severe difficulty breathing.
In gathering case histories from adolescents, doctors deliberately ask them about drugs, sex, smoking, and other social habits when their parents are out of the room. In this case, D’Andrea and Meyer didn’t need to worry. “Those kids were telling me everything,” D’Andrea said. “They were scared.” Prior to feeling ill, they told the doctors, they had all been using e-cigarette devices and vaping products containing THC, the psychoactive ingredient in cannabis.
But scientists warn that EVALI may be just the beginning. Factors other than acetate, they say, may have been at play in last fall’s outbreak. About 14 percent of EVALI cases are reportedly nicotine only, and the most recent FDA analysis of vaping products used by 89 patients found that in 26 percent of cases, no THC was detected at all.
Those British findings are now dismissed as “ludicrous” by Jeffrey E. Gotts, a pulmonologist at the University of California, San Francisco. “The 95 percent, they just appear to have pulled that number out of thin air,” says Gotts, who was the lead author of a comprehensive article on the subject in The British Medical Journal last September that undermined nearly every scientific assumption about the health risks of vaping.
From left: Connor and Sofia. Photo: Jonas Bardin. From left: Connor and Sofia. Photo: Jonas Bardin. From left: Lujayn and Tej. Photo: Jonas Bardin. From left: Lujayn and Tej. Photo: Jonas Bardin. More than a decade ago, Stanton A. Glantz received a visit in his office at the University of California, San Francisco, from a couple of young men who wanted to live the Silicon Valley dream: disrupt a major industry and make a lot of money.
“Well, no, no, no,” Glantz recalls them saying. “We just don’t think that’ll be a problem … because no kid would want to use this, and this is for adult smokers trying to quit, and blah, blah, blah.’’ That regulation, the so-called Deeming Rule, took the better part of five years to make its way through the federal bureaucracy. The final version required e-cigarette companies to submit an application to the FDA establishing that a new product benefited the public health before they could bring it to market; the process was known as a “premarket tobacco application,” or PMTA.
But it wasn’t just Juul. What resulted was a Wild West of unregulated, disparate products: different devices ; different “tanks” ; different coils ; different e-liquids ; and different flavoring components , some legal , some illegal . In terms of product safety, it was like a huge chemistry experiment with no controls and dozens of variables, and the guinea pigs were American consumers.
In April 2018, once vaping had taken off in the schools, a reporter from a local Kenosha, Wisconsin, newspaper interviewed an 18-year-old senior at Westosha Central High School who made no secret of his desire to become a millionaire. He described how he had started a lucrative business selling high-end athletic shoes out of his home in Paddock Lake, where he lived with his brother; his mother, Courtney ; and his grandfather Tom Blount.
At first, the drug ring Huffhines is alleged to have started purchased prefilled THC cartridges and sold them in lots of 100, police say; at some point, he switched his business model and started to purchase bulk quantities of distilled THC oil and empty cartridges. He hired ten people, he later told police, and initially paid them $20 an hour to manually load vaping cartridges by injecting THC oil into them with a syringe. His crew worked seven-hour days and filled out time cards.
Around the same time, two parents showed up one evening with their son at the Waukesha Police Department. The parents had uncovered a number of THC cartridges in the son’s bedroom, according to Waukesha detective Justin Rowe, along with roughly $2,000 in cash. On the basis of that initial tip, Rowe and his colleagues began an investigation into a possible drug ring distributing illegal THC vape cartridges in local high schools.
Courtney Huffhines seemed more concerned. On the same day as Tyler’s departure, she shared an article about the vaping epidemic with her sons by cell phone, according to police, and imparted some motherly advice: “And it’s not a joke. They have huge warnings out. Btw it is all vape and e Devices. So might need to look into another business.”
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