Goshen, N.Y. - In light of advisories issued by New York State Health Commissioner Dr. Howard Zucker, the Surgeon General, and the CDC, Orange County Commissioner of Health Dr. Irina Gelman is urging residents to stop using all vape products while the investigation into the definitive cause of vaping-associated illnesses nationwide continues.

“The bottom line is smoking and vaping is unsafe,” Gelman said. “E-cigarettes pose a health risk for youth, young adults, pregnant women, and adults who do not currently use tobacco products. While evidence exists that adult smokers who completely substitute vaping for traditional smoking reduce their exposure to many of the toxic chemicals and carcinogens present in combustible tobacco cigarettes, e-cigarettes are not risk-free and are not approved by the Food and Drug Administration (FDA) as a quit-smoking aid.”

According to the New York State Department of Health (NYSDOH), as of this month, 81 cases of severe pulmonary illness have been reported by physicians in the state, among patients who noted recent use of vape products. The vast majority of patients have reported use of both nicotine and cannabis containing products, including marijuana, THC, and CBD (76 percent), while some report using cannabis containing products only (20 percent) and a few report using nicotine-containing products only (four percent). A wide range of brand names and packaging descriptions have been reported and testing has revealed that products with identical packaging often have different chemical components. While vitamin E acetate has been strongly correlated with many cases, a definitive cause has not yet been identified. In New York State, patients have ranged in age from 14 to 69 years old.

Nationally, 530 confirmed and probable cases of lung injury have been reported from 38 states and one U.S. territory. Additionally, seven deaths have been confirmed in six states. The CDC has received complete sex and age data on 373 of 530 cases; nearly three fourths (72 percent) of cases are male; two thirds (67 percent) of cases are 18 to 34 years old; and 16 percent of cases are under 18 years old.

Various symptoms have been reported upon presentation, including headache; fatigue; nausea; cough; pleuritic chest pain; shortness of breath; fever; diarrhea; anorexia; and weight loss. Symptom onset has ranged from days to weeks prior to presentation, and all cases have consistently reported regular use of various vape products. At this time, all reported NYS cases have required hospitalization.

The NYSDOH strongly advises that all New Yorkers stop using e-cigarette and vape products until the definitive cause of reported vaping-associated illnesses nationwide can be better determined. While the negative health consequences of traditional tobacco are well established through decades of research and clinical practice, the long-term health effects of e-cigarette use are unknown.  Robust and ongoing evidence-based studies of these products have identified numerous risks and harms from both the nicotine-laced e-liquids and the devices themselves. If residents are substituting e-cigarettes for traditional cigarettes, we strongly recommend that people DO NOT return to smoking cigarettes.

“Vaping is an important issue and an alarming number of students are using electronic cigarettes and vaping devices, despite laws seeking to keep them out of young people’s hands,” Orange County Executive Steven M. Neuhaus said. “While vaping may appear to be a harmless alternative to cigarette smoking, recent studies suggests that health risks may exist and parents need to understand the potential issues that could arise from use of these products. As a father, I’m concerned about this health risk our children are facing today.

The NYSDOH strongly recommends that clinicians report all cases of suspected severe lung disease potentially associated with vape products to the Poison Control Centers (PCC) in New York State.

As per the CDC guidance, regardless of the ongoing investigation, the Orange County Department of Public Health recommends the following:

• Youth and young adults should not use e-cigarette products.
• Women who are pregnant should not use e-cigarette products.
• Adults who do not currently use tobacco products should not start using e-cigarette products.
• If you do use e-cigarette products, you should not buy these products off the street (for example, e-cigarette products with THC or other cannabinoids).
• You should not modify e-cigarette products or add any substances to these products that are not intended by the manufacturer.
• Adult smokers who are attempting to quit should use evidence-based treatments, including counseling and FDA-approved medications, do not return to smoking cigarettes.
• If you have recently used an e-cigarette or vaping product and you have symptoms like those reported in this outbreak and/or you need help quitting tobacco products, including e-cigarettes, contact your doctor or other medical provider.

Data from the 2019 Orange County Youth Survey shows that the proportion of youth reporting ever using an electronic vapor product was 15.1 percent of eighth-graders, 28.5 percent of high school sophomores and nearly 40 percent of seniors. During the same time period, the proportion who reported using a vape product in the last 30 days was 10 percent of 8^th graders, 18.4 percent of 10^th graders and 26.8 percent of 12^th graders.

The Orange County Department of Health Community Health Outreach team members have visited many local school districts to educate parents, teachers, staff and students on the risks of e-cigarette use, and continue to work closely with school districts and other community stakeholders. Additionally, the Orange County Department of Health conducts Retail Tobacco Dealer compliance checks throughout Orange County, instituting enforcement action in the event of a sale, in violation of NYS Public Health Law Article 13-F (Adolescent Tobacco Use Prevention Act) for the sale of tobacco and/or vaping products to an underage youth during a compliance check. The maximum fine for the first violation is $1,000. Subsequent violations result in fines of up to $1,500 each and the possible suspension or revocation of lottery and/or tobacco licenses.

If you are concerned about your health after using an e-cigarette product, you can call a local poison control center at 1-800-222-1222. Additional information and resources are available by visiting orangecountygov.com. and following links to the Department of Health and Healthy Orange and at www.healthyorange.com.

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