E-CIGARETTE and vaping-associated lung injury (EVALI), is a term that is coming up more often.
As a disease, EVALI is usually hard to diagnose because its symptoms can be similar to other respiratory diseases, including shortness of breath, fever and chills, cough, vomiting, diarrhea, headache, dizziness, rapid heart rate and chest pain.
Typically, doctors will evaluate the patient's history of e-cigarette use or vaping, and take a scan to see if there are hazy spots on the lungs, which indicate tissue damage.
However, long-time medical practitioner Dr Kumar Subaramaniam finds the increased usage of the term EVALI worrisome, as it is often discussed in the wrong context.
Dr Kumar said that the issue lies with certain parties, who bring up EVALI at the mention of vape, while repeating and spreading mistruths about vaping.
THE BACKSTORY OF EVALI
To put things into perspective, it's important to understand where EVALI came from.
"The term EVALI became mainstream after a string of lung injuries were reported among youths using e-cigarettes in the United States in the fall of 2019.
"The initial belief was that vaping was to blame, leading to backlash against vaping and even a complete ban in Massachusetts which lasted months, resulting in some vape shops closing for good," explained Dr Kumar.
(Photo credit: CDC | Unsplash)
Subsequently, the U.S. Centers for Disease Control and Prevention (CDC) identified the real culprit behind the EVALI outbreak — the presence of vitamin E acetate that was added into illegal Tetrahydrocannabinol (THC) products.
"This caused the mishap that left a bad reputation on vaping, which was touted to give many smokers a chance to quit smoking tobacco products for good.
"So, it was not vaping that was the problem, rather the misuse and abuse of the products. But the damage has been done and the half-baked truths surrounding EVALI live on to this day.
"The EVALI saga should not be used as a 'boogeyman' to dissuade us from seeking to regulate vaping and adopt a 'zero-tolerance' attitude. In fact, the EVALI saga in the U.S. shows above all the importance of regulations," said Dr Kumar.
ROAD TO REGULATION
Vaping has been growing since it arrived in Malaysia over a decade ago, yet regulations remain elusive.
Dr Kumar believes that Malaysia needs to regulate vaping for the safety of its users.
Regulations will allow the authorities and consumers themselves to be sure that the vape liquids in the market meet regulatory standards.
More importantly, perhaps regulations will pave the way for a greater understanding of how vaping, which is scientifically proven to be a less harmful alternative to smoking, can help the estimated five million smokers in the country kick the habit.
In fact, even health authorities around the world know that they cannot rely on the ineffective prohibition strategy, but require new interventions like vaping to aid smoking cessation.
"If we are to move forward in this country and put an end to the menace that is smoking, we need to arm ourselves with good science, facts and data," said Dr Kumar.
Dr Kumar Subaramaniam is a medical practitioner with a career spanning 25 years. He has worked extensively in the psychiatry department of various local hospitals and has special interest in mental health. Over the years, Dr. Kumar has provided patients with supportive counselling, particularly in wellness counselling, and has provided multiple public lectures on wellness.