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CDC Revises Case, Death Count for Vaping Illness

— As new survey data show continued increase in youth vaping

MedpageToday

The CDC narrowed its counts for the vaping-related lung illness, reducing the number of confirmed and probable cases to 380 while upping the death total to six.

Previously, the case count was higher as it included "possible cases that were still under investigation by states," the CDC said in a press statement on Thursday. "The current number is expected to increase as additional cases are classified."

Going forward, the CDC will only report numbers on "confirmed" and "probable" cases and as one combined number, as the are very similar.

Criteria for both include use of an e-cigarette or "dabbing" within 90 days of symptom onset, presence of pulmonary infiltrate (such as opacities on x-ray or ground-glass opacities on a CT scan), and no evidence in the medical record of other likely causes.

Confirmed cases, however, include the absence of pulmonary infection following a battery of tests, while "probable" cases can include cases where some tests have been performed to rule out infection but with no results yet, or where an infection is present but believed to not be the sole cause of the lung illness.

Cases have now been identified in 36 states and one U.S. territory. The six confirmed deaths each occurred in different states: California, Illinois, Indiana, Kansas, Minnesota, and Oregon.

Youth Vaping Surges Again

Meanwhile, the CDC on Thursday released preliminary data from the 2019 National Youth Tobacco Survey (NYTS) showing that electronic cigarette use among U.S. teens continues to rise, with roughly 5 million reporting vaping within the past month.

In the 2019 NYTS, 27.5% of middle- and high-school students said they had recently used e-cigarettes, compared to 20.8%, or 3.6 million kids, in the year prior. This 2018 total, which had nearly doubled that reported in 2017 (11.7%), led federal health officials to brand teen vaping as an "epidemic."

There was some good news in the new NYTS data, as cigarette smoking rates continued to drop among youth to the lowest levels on record.

In the 2019 poll, 5.8% of high-school students reported use of conventional cigarettes within the past 30 days -- down from 8.1% the previous year.

The new figures were released by the Department of Health and Human Services (HHS) Wednesday afternoon to coincide with the announcement by the Trump administration that the FDA will soon unveil plans to remove flavored e-cigarette products from the U.S. market, including menthol and mint products.

Fruit, mint, and menthol remained the most popular e-cigarette flavors among high school-age vapers in the latest NYTS polling.

Fruit was a favorite flavor among 65.9% and mint and menthol was a favorite flavor among 63.9% of high school e-cigarette users responding to the survey. About 1 in 3 reported favoring candy flavored e-cigarettes.

Campaign for Tobacco-Free Kids president Matthew Myers called the new e-cigarette numbers "shocking" in light of industry claims that they want only adult smokers to use the products.

"There are 1.5 million new youth (e-cigarette) users identified in the new survey, which is identical to the increase during the previous year when teen vaping was declared an epidemic," he told 鶹ý.

Myers added that the popularity of mint and menthol e-cigarette products among teens shows the importance of removing them, along with other e-cigarette flavors, from the market.

"When JUUL stopped distributing their mango flavored e-cigarette, the number of kids using mint and menthol skyrocketed," he said. "Mint is essentially a candy flavor, and it's the new 'mango' for kids."

Erika Sward of the American Lung Association told 鶹ý that the continued rise in youth e-cigarette use "underscores the urgency to address the youth e-cigarette epidemic."

"The American Lung Association supports ending the sale of flavored tobacco products to prevent youth vaping, and strongly encourages additional measures, including immediately removing any product that came onto the market illegally after August 8, 2016; stopping online sales; and increasing the federal age of tobacco sales to 21," Sward said.

Gregory Conley of the vaping trade group American Vaping Association said the continued decline in combustible cigarette smoking among youth suggests teen e-cigarette users are not transitioning to smoking cigarettes in large numbers.

"There has been all this talk of e-cigarette use leading to big increases in teen smoking," he told 鶹ý. "Low and behold, teen smoking decreased from 8.1% to 5.8%, which is one of the largest (single year) percentage declines we've seen."