MADDIE SOFIA, HOST:
You're listening to SHORT WAVE from NPR. Maddie Sofia here. Thanks for checking out this episode of SHORT WAVE, the daily science podcast from NPR. Here today with NPR health correspondent Allison Aubrey.
ALLISON AUBREY, BYLINE: Hey there, Maddie.
SOFIA: Today we're talking about something that's in the headlines a lot right now...
SOFIA: And you're going to start us off today with a story about a young woman that you met recently, Piper Johnson.
AUBREY: Right. So she's 18. And when she was in high school, her sophomore year, she started vaping. Then last summer, right around the time when her family was packing up the car to take her off to college, she started feeling some pain in her chest.
PIPER JOHNSON: You know, I didn't really think anything of it. I took some Advil for it. And then the day we left, I was like, I think I have bronchitis or something. Like, I was running a fever. My heart rate was, like, super, super high. I was super, like, lethargic and stuff.
AUBREY: So instead of heading to the college campus, she and her mom went to the hospital - first to the ER, and then to the ICU.
JOHNSON: My oxygen levels just kept going down, like more and more. First they put me on, like, one liter, then two liter. And then I had to be moved to the ICU because I was on 35 liters of oxygen.
SOFIA: Wow, that - she is, like, barely breathing on her own.
AUBREY: Right, gasping for air. And here's the crazy thing. I mean, all along, the doctors are like, oh, you have pneumonia. Oh, we're going to put you on antibiotics. It must be some kind of infectious disease. Have you been around other sick people? It took a long time before they realized this was vaping.
JOHNSON: Oh, I was terrified. I had no idea what was happening to me because I was, like, perfectly healthy a week ago.
AUBREY: I think Piper's story really brings into focus this wider epidemic of vaping. There are about 1,300 people like Piper who've become crazy sick - right? - in the hospital, walking around one day healthy, a week later, barely breathing.
AUBREY: So these cases, these very odd cases that come on out of nowhere, have really begun to shine a spotlight on this habit of vaping that used to be talked about as an alternative to smoking.
SOFIA: So today on SHORT WAVE, what we do know and what we don't about why vapors are getting sick.
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SOFIA: So how's Piper doing now?
AUBREY: You know, she's doing a whole lot better. She's actually in school doing fine. She has stopped vaping. And now she has become this advocate to get other young people, young adults like her, to stop. She participated in a rally. She demonstrated outside the offices of the e-cigarette company Juul this month as part of this big awareness campaign.
JOHNSON: I don't want to have anyone else go through, like, the pain I experienced because honestly, it was the most painful experience of my entire life. Like, I was laying in my bed, like, sobbing because it hurt so bad to breathe. Like, nobody should have to go through that.
SOFIA: Do we know why these people are getting sick from vaping?
AUBREY: That is the million-dollar question, Maddie. A majority of patients acknowledge vaping THC - that's the psychoactive component of marijuana. Many have used a type of counterfeit vapes called dank vapes.
SOFIA: OK, dank vapes? Are we talking about a company or...
AUBREY: Well, not a company, really. It's sort of a label that gets slapped onto some of these cartridges, these bootleg cartridges. And you really don't know what's in them.
SOFIA: Right. And dank is, like, code for...
AUBREY: Dank is kind of cool - good weed, I think. I don't know. Am I right?
SOFIA: I'm very impressed. Keep going.
AUBREY: OK. But, you know, that said, the outbreak of this epidemic is unclear. I mean, in the beginning, there was this hunt for this singular cause. You kept hearing from the CDC any day, like no stone unturned. We're going to find the thing causing this epidemic. Well, turns out it's probably a lot more complicated. I mean, for starters, some people have only been vaping nicotine. And let's just talk about what you find in these nicotine vaping fluids.
All right, for starters, there's a nicotine, one of the most addictive substances known. Then you add in a little volatile organic compounds, such as benzene.
SOFIA: Not great.
AUBREY: Who doesn't want that in their lungs? Put some trace metals in there. Sound appealing? Then you're going to top off this cocktail with the flavorings. Now we know that the flavorings are part of what teens are attracted to.
AUBREY: They say, oh, it's watermelon flavor. It's, you know, Juicy Fruit flavor. Well, guess what? They don't make the watermelon flavor out of the fruit.
SOFIA: Right (laughter).
AUBREY: They make these things out of chemicals. And one chemical they use is called diacetyl. Diacetyl is definitely not something you want to be voluntarily putting into your lungs. It can lead to this condition where the tiny air sacs in your lungs become scarred and narrowed. And this is not lost on investigators at the CDC. Here's the woman leading the investigation. Her name is Anne Schuchat.
ANNE SCHUCHAT: There may be a lot of different nasty things in e-cigarette or vaping products. And they may cause different harms in the lung. It is pretty much impossible for you to know what is in the e-cigarette or vaping product.
SOFIA: So the government doesn't even know what's in this stuff, right? And yet, it feels like it's becoming more and more popular.
SCHUCHAT: Absolutely. Teen vaping has definitely become more popular. Federal surveys show that 25% of high school seniors say they have vaped nicotine in the last 30 days.
SCHUCHAT: That's an astounding number.
SOFIA: OK. And we should say for people who are like, why is it surprising that vaping is unhealthy, this stuff has been heavily marketed as a healthy alternative to cigarettes, as a way to get you off cigarettes, right?
SCHUCHAT: That's right. I mean, Juul, which is far and away the biggest company making these e-cigarettes, earlier this year launched a big ad campaign called Make the Switch.
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UNIDENTIFIED PERSON #1: I was a pack-a-day smoker for 33 years.
UNIDENTIFIED PERSON #2: I popped a pod in it and took a couple of puffs. And I was surprised at how similar it was to a cigarette.
UNIDENTIFIED PERSON #3: He uses Juul in the house whenever he wants. So it keeps him in our house instead of keeping him out of our house.
AUBREY: You know, I should point out that it is possible that if you're a two pack a day cigarette smoker, switching to e-cigarettes could be beneficial. There could be some harm reduction there. But public health experts agree that there is no chance at all that hooking a new generation of young people on nicotine via these e-cigarettes is a good thing to do.
SOFIA: OK. So we mentioned the government can't say exactly what these things are that might be dangerous for some people. Is there anything they are doing in the meantime?
AUBREY: Well, you know, they're doing lots of things. The CDC has intensified its warnings. The FDA has galvanized its criminal unit to start investigating. But really, right now, it's still a big, hot mess. I mean, we're talking illicit THC, regulated, you know, e-cigarette products. There's so many possibilities out there. I will say that the regulation of e-cigarettes clearly falls under the FDA purview. And President Trump at one point came out in support of a national ban on flavored e-cigarettes. But so far, there's been no action on the federal level. We have seen states step in to act independently.
SOFIA: Right, right.
AUBREY: And more states are looking into it.
SOFIA: So this is something you've talked about before. But, you know, this is personal for you. You've got the teens at home.
AUBREY: That's right. I have two teenage sons. And my older son was a freshman in high school. And so one day, we were in the driveway. And my husband spotted this plastic metally (ph) thing that was cracked on the driveway. And he picked it up. And my husband was like, I think this might be this vaping thing.
SOFIA: Your husband was like...
AUBREY: I was kind of like...
SOFIA: ...That's a dank vape, Allison.
AUBREY: (Laughter) Right, yeah. No, we were both sort of clueless, right? Here we are, these middle-aged people. Our son is vaping, and we're like, what is this, right? So we - finally, we confront him. And, you know, he acknowledges, yes, it is a vape, and, quote, unquote, "everybody is doing it," right?
AUBREY: You know. And I think the reason why my husband and I were so alarmed by this is that this stuff, nicotine, is so incredibly addictive, right? I mean, there's now evidence that it primes the brain for addiction to other substances. It can definitely get in the way of learning. It can cause attention problems. I mean, there's just a host of stuff that's bad about this. And Juul and other vape makers have found a way to make these vapes really, really potent. They're using nicotine salts. And experts say this may be making it even more addictive.
SOFIA: Right. And there really is this, like, vaping culture in high school your son kind of alluded to.
SOFIA: I mean, I remember watching these videos of kids kind of showing off smoking in the classroom, like, when the teachers' backs were turned, right?
AUBREY: As if it were designed to be hidden.
SOFIA: Yeah. Yes. And so there's that culture combined with the, like, truly addicting substance of nicotine that feels like it's just creating this environment for a new generation to pick up nicotine in a way that's kind of been advertised as, you know, not so bad.
AUBREY: And, you know, critics are saying look; I mean, our generation, my generation of teenagers, they're the guinea pigs here.
SOFIA: NPR health correspondent Allison Aubrey, thank you.
AUBREY: Thank you, Maddie.
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SOFIA: I'm Mandy Sofia. Come back tomorrow for an episode about the science of ASMR and how that's connected to a big Internet trend of the moment, slime. That's tomorrow on SHORT WAVE from NPR.