By MultiCare Health System, for the Reporter

E-cigarettes continue to capture headlines as the number of vaping-related respiratory illnesses and deaths throughout the United States increases.

As of Oct. 1, there have been more than 1,080 cases of vaping-related illnesses in 48 states and one territory – as well as 18 deaths – since the first cases were reported in April. The exact cause is unknown.

The illnesses typically start with symptoms of coughing, shortness of breath, fatigue, chest pains, nausea, vomiting and diarrhea, and all patients involved have a history of using e-cigarette products, either with nicotine or THC, the psychoactive compound of cannabis.

E-cigarettes work by heating a liquid (sometimes called a “juice”) to produce vapor that’s then inhaled into the lungs. The liquid may contain nicotine or THC or CBD oils, among other substances and additives. Using an e-cigarette is referred to as vaping.

A recent study by the Mayo Clinic found that “toxic chemical fumes” may be causing the illnesses. The lung damage seen in the study resembles chemical burns. But research is still in the early stages and the specific substance causing the illnesses is unknown.

Public health officials, the Food and Drug Administration (FDA) and the Centers for Disease Control (CDC) urge everyone to avoid purchasing or using e-cigarette products, especially those containing THC and those sold informally or “off the street,” until more is known about these illnesses.

If you have recently used vaping products and have any of the symptoms connected to this outbreak, see a health care provider right away.

Are e-cigarettes safe?

Health providers have been discouraging the use of nicotine e-cigarettes for some time because not enough is known about the long-term effects, says David Ricker, MD, medical director of pulmonary programs for Mary Bridge Children’s Hospital & Health Center.

“It’s useful to remember that it actually took decades for the medical establishment to recognize the adverse health effects of tobacco,” Dr. Ricker said. “E-cigarettes have only been in use for a bit over 10 years.”

Though e-cigarettes are touted as a safe alternative to cigarettes, they often still contain nicotine, an addictive compound found in traditional cigarettes, along with other dangerous chemicals such as benzene, formaldehyde, cadmium, lead and nickel.

“The harmful effects of vaping are extensive and include inhaling an addictive substance as well as harmful chemicals and carcinogens, an increased risk of smoking traditional cigarettes, normalization of smoking behaviors and the risk of poisoning through accidental ingestion or skin absorption,” Ricker said.

On top of this, many e-cigarette liquids are made in kid-friendly flavors such as pineapple and bubble gum, and use of e-cigarettes is prevalent among teens, with more than 1 in 4 high school students reporting vaping in the past month in the most recent government survey.

Gov. Jay Inslee, as well as lawmakers in many other states, have called for a ban on all flavored vape products.

MultiCare Health System is a not-for-profit health care organization with more than 18,000 employees, providers and volunteers.