The Student Health Center sent a campus-wide email on Aug. 31 that drew attention to an alert from the Centers for Disease Control and Prevention (CDC) warning about pulmonary diseases associated with e-cigarettes.

As of press time, 450 possible cases of lung illness related to the use of e-cigarette products have been reported from 33 states and one U.S. territory, according to the CDC. Five deaths have been confirmed in California, Indiana, Illinois, Minnesota and Oregon, according to the CDC.

Eileen Bevilacqua, R.N., director of the Student Health Center, said providers at the Health Center are urging students to quit smoking e-cigarettes immediately. Bevilacqua estimated that 40% of the students who are seen in the Health Center admit to using an e-cigarette device.

“If the student is a regular user, a nicotine replacement, the patch or gum, is recommended,” Bevilacqua emailed in response to The Hawk’s request for an interview.

According to the CDC, e-cigarette devices are also called e-cigs, vapes, e-hookahs, vape pens, mods, tanks or electronic nicotine delivery systems.

E-cigarettes are devices that operate by heating a liquid solution to a high enough temperature producing an aerosol that can be inhaled, according to Truth Initiative, an organization that aims to inform young people about tobacco and the industry behind it.

Most e-cigarette solutions contain nicotine, flavoring and humectant, a substance used to retain moisture. At least 60 chemical compounds are in e-liquids, and there are even more in the aerosol they produce, according to Truth Initiative.

Although the CDC and the U.S. Food and Drug Administration (FDA) are exploring vitamin E as one of the possible inflammatory chemicals causing the pulmonary illness, they have not identified any specific substance or e-cigarette product that is linked to all cases.

Respiratory, gastrointestinal and non-specific constitutional symptoms have all been reported by patients suffering from diseases associated with e-cigarettes, according to the CDC. Many patients with these diseases report using products with liquids that contain cannabinoid products.

Chris Bostic, deputy director for policy at Action on Smoking & Health (ASH), an organization that aims to eradicate cigarettes and decrease tobacco related deaths, said because e-cigarettes use vapor, consumers can be misled about their harmful effects.

“Twelve to 15 years ago, there was not as much nicotine [in e-cigrettes], and now they are trying to make something that is a true replacement to cigarettes,” Bostic said. “Once you try them, you get addicted very, very quickly.”

To account for diversity in product design, researchers have classified e-cigarettes into three generations, according to Truth Initiative. First generation e-cigarettes resemble combustible cigarettes and are disposable, second generation e-cigarettes are larger and pen shaped and third generation cigarettes don’t resemble combustible cigarettes.

The amount of nicotine in e-cigarettes depends on the brand and generation, but some e-cigarettes deliver nicotine as efficiently as combustible cigarettes.

According to the U.S. Department of Health and Human Services, as of 2017, at least 7.4% of college students are current e-cigarette users, and 30.7% have tried e-cigarettes. Additionally, 11.7% of high school students and 3.3% of middle school students use e-cigarettes, according to the 2017 National Youth Tobacco Survey.

Maddy Mancino ’23, who uses a third generation e-cigarette with a nicotine solution on a daily basis, said that she started using e-cigarettes on and off around her junior and senior years of high school.

“When I was a senior and I turned 18, I bought my own JUUL,” Mancino said. “That is what I started using more frequently. Then I got a Flair, which just hits better.”

Bostic said even though e-cigarette companies claim they don’t market to minors, some of their products make that difficult to believe.

“When you are marketing gummy bear flavored pods, it’s hard to imagine they are marketing towards 40-year old smokers,” Bostic said.

Brandon Baughler ’21, who uses a Novo, a third generation e-cigarette, with a nicotine solution on a daily basis, said he believes the flavors of the solution affect his cravings.

“The Novo has better flavors,” Baughler said. “It is also really sweet. Sometimes I get a craving for that taste again.”

The Hawk reached out to five e-cigarette companies, Fuma, JUUL, Vapor4Life, Blu, Flair and Mojo, but none responded to questions by press time.

Michigan became the first state to ban flavored e-cigarettes on Sept. 4 in an attempt to protect youth and young adults from potentially harmful vaping related illnesses, according to Michigan State Health Department.

Bostic said legislation is the most effective way to simultaneously decrease the percentage of youth and young adults that use e-cigarettes and to limit the economic implications of e-cigarettes on the American healthcare system.

“Regular cigarettes cause about 300 billion dollars in damages and climbing every year,” Bostic said. “Certainly e-cigarettes are not that high yet, but they are going to have an impact we just haven’t calculated that yet. It is going to get worse as more people use them and as people use them for longer.”

Although Baughler said he doesn’t think e-cigarettes are better than combustible cigarettes, e-cigarettes are more convenient to use.

“Cigarettes leave that smell on all your clothes forever and you have to go outside to light a cigarette,” Baughler said. “With a vape it is so easy and so accessible.”

Mancino also said she doesn’t believe that e-cigarettes are better than combustible cigarettes, but she doesn’t plan on stopping completely.

“It definitely concerns me and makes me want to slow down my use,” Mancino said. “Am I ever going to stop? No. But, do I think about those concerns? Yes, on the daily.”

Baughler said almost no outside information would make him stop using an e-cigarette.

“I am just kind of stubborn in the way,” Baughler said. “It would just have to be my decision. It has to be something I discover on my own.”

Bostic said his organization constantly looks for new solutions in an effort to to eradicate cigarettes and decrease tobacco related deaths.

“[E-cigarettes] are vapor, but people think that means it’s water vapor, and it’s not,” Bostic said. “There is no water in there at all. You can get the same results by holding your head over a grill for several hours a day and sucking in the smoke from that.”