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August 8, 2019

Vaping Seizures, Part 2: The Power of Suggestion

Jim McDonald

On his way out the door at FDA, Scott Gottlieb dropped a stinkbomb on the vaping industry, intended to cause even more reputational pain for the small businesses that work to help smokers.

Vaping may cause unexplained seizures, Gottlieb announced. The story exploded and became the vape news du jour. Of course, the fine print ruined all the fun. “We want to be clear that we don’t yet know if there’s a direct relationship between the use of e-cigarettes and a risk of seizure,” the then-commissioner admitted.

Now the FDA is back with an update, and guess what? When you announce that vaping might cause seizures, suddenly people come out of the woodwork to report seizures from vaping.

“The FDA is continuing its scientific investigation to determine if there’s a direct relationship between the use of e-cigarettes and a risk of seizure or other neurological symptoms,” said Acting FDA Commissioner Ned Sharpless.

“Although we still don’t have enough information to determine if e-cigarettes are causing these reported incidents, we believe it’s critical to keep the public updated on the information we’ve received based on the agency’s initial request for reports earlier this year.”

The original announcement in April was based on 35 self-reported incidents over about nine years. The new and improved seizure count is 127, between 2010 and 2019. FDA has posted all of the reports, which come from the agency’s Safety Reporting Portal. It’s important to understand that these are just the opinions of ordinary people, not diagnoses from doctors.

 

Seizures are temporary electrical disturbances in the brain, and usually indicate a serious neurological problem like epilepsy. More than three million Americans have epilepsy, so it would certainly not be a stretch to say that 127 of the many millions who have vaped in the last ten years would be likely to have a seizure.

 

The very first new report reads like this: “My daughter had recently started vaping in an effort to quit smoking. On 11/3, she had a grand mal seizure. Subsequent neurological exams showed no evidence of scarring or any other cause for the seizure. The possibilities presented were: maternal [history] of seizures (I had a seizure disorder as a child, but do not take meds and haven't had a seizure in over 25 years), quitting smoking/vaping, withdrawal from Percocet used for oral surgery pain and a combination of all triggers. I heard on the news this morning that the FDA is looking into the link between ecigs and seizures, so wanted to report.”

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There are reasons listed other than vaping that the woman’s daughter may have had a seizure, including family history and opioid withdrawal. The person reporting the event didn’t see a possible vaping connection herself (nor did her daughter’s doctors) until the FDA suggested it.

Here are some excerpts from other reports:

  • “I was using a Juul E Cigarette device and after 1 hit of it, I blacked out and I’m pretty sure I had a seizure.”
  • “ As more and more news reports come out relating seizures to vaping, and knowing my son was vaping excessively, and also vaping extremely high potency nicotineI truly believe his seizures are the cause of vaping. He had NO other health issues.”
  • “I truly believe my son's seizures were caused by vaping….I believe that the vaping he was doing was out of control as he was a nicotine addict, and this caused his seizure disorder.”
  • “I believe vape smoking is the cause of my son's seizure. There is no history of any kind of seizures until now. He had stopped for a short while and the seizures had stopped and upon reuse they began again….I have always suspected it was vaping related and have been very vocal about it.”
  • “This is a serious problem affecting teenagers and has completely infiltrated our school systems. The fact that these products contain toxic levels of nicotine and other dangerous chemicals when ingested is UNACCEPTABLE….These products are dangerous and marketed to CHILDREN. I can provide any additional information needed in an effort to help reduce the risk of anyone else having to deal with this.”
  • “My son's friend from school Vaped at school, had a seizure and began vomiting and choking.”
  • “I have had multiple seizure like episodes as well as other neurological symptoms such as brain fog, slurring of speech, head burning and more.. This has been an on going thing for months and no doctor can find out what's going on. This all started shortly after I started smoking the JUUL.”
  • “I have been vaping for over 5 years but around two three years ago I started to experience having grand mal seizures and I seen the link between the two and I was just wondering if that could be why I started having seizures for no reason out of the blue cuz I've never had any of my life….I was taking Xanax three or four days before the seizures but the doctor told me that had nothing to do with the reason why I had the seizures and they don't know why I had them and still don't”
  • “After using a nicotine vape pen, my son experienced seizures….Use of this product can cause a toxic ingestion of nicotine, seizures, and erratic heart rates.”
  • “My son has had 2 seizures in the past year. It was determined from his Pediatric Neurologists that it is from Vaping. Both times he had a seizure he had just vaped. The hospital ran series of tests, MRI, EEG, EKG, etc. No Epileptic symptoms. This really needs to be investigated. I'm willing to give ANY information you need….This should be investigated. Glad this report came out.”
  • “My wife is healthy and has never had any of these issues before. She is no longer smoking the e-cigarette and we have had no issues since. I am not a medical expert but I know it was cause[d] by the Juul.”
  • “The hospital doctors felt it was medication [related]…. I saw the report on Nightly News tonight and that is the reason I am reporting this now. I have printed the story on Juul and seizures and will take to my neuro at my appointment.”
  • The last patient also smokes cigarettes and uses tramadol. Tramadol is a powerful pain killer that is known to cause seizures. That’s why the doctors told her the seizure was probably medication-related. But she watched the nightly news and made the JUUL connection. She obviously doesn’t think the American Spirit cigarettes she smokes could have caused the seizure.
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    It’s well known that nicotine poisoning can cause seizures, but it’s highly unlikely that anyone would be able to vape (or smoke) enough to reach that stage of intoxication. It would require vaping heroic amounts of nicotine while simultaneously vomiting and being overcome with dizziness. True nicotine poisoning is likely to be caused only by ingesting or injecting the drug.

    “We appreciate the public response to our initial call for reports, and we strongly encourage the public to submit new or follow-up reports with as much detail as possible,” said Acting Commissioner Sharpless.

    If there’s one thing we can take to the bank, it’s that the public will respond every time the FDA publicizes this dubious link between vaping and seizures. And that this agency will take every opportunity to pour a little more poison in the well of harm reduction for people who smoke.

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    Jim McDonald

    Vaping for: 13 years

    Favorite products:

    Favorite flavors: RY4-style tobaccos, fruits

    Expertise in: Political and legal challenges, tobacco control haters, moral panics

    Jim McDonald

    Smokers created vaping without help from the tobacco industry or anti-smoking crusaders, and I believe vapers have the right to continue innovating to help themselves. My goal is to provide clear, honest information about the challenges vaping faces from lawmakers, regulators, and brokers of disinformation. I’m a member of the CASAA board, but my opinions aren’t necessarily CASAA’s, and vice versa. You can find me on Twitter @whycherrywhy

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