A man vapes outside a shop in East Liverpool, Ohio. (Shannon Stapleton/Reuters)

A lot of us on the right — including yours truly — have been quite enthusiastic about the potential of vaping to reduce smoking deaths without infringing on smokers’ personal freedom. The U.K.’s Royal College of Physicians estimates that vaping is, at most, only 5 percent as dangerous as smoking. As I wrote back in 2016, “this implies we could maintain our current level of safety even if 19 nonsmokers took up vaping for every smoker who switched (or would-be smoker who vaped instead).” The potential is enormous.


When it comes to new products, though, there is always a chance of unknown dangers — and recently there have been reports of a mysterious lung disease among vapers. Kaiser Health News has an excellent and thorough (if somewhat slanted) report today that ought to put this problem in focus.

As of August 22 there were nearly 200 reported cases of vaping-related illnesses from 22 states, and at least one death. These numbers aren’t really comparable to those for smoking, whose consequences normally come after decades of use and are counted much more thoroughly than this new problem is. But it’s at least worth pointing out that smoking is estimated to kill nearly half a million Americans each year, and that for every person who dies, 30 more get serious smoking-related illnesses. So far, then, the mystery lung disease is just a blip on the radar in terms of the overall problem we’re trying to address.

Further, while a lot remains to be learned about the illness, there are strong suggestions it’s caused by bad or counterfeit products, not by normal vaping. The cases cluster geographically, and in some states they have been found exclusively among those who vape cannabis products, not nicotine. Scott Gottlieb, the former FDA director who launched a crackdown on vaping when studies showed teen use on the uptick, told KHN he suspects the problem is counterfeit pods, both because of the clustering and because the FDA inspects the facilities of legitimate manufacturers to ensure the products aren’t contaminated.


In terms of policy, it’s worth keeping an eye on this problem, figuring out what is causing it, and punishing anyone selling tainted vaping products. It’s also worth setting up a better system for keeping track of issues with vaping liquids and accessories. And of course, the FDA should keep in mind everything we learn about this illness as it continues to implement its new regulatory regime (however much I hate that regime). We should also keep studying the consequences of vaping, and especially how those consequences vary according to which products people use.

For the time being, though, this seems like a problem limited to small batches of bad products — not unlike the foodborne illnesses that kill several thousand Americans each year — rather than a reason to change course on vaping overall.