Get vaping injury patients to follow-up care quickly, CDC urges doctors
New guidance this week from the federal Centers for Disease Control urges doctors to quickly connect patients hospitalized for vaping-related lung injuries with follow-up care after their release.
Nicholas Nacca, an assistant professor and medical toxicologist at the University of Rochester Medical Center, said when injury symptoms return, they can be fatal.
URMC has treated 28 cases of what’s become known as EVALI -- e-cigarette or vaping product use-associated lung injury -- according to a spokesperson. That’s more than half of the cases in the state health department’s 17-county Western New York region.
The CDC’s previous guidance had been to schedule patients for outpatient follow-ups within about two weeks after their discharge from the hospital. Now the agency says that should happen within two days.
Nacca said that’s an important update because some of the EVALI patients seen at URMC go back to vaping within days of being treated for their lung injuries. He said addiction is probably only partly to blame.
“People have become very attached to these products. It can be very emotional,” he said. “They may not believe the cause of the diagnosis, and they may leave the hospital and resume vaping in short order.”
Nacca said doctors need to be aware of how deep that attachment can be, and how much work it might take to lead people away from vaping.
“Some patients won’t take our advice the first time we give it, and they may need to hear it from multiple providers,” he said. “We need to listen to them, and have a conversation -- really a two-way conversation -- about these products.”
Vaping advocates point to the products as a less dangerous alternative to conventional cigarettes, and in a recent move to ban certain flavors of vaping liquid, the federal Food and Drug Administration said it sought to find a balance between reducing access for youths and “maintaining availability of potentially less harmful options for current and former adult smokers.”
But that position has met fierce opposition from many health care professionals.
“If someone’s saying, ‘OK, should I jump out of the 10th-story window, or the fifth-story window,’ you know, you’d say, ‘Well, it’s less harmful to jump out of a lower window than a higher window,’ ” Ossip said, “but you would not -- no clinician is going to recommend that.”
The CDC has identified illicit products like THC, the psychoactive ingredient in marijuana, in most cases of vaping injuries, but the federal agency and other local public health authorities are still urging people not to vape at all.