“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,”
—Gottlieb and Abernethy FDA.gov press release
According to media outlets with anti-vaping agendas, there is an increasing number of seizure cases related to e-cigarettes (35 in the last decade). Apparently, these are all vaping related. Now, all e-cigarette companies are held accountable because somebody chose to ingest vape flavors in their liquid form, instead of, say, vapor, as the term vaping implies.
For argument’s sake, let’s say I choked on hot sauce from Taco Bell because I decided to snort it. In this reality, I get to sue Taco Bell and blame all fast food restaurants for making this choke-hazard, evil hot sauce. First of all, that’s not how the sauce is supposed to be consumed, similar to how vape juice is not meant to be ingested in its liquid form.
My bullshit sense is tingling. With the media’s extensive history of using our biases against us, I’m having a hard time believing anything contained in a headline. A headline could read, “Vaping Kills Fifty People per Day Plus a Golden Retriever” and people will share it and link to it. Here’s the catch, though – most people sharing these articles don’t even read them!
Somewhere in there says, “don’t swallow e-liquid.”
Patheos.com contributor David Gee provides insight into this phenomenon. He states in his article, “Most people don’t read the news. Instead, they read the headline and determine if it’s worth sharing.” He goes on to describe the proclivity of sharing news without reading the actual body of content. It is a sad state of affairs, but it is the reality of our current situation as a society.
And truth be told, I’ve done that myself on occasion. Not the sharing of articles, per se, but concocting a strong opinion based on what I read on a headline. Our natural biases are the fertile ground in which the media plants its seeds of agenda-driven drivel. Once a cognitive button is pressed, they can steer our attention down a slippery ride of misinformation.
We all remember the classic Science Post satire article titled “Study: 70% of Facebook users only read the headline of science stories before commenting.” If you recall, the body of the post contained Latin gibberish and no actual content. Still, proving its point, the article was shared and went viral.
The media is known for taking assumptions and turning them into fear-inducing headlines – all for clicks and ad-revenue. Plenty of agenda-driven politicians spew misinformation regarding vaping and e-cigarettes without understanding a shred of the science behind it. For example, Rep. Rashida Tlaib joins the war against JUUL with misinformed nonsense. Tlaib claims JUUL as a company has “used our broken system to target teens.”
Rep. Rashida Tlaib is blatantly anti-science. This is a lie.—> Shoshana Weissmann, Sloth Committee Chair ???? (@senatorshoshana) 26, 2019
"I'm not going to sit here and allow this committee to be used ... to say that e-cigarettes, vaping, JUUL, is not killing our people; they are."
You’d assume somebody in the House of Representatives would take science more seriously. But who am I to talk – I’m just a guy on the internet.
CNBC.com author Angelica LaVito reports how e-liquids, when swallowed, can cause a myriad of side effects, such as: dizziness, tremors, nausea, and seizures. She also writes, “The FDA said the evidence it has analyzed so far doesn’t establish a clear pattern or cause for the cases.”
The operative word here is “swallowed.” Why would anyone take a gulp from a bottle of vape juice? It is not meant to be a beverage. It is meant to be inhaled after the device turns the liquid into vapor.
The FDA reports that 35 people have suffered from vaping related seizures since 2010. That is a low number in almost a decade. Considering the massive amount of people vaping, 35 is not even 1%.
FDA’s former head honcho Scott Gottlieb stated the following in their April 2019 statement with respect to ongoing scientific investigations regarding seizures following e-cigarette use:
Among the efforts underway, we recently announced that we’re looking at the potential for direct effects of harm from e-cigarettes on the lungs as well as other health factors that these products could negatively impact.
- Gottlieb, former FDA Commissioner
In other words, they don’t know shit. Vaping companies aren’t claiming that nicotine is good, or vaping is healthy. Vaping is saving lives by working as a replacement tool for those who wish to quit smoking. The research is massive on this topic, and even Harvard Medical School agrees to an extent. The Economist agrees since 2014, referring to the ritual of smoking and vaping as a cessation tool:
The latest investigation of vaping suggests it can help you quit smoking >—> The Economist (@TheEconomist) 19, 2014
Like people on diets using meal-replacement products like Slim Fast to lose weight, the same applies to nicotine. Why is vaping effective as a replacement? Because it works very much like a nicotine patch and other nicotine replacement therapies (NRTs). The best thing about it is that you can enjoy great flavors with it and taking care of the device is a hobby of sorts.
Imagine struggling to lose weight and discovering a meal-replacement product that tastes like your favorite unhealthy food? Something that will aid you into full cessation by slowly edging out the craving for it. The meal-replacement wouldn’t be as healthy as broccoli but it’s a thousand times healthier than fast food. Wouldn’t that make for a decent way to trick your cravings and provide you with a faster route to fully quitting?
Let’s use car company Tesla as an example. They receive plenty of bad press over electric car fires. When it happens, a flurry of articles is unleashed to the public about electric cars and batteries and other fearmongering B.S. – but statistics show that more than 150 regular gas cars go up in flames EACH DAY. Regular gas cars aren’t clickworthy; it’s expected and normal.
“If, tomorrow, I tell the press that, like, a gang banger will get shot, or a truckload of soldiers will be blown up, nobody panics, because it's all "part of the plan". But when I say that one little old mayor will die, well then everyone loses their minds.”
- “The Joker” by Christopher Nolan in The Dark Knight
In the FDA press release, Gottlieb said they’re releasing information about seizures with the hope of alerting the public. But sadly, there isn’t enough evidence to support the claims, yet. Whether or not vaping leads directly to seizures is unproven and highly unlikely. Author Gigen Mammoser at Healthline.com writes the following:
“Information is sparse, and the link between vaping and seizures isn’t clear. For example, no specific brands or e-liquids are named in the statement. Seizures have also occurred in both first-time users and experienced users alike, making it difficult to identify a pattern of use leading to these incidents.”
Nicotine can lead to seizures
After clarifying what the FDA doesn’t know, let’s begin delving deeper into the actual issue of seizures.
A seizure is an unintended and abnormal surge in electrical brain activity. Most commonly, a seizure is depicted as a convulsive episode when a person shakes uncontrollably. The truth is more complicated than that.
There are seizures called “generalized seizures” which involve the entirety of the brain. And there are smaller ones called “partial (focal) seizures,” which target a specific part of the brain. The latter could grow into a generalized seizure.
According to WebMd, the cause of seizures is mostly unknown. The neurons in the brain exchange electrical impulses which allows communication between the nerve cells. If this communication is disturbed, it can lead to a seizure. Many lifestyle choices that aren’t fully understood could have an impact between this communication. The Mayo Clinic states that even NRTs could cause a seizure:
“Medications, such as certain pain relievers, antidepressants or
smoking cessation therapies, that lower the seizure threshold.”
Yes, vaping contains nicotine and nicotine could be the causal factor in someone’s seizure. Outlawing vaping because of that isn’t realistic and here’s why: Common beverages like coffee, soda, beer, and wine have also been linked to seizures. Lack of sleep, drugs, stress, visual stimuli are linked to seizures as well. Should we outlaw Starbucks, then?
Sadly, many uninformed users misinterpret the intake of vaping liquids and consume it incorrectly. Whether they ingest it in liquid form or chain-vape until they vomit, they do not represent the entirety of the market. Similar to how some vape kits blow up and the headlines allude to scary stories about vapes exploding in pockets and breaking people’s jaws and legs. It is most often because they were not well-versed in battery safety and ohm’s law – which is a necessary step towards sub-ohm vaping. A mechanical mod isn’t an intuitive device anyone can understand. They require reading and studying and maintenance.
The Centers for Disease Control and Prevention (CDC) states that 60 mg of nicotine could lead to death if the person weighs less than 150 pounds. Overdosing from NRTs like nicotine patches and gums is unlikely.
A research study performed behavioral and immunohistochemical studies in rats to understand the mechanisms behind nicotine-induced seizures. They were able to induce seizures in rats by injecting nicotine directly into the amygdala:
“Nicotine at doses from 1 to 4 mg/kg (i.p.) dose-dependently produced motor excitement both in mice and rats, inducing Straub tail and tremor (score 1–3) at low doses (i.e., 1–2 mg/kg, i.p.) and convulsive seizures (score 4 or 5) at high doses (i.e., 3–4 mg/kg. The incidence of nicotine-induced motor excitement including seizures was normally transient and subsided within 10 min.”
—from “Nicotine Elicits Convulsive Seizures by Activating Amygdalar Neurons”
However, the delivery system via the nACh receptors isn’t akin to inhaling nicotine in vapor form. The literature doesn’t indicate the same response exists in humans.
Vaping irresponsibly could lead to having a seizure by nicotine poisoning. If you’ve ever experienced diarrhea, sweating, tremors, etc., it’s likely that you were dealing with nicotine poisoning. Healthline.com proclaims, “it’s extremely difficult, if nearly impossible, to cause nicotine poisoning from traditional methods of consumption, like smoking.”
As we discussed earlier, abnormal electrical activity in the brain leads to seizures because of miscommunication between nerve cells. Drugs and other factors can cause this disturbance. The brain of a teenager is still developing and adding nicotine can mess with nerve cells as they evolve and grow. Teen smoking is strongly discouraged for this reason and is the basis of this anti-vaping war.
The assumption is that nicotine poisoning is what leads to the seizure. Not all seizures are equal and not all seizures share the same causality. Poisoning occurs when someone spills liquid in their eye or skin, or most commonly, swallowing the e-liquid.
Other possible causes involve chronic consumption, also known as “chain vaping.” Smoking e-liquid with high nicotine formulations can also be a factor. Or even worse, chain vaping high nicotine e-liquids.
According to WebMD, the symptoms come in two stages:
During the first 15 minutes to an hour the early symptoms include:
- High-paced breathing
- Quick heartbeats
After a half hour of that, the symptoms diminish into a slower heartbeat, lethargy, feeling weak, diarrhea. During this period is when a seizure could make its entrance.
Nicotine poisoning leading to seizures has been common knowledge long before vaping came into the scene during the mid-2000s. For example, something called Green Tobacco Sickness.
Green Tobacco Sickness is nicotine poisoning caused by handling tobacco leaves. The same symptoms apply (nausea, vomiting, etc.).
Agricultural workers handling the leaves repeatedly come in contact with the tobacco leaves. When the tobacco leaves mix with any sort of moisture, like sweat or rain, it is absorbed by the skin more easily. After continuous exposure to this, green tobacco sickness happens.
Because of Green Tobacco Sickness, agricultural regulations had to be implemented regarding the reduction of exposure by wearing different clothing, cleaning methods, and general handling.
Just like the Green Tobacco Sickness, the JUUL Cartridge Chewing or E-Liquid Sickness, or whatever name will be chosen, should take a lesson from the U.S. Department of Labor and OSHA and apply the same principles. The agricultural equivalent seems a less obvious version of our current dilemma.
It’s difficult to consume the e-liquid from the cartridge because it packs the liquid inside, unless you try hard and break it open, you can’t consume it in liquid form. An adult drinking the e-liquid from a bottle should raise other concerns about mental health rather than the potential of seizures or nicotine poisoning.
A lot of the warnings regarding poisoning involves the direct ingestion of e-liquids. Take basic precautions and avoid this altogether by not drinking e-liquid like it’s an apple juice. Also, keep it out of reach from children.
Is E-Liquid Fatal?
The vape juice (or e-liquid) contained in a cartridge, pod, or bottle can be highly toxic for humans and pets. It must be consumed only in vapor form. Drinking the liquid is toxic.
E-liquid can be purchased in hundreds of flavor options, including dessert flavors, fruits and candies, etc. This can look appetizing to kids and could lead to someone trying to drink it, assuming it’s a beverage. It’s not a stretch to assume that considering the packaging displays donuts and flavors in colorful graphics.
Instead of debating about how toxic a tablespoon of e-liquid is to children and pets, the simple solution is to keep it out of reach from them.
It is commonly documented that a fatal dose in humans is estimated to be around 50-60mg. This is based on a 1969 study on mice and rats that did not involve humans or describes human toxicity in any way. The exact amount isn’t known.
“Nicotine is a toxic compound that should be handled with care, but the frequent warnings of potential fatalities caused by ingestion of small amounts of tobacco products or diluted nicotine-containing solutions are unjustified and need to be revised”
— Bernd Mayer, “How much nicotine kills a human”
Archives of Toxicology at NCBI
Researchers are still performing extensive research on the toxicity of e-liquids and vaping in general. A website called eliquidinfo.org is amassing a list of flavors and their chemical compounds. For example, for “menthol” flavor, you see the LC50(% by volume), cell type, and CAS numbers.
CAS numbers are simply unique numerical identifiers assigned by the CAS (Chemical Abstracts Service):
“CAS Number is a unique numerical identifier assigned by the Chemical Abstracts Service (CAS) to every chemical substance described in the open scientific literature (currently including all substances described from 1957 through the present, plus some substances from the early or mid 1900s)
- CAS Registry Number on Wikipedia.org
Researchers are slowly moving toward a better understanding, but as of today, the science isn’t fully there.
Are PG / VG Safe?
PG: The U.S. Food and Drug Administration gives Propylene Glycol the GRAS rating – meaning it’s “generally recognized as safe”. Yup, the same FDA that does all that other stuff against vaping. That’s probably why the link can only be found using the Wayback Machine.
We know propylene glycol (PG) is a substance used in many products and belongs to the same chemical group as alcohol. It’s basically a runny, odorless, sticky, flavorless liquid. It is used as an additive in foods because it retains moisture and that is useful for preserving food and increasing shelf life. This applies to most processed foods such as pastries, beverages, snacks, etc.
According to Healthline, PG is commonly used as an anti-caking agent, dough strengthener, moisture preserver, texturizer, processing aid, among other things. They also offer the following, reassuring statement, “Overall, apart from people with allergies and one case of excessive consumption, there have been no other reported cases of negative or toxic effects of propylene glycol in foods.”
VG: Vegetable Glycerin receives the GRAS rating as well. Glycerin, to be exact. It is a substance “recognized as safe when used in accordance with good manufacturing practice.”
Common household items around your house probably have VG. Pet food, soap, sugar substitutes, creams, etc. It is recognized as a benign organic liquid with low toxicity when inhaled.
VG is the ingredient which allows for those massive clouds you see at cloud-chasing competitions. Cloud-chasers aim for high VG e-liquids. It’s a chemical extracted from vegetable oil. When passing through the atomizer, it transforms into substantial vapor and is an ideal ingredient for sub-ohm vaping.
When abusing PG and VG, there are several side effects you could experience such as dry mouth, thirst, etc. Much like alcohol causes vomiting when sinking the bottle a little too deep, and a little too often.
Additionally, people tend to panic when they spill e-juice on their skin. They scrub and wash and rub it off in a white-hot panic. That’s understandable, but don’t blame PG / VG for that. Both of those ingredients are harmless on the skin. The problem, however, lies on the nicotine. Remember the Green Tobacco Sickness situation we discussed? It’s the same problem. You want to avoid the nicotine passing through your skin and weaseling its way into your bloodstream causing all sorts of havok.
If you spill some vape juice on yourself, calm the eff down. Wash your hands a few times until it’s fully removed. PG and VG are water soluble, too, so even less the reason to freak out. Lather, rinse, repeat.
Clandestine Vape Liquids
Another concern regarding vapers experiencing seizures is when users purchase clandestine e-liquids. I’m referring to products bought from friends or through other mediums other than regulated vape stores (online or otherwise).
The problem with purchasing clandestine e-liquids is that you don’t know which chemicals you’re getting. That is why ingredients in e-liquids are regulated and must have a GRAS rating with the Food and Drug Administration.
Our hobby receives an onslaught of bans and taxes every time some idiot does something they shouldn’t. Somebody ate a JUUL pod, or purchased off-the-counter, clandestine, illegal CBD oils that are not regulated. Or tried to vape their own, home-made liquid not understanding the chemistry. Look at them now, they’re convulsing on the ground. Call the media! Vaping did this!
The best idea is to vape only proper, regulated e-liquids from reputable stores and companies.
Does Vaping Cause Seizures?
DashVapes provides an excellent observation regarding the FDA’s press release, “they aren’t really sure if vaping could actually lead to seizures but they still announce it anyway.” It’s very common to cry “mean media is fearmongering” but if this isn’t that, then what is?
Before making the claim that X causes Y, let’s interrogate the details. If vaping caused a seizure, why not mention which e-liquid and device were used? Or the seizure history of the person – among other important details. None of this is discussed in the news.
The FDA continues with their investigation of seizures caused by e-cigarettes because it feeds into their agenda, perhaps. They feed it until its nice and plump before the big cookout.
Let’s talk about what we DO know — and what we know about what we don’t know: Chemicals found e-liquids could lead to seizures, but so does soda or coffee. The harsh truth here is that we don’t really know. There is only so much research as of 2019.
There are many possible causes including vaping clandestine e-liquids with improper chemical binding that possibly triggers a seizure. It could be the user’s abuse of chain-vaping and experiencing nicotine poisoning which could lead to said seizure. Another cause could be the person’s disposition or previous history with seizures unrelated to vaping.
The moral of the story is to avoid nicotine poisoning and other factors that could potentially lead to seizures. If you are seizure prone, then probably consuming nicotine is not the best idea.
In this day and age of cringey Tik Toks and teenagers swallowing Tide pods for Instagram likes, we have to remind everyone of common sense, such as “don’t swallow that e-liquid because it’s toxic”, or “keep your e-liquids far from your children’s reach,” just like you would with ANYTHING dangerous.
Having experienced nicotine poisoning myself, I can attest to the fact that it was my own ignorance of nicotine salt formulation at the time. I vaped a lot more than I should’ve and began experiencing vomiting, tremors, and sweating. It’s not a stretch for me to imagine having a seizure at the worst moment of the poisoning. I wish I knew what I was vaping at the time. I wish I’d been informed.