“Do E-cigarettes really cause seizures?” or has the FDA jumped the bandwagon too soon?
There was a special announcement by the Food and Drug Administration (FDA) last week about a new health risk that links e-cigarettes. This announcement although seems alarming was not backed up by sufficient proof and research, some might even say only speculations.
.@SGottliebFDA: “Today, FDA’s notifying the public of a potential emerging safety issue. We have reports indicating that some people who use e-cigs – especially youth and young adults – are experiencing seizures following their use of e-cigarettes.” pic.twitter.com/6jmZecFRPi— U.S. FDA (@US_FDA) 3 April 2019
Just weeks after a statement that the FDA is restricting flavored e-cigs they are not claiming that they have received 35 reports, from 2010 to early 2019, of people suffering from seizures after vaping. These results, however, came from their safety reporting portal, in which users themselves can share their experiences and report any health problems. Whenever any research gathers data where public reports it, it leads to public perception bias leading to flawed study.
E-cigarettes or vapes use nicotine in a liquid form that is inhaled via battery operated heat. This is an alternative to tobacco filled cigarettes that are known to cause many health problems.
According to a study in UK e-cigarettes and vapes were shown to decrease cigarettes biomarkers toxicity in the human body when compared to tobacco filled cigarettes. In this study, the research team measured several parameters including cardiovascular, psychometric, brain activity, quality of life and biomarkers of toxicity.
FDA also made a statement saying the evidence it has analyzed so far doesn't establish a clear pattern or cause for the cases. FDA commissioner, awaiting retirement, said: “We want to be clear that we don't yet know if there's a direct relationship between the use of e-cigarettes and risk of seizure”.
According to FDA out of 35 people that have reported the incidence of seizures in past 9 years, some have also reported the use of drugs in addition to vaping like marijuana or amphetamines (which are known to cause a number of health related issues including seizures). It should also be known that out of these 35 people, some had a prior history of seizures/epilepsy. There was also a lack of information about brands of e-cigarettes and if some users had any previous medical conditions. FDA did not disclose how many people out of these 35 complained of seizures purely due to vaping. Which marginally decreases the credibility of such reports.
A seizure is actually electrical disturbance in the brain that leads to involuntary movement of the body. Seizures can be of different types depending upon etiology and what part of the brain is behaving abnormally. It can range from just abnormal movement of eyes or one arm to full body. A full body or generalized seizure can be associated with tongue biting or losing control over bowel and bladder which can lead to the voiding of urine/feces. There are a number of causes of seizures leading from something as simple as low blood sugar. Other causes may include certain medications, drugs, space-occupying lesions in the brain (tumors), infections or head injury, etc.
According to the Center of Disease Control (CDC), as of 2015, there are 3.4 million cases of epilepsy/ seizures in the United States. Out of these, around 470000 are children and rest are adults. Epilepsy can occur at any time at any age.
The statement by the FDA regarding seizures and vaping also needs to take account of the prevalence of epilepsy among the United States population. Statewide research which should rule of the possibility of undiagnosed epilepsy among e-cigarettes user could also bring light to claims of any relation of vaping to e-cigarettes. This should also take account of usage of drugs, family history of epilepsy, predisposition to seizures as well as diabetes hypertension or other known factors of seizures in addition to vaping. This will lead to a proper unbiased study ruling out or in of any possibility of the relation of e-cigarettes to seizures.
In addition to this, the FDA also said that e-cigarettes and vaping can offer an alternative for smoking addicts to move from tobacco filled cigarettes to something that does not have all the risks.
It should be noted that in the US alone, there are around 10.8 million users of e-cigarettes and vaping under the age of 35.
Any research based on 35 people in the last decades with incomplete information about conditions of use of e-cigarettes can lead to unnecessary panic among the population.
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