Hurricane Dorian Update; Lung Illness And Vaping

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This message comes from on point sponsor indeed. If you're hiring with indeed you can post a job in minutes set up screener questions than zero in on your short list of qualified defied candidates using an online dashboard get started at indeed dot com slash n._p._r. Podcast from n._p._r. P._r. and w._b._z. You are boston magnetron already and this is on point hundreds of otherwise healthy. Young people are suffering from serious lung injury that seems to be linked into vaping. It's heightening concerns about the ubiquity of e cigarettes especially amongst teenagers so we'll talk about that a lot a little later this hour but i today let's talk talk about hurricane dorian almost unimaginable devastation it has wrought on the bahamas and where hurricane doria is headed next and if you're anywhere endurance path we'd we'd like to know what you're seeing or have seen and experienced now. You'll remember that when dorian win over the bahamas it was a category five hurricane that time and it stalled over the bahamas for more than twenty four hours staying at a category five the images that we're seeing out of the bahamas are almost unimaginable total devastation in parts of of the islands here's bahamas prime minister hubert minutes in a news conference yesterday saying the bahamas faces quote one of the greatest national crises in our country's history and then and he said this of the twenty five individuals that were transported to new providence to has already succumbed that would take the debt the number. That's two seven again. I want to show uninformed beaming population relation that'd be can expect more dense to be record. That's the prime minister of the bahamas hubert minutes. We'll joining us now. From nassau in the bahamas is morgan chessy n._b._c. news correspondent morgan welcome to on point and tell us what have you seen that has it's been just stay wild past thirty six hours here in the bahamas is going as showed the truth devastation that it's brought to specifically the northern islands here and you just heard the prime minister you're outside the home full basalt where those victims from avocado and had been brought the military helicopter two ambulances here on across it silent and then they've been receiving much needed medical care here and following that statement by the prime minister on to add that that number will likely be going coming up in the days ahead. I'll just striking because his parents he was a physician so whenever i spoke to him he says it's an especially hard because he knows just how how much damage hurricane can bring but following that and says that in his lifetime and never seen such a powerful storm strike with such detail consecutive sustained amount of times and that's really what is set for into port kit advocate weiland where i made landfall with wind gusts recorded of more than two hundred and twenty miles an hour hours and a sustained whenever that one hundred seventy five miles an hour tornado was bringing speed through about that same amount but only for seconds or minutes any time whereas doing who's bringing these winds for hours leveling everything in the past right now. This is one of the first days that relief and rescue efforts are really beginning in earnest on both sides <hes> simply because during and let the remnants of dangerous conditions both the year that kept a a lot of people from approaching does hard at every grand bahama on avocado island and we're now seeing that agencies able to go into avocado which dude with clean drinking water to help the five or six thousand people many of which are now homeless in that area and are all six hundred grand bahama workflow is a significant concern to the right right so grand bahama. I'm seeing here at least three out of every four homes on grand bahama underwater the airport under six feet of water and avocado island island as you mentioned a couple of times morgan the aerial footage that we're seeing coming out of there. It's unrecognizable as a place of habitation and civilization totally pulverised so billions of dollars at the very least of damage here <hes> what what what additional help do does the bahamas need lead and <hes> you know cannot aid make its way in i think from a health standpoint in need absolutely every bit of help. They can get automobile fronts. This is an unprecedented stored that has done catastrophic damage to these islands to the point where they may never looked the same simply because the power power of door and then a lot of these uninhabited smaller orlands i'd have been covered by that storm surge even after during passes and never be seen again from source standpoint are of course those emergency aid isn't going in to help those longer ground <hes> but the prime minister saying that this is a process that take years to recover from especially when you hear the early reports that about half of our buildings on avocado in grand bahama are either damaged or describing <hes> you mentioned billions. I don't disagree with that number at all important to note that these agencies are just now getting in we walk the dentist is brought to a lot of these areas <hes> for days or weeks to come simply because the damage is so severe <hes> a lot of these spots lots of slow inaccessible at this point in time <hes> we do know that airstrips are being cleared off of debris but there's not much you can do whenever they have flood waters. Where's that are covering as you mentioned that airport runway freeport which is still managed. We've seen videos of the police news in the flooded so i as long as the bahamas descent struggles is and then either the heinous people are <hes> are doing well morgan chessy n._b._c. You see news correspondent joining us from nassau in the bahamas morgan. Thank you very much. Thank you magna so obviously the bahamas have weeks months even years years of recovery ahead of the island's but hurricane doreen is now moving towards the east coast of the united states it has been downgraded from that previous category category five rating but here's jacksonville florida mayor lenny curry urging residents to remain vigilant about hurricane dorian. He spoke yesterday. This is no time to rest and i think that everything's gonna be okay. This is still very serious. Storm effects that are gonna come through our coast and could affect low lying areas well joining us now is lindsay kilbride reporter quarter for w._j._c. t in jacksonville florida lindsey welcome to on point. Thank you for having me so first of all. What are you seeing there in jacksonville and bill <hes> and how is florida preparing for what might come with dorian well as you know. It's been a slow crawl this hurricane so we're all sort of just waiting at this is point <hes>. There's a lot of evacuations mandatory evacuations two big zones here in jacksonville had mandatory evacuations. I know that's the same for almost all coastal title cities in in florida and up into georgia as well <hes> so it's kind of a question of people are are actually heating those calls. I know we've had a few the big storms over the past few years. <hes> you know there were a lot of category five hurricanes in the atlantic in two thousand six two thousand seven but then it was almost a decade until matthew you in two thousand sixteen when we really saw this again and then since matthew <hes> it's just been <hes> erma maria michael now dorian <hes> so breath at least <hes> matthew and irma really impacted jacksonville and people are sort of just comparing the storm to what's it going to be most like. Is it going to be <hes> like erma. Where we saw a a lot of inland flooding we saw <hes> areas that never thought they would get flooding <hes> their houses just filling up with water and sort of like the north in west area of jacksonville. I think you mostly expected at the beach. Which is what we saw with matthew. It's looking like it's going to be closer to something like matthew because it is skirting <music> outside of florida whereas irma kind of went <hes> kind of southwest over florida so we were on the storms east side and that brought some really unique conditions nations that we're not seeing this time <hes> but you know we're. We're just kind of waiting it out. I mean we've been waiting for so long to see like is it. Coming is going to impact us. We're going to see we were still going to see that flooding. We're going to see really really high surf and it's really gonna probably impact the the more coastal beach area <hes> which is what happened during in matthew sorry to interrupt their good. I was just gonna ask you to to remind us <hes> sort of what what the impact of matthew was. If it seems like at least where you you're in florida right now might be a little more like be a little bit more like that sure i'm so with matthew it really impacted a city just south of us which is in our listening area as well which was saint augustine <hes> which so so with fat we had just entire roads just chunks of roads on the coast just missing seeing just being pummeled by the water. A lot of businesses and homes were flooded as well <hes> so we already see a lot of beach <hes> <hes> a lot of the sand is being a road really badly even just overnight even though it's not even here yet so i think people are kind of thinking more of the beach areas are going to be impacted acted i see now. I'm seeing reports here. Meteorological reports that say that the carolinas might be facing a triple threat of high winds and flooding rain and storm surges <hes> and as you said it maybe perhaps not not that bad in in in jacksonville right now but still as as the mayor said no time to to to relax. Are there evacuations going on or have there been going. They've been going on in jacksonville. Yes aso evacuations were ordered earlier this week. I believe sunday afternoon for jacksonville and then some of the other cities ordered the same <hes> on sunday and monday as as well <hes>. It's <hes> i would say that we are. We are expecting some of the same conditions <hes> you know sixty five sixty five mile per mile per hour gusts along the coasts <hes> but it's a little different story inland which is sort of like forty mile an hour gusts but sustained winds of thirty five fifty four miles per hour is what <hes> the latest i've heard from the national weather service meteorologist. That's here in jacksonville <hes> so so that's kind of what we're expecting obviously like the storm. Surge is probably expected to be half of what we saw during irma which is good news because that is really what impacted people dylan jacksonville. I mean every a lot of people's homes were destroyed. Just completely gutted. I mean it really impacted some of these low income communities in the northwest area who who never expected it and just you know like a nearby tributary completely overflowed in their homes were waist-deep. We don't think that's going to happen this time which is good news but it's still going to be a lot higher than normal normal right now. We already have <hes> some really high levels and our river. We just don't have these other conditions. Irma brought which was we had an incredible amount of rainfall. We had this big sow you know push of win that just completely drenched us so lindsey we just have about a minute left to go and he named all those storms big-name storms and i'm thinking at the same time we're uh-huh hurricane season is by no means over this year. I mean have these the the frequency of these big stores. How has it changed life in jacksonville saville. Yeah i mean there's a lot of talk about is our cities sustainable. <hes> with the you know the sea level rise with these <hes> new you storm so it's definitely something that we're they're calling local officials to take notice and take seriously well lindsey kilbride reporter for w. J. c. t. at n._p._r. Appear a member station serving northeastern florida. She's with us from jacksonville florida lindsey. Thank you so much indefinitely. Stay safe. Thank you well. When we come back. We will talk about about the mysterious vaping related illness that some doctors are saying maybe turning into an epidemic this point this message it comes from an points sponsor indeed when it comes to hiring you don't have time to waste you need help getting to your shortlist of qualified candidates fast with indeed post a job in minutes set up screener questions then zero in on qualified candidates and when you need to hire fast accelerate your results with sponsored jobs new users can try for free when you sign up at indeed dot com slash n._p._r. Podcast terms conditions and quality standards supply starting college can be overwhelming everyone from almost every background. Has that fear that they got in here by accident. That's scary. N._p._r.'s kid is here to help. Make your freshman year a little easier. Listen to n._p._r. Life kids new guide on college sports subscribe to life kit all guides for all the episodes all in one place place. This is on point magnetic roberti. We're gonna spend the rest of the hour talking about a spike in reports of vaping related illness. It's including being severe shortness of breath vomiting fever fatigue c._a._t. Scans revealing young lungs filled with cysts. Najah lls the doctor so far have reported more than two two hundred people across the country with this mysterious long illness that seems to be linked with vaping. There's been one fatality thus far in illinois and public health officials in oregon said last night. They're investigating another death. They think could have been caused by this vaping related illness now the center for disease control and prevention and the food and drug administration say say they are working tirelessly to get to the root of seemingly new respiratory disease but there's still a lot of questions about exactly what's causing it and if that means something about the safety of vaping and e cigarettes so we want to hear from you d- vape <hes> what are your questions what questions for health experts about this vaping isn't related illness join us anytime on point radio dot org or twitter and facebook at on point radio. We'll any us from chapel hill. North carolina is ilana jaspers jaspers. She is a professor of pediatrics microbiology and immunology at the university of north carolina chapel hill. She's a toxicologist and the deputy director of the u._n._c. center for environmental all medicine asthma and lung biology professor jaspers welcome to you hi how are you. I'm doing well. Thank you so much for joining us today. Also yeah also with that's from queens. New york is dr melody peraza. She's the chief of pediatric pulmonologist at new york university's winter hospital on long island dr peraza walk. Ah peres per sorry prasada. Forgive me dr prada welcome to you. Hi how are you. I'm doing very well so the first full dossier presider you've have you seen <hes> cases of this faith vaping related illness. Yes i have and i have seen cases it mid july who presented very different ways one of them presented with <hes> acute respiratory distress and <hes> had a a very rough <hes> i._c._u. Admission full life support for one week and he's doing well now and the second case is more of a chronic exposure for three months to raping and he had weight loss twenty up to twenty five pounds in three months and cough and fever and nigel's in the long okay and so how is it that it seems as if we hadn't heard of cluster of cases before now is there's something about vaping recently that has suddenly made all these pop up about what that is a million dollar question why now how but <hes> it is for my experience with those two patients of dave are vaping t._h._c. which were take <hes> dave using not the the the regulator to product but from the dispensary is but <hes> the ones we try made maybe someone spaceman aw garage so they are homemade products and i believe that now that it is becoming becoming more and more popular among teenagers <hes> they choose a product which can be faked and cheaper and that might be the problem. I see now we eat. We dare not regulate okay so we did reach out to jewel in one of the biggest e cigarette manufacturers to see if they join us they declined but they sent us a statement that includes <hes> quote weak men c._d._c. for its investigation and we will continue individuals monitor all reports we have no higher priority than product safety which is why we have implemented industry-leading quality controls and then there statement goes on to say <hes> that reporting also suggests that many patients were vaping t._h._c. regardless those reports reaffirm the need to keep all tobacco nicotine products out out of the hands of youth and jewel underscores that they do not sell t._h._c. in their jewel cartridges but professor jaspers. There's a are you surprised by the sudden reports of vaping related illness. I'm not exactly sure that all of this is just something that has been happening since july. I'm and maybe dr. Prasada can sort of comment on that. When i've been <hes> we've been i'm doing good related research for a couple years now and it's been giving talks at different institutions and i usually ask the audience or physicians or healthcare providers within the audience <hes>. Have you seen anybody that has come in that presented with cough or symptoms that are sort of very broadly describing respiratory related illnesses <hes> and very often. I've heard from healthcare providers. These are respiratory therapists or pulmonologist and they've <hes> you know what i've seen something like that <hes> they sort of reported they thing <hes> but i didn't really should have you know pay much attention to this on so i think these these cases they may have been more isolated over the past two three four years and more <hes> more dense in certain areas <hes> since june july but i think some of these cases have been here before and it's just now there's increased awareness to make the link between vaping <hes> andy's acute respiratory <hes> lung injury. I see the actually that leads me to what was going to be my next question in which is a cd f._d._a. C._d._c. lead investigation going on right now. But can we say for certain that we're calling it vaping related but can we you say for certain at all. The vaping is what's causing these illnesses. I think that's part of the investigation at c._d._c. is doing right now. One of the problems <hes> <hes> that is on the c._d._c.'s facing is when you look at 'electronic health records which is one of the ways you could actually do a systematic analysis of love whether they were vaping <hes> whether these injuries are vaping belated not he's like twenty calls records have very poor documentation an off vaping and vaping history <hes> dr prasada can probably comment a lot better on this than i do <hes> when you look at sort of what physicians and healthcare providers the options they have in terms of documenting vaping history up until very recent. There's very little little these <hes> you know in in in addition to <hes> doctor's notes which have to be handwritten notes. There's not really a good dropdown menu. There's no icy the nine or ten code <hes> that would give doctors option. Yes this is vaping related. It's not really classified in any kind of electronic health records. I see so dr prasada. Would you like to comment on yes. Yes that's a very good point. As a matter of fact we use one of the <hes> <hes> rally establish a electronic health record system called a pitch at n._y._u. Winthrop and and what is happening is <hes>. There is a smoke cessation very <hes> strong. You know you have to make sure that you ask after a certain age to all our patients have smoking history etc but there was no waiting history as a matter of fact i was going to that's one of my my <hes> goal that i'm going to talk to the people and try to put that in that's an extremely good point <hes> yes. It needs nice to be integrated to electronic health record size now. I'm looking at a joint statement here from the f._d._a. And the c._d._c. and it says it's quite lengthy but a part part of it says more information is needed to better understand whether there's a relationship between any specific products or substances and the reported illnesses at this time there does not appear to be one product involved in all the cases although t._h._c. and cabinet wade's use has been reported in many cases so i mean dr preside. I suppose there's a lot of people listening right now. Who might just want to know. Should i be vaping or not. Should i just not use products. Teach i mean what would you advise. People okay so i'm a pediatric pulmonologist. I'm a clinician and we know that anything you inhale which has chemicals in it is not good for foia so initially in two thousand seven when these e cigarettes were created they were <hes> teetered was people who are doing traditional channel smoking and would like to quit because as you know nicotine is an addictive substance and they would gradually convert convert into eastgate and then gradually enough even the e cigarette but recently this practice has been changed and now all the your youngsters you even the middle school and high schoolers are thinking maybe that this is a cool thing and even they do not have nicotine addiction day start to rape so if you are not you haven't started vaping i would become and very very strongly not to start and if you do if you have started raping and you are doing vaping i would definitely go with the regulated product as far as t._h._c. an e cigarette and and even try to come off because now there's more and more evidence that is <hes> suggesting all these chemicals can have even long-term effect <hes> okay professor jaspers. What's your thought on that. Yeah yeah i i i take a more <hes> potentially radical approach to this <hes> i i do think that <hes> isa roots while they were or originally designed and invented to for smoking cessation. I think from the get go they were marketed and there's tributed to really also so attract. <hes> you know young adults when you look at the original sort of advertisement that was going on in two thousand eight two thousand nine with you know it was basically taking a page out of the tobacco industry playbook you know having this sort of sex appeal very you know very young hip kind of people people doing this. You are attracting not your sixty five year old c._o._p._d. Two packs a day smoker. You're actually attracting potentially new new and young adults so i think from the get-go it was the market <hes> or or the market that they tried to explore and land was including young adults <hes> now one of the things that that's really on really urgent now. Is you have a lot of these fourteen fifteen sixteen year old kids who because they were attracted to jewel and other pod based systems and the e cig industry now addicted to nicotine eighteen and what do we do with these kids now. <hes> there's really nothing <hes> not much that that we can do for them in terms of really tweeting pharmacologically treating nicotine addiction and attendance and that's something that's really urgently urgently-needed because we now have a generation <hes> on that is really sad on we now have generation that is nicotine addiction that would normally not have tried nicotine and professor gestures if i may i mean you you're you're you're not saying the word jewel but presume you really mean jewel because they're the they're the big product here in the east cigarette market and if i can just return to a statement easement that we receive from jewel i mean they emphasize that quote regardless of the fact that <hes> that first of all that <hes> as i mentioned before that some of the patients were vaping t._h._c. and you'll goes on to say quote regardless those reports refer reaffirmed the need to keep all tobacco and nicotine products out of the hands of youth through significant actions actions and regulation on access and enforcement. We must also ensure illegal counterfeiting copycat products which may be made with unknown ingredients and under unknown own standards and those that deliver control substances that those stay out of the market so ju ju. They're saying you know they stand by their product but that it might be these counterfeit products that potentially live teach seeing them. That are the problem well. That's you know that's all good on but i don't think to be quite honest and to be very blunt. I don't think we would be in the situation that we have now had you not been invented and been on the market so yes while they are now realizing this is probably a product <hes> and i'm not going to the safety of their product or the quality control of their product. I'm not doubting that <hes> but what i am saying is. I don't think we would have twenty to twenty five or even thirty percent of high. Schoolers addicted to nicotine and using pot hot based systems had you'll never been on the market and there are a lot of sort of copycat products. Now that are mimicking jewel because jewel has been so successful successful so <hes>. That's you know i think they're they're trying to do the best they can now on but i don't think we would be in in the situation situation that we have now had you not been <hes> put on the market and twenty sixteen fifteen. Let's go to tyler who's calling from sioux city iowa tyler. You're on the air. Hi <hes> though my question was how how is it that still go ahead tyler <hes> hi <hes> yeah i was wondering why the <hes> why these injuries we're just happening now recently and in such a large amount given that they've been around for over a decade and there are many people who see improvement in lung long function who used it as a smoking cessation tool and why is it that these injuries are only isolated to the united states of america. We're not seeing them in europe europe when when baby gets popular there's well. He asked a good question. Let me turn it back to our panel here tyler. Thank you for your call. Dr presente the tyler's question russian about have there been global incidences of this or is it just located in the u._s. It seems like right now. We are seeing it more in the u._s. But <hes> maybe maybe they are not recognizing just like a professor justice comment earlier <hes> it might have been around but because people blonde not thinking they might have just thought that it is a different type of respiratory infections type or or <hes> <hes> just <hes> viral infection so <hes> yes. That's a very good question but we might be recognizing. It's more now. Let's see later to reap professor jasper. Did you a share your thoughts on that yeah so one of the big differences between the the u._s. or the products that are allowed on the u._s. Market and the products that are distributed on the european market is nicotine content <hes> on the european mark from what i understand. <hes> no product is allowed that has more than two percent by volume nicotine content. <hes> jewel is at five and a lot of the knock of jewel. Usual products are up to eight percent of nicotine so nicotine content. <hes> jewish actually has a european product which is at one point five or one point seven percent nicotine whereas the u._s. product at five percent nicotine so the products are actually slightly different and what is being used in europe is is a different product and what we have in the u._s. That could be a big difference. It's just a pure matter of juice okay well. We are talking this hour about this. Mysterious potentially vaping related illness. That's popped up in more than two hundred people in the united states prompting c._d._c. investigation into its and we're joined today by professor ilan jaspers asperger's she is professor of pediatrics microbiology and immunology at the university of north carolina chapel hill. Dr melody presider joins us as well. She's chief of pediatric pulmonologist at n._y._u. Winthrop hospital in long island new york and we want to hear from you. What are your questions about. This vaping related illness is it just commander of counterfeit products coming into the u._s. market or do you have bigger questions about e cigarettes overall. This is on point <music>. What do all of these people haven't common kamla harris. Keep food adjudge and bernie sanders. They're all running for president and they've all sat down with us on the n._p._r. N._p._r. Politics podcasts appeals gonna drive me crazy. We are going out on the trail with as many of the democratic presidential candidates as we can and bringing you in indepth interviews with them. Come along by subscribing to the n._p._r. Politics podcast this is on point. I magnin <unk>. We're talking about this. Mysterious vaping related deleted illness. That's popped up in the united states prompting c._d._c. investigation and we want to know what your questions are about it now. Jewel is the big company in the east cigarette world and you alab ceo. Kevin burns spoke to c._b._s. This morning last week about the c._d._c. Investigation and the fact that some of these severe aveer lung diseases seem to be linked to the use of e cigarettes and here's what burns said c._d._c. is leading the investigations obviously in close contact with them so are working with that. We'd like to get their charging the investigation. We'd like to get all the specifics that we can. We want to make sure we have access to the information. So if there's any issue that was driven associate with us that we get to the root cause understand that that's jewel c._e._o. Kevin burns now former f._d._a. Commissioner dr scott gottlieb spoke to c._n._b._c.'s squawk squawk box team last week to talk about these mysterious illnesses and here's what he said about his views on what he thinks is jules culpability here where they bear responsibility here because they've put these sticks in the hands of the kids and now the kids are going out and buying these illegal pods they can take steps to try to crack down on some of these kind of products themselves they prob- they can't reengineer their product to not be compatible compatible with these counterfeit products unless they file an application with f._d._a. Because what they've stuck with is the product that they ahead on the market as of august of two thousand sixteen they could be bringing a new product on the market that might be foolproof against counterfeit <hes> pas but they'd have to go through the application process and so far. They've been reluctant often to do that. That's former f._d._a. Commissioner dr scott gottlieb. Let's go to harrison who's calling from edgar town massachusetts harrison. You're on the air. Hi ah yes thank you <hes> my father has smoked cigarettes and barrow on for about forty five years he ran into some long related issues and thankfully he quit cigarettes but he still oh continue to smoke pot in effort to help save any sort of healthy as since switch to the vaping products which have t._h._c. in it is he actually better off just sticking with the plant based product as opposed to the ave product. Thank you harrison. Thanks for your question professor lawn adjusters. You have a response for harrison so oh so this is. This is an interesting question and i don't so chemically speaking. I'm not sure i know the answer to that but sort of behaviorally speaking <hes> when you when you smoke pot <hes> you have a defined start and an end for you know four years sort of pot smoking session you have joint you start lighting it up there. I don't know twelve fifteen hits per joint and then you are done with these vaping t._h._c. on devices. There's less of a the flying star in an end. When you load your t._h._c. oils or waxes into your vaping device you can get many many many more puffs then then you would get out of a single joint so the dose will probably change the number of puffs of number of hits you take from vaping t._h._c. <hes> versus actually smoking joint is going to be quite different so i'm sort of not exactly sure how to address this but this is something really to considering considering. If you're one of the things you may want to ask your father is how many hits he actually takes now versus <hes> how many hits he took when he was just smoking a joint joint and professor jaspers before we go any further. Let me share my extreme apology to you kept. I keep mispronouncing your first name for some reason. My brain is just not processing basic information properly today. Luna jaspers and i do it right that time down warriors okay well so sue so dr presided. Let me ask you a follow up question. What professor jaspers said i'm wondering about the <hes> the actual oils or the chemicals that the nicotine is suspended in in in in the pods in the cartridges are are those harmful or safe. Do we know now. They are actually quite harmful. Role in an e cigarette go tambi up to fifty sixty chemicals <hes> so it is it is actually quite hey to dangerous but if you're talking about the t._h._c. for that <hes> a person who is asking the question it is a really really important if he's going to do the vaping he needs to get it from a dispensary not go and just get get it <music> out in the street because that is what is making this very very difficult for us <hes> for our cart which form the patient that we had and we send it to the department of health and initial results came back to the scene with vitamin e. in it and any kind of oil when you start got inhaling into your lungs time potentially cho's lightweight night is which is <hes> quite a dangerous and <hes> my recommendation would be to <hes> if that's a very good point with the hits but also if he's to continue vaping it has to be a licensed dismay well if i can just jump in here and say dr presided forgive me for interrupting but but a completely take your point about buying the product from licensed dispensaries but this is where once again we run into the issue of young people right of teenagers because we have a lot of states as raising raising the age of purchase to twenty one so where they're where they're going to get it. What are they usually get this stuff and also <hes> for obvious reasons seasons dispensaries. The product is much more expensive so they would like to go for the cheaper product. Yes well. Let's go back to our callers. Let's go to marley who's calling from buffalo new york marley. You're on the air hi. I'm just calling more a <hes> like personal. Uh-huh perspective. I used to smoke a lot and then i switched over to vaping and i used to not be able to walk up a flight of stairs. Now i can run on a treadmill milford five miles without stopping and i do understand the point that <hes> your guests was making about how there is no real real start and stop like with a cigarette you light it you stop and then you know you wait till you're next cigarette or this can be continuous but even so with that. I still see an improvement in lung function. I still see an improvement in overall <hes> like there's less fatigue throughout the day <hes> and and i i i know that a lot of this conversation is focusing on the children. That's getting into the hands of the kids which i think obviously is a huge problem and does need to be more regulated but to just throw out the entire. It's like okay so there's two hundred cases that have seen across the u._s. Vaping is now being demonized in a huge huge way. My state of new york is saying that now they want to ban any further they shops from opening and even no there are cigarettes in every single store every single grocery store. I saw one at a toys r. restaurants. I saw that cigarettes are so i mean i just i. I just don't think it's necessarily i don't wanna say fair. You know can't everything with a broad brush but i do think that e cigarettes are helping some people like my marley extra. Thank you very much for your call and professor jaspers. <hes> let me turn back to you here. Is there a risk of an overreaction here so marley. Thank you so much for for that call. I think that's actually a very very good point. You're bringing up <hes> they have been a few clinical studies now looking at <hes> vaping as a cessation mm tool <hes> and i have not seen anything that convinces me that it is a really effective and long-term way of is getting people off of nicotine <hes> but you know again. We're early in the process and i i would love to be convinced otherwise professor can should've been here because 'cause we did also reach out to the vaping technology association. They're the trade group. <hes> for e liquid cigarettes etc they sent us also a lengthy statement and in fairness the beginning of it they they strongly encouraged us federal investigation to go on and be comprehensive but then they also say that quote importantly major medical groups and governments have conclusively determined that vapor products are ninety five percents safer than combustible cigarettes and and studies have shown that they are nearly twice as effective at helping adult quit smoking than traditional methods okay so i didn't mean to sort of jump in there but i'm sorry <hes> <hes> so those two statements came from the u._k. <hes> and the ninety five percents state of safer statement came from public health england <hes> which which basically used very early first generation e cigarettes and looked at the number and concentrations of known carcinogens that are in cigarettes and basic compare them to what came out of an e cigarette and e cigarette had ninety five percent less of these <hes> chemical christina jones. That's that's not a fair comparison comparison because it's a very different product. Why would you soom but the same things are coming out of an e cigarette as they are coming out of a cigarette so that statement was made ah way back in the twenty in two thousand fifteen but public health england the other study that was cited by the vaping twice as effective as cigarette or as other other conventional products that is also a clinical study that was conducted in the u._k. Where e cigarettes actually increase the number of <hes> people <hes> having successful cessation from <hes> ten percent to eighteen percent or nine point nine percent to eighteen percent. The problem in that study was that after a year the eighteen percent that had used e cigarettes or still nicotine-dependent whereas the people that use conventional therapies actually completely kicked nicotine dependence so i think we need to really carefully look at these clinical trials and look at these data. I look at these statements <hes> before you know we sort of using a broad stroke no having said that <hes> i don't want to sort of throw e cigarettes completely out as a potential cessation tool for those on like the caller from from new york <hes> for those who really used them effectively as a cessation too. I do think that they may have a place in our society to do that but it needs to be regulated in that fashion and cannot be just accessible to everyone and <hes> without having any kind of you know prescription for over matter term well and our caller. Marley from new york was also concerned about people who use e cigarettes becoming demonized by this process and did not want that to happen for sure. Let's go to daniel calling from annapolis maryland daniel. You're on the air all right. How are you doing all right which is yeah. We're with you daniel. What's your comment involved. In factor of a <hes> cigarette excuse and there is nicotine and these new pod system is twenty times paper fate <hes> typically it's suspended and vegetable glycerin and propylene glycol which can be found a lot of medicine daniel so sorry to to cut you off there but your line is really shaky and i think people might have had a tough time hearing you so let me turn to dr prada here and say that dan daniel daniel was saying that he has worked in the e cigarette in the vaping industry and he was he believes that the new pods have a much higher concentration of nicotine gene and that that is what he thinks is causing these illnesses your thoughts on that unfortunately i do not have have any comment on that because the patients i took care <hes> they did not have nicotine issue. It was all but i would imagine agean <hes> i'm going to ask professor jasper who seems to have more experience with nicotine area and get your thoughts on this because i cannot comment on okay nicotine content on a professor gestures. Go ahead yeah so so on the i e cigarettes so came on the market had about one point two to three point six percent <hes> nicotine and and the regular cigarette. It's i believe it's about weight by volume about one point. Five five and these <hes> jewel has five percent to six percent and these new sort of knock off <hes> you know systems pot systems have up to what i've seen lately eight percent. That's ridiculous. High amount of nicotine <hes> that you know should be should not be allowed. I mean it's ridiculously high and so suddenly occurs to me you know a lot of the concern <hes> public health concerns around conventional cigarettes was with those combustion in products and not only what they do to the lungs of the person's smoking the cigarette but that second hand smoke do we know of what health effects if any the vapor coming out of e cigarettes might have to as a secondhand source yeah that's that's a really interesting point and and really an open question and and and i think there were a few there's a handful of articles that have reported health effects linked to secondhand beeping exposure through certainly art should be because i mean these are aerosols that are going to be available to summer mild and they're going to be inhaled by the person next to the vapor so <hes> <hes>. It's not been investigated enough. It's a really really good question. Don't you present factly right. Most likely there is going to be a link because because there are ultra fine particles which are going to be released with the raping and if you are next to that person absolutely okay. I believe that there will be issues with that down the line but <hes> so you believe that we do. We don't yet have conclusive studies around that. It's it's an area not not yet but it is common sense that if you are weeping and there is the smoke coming out with all these <hes> chemicals emiko's in it the person who is next to you will be inhaling it to okay so. I believe that there will be issue. I want to sneak one last call in here. Camello l. is calling from baltimore maryland camille. You're on the air. We've got about thirty seconds to see if we can get your your your comment in here. Hi very briefly my nineteen year also experienced a situation where he was vaping with friends. He passed out had a sustained heart rate of one hundred and seventy beats per minute per minute in the e._r. For seven hours it was it's quite scary and the doctor said he would have gone into cardiac cardiac arrest had we not been there to catch him when he passed out and call nine one nine one one so so from a parent perspective is quite alarming and there needs to be increased education <hes> pertaining to what you're getting a lot of times. These kids don't know what they're smoking right. It's a great point. Thank you so much for calling. I hope your son's doing alright. Professor jaspers got thirty seconds left here. What do you what do you think about camille said yeah. I hear you're absolutely absolutely right on. There's been actually a study that came out where with the questionnaire and they actually questioned you know the the demographic that you're that her son is in whether <music>. I'm you know what they're vaping about. Forty percent of the kids basically answered no. I'm just vaping flavors and water <hes> your their urine analysis show that they had high <hes> ah nicotine metabolite so a lot of kids don't even know that they are vaping high nicotine products and slowly actually pretty rapidly become addicted to nicotine well. Meanwhile as i mentioned we're seeing a lot of states raising the e cigarette buying asia twenty-one and just very recently michigan michigan became the first state to ban those flavored e cigarettes so a lot of attention to this on the state and federal level professor ilana jaspers professor pediatrics microbiology and immunology at the university of north carolina chapel hill. Thank you so much for being with us. Thank you for having dr melody presider chief of pediatric pulmonologist at n._y._u. Winter possible on long island dr prada thank you you thank you meghna chucker bardy. This is on point.

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