Toxic Company: The Vaping Crisis in the LGBTQ Community by Jonathan Lucero McKinney

We are amidst an epidemic. By now, I’m sure you’ve heard about the vaping crisis that has resulted in 18 confirmed deaths in 15 states. As the death toll rises, many states have decided to ban the sale of vape liquids altogether. In fact, e-cigarette or vaping products have been directly tied to significant lung injuries across nearly every state in the country. Wake up and listen, because we are especially vulnerable to these health consequences. LGBTQ folks are more likely to smoke than straight cisgender people. About one in five people in our community report smoking cigarettes, and the trend for vaping products is the same. The 2018 Behavior Risk Factor Surveillance System showed that those identifying as lesbian, gay, or bisexual are more than twice as likely to vape than those who don’t identify this way. Just go to one of Providence’s gay bars and see for yourself.

We have risk factors that make us vulnerable to the corporations selling these products. The stress and stigma that our community faces with understanding our sexualities, identities, and how we fit in this world can make us think that puffing our problems away is a useful, albeit short-lived, solution to our issues. We are also targeted by aggressive marketing efforts. In the mid 90s, large tobacco companies initiated a marketing campaign called Project SCUM (Sub-Culture Urban Marketing) to target LGBTQ populations. As if the name doesn’t already tell you that these companies didn’t have our best interests in mind, these enormous corporations still push their products through bar sponsorships and promotional efforts at Pride events to specifically increase their visibility to our community.

Since LGBTQ individuals are five times less likely to reach out for smoking cessation assistance, and are also less likely to have health insurance (where a health professional could help you quit), it is abundantly clear that the influence these corporations have over us is staggering. Once they hook you on their products, it’s an extremely difficult habit to kick. Many vaping products are marketed as smoking cessation tools, but the fact of the matter is that they’re extremely addictive. Kevin Burns, CEO of Juul, agrees with the Centers for Disease and Control (CDC) saying, “If you’ve never used nicotinecontaining products, don’t start!”

Concern continues to grow now that we’re seeing this outbreak of lung injuries and deaths related to vaping. We still need more research to identify what chemical or chemicals are causing these toxic effects, but it has been reported that lung infection from contaminated e-liquids or dirty vaporizers is likely not the cause. A local gay man, Stephen, states that “I started vaping to help me quit cigarettes, but found them too harsh on my lungs, so I stopped.”

Most afflicted users reported a history of using THC-containing products, which is the substance in marijuana that makes you feel high. It’s not likely that THC is the culprit. Recent CDC findings indicate the cases could be caused by the additive vitamin E acetate, unknown additives, or vaporized byproducts in the e-liquids.

Stephen commented about his use of THCcontaining vape products, “I love the taste from the marijuana vapes. It’s a different high and just feels cleaner.” He went on to say that if he could still buy them locally, he would.

Stephen, who was found sipping a drink at Mirabar, along with three other LGBTQ individuals I interviewed for this story, declined to have a picture taken or to reveal their full names. All of them stated they wouldn’t want friends, family, or employers to find out about their vaping. There seems to be a negative stigma attached to the behavior, and although there are some people who vape who are outspoken, there is still fear of public judgment. LGBTQ individuals may initially start vaping to escape stress, but find themselves driven to keep quiet about doing it.

Dr. Philip Chan of Open Door Health comments, "Vaping is an increasing public health concern. There have been recent reports of lung injury cases associated with the use of e-cigarette and vaping products, including here in Rhode Island. In general, nicotine is highly addictive and the use of e-cigarettes or vaping products is unsafe for all ages and especially youth and younger people."

In fact, around 80% of the vape-related lung injuries are in people under 35 years old. The Rhode Island Department of Health released data to show that LGBTQ youth vape at higher rates than straight cisgender people. Teens in Rhode Island are encouraged to text HOPE4RI to 88709 to obtain the facts on vaping and get help quitting.

The staggering number of cases of vape-related illness has led Massachusetts to put a four-month ban on vape sales, declaring it a public health emergency. Other states in New England have followed suit, citing concerns for public health. It will take some time to determine if any of it is safe. For the time being, the CDC has published some symptoms to watch out for in vape users. Cough, shortness of breath, chest pain, nausea, vomiting, diarrhea, fatigue, fever, and abdominal pain could all be signs of something serious. Symptoms can occur over a few days to several weeks.

Rhode Island Department of Health Director Nicole Alexander- Scott comments, “Every person in every community in Rhode Island deserves an equal opportunity to be healthy, regardless of their sexual orientation, [and] part of giving everyone an equal opportunity to be healthy means educating everyone about the serious health risks associated with vaping, and educating everyone on the fact that those health risks are 100% preventable. Help is available today for anyone who wants safe, effective tools to help quit vaping or smoking at no cost.”

We all know someone who vapes, or perhaps you do it yourself. The alarm is sounding and the time is now to take a step in the right direction to stop vaping. As part of the LGBTQ community, we understand that life may throw more obstacles our way than other individuals. Deciding to vape or smoke is not a healthy way to deal with these struggles. We’ve been subjected to outrageous marketing campaigns that have lined the pockets of smoking and vaping corporations for far too long. Becoming an advocate for ourselves and our friends is the only way we can get a grip on this epidemic.

Jonathan Lucero McKinney is a clinical consultant and medical writer passionate about public health education. He lives with his boyfriend in Providence.