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Deaths tied to vaping have occurred mostly among older users

A vaping device.Keith Srakocic/Associated Press/Associated Press

The wave of vaping-related illnesses around the country has mostly befallen young adults, but the patients who died have typically been older — including a Hampshire County woman in her 60s who is the state’s first known death from the malady.

Nationwide, the median age of patients who have fallen ill is 23, the latest federal data show. Eighty percent of them are under 35. Meanwhile, the median age of patients who died is 50.

Older patients could face more complications for a variety of reasons, doctors said Tuesday. The illness, which publicly emerged in late August, appear to be caused by undetermined toxic chemicals in vaping products that can lead to different reactions in people, depending on their age and pre-existing health issues.


Many of the adults who vape with electronic cigarettes, for example, started smoking cigarettes years earlier, so their lung function is already diminished, and perhaps they already have lung or heart diseases.

“There’s a lot of other baggage that comes with getting older, a lot of medical problems that ultimately affect how a person will heal,” said Dr. Sucharita Kher, a pulmonologist at Tufts Medical Center who has treated several adults with vaping-related ailments.

To be sure, younger patients have also died of lung injuries. On Tuesday, New York officials announced a 17-year-old had died, the youngest known victim.

But older adults tend to have other health issues that can worsen the illness.

“Their lungs don’t have the ability to bounce back as much as a younger person,” said Dr. Albert Rizzo, chief medical officer of the American Lung Association.

People with asthma, obesity, heart disease, diabetes, or other lung or heart issues may suffer more because their body is already under strain. The vaping-related lung illnesses lead to low oxygen levels in patients, complicating any of those underlying issues.


“Anything that makes the oxygen levels lower will put stress on other parts of the body,” Rizzo said.

The lungs typically reach peak development in the early to mid-20s then decline after that at varying speeds, depending on the person’s environment or such lifestyle choices as smoking cigarettes or vaping, Rizzo said.

Heavier smokers or vapers are likely to experience more damage than someone who has inhaled toxins less frequently, he said.

Because of medical advances, it’s rare for middle-aged people to die of lung failure, said Dr. Edward W. Boyer, a toxicologist with Brigham and Women’s Hospital and an associate professor of emergency medicine at Harvard Medical School. So the fact that people are now dying from that most likely indicates they already had some lung damage, probably from smoking.

“You’ve already preloaded damage to your lungs, and now you’re heaping on something that’s even more damaging,” Boyer said. “Even if they didn’t smoke, age matters.”

Nationwide, 1,080 illnesses and 23 deaths have been reported. Federal officials say most of the cases seem linked to concentrated marijuana oil vape products, largely those purchased from unlicensed sellers.

However, 17 percent of affected patients interviewed nationwide reported vaping only nicotine. And no single product or chemical has been linked to all cases.

An initial report indicated the Hampshire County woman had vaped nicotine, according to the Department of Public Health, which added that it is still investigating what products she used and where she purchased them. The woman has not been identified.


She was among the 121 suspected cases reported to Massachusetts health officials since Sept. 11. That’s when the state started requiring clinicians to notify the Department of Public Health about patients who vaped and had otherwise unexplained lung abnormalities and worsening symptoms such as trouble breathing, fatigue, chest pain, coughing, or weight loss.

On Sept. 24, Governor Charlie Baker banned the sale of both marijuana and nicotine vaping devices and products for four months, the toughest measure in the country. Other states, such as Rhode Island, have banned flavored electronic cigarettes.

So far, Massachusetts has determined 19 cases in which lung injuries are confirmed or suspected to be part of the nationwide outbreak. State health officials last week released details for 10 of the 19 patients whose cases are at least probably linked to vaping. They were mostly female. Five were under age 20, three were 40 to 49, and two were 20 to 39.

Of the 10, five reported vaping only cannabis oils, four reported vaping both marijuana and nicotine products, and one reported vaping only nicotine. Officials have not specified where any of the products came from.

Kher, of Tufts, urged people who vape nicotine to consult with their doctors and use the state’s free assistance program to help them quit.

“This should be a wake-up call for a lot of people,” she said.

Naomi Martin can be reached at naomi.martin@globe.com. Follow her on Twitter at @NaomiMartin.