New York is still grappling with the surge of cases of serious health problems associated with the use of e-cigarettes. Across the state, the most recent figures list 182 cases of vaping-related illness: some definite, some under investigation.
There are some cases of EVALI (e-cigarette or vaping product use-associated lung injury) everywhere across the nation, like a Detroit case that led to a double-lung transplant.
While the state Health Department is listing totals and counties where the cases occur, it is not telling local health departments who is ill and where that person lives. Cases are even reported to the state's Poison Control Center rather than to local health departments.
Niagara County Public Health Director Daniel Stapleton said the speed of the arrival of these cases may be overwhelming health processes.
"Until this got national attention, there was no request for this type of information," Stapleton said. "I think it's been a fact of catching up and now that actually these cases were being identified and providers knew to identify them, it went up significantly."
Stapleton said vaping and the chemicals involved are pushing back against years of success in persuading people to quit smoking, especially among young people who experience the "invincibility factor" that the chemicals in the gadgets cannot harm them.
"Used to be, when we were combatting tobacco use, we saw a progressive decline in the number of people who were smoking," he said, "but then what happened about five years ago, you started seeing e-cigarettes use increasing and it completely wiped out the decrease we had in smoking, at least for the last five to 10 years."
Stapleton is dealing with at least four cases, while the remaining 178 cases or suspected cases are spread across Erie, Orleans, Cattaraugus, Chautauqua and Genesee counties.
"By the time you do know what it is, because you are looking for signs and symptoms, the case may be progressing or it may have ended its course," he said, "but the problem is that you don't know until those signs and symptoms are showing."