Earlier this month, the U.S. Supreme Court ruled to uphold the Food and Drug Administration’s refusal to authorize the sale of kid-friendly flavored e-cigarettes and vapes, including flavors like cotton candy, sour grape and pink lemonade.
I’m glad they did. It’s widely accepted in the medical profession that vaping is bad for kids.
But the decision comes too late for my step-grandson, Walker McKnight, who died on New Year’s Eve at age 25 after a six-year battle with health problems his doctors attributed directly to vape use.
I met Walker when he was a tow-headed toddler, shortly before my daughter married his father in 2003. He grew up an athlete, competing in gymnastics and elite-level competitive cheer. By the time he went off to Florida Atlantic University on a full scholarship, he was 6-feet-2 inches tall and a muscular 200 pounds
Then he fell victim to the combined siren song of peer pressure and pervasive marketing and in late 2018, bought his first vaping device and a package of mango-flavored pods at a local gas station.
“I thought, ‘They wouldn’t sell them if they were dangerous,’ and everyone was using them,” he told us later. “I told myself I could quit any time I wanted to, but I would just get all twitchy if I didn’t have one.”
His parents didn’t know about his vaping, so when he fell ill in early 2019, they didn’t suspect anything. Doctors near the campus diagnosed him with flu and gave him antibiotics and steroids. But his condition worsened, and when he came home from school that March, his parents took him straight to the local emergency room, where he was diagnosed with pneumonia and admitted to the ICU.
And then it got really bad.
Walker was placed on a respirator, put in a medically-induced coma and hooked up to an ECMO machine that took over for his heart and lungs. Doctors identified the culprit as an adenovirus, but were surprised it had taken hold in such a robustly healthy college athlete.
Then his parents cleaned out his dorm room and found a stash of used JUUL pods. Once they reported his vape use to his doctors, it solved the mystery of what had weakened his lungs so much that a typically mild virus could push him to the brink of death. The diagnosis was changed to EVALI – e-cigarette or vaping product-associated lung injury.
Critical care specialist Dr. Charles Hunley with Orlando Regional Medical Center said he had treated a number of vaping-related cases up to that point, adding that Walker’s case “was the worst I’ve seen so far.”
For many weeks, Walker drifted in and out of consciousness as doctors worked to keep his lungs from collapsing and his organs from shutting down.
“He begged us to just let him die,” said his mom, Candy, a critical care nurse. “No one can imagine what it is like to watch your child go through that.”
When he finally left the hospital in July, Walker was 80 pounds lighter, his body scarred from all the surgical procedures to keep him alive. He was tethered to an oxygen tank and had damaged kidneys and only one working lung.
The next five years would be a roller coaster for Walker and his family. There was joy when he survived a double-lung and kidney transplant, then sadness when his body rejected the organs more than two years later. In the last two years, his health declined at an increasing pace, and doctors finally told the family there was nothing more to be done.
Once Walker understood that the life he had planned was gone, his goal became to use the time he had left to make a difference for those who hadn’t yet set foot on the same road. When he was able, he spoke at middle and high school assemblies, warning of the dangers of vaping. He spoke with TV stations and anti-tobacco organizations and was the focus of an article in “People” magazine.
The last time I saw Walker this past fall, he was too weak to get out of the car, but even with his ravaged body, exhaustion and struggle to breathe, he gave me one of his megawatt smiles. That same smile shone out from a framed photo at his memorial service in January, where his parents urged everyone to be as angry as they are.
According to the Centers for Disease Control, 1.6 million middle and high school students in the U.S. regularly use e-cigarettes. A 2024 survey showed that 88 percent of them use flavored e-cigarette products, despite those now being technically illegal.
The CDC notes that adolescent brains are particularly susceptible to the adverse effects of nicotine, the addictive ingredient in vape pods.
“Nicotine can harm the parts of an adolescent’s brain that control attention, learning, mood and impulse control,” according to the CDC website. “No tobacco products, including e-cigarettes, are safe, especially for children, teens and young adults.”
Vape manufacturers and marketers insist their product is a safe and valuable alternative for smokers who are trying to quit. But I’m not sure whose legs they think they’re pulling. Do they really believe a 40-year-old longtime smoker needs a hit of “Killer Kustard” or “Strawberry Milkshake” to effectively transition away from cigarettes?
Yolanda Richardson, president of the Campaign for Tobacco-Free Kids, noted the FDA authorizes the sale of only 34 e-cigarette products, none of them fruit- or candy-flavored.
“But manufacturers continue to flood the market with thousands of illegal, unauthorized products,” she said in a written statement.
Kristy Marynak, a senior scientist at the CDC, said recently that the growth in sales of unapproved products has been “explosive.” “The number of brands increased by 46 percent over two years to about 200 brands, and those brands market thousands of products,” she said early this year. “This is an industry that is very motivated to stay in business and continue marketing products that are highly addictive and heavily flavored.”
I don’t have a problem with adults buying and using nicotine products. Hey; you’re a grown up; you want to trash your lungs, be my guest. But marketing these harmful products to kids is WRONG and needs to stop.
It can be tough to know if a young person is using vapes, since they are typically compact and inconspicuous. The devices – which can look like pens or USB sticks or even asthma inhalers – use a battery to heat and aerosolize the flavored liquid, which is then inhaled into the lungs.
Kids can easily conceal them in sleeves or pockets or hoods, and they don’t give off any tell-tale odor or sound.
Groups like parentsagainstvaping.org and truthinitiative.org are working to educate people about the dangers of vaping in young people, and are working to pass legislation to even more tightly regulate the way tobacco products are marketed and sold in the U.S.
Walker’s mom was happy to learn I was writing this column.
“People need to talk to their kids about this. They need to work with their kids’ schools and their friends’ families to make sure everyone is on the same page.
“If we can get the message about vaping out to other families, maybe we can prevent what happened to our son from happening to someone else’s kid. It’s your worst nightmare.”