Teenager Rosey Christoffersen loved soccer from an early age, with her enthusiasm matched by a knack for scoring goals. He attended regular training sessions and played weekly matches with a local club, but one season he became alarmed by his rapidly declining fitness.
“I’m gassed,” she told her manager at Wallasey Wanderers in Wirral as she battled exhaustion, pleading to be taken off at half-time. He also complained to his family of chest pains.
She had previously been an occasional smoker, but had taken to using vapers with gusto and soon found it to be a compulsive habit. His local GP surgery assured him that the chest discomfort was likely a pulled muscle.
“He would go to the local store and buy these vape liquids, but you’d never see the same bottle twice,” said Rachel Howe, 45, his mother. “There would be fumes of coconut, cherry and bubblegum. It was constantly in his mouth.”
On Valentine’s Day 2015, he collapsed in the street. Howe said: “A member of the public called me on his phone and said, ‘We’re with your daughter and she’s on the ground.’ Someone called an ambulance.
Both of Christoffersen’s lungs had spontaneously collapsed, a condition known as bilateral pneumothorax. By the time he arrived at nearby Arrowe Park Hospital in Birkenhead, he was brain dead.
“I’m always glad I was spared that moment when it went down,” said Howe, who lives in Wirral. “I don’t know how I would have dealt with it. When I saw her in the hospital, it was like she was sleeping comfortably, but I just knew she wasn’t there.”
Christoffersen’s family was dealing with overwhelming grief, but also with a lingering question: How could a healthy teenager suddenly collapse and die?
His mother asked one of the emergency room doctors if prolific vaping might have been a factor. “We don’t know what we’re dealing with, e-cigarettes,” he told her. “In 10 years we will know the damage we are doing.”
The government is keen to promote e-cigarettes to smokers because evidence so far suggests they have a “small fraction of the risks” of tobacco. Some doctors warn that the rules for the marketing and sale of e-cigarettes in the UK are too lax and say more research is needed into the health risks.
The Observer has revealed in investigations into the vaping industry in recent weeks how one of the leading brands is apparently breaking the rules for promoting vaping to young people on TikTok. Respiratory doctors have also spoken out to warn of “a generation of children hooked on nicotine” and called on the government to urgently review the regulations.
No inquest was held into Christoffersen’s death, and over the years his mother has researched links between e-cigarettes and potentially fatal lung conditions online. Pneumothorax is a rare condition and can occur in healthy adults, but some doctors are concerned that it may be related to vaping.
The newspaper Respiratory Medicine Case Reports reported in May last year a growing association between pneumothorax and e-cigarettes, but said it had not yet been established as a risk factor.
Howe is convinced vaping was involved in her daughter’s death and wants the government to introduce stricter controls on e-cigarettes to stop them appealing to children and young people. “There needs to be a massive investigation into this,” he said. “In the meantime, they should be treated like tobacco and only sold from a locked cabinet behind a counter.”
Christoffersen, who attended Hilbre High School in West Kirby and City of Liverpool College, had a talent for theater as a student, acting in a stage adaptation of Anthony Burgess’s novel. A clockwork orange.. Her mother describes her as “a ball of energy, full of fun”. She loved swimming, loved Liverpool Football Club and was a regular at Wallasey Wanderers, winning a local league and cup when she was with the under-14 team.
He started smoking occasionally when he was 16 and started using e-cigarettes in September 2014, a few months before his death.
Her mother said: “All her friends were vaping. She hated it because she was on it all the time. I think she became more addicted to vaping than she ever was to cigarettes. She started having chest pains and having a little difficulty breathing.”
Howe said she thought vaping was likely the cause, but did not consider her daughter to be at risk of sudden death.
A week after Christoffersen’s collapse, his life support was turned off. His mother was at his bedside as his life slipped away. “I told him to swim, because he loves to swim. It was a little fish. And I asked them to open the window, and these shafts of sunlight came through and shone right through it.”
Christoffersen died on February 21, 2015, three days before his 19th birthday. The previous week he had told his mother that he wanted his organs to be donated to save lives. He donated his kidneys, liver, skin grafts, heart valves and bones for facial reconstruction.
“Afterwards I found out about all the people who had helped, and one lady even wrote to me that she took her liver,” Howe said. “My daughter died and helped save eight people. It’s fantastic.”
Now she hopes another legacy from her daughter will be a warning that e-cigarettes are not risk-free. “I see kids vaping and I go and tell them I think my daughter died because of e-cigarettes,” she said.
Professor Andrew Bush, consultant pediatric chest doctor at the Royal Brompton and Harefield Hospitals and director of the Center for Paediatrics and Child Health at Imperial College London, said he was extremely concerned about the potential adverse health effects of e-cigarettes , and there were cases of acute lung. injuries associated with its use worldwide.
He said: “Lawmakers should take this seriously and treat e-cigarettes like tobacco in terms of advertising and plain packaging.”
A safety review by the Committee on Toxicity of Chemicals in Food, Consumer Products, and the Environment concluded that the risk of adverse health effects from vaping products is expected to be much lower than that from cigarettes. The review found that exposure to particulate matter and nicotine could be associated with adverse health effects and that the effects of inhaling flavoring ingredients are uncertain.
Between May 2016 and January 2021, the UK Medicines and Healthcare products Regulatory Agency received 231 reports of 618 adverse reactions believed to be associated with the vaping product. Since May 2016 there have been three deaths in the UK linked to vaping products.
Wirral University Teaching Hospital NHS Trust, which includes Arrowe Park Hospital, said an initial check of its records did not indicate Christoffersen’s death was reported to the coroner.
He said it was not possible to carry out more detailed checks on the case in the time available.
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