Rosie Christopher has been passionate about soccer since she was a child. Her love for the game has been complemented by her natural talent for scoring goals. She regularly participates in training programs and competes in weekly matches with a local club. However, during one season, she was shocked when her physical condition rapidly deteriorated.
I'm so angry," she told her coach at Wallasey Wanderers, because she was exhausted and asked to be taken off during the halftime break. She also complained to her family about chest pain.
She used to occasionally smoke, but started using flavored e-cigarettes and soon found it to be a compulsive habit. A local general practitioner assured her that her chest discomfort was likely due to a pulled muscle.
She would go to local stores to buy these e-liquids, but you would never see the same bottle twice," said Rachel Howe, the 45-year-old mother. "Coconut, cherry, and bubble gum flavored e-cigarettes are always in her mouth.
On Valentine's Day in 2015, she collapsed on the street. Hao stated: "A member of the public called me and said, 'We are with your daughter and she is on the floor.' An ambulance was called.
Rachel Howe, 45, is calling for more research into the impact of e-cigarettes and stricter legislation regarding their sale to young people. She strongly believes that e-cigarettes were the cause of her teenage daughter Rosey Christoffersen's death. Photo: Gary Carlton/The Observer.
Both of Kristoffersen's lungs collapsed spontaneously, a condition known as bilateral pneumothorax. By the time she arrived at Arrowe Park Hospital in Birkenhead, she was already brain dead.
I always felt relieved when she narrowly escaped injury after falling," said Hao, a resident of Willer. "I don't know how I would have coped if something had happened to her. When I saw her in the hospital, she looked like she was sleeping comfortably, but I knew she was gone.
Christopher's family is facing a great deal of grief, but they're also struggling with a stubborn question: how could a healthy girl suddenly collapse and die?
The mother asked an emergency doctor if her daughter's heavy use of electronic cigarettes could be a factor. "We don't know what we're dealing with when it comes to e-cigarettes," he told her. "We'll find out the damage we're causing in 10 years.
The government is keen on promoting e-cigarettes to smokers as evidence thus far suggests that they pose little risk compared to tobacco. However, some doctors have warned that marketing and sales regulations for e-cigarettes in the UK are too lax and that further research is needed to assess their health risks.
The Observer has recently uncovered that one of the leading brands in the e-cigarette industry has apparently disregarded regulations on promoting e-cigarettes to young people on TikTok. Respiratory doctors have also sounded the alarm on "a generation of children addicted to nicotine", calling for urgent government action to revise related regulations.
No investigation has been conducted into Kristofferson's death. For years, her mother has been researching the possible connection between electronic cigarettes and deadly lung diseases online. While pneumothorax is a rare condition that can occur in seemingly healthy adults, some doctors are concerned that it may be linked to vaping.
In May of last year, the journal "Respiratory Medicine Case Reports" reported a growing association between pneumothorax and e-cigarettes, but stated that it has not yet been established as a risk factor.
Hao firmly believes that electronic cigarettes played a role in her daughter's death, and she is calling for stricter government control over these products to prevent their appeal to children and young adults. "There needs to be extensive research done on this," she said. "In the meantime, they should be treated like tobacco products and only sold behind closed and locked counters.
Christopherson attended Hillbre High School in West Kirby and Liverpool College and had a natural talent for drama from a young age. She performed in a stage adaptation of Anthony Burgess' novel "A Clockwork Orange." Her mother described her as "a lively ball full of fun." She enjoyed swimming, supported Liverpool Football Club, and was a regular player for the Wallasey Wanderers, winning local leagues and cups in the under 14 age group.
She started smoking occasionally at the age of 16 and began using e-cigarettes in September 2014, a few months before her death.
Her mother said, "All of her friends are vaping, and it bothers me because she's always doing it. I believe she's more addicted than ever before. She's started experiencing chest pain and some difficulty breathing.
Hao stated that she believes vaping might be the cause, but does not believe her daughter is at risk of sudden death.
After a week of being hospitalized, Christofferson's life support was eventually turned off. Her mother was by her bedside as she slowly passed away. "I had her swimming because she loved swimming. She was a little fish. I had them open the windows and the sunlight came in and was shining directly on her.
On February 21st, 2015, three days before her 19th birthday, Kristofferson passed away. The previous week, she had expressed her wish to donate her organs to save lives. She ultimately donated her kidneys, liver, skin grafts, heart valves, and bones for facial reconstruction.
Later, I discovered all the people she had helped, including a lady who even wrote to me saying she had received her liver,” said Haou. “My daughter may have passed away, but she saved eight lives. It's incredible.”
She now hopes that her daughter's legacy will serve as a warning that e-cigarettes are not without risk. "When I see kids vaping, I tell them that I believe my daughter died from it," she said.
Professor Andrew Bush, a pediatric respiratory consultant at Royal Brompton and Harefield Hospital as well as director of the Imperial College London's pediatric and child health center, has expressed deep concern over the potentially harmful effects of e-cigarettes on health and the emergence of cases of acute lung disease linked to their use across the globe.
He said, "Legislators should take this seriously and regulate e-cigarettes in advertisements and packaging in the same way as tobacco products.
According to a safety review by the Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment, the risks of electronic cigarettes on health are expected to be far lower than those of traditional cigarettes. The review found that exposure to particles and nicotine may be associated with adverse health effects, while the impact of inhaling flavorings is still uncertain.
Between May 2016 and January 2021, the UK's drug and healthcare regulatory agency received 231 reports, of which 618 adverse reactions were deemed to be associated with e-cigarette products. Since May 2016, there have been three deaths in the UK linked to e-cigarette products.
The teaching hospital at Wirral University NHS Foundation Trust (which includes Arrowe Park Hospital) has stated that initial checks of their records do not indicate that Christopherson's death was reported to the coroner.
However, it is not possible to conduct a more detailed investigation into the case in the short term.
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