Ashley Clay, MSPAS, PA-C
According to the National Institute of Health, vaping is on the rise—a survey of 12th graders revealed a 9% increase in vaping among that group, from 28% to 37%, in a one-year time period, from 2017 to 2018.1 The National Youth Tobacco Survey indicated that more than 5 million middle and high school students reported using e-cigarettes, one million of those on a daily basis.2
The CDC and FDA analyzed the results and concluded that many adolescents believe that electronic cigarettes are not as harmful as conventional, standard cigarettes, attributing to increased use among youth.3
As vaping is becoming more mainstream among American youth, concern surrounding unknown long-term health consequences of vaping is in the forefront. This is particularly true with recent outbreaks of vaping-related illnesses, that have affected both youth and adults. As of January 14, 2020, the CDC reports 2,668 vaping-related hospitalizations or deaths in all 50 states, Washington D.C., Puerto Rico, and U.S. Virgin Islands. Visits to the emergency department for vaping-related symptoms was at an all-time high in September of 2019, with 116 visits per million.4
What are E-Cigarettes and What is Vaping?
Electronic nicotine delivery systems (ENDS) have a variety of names: e-cigarettes, e-cigs, vape stick/pen, mod, and vape pod to name a few. Contrary to what the term “vaping” suggests, users of e-cigarettes do not inhale water vapor. An ENDS device heats a chemical liquid mixture into an aerosolized form that the user inhales into the lungs delivering nicotine, flavorings, and other ingredients, which can include THC (the addictive, psychoactive substance in marijuana), metals (like lead, nickel, tin), vitamin E acetate, and other chemicals that either are known to be carcinogenic or that have not been determined to be safe for inhalation. Vaping devices vary in appearance; some may be small and look like a cigarette while others may be larger and customized—they can also be disposable or rechargeable.
Why is Vaping Concerning?
There are multiple reasons to be concerned about vaping. ENDS products can vary widely in concentration of ingredients, including nicotine levels. Nicotine, the addictive substance in tobacco, causes damage to the developing brain (your brain develops until roughly 25 years of age)—this damage to the brain can affect attention span, mood, and impulse control.5 Vaping has been shown to bring on symptoms of nicotine dependence in youth,6 and use of e-cigarettes may be an invitation to young people to further experiment with other addictive substances, like alcohol and drugs, or turn to traditional burned cigarettes or cigars.
Evidence suggests vaping causes cardiovascular and lung injury. By inhaling the aerosol produced by e-cigarettes, the tiny particles that get introduced into the lung (both from the liquid solution and the actual device itself) bring about increased blood pressure, changes to resting heart rate, and damage to cells that line blood vessels.7
Lung injuries caused by vaping have been in the news recently. Much research is being done by the CDC and other health authorities to identify the causes of lung injuries in users of vaping products. So far, an ingredient in vaping products, vitamin E acetate, has been linked to lung injury. Vitamin E acetate is found in food and skincare products; it is also used as an additive in vaping products, most commonly in those containing THC.8 While vitamin E acetate causes no injury when ingested or used on the skin, it is harmful to the lungs when inhaled. Even though vitamin E acetate has been identified as a likely contributing factor, the CDC warns that further investigations are underway—and other causes of vaping-related lung injuries may surface.
Vaping poses a risk to pregnant women as the chemicals can harm a developing fetus. Vaping is also dangerous for bystanders as the chemicals are toxic, even secondhand. Vaping devices have been known to overheat and explode, causing burns and other injuries. Their liquid can also leak, causing burns, or even nicotine poisoning if it is absorbed through the skin or ingested.9
Is Vaping a Safer Alternative to Regular Cigarettes?
Controversy exists regarding using electronic cigarettes as a tool to stop smoking traditional burned cigarettes. E-cigarettes have fewer harmful chemicals than burned cigarettes, which kill half of people who smoke them long-term.10 However, less chemical exposure does not make e-cigarettes a healthy alternative. It is important to remember that currently the FDA has not approved e-cigarettes as a smoking cessation tool. Nicotine replacement therapies—including patches, gum, and lozenges—are still the preferred aid for quitting smoking.11 Anyone who vapes should be aware of the risks and immediately seek medical attention if they develop symptoms associated with vaping-related health issues, such as:
- Fever, loss of appetite, weight loss
- Cough, shortness of breath, chest pain
- Nausea, vomiting, abdominal pain, or diarrhea12
How Can I Stop using Tobacco Products?
If you use tobacco products, it is never too late to quit: Talk to your healthcare provider today. For free assistance (including smoking cessation programs, building a quit plan, information on nicotine replacement therapy, and smoke free apps) call 1-800-QUIT-NOW or visit smokefree.gov.
1 NIH News in Health, “Vaping Rises Among Teens,” National Institutes of Health, https://newsinhealth.nih.gov/2019/02/vaping-rises-among-teens
2 U.S. FDA, ” Youth Tobacco Use: Results from the National Youth Tobacco Survey,” https://www.fda.gov/tobacco-products/youth-and-tobacco/youth-tobacco-use-results-national-youth-tobacco-survey#1
4 Centers for Disease Control and Prevention, “Outbreak of Lung Injury Associated with the Use of E-Cigarette, or Vaping, Products,” https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html
5 Centers for Disease Control and Prevention, “Quick Facts on the Risks of E-cigarettes for Kids, Teens, and Young Adults,” https://www.cdc.gov/tobacco/basic_information/e-cigarettes/Quick-Facts-on-the-Risks-of-E-cigarettes-for-Kids-Teens-and-Young-Adults.html
6 Truth Initiative, “E-cigarettes: Facts, stats and regulations,” https://truthinitiative.org/research-resources/emerging-tobacco-products/e-cigarettes-facts-stats-and-regulations
8 “Outbreak of Lung Injury Associated with the Use of E-Cigarette, or Vaping, Products.”
9 World Health Organization, “E-cigarettes: how risky are they?” January 20, 2020, https://medium.com/@who/e-cigarettes-how-risky-are-they-de469b1cd334
10 “Quick Facts on the Risks.”
11 SmokeFree.gov, “What We Know About Electronic Cigarettes,” https://smokefree.gov/quit-smoking/ecigs-menthol-dip/ecigs
12 Marisa Cohen, “What Are the Early Warning Signs of Vaping Illness?” https://www.webmd.com/lung/features/vaping-illness-symptoms#1