[Originally published: December 3, 2017. Updated: September 25, 2019.]
In the past week, hundreds of new cases of vaping-related lung disease have been reported to the Centers for Disease Control and Prevention, a top agency official told Congress on Tuesday, September 24.
Last week the CDC said that a mysterious lung disease has thus far sickened 530 people. The total number of fatalities in the U.S. due to vaping related illness now stands at nine.
What, if anything, can be done to curb what has become an epidemic of vaping among tweens and teens?
As early as December 2018 the Surgeon General of the United States, Jerome Adams issued an advisory declaring e-cigarette use among teens an epidemic. It contains information for parents, teachers and health professionals.
The Surgeon General’s advisory, was issued following a finding that e-cigarette use has increased dramatically in the last year. It was a call to action. Dr. Adams said, “We must take action now to protect the health of our nation’s young people…” The increase in e-cigarette use was the largest one-year spike of any kind in the 44 years that substance abuse by young people has been tracked.
Vaping and marijuana use are now more common among teens than cigarette smoking, with nearly 1 in 3 12th graders reporting using some kind of vaping device in the last year. The survey of 8th, 10th and 12th graders confirmed that teenagers’ use of alcohol, tobacco, prescription opioids and other stimulants has either dropped or remained static at last year’s record-low levels, but that the popularity of vaping devices continues to rise.
The study went on to say that when 12th-graders were asked what they believed was in the vaping mist, more than half (51.8%) said “just flavoring,” even though the devices are most often sold with nicotine.
The New York Times quotes Thomas J. Glynn, a former director of cancer science at the American Cancer Society, who lauds the decline in tobacco use, calling it, “an astounding accomplishment in public health.” But, he adds that despite inconclusive evidence on the risks of vaping we, “have to have alarms out.”
If you are like me, you have some vague notion of what vaping is, but you couldn’t explain it if you tried and until recently you had never even heard of Juuling.
Our teens are vaping in large numbers so let me attempt to clear away some of the mist.
The Facts about Vaping
Vaping-What is it?
According to the National Center on Addiction and Substance Abuse (NCASA) vaping is the, “act of inhaling and exhaling the aerosol, often referred to as vapor, which is produced by an e-cigarette or similar device.”
Teens seem to have gotten the message that smoking real cigarettes is a bad idea but many are under the misapprehension that vaping is a safe alternative. According to the CDC vaping is all the rage among teens. High schoolers are doing it and increasingly, middle schoolers are as well.
The Delivery System
E-cigarettes were introduced to the mass market in 2007. Instead of smoke they produce an aerosol that looks like water vapor. That vapor can be delivered via any number of vaping devices (including e-cigarettes, vape pens, USB memory sticks called Juuls and advanced personal vaporizers which are also referred to as ‘MODS’). The e-cig looks like a standard cigarette, the vape pen looks like a large pen and the Juul like a thumb drive.
All vaping delivery systems have the following in common: a mouthpiece, a battery, a cartridge that holds the e-juice or e-liquid, and a heating component. The basics of the mechanism are that a heating element powered by the battery heats up the heating component which then turns the e-juice into a vapor which is inhaled into the lungs and then exhaled.
What is Inhaled?
NCASA states that, “The e-liquid in vaporizer products usually contains a propylene glycol or vegetable glycerin-based liquid with nicotine, flavoring and other chemicals and metals…The e-juice can contain varying amounts of nicotine. Some people use these devices to vape THC the chemical responsible for most of marijuana mind-altering effects…”
E-cigs can be used to vaporize opiates and synthetic substances as well. There are thousands of flavors of e-liquids.
Is Vaping Safe?
There are those who argue that vaping is less harmful than smoking, but almost no one asserts that vaping is entirely safe. It’s important to reiterate that many teens think that it’s a completely safe alternative to smoking cigarettes. Further, they have little idea what they are inhaling and many believe that they are not smoking. You can vape a product with or without nicotine.
Nicotine-we know that nicotine is addictive and vaping over a long period of time can lead to nicotine addiction.
Nicotine-free e-cigs-even without the delivery of nicotine, studies have shown that the chemicals found in e-cigarette liquid, flavorings and aerosols are unsafe. The particles released by the vapor contain “varying amounts of toxic chemicals, which have been linked to cancer, as well as respiratory (popcorn lung), and heart disease.”
There is also concern that vaping is the gateway to harder drug use. Additional research is needed to ascertain the safety or lack thereof of the chemicals inhaled during vaping.
It is, however, safe to say, that NOT vaping is better for you than vaping. It MAY (not clear yet and depending on whether you are using nicotine-free e-cigs) be marginally better than smoking conventional cigarettes, but it is NOT better than not smoking at all.
Why do the kids love it?
Kids love vaping because it’s fun, tasty, easy to conceal and their friends are doing it. There are a multitude of flavors to indulge in and they can do vape tricks with the vapor (YouTube has a plethora of “how to” videos). A starter pack is relatively affordable and easy to get.
According to the National Institute on Drug Abuse, under FDA regulations designed to protect the health of young Americans, minors can no longer buy e-cigarettes in stores or online.
Furthermore, the FDA now regulates the manufacture, import, packaging, labeling, advertising, promotion, sale, and distribution of e-cigarettes.
Dripping is relatively new delivery system. It delivers a stronger hit, denser smoke and a more intense taste. Dripping is manually dropping e-cigarette liquid directly onto the hot coils of the vaping device.
The Juul is just another type of vape pen in the form of a device that resembles a thumb drive that has in recent years become popular among younger kids because of its diminutive size and its pod system which make it easy to use.
In a recent Boston Globe article called Juuling, “The Most Widespread Phenomenon You’ve Never Heard of” and referred to it as, “a new front…in the never-ending game in cat and mouse between teenagers and adults.”
Young kids can easily get their hands on a Juul even though the website says that its products are for those 21 and older.
You can find much more information on vaping at:
Office of the U.S. Surgeon General https://e-cigarettes.surgeongeneral.gov/getthefacts.html
The National Institute on Drug Abuse https://www.drugabuse.gov/publications/drugfacts/electronic-cigarettes-e-cigarettes
The Centers for Disease Control, https://www.cdc.gov/mmwr/volumes/65/wr/mm655051a2.htm
The National Center on Addiction and Substance Abuse https://www.centeronaddiction.org/e-cigarettes
The New York Times https://www.nytimes.com/2017/12/14/health/teen-drug-smoking.html?hp&action=click&pgtype=Homepage&clickSource=story-heading&module=first-column-region®ion=top-news&WT.nav=top-news