Everyone knows smoking is extremely harmful to our health, causing cancer, heart disease and numerous other health complications. Thankfully, smoking rates have declined over the last fifty years as more and more people have come to realize the danger posed by tobacco use.
But what about vaping?
Vaping, the inhalation of an aerosol from an electronic cigarette or other device, has been around for several years but has been in the news a lot recently due to a rash of serious illnesses and even deaths that have been attributed to lung injury caused by vaping.
While the serious dangers posed by tobacco cigarettes are well-established and undisputed, far less is known about the impact of vaping on the human body. The federal agency that regulates tobacco and e-cigarettes, the Food and Drug Administration (FDA), is still evaluating e-cigarettes to determine what types of chemicals they contain and their effects on people’s health.
What Do We Know About Vaping?
Even though vaping products do not yet carry a Surgeon General’s warning about serious health consequences like tobacco cigarettes do, that does not mean they are safe – it simply means that scientists do not yet have enough data and research available to draw firm conclusions about the effects of vaping.
The U.S. Centers for Disease Control and Prevention (CDC) reports that while e-cigarettes generally contain fewer chemicals than found in tobacco cigarettes, they still contain “harmful and potentially harmful substances.”
Some smokers believe that using e-cigarettes will help them quit smoking altogether and take up vaping as a smoking cessation technique. However, there is no scientific evidence that vaping is effective for that purpose.
“Smokers are far better off quitting smoking altogether than they are if they switch to e-cigarettes and under no circumstances should a pregnant woman ever vape,” says Dr. Lynne Tilkin, a primary care physician. “The nicotine in e-cigarettes will harm the fetus, just as with tobacco cigarettes.”
For smokers who want to quit smoking, there are FDA-approved smoking cessation products available, such as patches, gum and lozenges, all of which have proven to be effective. Additionally, your physician can prescribe medication to help break the smoking addiction, as well.
How Does Vaping Work?
When someone smokes a cigarette, he inhales the smoke that’s created by the burning tobacco. The smoke contains nicotine, a highly addictive and fast-acting chemical. The nicotine is inhaled deep into the lungs, goes into the bloodstream and delivers a pleasurable sensation to the brain. This all happens within a few seconds and repeats every time the smoker takes a drag on the cigarette.
When a smoker goes a long time without a cigarette, the nicotine level in the bloodstream diminishes, leading to intense cravings. As the cravings intensify, the smoker can become anxious, irritable and have difficulty concentrating. Nicotine is powerfully addictive.
The vaping process is similar to smoking. The biggest difference is that vaping does not involve burning tobacco. Instead, the vaping device heats liquified nicotine, producing an aerosol that is inhaled. So, the user still gets the nicotine delivered to the brain just like with smoking.
The absence of tobacco and the tar it creates is one of the reasons some believe vaping may be a safe alternative to cigarettes. However, as the CDC has already documented, e-cigarette aerosols are not “harmless water vapor,” as they contain many chemicals and their overall impact on the body is still uncertain. Further, different vaping products contain different chemicals and some clearly seem to pose serious risk, as the recent lung injury outbreak demonstrates.
According to the CDC, “(t)he e-cigarette aerosol that users breathe from the device and exhale can contain harmful and potentially harmful substances, including:
- Ultrafine particles that can be inhaled deep into the lungs
- Flavorings such as diacetyl, a chemical linked to a serious lung disease
- Volatile organic compounds
- Cancer-causing chemicals
- Heavy metals such as nickel, tin, and lead”
Vaping devices go by many different names and come in different shapes and sizes. E-cigs, e-hookahs, vape pens, mods, vapes, tank systems are all types of vaping devices. What they generally have in common is a battery, a heating element and a tank to hold the nicotine liquid.
Vaping & Young People
Unfortunately, there has been a steady increase in vaping among children and teenagers. Due to this increase, and the unique dangers nicotine poses to young people, the U.S. Surgeon General has issued an advisory labeling youth vaping as an “epidemic.”
The CDC reports that in 2019, more than one in four (27.5%) of high school students had used an e-cigarette product within the last 30 days. This is up 1.5% from 2011, meaning greater awareness about the dangers of vaping has yet to slow the number of young people who are doing it.
“While there are a number of unanswered questions about vaping, one thing that there is absolutely no debate about is that e-cigarettes are completely unsafe for children, adolescents and teenagers,” says Dr. Jason Ledbetter, an internal medicine physician. “That is because vaping devices contain nicotine and nicotine is proven to harm brain development, which continues into the mid-twenties.”
And, of course, due to the highly addictive nature of nicotine, any use of e-cigarettes increases the likelihood that a young person will get hooked on vaping or even pick up smoking. Parents should talk with their children about the dangers of both smoking and vaping.
Parents should also be aware that vaping products now come in a variety of shapes and sizes and may not appear to be an e-cigarette. For example, some popular e-cigarette products resemble a USB flash drive, making it easier for young people to take these products to school and elsewhere undetected.
Vaping & Lung Injury
Between March and December 2019, the CDC had catalogued more than 2,500 “hospitalized e-cigarette, or vaping, product use-associated lung injury (EVALI)” cases and a total of 55 deaths associated with vaping-induced lung injury. This outbreak appears to have peaked in September.
Those affected with vaping-induced lung injury reported symptoms including shortness of breath, chest pain, cough, nausea, vomiting, diarrhea, fever, chills and weight loss. Some patients’ symptoms developed over the course of a few days while others developed over a few weeks.
While the CDC and FDA are still studying fluid samples from the lungs of victims and cannot yet draw any firm conclusions, they have noted a greater incidence of victims having used a THC vaping product. THC is the compound in marijuana that produces the high.
The CDC also notes that many of the victims had levels of vitamin E acetate in their lungs. Vitamin E acetate is an additive frequently used with vaping liquids containing THC. While vitamin E acetate is commonly found in foods and cosmetic products and is known to be safe if ingested or applied to skin, it is unknown what its effect on the body is if inhaled, as clearly happened in at least some of the documented lung injury cases.
Despite this correlation, the CDC and FDA are not yet drawing a causation between lung injury and vitamin E acetate and it is important to note that some victims did not have the substance in their body and reported vaping only with nicotine, not THC. CDC and FDA note that while vitamin E acetate “appears” to be associated with many of the lung injury cases, there may be additional causes, as well.
Another commonality researchers have identified is that many of the lung injury victims appear to have obtained their vaping equipment from a friend or informal source. CDC and FDA advise not using a vaping product obtained informally, not using a THC-containing vaping liquid and not using any vaping product containing vitamin E acetate.
The Bottom Line
For now, here is the bottom line on vaping:
- Vaping is never safe for young people and teenagers because it can affect brain development and get them hooked on nicotine, which is extremely addictive. Parents should make sure their kids understand the dangers of both smoking and vaping.
- Vaping is never safe for women who are pregnant.
- For people who currently smoke cigarettes, vaping may be less harmful than smoking BUT it is certain that e-cigarette products contain numerous chemicals and their effects on the human body are still not fully understood.
- For smokers trying to quit smoking, see your physician and talk about prescription medication options and nicotine replacement therapy – these are treatments that are scientifically proven to work and have been approved by the FDA.
- Never use vaping equipment obtained informally from a friend or someone off the street.
- Never use vaping fluid containing THC.
“While there is a lot left for researchers to learn about vaping, it is clear that vaping poses considerable dangers and our advice is simply, ‘don’t do it,’” says Dr. Tilkin. “And on top of the unknown chemicals you are inhaling, the e-cig can explode in your pocket or in your face – we’ve tragically seen people die as a result of such an explosion. The bottom line is, it’s just not worth the risk.”
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