The truth about vaping

The long-term effects of vaping are still unknown, but it’s become clear that vaping and e-cigarettes are addictive and potential gateways to combustible cigarettes.

Anti-tobacco advertising, smoke-free environments, increased tax on cigarettes and society’s outlook on smoking has drastically curbed smoking rates amongst New York State high school students.

In fact, New York has the lowest smoking rate in the country at 4.3 percent, down from 28 percent two decades ago. While this is certainly good news for New Yorkers, vaping has almost replaced cigarette smoking — New York has the highest rates of vaping with 20 percent of high school students using e-cigarette/vaping devices. Teens are now vaping instead of smoking cigarettes.

Vaping may seem like a smoking cessation tool, but more data is needed to demonstrate whether or not e-cigarette/vaping devices are safe and effective. Hopefully, the FDA will regulate these devices, including the amount of nicotine in these products with accurate labeling.

Until then, vaping doesn’t seem to be going anywhere anytime soon. Here’s what’s happening.

Vaping methods and harms

Vapes, vaporizers, vape pens, hookah pens, electronic cigarettes (e-cigarettes or ecigs) and e-pipes are some of the many terms used to describe electronic nicotine delivery systems (ENDS).

These products use a liquid, or “e-liquid,” that most often contain nicotine, as well as varying compositions of flavorings, propylene glycol, vegetable glycerin and other ingredients. The liquid is heated into an aerosol that the user inhales.

ENDS may be manufactured to look like conventional cigarettes, cigars or pipes. Some, called Juuls, resemble pens or other everyday items like flash drives. Larger devices, such as tank systems or mods, bear little or no resemblance to cigarettes.

E-cigarettes have the potential to addict a new generation that might not otherwise have experimented with traditional cigarettes. They contain nicotine, which is as addictive in cigarettes as in vaping devices and e-cigarettes. If these devices are not regulated and this trend continues, it’s almost certain the rates of smoking among youth will increase, reversing the great progress in smoking cessation and tobacco use.

There are currently 466 electronic and e-cigarette brands and 7,764 unique flavors. Some flavors can cause popcorn lung (bronchiolitis obliterans) — a term named after workers at a popcorn factory were exposed to diacetyl, the buttery flavor, causing a bad reaction. That same type of flavoring is used in many e-cigarettes. Severe burns and injuries have also been associated with e-cigarette explosions.

Tobacco manufacturers are also in on vaping. The company that sells Kool sells Blu. Marlboro sells Mark Ten and Camel sells Vuse.

Basically, these Big Tobacco corporations are replacing their old cigarette customers with new, younger customers they hope to keep for a lifetime by promoting a new product.

There are currently 466 electronic and e-cigarette brands and 7,764 unique flavors.

Uncrowning Juuls

Waves of teenagers are using Juuls. Some are calling it an epidemic. These devices electronically heat nicotine into a vapor and can be recharged through a computer’s USB port. Manufacturers have targeted younger populations by offering various flavors such as bubble gum, Captain Crunch and Reddi-wip.

Why are Juuls and these vaping devices so attractive? The federal government is looking to find out. Just weeks ago, FDA Commissioner Scott Gottlieb, MD, called on Juul and two other vaping manufacturers to investigate how they are notifying young people of potential harms and to learn why they are so appealing.

With Juuls coming in various shapes and sizes, it’s easy for kids to sneak the device into school and use at will. They are also being used to inhale synthetic marijuana.

Scary but true vaping facts

  • More than 85 percent of e-cigarette users (ages 12-17) use flavored e-cigarettes.
  • The most frequently reported reasons for vaping among teens: Flavors, friend or family member uses them and they think they are safer than other tobacco products.
  • Nine out of 10 young adult e-cigarette users said they use e-cigarettes flavored to taste like menthol, alcohol, fruit, chocolate or other sweets.
  • More than 51 percent of e-cigarette-related poisonings were children 0-5 years old.
  • E-cigarette calls to poison control increased from 1 in 2010 to 215 in 2014.
  • E-cigarette calls more likely to report adverse effects such as vomiting, nausea, eye irritation.
  • Ingesting 0.5-1.0 mg/kg of e-liquid can be lethal.

Patricia Folan, RN, DNP, is the director of the Northwell Health Center for Tobacco Control. A registered nurse with more than 30 years of experience, she has presented research and tobacco control information at local, national and international conferences, and she is member of the Tobacco Control Committee of the American Thoracic Society.