Electronic cigarette use is increasing among middle school and high school students. More than 3.5 million of them used e-cigarettes in 2018, according to a report from the Centers for Disease Control and Prevention (CDC). Though they may not contain tobacco’s cancer-causing tars, they do contain its addictive substance, nicotine. No matter what you call it, Vaping or E-cigarettes, it’s still smoking and still highly, highly addictive and all the flavored additives can cause pneumonia and more serious issues.

Juul, the company with a 72% market share in e-cigarettes, has promoted them as a way for adult smokers to quit tobacco and protect their health. But in the past two years, “Juuling”, or vaping with other products, has become an alarming trend among teens, and one that public health officials fear could turn into a nicotine addiction epidemic.    

The recent news regarding nearly 200 illnesses and one fatality linked to vaping are further raising concern. So far, the illnesses are thought to be tied not to commercial e-cigarettes but to the vaping of THC (the psychoactive ingredient in marijuana) oils and waxes. In addition, there has been an alarming increase in cases of pneumonia in people who vape. The hardest-hit state is Wisconsin where medical and recreational cannabis is illegal. When products are not legal and regulated, there is more chance for dangerous street formulas to be used.

E-cigarettes work by electronically heating up a mixture of nicotine salts, glycerol, propylene glycol, benzoic acid and flavorings and converting that liquid into a vapor that is inhaled. Most of the non-nicotine ingredients are food grade and considered safe individually, but the long-term effects of these when combined as an aerosol are unknown. Sealed pods, cartridges, or “refillable tanks” hold the vaping e-liquid. The refillables allows the user to potentially create a more dangerous mix of additives. Here are the American Cancer Society’s warnings about e-cigarettes’ contents: 

  • Volatile organic compounds (VOCs): At certain levels, VOCs can cause eye, nose and throat irritation, headaches and nausea, and can damage the liver, kidney and nervous system.
  • Flavoring chemicals: Some flavorings are more toxic than others. Studies have shown that flavors contain different levels of a chemical called diacetyl that has been linked to a serious lung disease called bronchiolitis obliterans, which can cause permanent lung damage.
  • Formaldehyde: This is a cancer-causing substance that may form if e-liquid overheats or not enough liquid is reaching the heating element (known as a “dry-puff”).

Brad Drummond, M.D., an assistant professor of medicine at Johns Hopkins, weighs in, “Many of the studies that have been completed demonstrate that there are harmful toxins and carcinogens in electronic cigarettes, and it’s still unclear how these exposures might translate to long-term harm.” 

More than 8,000 flavorings are available in “e-juice” such as cotton candy, banana split, Sweet Tarts, Kool-Aid, and Skittles–the list goes on. Obviously, these are designed to appeal to teens and young adults, not your 45-year-old smoker trying to quit.  

What About the Nicotine?

Nicotine is a toxic substance and an addictive stimulant. It increases heart rate, blood pressure, and adrenaline production, and over time can contribute to: 

  • Increased risk of blood clots
  • Atherosclerosis
  • Peptic ulcers
  • Changes in heart rhythm 
  • Lung spasms 
  • Bladder cancer
  • Lung cancer
  • Heart disease

The harm to children and teens is especially worrisome to healthcare providers. Nicotine can affect the development of young brains. “The prefrontal cortex, the area of the brain responsible for decision-making, logic, personality expression, and many other traits integral to one’s personality, is not fully mature until around the age of 25,” Dr. Lawrence Weinstein, Chief Medical Officer of American Addition Centers, says. “Introducing nicotine to the brain 10 years prior to that, without speaking of the massive amount of nicotine contained in each cartridge, will undoubtedly alter that developing brain.”

Yale health researchers who have been studying the health effects of vaping and e-cigarettes agree that although vape devices can help adult smokers quit smoking cigarettes or stop using nicotine, vaping ups the risk a teenager will smoke regular cigarettes later. Kids who would not try cigarettes are more likely to try something that tastes sweet, doesn’t smell bad and is easy use while avoiding getting caught by adults. 

Parents should talk openly with their kids about e-cigarettes and vaping, as they undoubtedly know someone who has used these devices. It’s an important conversation that might go something like this:

“It’s normal and natural to want to try new things, like vaping, especially if your friends are doing it. Vaping is as bad or worse than smoking. You should not smoke or vape because you could become very sick and it’s very addictive. I hope you’ll make a good and healthy choice to say no to vaping and smoking.”

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