I found an E-cigarette in my 16 y/o's Room. Should I be worried about Vaping?
E-cigarettes were invented in 2003 in China by a Chinese Pharmacist named Li Chak, and have spread to every corner of the Globe. Sales in the United States have increased exponentially. Common age of the first e-cigarette in America is often adolescence; 15-16 years. The addition of various flavors and other additives make the e-cigarette highly attractive and marketable to youth. Unlike cigarettes, tobacco, and other tobacco related products, current FDA restrictions allow unfettered access to e-cigarettes.
E-cigarettes are a handheld electronic device that works by heating a liquid, which generates an aerosol, or a “vapor” that is inhaled by the user. Hence the term “vaping” to describe the use of e-cigarettes. The liquid found in e-cigarettes include nicotine, propylene glycol (yes folks – the same substance found in antifreeze!), glycerine (also found in soap – anyone remember vintage Ponds Glycerine Soap?), and various chemical flavoring agents (known as “e-liquid” or “juice” and available in a variety of flavors and colors and designs) . The active chemical ingredient in tobacco and tobacco products is also nicotine. Additionally, vaping delivery systems have often been used as cannabinoid delivery systems, allowing an alternative delivery of marijuana-related compounds to young adolescents. When a user exhales, the chemicals unabsorbed by the body are released to the air. When the liquid contents of the vape are exhausted, the user experiences a “dry vape” which may contain significant amounts of formaldehyde. Yes, formaldehyde – the same compound used to preserve cadavers in the Anatomy Lab for medical students to dissect.
Vaping and tobacco causes its effect on the body through nicotine. Nicotine receptors are ubiquitous in our bodies, found in every organ through the parasympathetic cholinergic nervous system and a spoke in adrenaline production causing the “rush” of a cigarette. Subsequent releases in dopamine and stimulation of the pleasure centers of the brain is responsible for the “high” of smoking. Other physiological effects of Nicotine include increased heart rate, palpitations, effect on small vessels of the vasculature, and irritation of the tracheobronchial tree. Nicotine addiction, mainly through its effect on the brain, is as challenging to counter as Heroin addiction – precisely why we must seriously consider the rationale behind allowing vulnerable adolescents exposure and access to e-cigarettes.
The difference between traditional cigarettes and the Vaping devices is the lack of tar, carbon monoxide, carbon dioxide, and other carbonaceous products found in a traditional cigarette. It is these substances largely responsible for the inhalation of over 900 known carcinogenic substances with every puff of a cigarette causing the strong association between smoking and cancer.
Vaping allows individuals addicted to nicotine the benefit of transitioning from cigarettes to vaping devices, allowing them to experience the effects of nicotine without inhaling the dangerous chemicals found in vaping devices. The use of such devices have been studied in various European studies, where they remain a common bridging device to help smokers stop smoking.
The beneficial uses of vaping, e-cigarettes, and the nicotine patch will be considered in a separate article. Lets get back to our Mother and her son now.
The very definition of adolescent youth is the immature inability to make adult responsible decisions. That’s why as parents its our important job to guide our children.
The relatively newer nature of vaping means inadequate clinical research work has been done to definitively establish the long term consequences of vaping. Remember - cigarettes and the reign of King Tobacco in the 1950s – when smoking was not only condoned but considered absolutely healthy!! Lets hope we have moved past such thinking. Nicotine remains one of the most highly addictive drugs known.
Vaping has often been shown in America as a “gateway drug” to introduce young susceptible adolescents into starting to smoke real cigarettes and tobacco. Once the young adolescent is addicted to nicotine in the vape, he looks to augment the hit with additional tobacco or a different drugs, such as cannabinoid products. The same plastic vaping device may be filled with cannabinoid products to achieve a “hit”. What starts as a cute flavored vape in a lovely package turns into a full blown addiction with untoward consequences.
When Physicians assess the role of smoking and cigarettes, we always as about “packyears”. This refers to how many packs of cigarettes an individual has smoked times the number of years the smoker has been smoking. This means a 16 year old who graduated to cigarettes from the vape who needs 2 packs of cigarettes a day, at the age of 36, will have a 40 pack year history of smoking. Considering the risk of cardiovascular and pulmonary complications, as well as cancer, has a direct linear relationship to the pack-year history of smoking. By the prime of life, the young kid vaping will have exposed himself to significant risk of early death.
So here it is. The bare naked information about vaping. The choice is yours.
1. Cdc.gov. “Electronic Cigarettes”. August 2018 online publication
2. Ebbert et al. “Counseling patients in the use of Electronic Cigarette.” Mayo Clinic Proceedings. 90(1): 128-134
3. Tremblay et al. “Regulation profiles of e-cigarettes in the United States: A Critical Review with Qualitative Analysis”. BMC Medicine. 130:41-45
4. Grana et al. “E-cigarettes: A Scientific Review”. Circulation 129(19): 1972-1986