The Vaping Crisis is a Local Crisis

 

Medical Moment

by Diana Koelliker, MD


You have have seen the headlines. There’s a vaping crisis in this country, and it’s teens and young people who seem to be hit the hardest. 

As a physician, I field many questions from patients and parents, here’s a rundown of what you need to know

 

Is there really an epidemic of adolescents/teens using vape products?

YES! This is a huge problem across the country and especially in our region. It was estimated that more than 3.5 million kids in this country were vaping at the end of 2018. 

That’s about 20 percent of kids nationwide. 

In Colorado, our average was 27 percent and in the Telluride region it was almost 50 percent according to our most recent survey (2017 Healthy Kids Colorado). 

This was similar in many other resort areas in Colorado where the 30-day rate of teen vaping was higher than state and national averages. What was even more concerning about that survey is that those same kids considered smoking cigarettes to be hazardous (85 percent), but only 46 percent thought that vaping everyday was harmful. 

Juul, the largest manufacturer of e-cigarettes, sells cartridges that are 5 percent nicotine. That is higher than many other manufacturers, which average about 2.5 percent nicotine. One Juul cartridge contains as much nicotine as 1.5 to 2 packs of cigarettes. 

Some teens admit to using 1-2 pods a day!  

Nicotine has been shown to be harmful to young, developing brains. It can lead to depression, anxiety, problems with attention and sleep, and has been shown to increase the risk of lifelong addiction (to nicotine and other substances). 

There are about 200 puffs per pod, and the effects of inhaling these heated chemicals is unclear. This has been labelled an epidemic by the CDC and the surgeon general has issued a warning due to the recent surge in e-cigarette use among our youth. 

What is vaping? 
Vaping is the inhalation of a vapor created by an electronic cigarette (e-cigarette) or another vaping device. E-cigarettes are battery-powered smoking devices that have cartridges filled with a liquid that usually contains nicotine, flavorings, and chemicals. 

The liquid is heated into a vapor, which the person inhales. Vaping devices can use pre-filled cartridges, or you can fill them with various liquids yourself. Some cartridges or liquids can contain THC (the active ingredient in marijuana that causes the “high”), while some are “just nicotine.”  

Why vape?
The e-cigarette industry emerged onto the consumer market in 2007 as an alternative to smoking traditional cigarettes — it was initially proposed to help people quit smoking. 

Touted by many to have less deleterious health effects than lung disease and cancer-causing cigarettes, some initial studies showed higher success rates for smokers who were trying to quit when they utilized e-cigarettes. 

Initial marketing campaigns indicated that vaping was a “healthier option” and didn’t have the long-term consequences of smoking. However, there are no long-term studies about the effects of vaping. 

The inhalation of superheated chemicals (like formaldehyde and diacetyl) have known harmful effects on lung tissue and laboratory animal studies show that these substances as well as nicotine have harmful effects on blood vessels. 

Current research shows that 1/3 of the deaths attributed to cigarettes is due to vascular disease, or the damage done to blood vessels in the body that lead to strokes, heart attacks and kidney disease. It is possible that vaping could have similar effects once long-term studies are conducted.

What is the latest with the recent severe pulmonary illnesses and deaths related to vaping?
As of this week, there have been more than 450 vaping-related pulmonary illnesses and 6 deaths attributed to the use of e-cigarettes. There has not been a single product or item linked to all of these cases, but the investigation is still underway. Recent focus on the presence of vitamin E acetate in some of the cases has led to speculation that it might be linked to a thickening agent that some consumers and vendors on the black-market are adding to liquids that are put in the vape devices. 

Many of the cases have involved THC-containing liquids, but some patients state that they were only using nicotine vape products. In any case, these products are not currently regulated by the FDA and many organizations (CDC, American Lung Association, AMA, etc.) have warned about the potential risks of irreversible lung disease and even death from using e-cigarettes. They are encouraging people to abstain from vaping until a confirmed causative agent is identified.

What can you do?
First, if you aren’t a smoker, don’t start vaping now. 

If you are pregnant, a young adult or have underlying heart or lung disease, you should not vape due to the many risks associated. That means all vape products: CBD, essential oils, vitamins, THC, nicotine, all of it. 

Do not use “black market” products or cartridges that have been refilled or obtained by non-traditional routes.  

According to the CDC, “people who use e-cigarette products should not buy these products off the street and should not modify e-cigarette products or add any substances that are not intended by the manufacturer.” 

If you are an adult that vapes, be aware that there are products out there that could result in severe illness with only minimal to moderate exposure. 

Talk to your kids about the dangers of vaping. 
There are so many great resources out there to help. 

If you are concerned that your child is using regularly, get them help!

Nicotine is as addictive as heroin in some animal studies. If your child is addicted, they will need help to quit. A good online resource can be found at mylifemyquit.com. This is an enhanced tobacco cessation program specifically for teens who want to stop using tobacco products, including electronic cigarettes and vapes introduced by National Jewish Health. 

Your local health care provider can also help with resources, like the primary care team at the Telluride Medical Center. 

It is also important to talk to teens about the potentially life-threatening consequences that can come from just casual use, particularly if obtained from unconventional sources listed above. 

Teens are especially at risk of getting these products since in theory, they shouldn’t be able to buy them legally. It’s never too early to start talking to your kids about the dangers of vaping. 

Wouldn’t it be great if this next generation thought vaping was as dangerous as smoking cigarettes, from a young age?

Medical MomentsTiffanie Lanmon