Vaping isn’t helping cessation, but it’s hooking our teens
When electronic cigarettes first came on the market, we hoped they might help reduce the tremendous harm caused by tobacco cigarettes. If smokers inhaled a vapor containing nicotine, flavorings and other additives rather than the multitude of cancercausing chemicals in tobacco smoke, there might be some benefit.
While some adults have used e-cigarettes to wean themselves from tobacco, research indicates that e-cigarettes are really just another nicotine delivery device with its own unique hazards that addict users to nicotine. This is especially concerning for teens and young adults who are using e-cigarettes with alarming frequency.
One recent study did suggest that e-cigarettes helped adults stop smoking. However, those who quit tobacco continued to consume e-cigarettes and nicotine a year later. More common appears to be the experience of smokers studied by Dr. Russell Bowler, a professor of medicine at National Jewish Health. He found that most of the tobacco smokers who started using e-cigarettes in hopes of quitting tobacco continued to smoke tobacco at similar or higher levels five years later. Former smokers who began using e-cigarettes were more than 16 times as likely to resume tobacco smoking.
Additional research at National Jewish Health has shown that, while less harmful than tobacco smoke, e-cigarette vapor itself is harmful. It injures cells lining the airways and blood vessels in the lungs, and increases susceptibility to respiratory viruses.
E-cigarette use, or vaping, by teens and young adults is especially worrisome. After decades of decline, the consumption of tobacco products has taken a U-turn and begun a precipitous climb. Vaping among middle and high school students increased 900 percent from 2011 to 2015 and nearly doubled in just the last year.
Today, one in 20 middle schoolers and one in five high school students use e-cigarettes. College students and young adults vape at similar or even greater rates.
Research has shown that youth who try an e-cigarette are more likely to begin smoking tobacco. The Surgeon General and the Food and Drug Administration have both called e-cigarette use by teens and young adults a serious public health threat.
Nicotine in e-cigarettes poses unique threats to young users’ health. Adolescence is an important period of brain development when learning capacity, decision making, working memory, reward processing and emotional regulation all grow and mature. Nicotine use during adolescence profoundly alters this process, priming the brain for future addictions and increasing the risk of mood disorders, intellectual problems and impulsiveness.
E-cigarettes have become immensely popular, fueled by flavors and marketing targeted at young people. Peer pressure to vape is bearing down on those who don’t. Many don’t even realize they are vaping nicotine and mistakenly believe they are inhaling simple water vapor. Teenage brains are especially susceptible to nicotine’s addictive and rewarding effects, yet many fail to recognize the threat e-cigarettes pose to longterm mental and physical health.
After decades of fighting to reduce harm from tobacco, it is astounding that a new generation faces a renewed threat from tobacco. We must help young people avoid nicotine and quit e-cigarettes. Teens can call the Colorado QuitLine (1-800-QUIT-NOW), which recently lowered the age of eligibility for services to 12.
As the operator of the Colorado and many other state quitlines for 17 years, National Jewish Health has extensive experience treating nicotine addiction with personalized plans to avoid nicotine, navigate peer pressure and manage nicotine withdrawal. At the same time, the FDA must tighten regulation of e-cigarettes and follow through on promises to close down manufacturers who don’t meaningfully limit youth access to e-cigarettes.
JUUL, the dominant company in the market, must follow through on its action plan to cease marketing to youth and limit their access to its products.
We urge Colorado legislators to pass the recently introduced bill to raise the age for legal purchase of e-cigarettes. Together, we can protect our youth from the dangers of e-cigarettes and vaping.
Dr. Michael Salem is president and CEO of National Jewish Health. Thomas Ylioja, PhD, is an assistant professor of medicine and clinical director of health initiatives at National Jewish Health.