UP IN SMOKE
Vaping is a popular and potentially dangerous trend among teens. Learn about the health risks of electronic cigarettes and how to protect your kids.
Electronic cigarettes have become a popular and potentially dangerous trend among teenagers. Here's what parents need to know to protect their kids.
To teenagers, they are cool, hip and trendy. To parents and health experts, they are dangerous and potentially life-threatening.
They are electronic cigarettes and their use—known as “vaping”—has drastically increased among teens, according to the 2019 Monitoring the Future Survey from the National Institute on Drug Abuse. In fact, rates have doubled in the past two years. According to the survey, about 10% of 8th graders, 20% of 10th graders, and 25% of high school seniors have done vaping in the past month.
As electronic cigarettes have become more popular, so too have concerns about their health risks among teenagers, including transitioning to regular smoking. “It is essential that parents help their teens understand the possible harmful effects, and help them take the necessary steps to either quit vaping or avoid giving in to temptation or curiosity,” says Dr. Oscar A. Alea, a pediatric pulmonologist at Golisano Children’s Hospital of Southwest Florida.
Electronic cigarettes are battery-powered devices that heat a liquid into a vapor that can be inhaled. The vapor may contain nicotine (the addictive drug in tobacco), flavoring and other chemicals. Other substances can be added too, like marijuana and hash oil. (In fact the Monitoring the Future Survey also noted a sharp rise in marijuana vaping among 12th graders in the past year.)
Electronic cigarettes are used to help people break their smoking habit, similar to using nicotine patches and gum. However, e-cigarettes are not approved by the FDA as a quit-smoking aid, and there is limited evidence they actually help smokers quit.
E-cigarettes come in different shapes and sizes. Some look like regular cigarettes, cigars or pipes, while others resemble USB flash drives and pens. They also go by various names. E-cigs and vapes are the most common, but other names include e-hookahs, mods, vape pens, tank systems and electronic nicotine delivery systems, or ENDS.
E-cigarettes have only been around for a decade, so research on their health effects is limited. Still, enough evidence exists that shows a clear link between nicotine use and a higher risk of several health problems.
Nicotine also is strongly addictive. “Nicotine is more addictive than heroin or cocaine,” says Dr. Alea. “And some e-cigarettes contain up to four times the concentration of nicotine as regular cigarettes.”
First, look for the physical signs of possible vaping, such as regular coughing not related to a cold, bloodshot eyes, increased thirst, nosebleeds and shortness of breath.
In some ways, e-cigarettes are more dangerous than regular cigarettes. “Because you can increase the voltage of the device, you can inhale more nicotine than from a regular cigarette,” emphasizes Dr. Alea.
Long-term exposure to nicotine can raise the risk of cancers, such as lung, pancreatic and breast, as well as heart disease. “Vaping also could be used as a coping mechanism and mask physiological problems, like depression and anxiety,” says Dr. Alea.
Teen e-cigarette users are more likely to become regular smokers, too. About 30% of e-cigarette users begin smoking within six months compared with 8% of nonusers, according to the National Institute on Drug Abuse.
Inhaling the vapor also can cause inflammation and scarring in the lungs that can
lead to long-term breathing problems, according to Dr. Alea. “Lungs are still developing until age 21,” he says.
In 2019, there were approximately 2,400 cases of hospitalization associated with vaping lung illness and 52 deaths, according to the Centers for Disease Control and Prevention.
In particular, vaping may increase the risk for “popcorn” lung, says Dr. Alea. This is the nickname for bronchiolitis obliterans, a lung disease that can damage the smallest airways and cause persistent coughing and shortness of breath.
Rules of Attraction
Why are teens attracted to vaping? It is not just one reason. “The main attractions are often modern technology and vapor flavoring,” explains Dr. Alea. There is also vaping’s rebellious appeal. “Vaping can be done discreetly since you don’t smell like smoke afterward, so kids know they can get away with it,” he says. “And then there is the constant battle with teenage peer pressure and wanting to fit in.”
Teens also are heavily targeted by e-cigarette advertising. In fact, approximately seven in 10 teens are exposed to e-cigarette ads. Among middle school students, almost 53% see regular retail advertisements, 35.8% internet ads, 34% TV and movie ads, and 25% print ads.
Perhaps the most significant problem with vaping is a simple lack of knowledge about the products. “Kids don’t see them as ‘real’ cigarettes, so feel they are safe,” says Dr. Alea. In fact, research has found that many teens are not aware of e-cigarette ingredients. The National Institute on Drug Abuse also found that 66% of teens say e-cigarettes contain just flavoring, 13.2% say nicotine, 5.8% say marijuana, and 13.7% don’t know.
Lack of federal oversight is also a major issue. Manufacturers can only sell e-cigarettes to people age 18 and older, but right now, the Food and Drug Administration (FDA) does not regulate e-cigarettes, which means companies do not have to list the products’ ingredients or potential health warnings on their labels.
However, the FDA recently won an appeals court case against several e-cigarette manufacturers that the agency can regulate e-cigarettes like traditional tobacco products. If the decision is not contested, the FDA could soon require e-cigarette companies to do the following:
• Provide FDA with a list of ingredients used in their products
• Submit their products for regulatory review
• Include health warnings on packages and in advertisements for their products
• Refrain from advertising their products as “light” or “mild” without explicit consent from FDA
• Refrain from giving out free samples of the products
Until FDA regulation becomes a reality, it’s up to parents to educate teens about these products.
What can parents do to protect their kids from vaping? First, look for the physical signs of possible vaping, such as regular coughing not related to a cold, bloodshot eyes, increased thirst, nosebleeds and shortness of breath. Changes in mood and attention are also common.
If parents do suspect vaping, they should speak to their kids about their experience or exposure to vaping. “Ask your teen about what they’ve heard and what they know,” says Dr. Alea. “Use open-ended questions that encourage the child to ask questions and direct the conversation. This way, they won’t feel attacked, and you can encourage their feedback in a nonjudgmental way.”
If vaping is related to possible emotional or mental issues, they can explore that with their child and seek medical care, if needed.
Finally, parents should share with their teen the dangers and long-term consequences of vaping. “Show them that you want to offer support,” says Dr. Alea. “Ultimately, they have to make a choice not to use, but with the right information and guidance available, they can make the right decision when the situation arises.”
“Vaping can be done discreetly since you don’t smell like smoke afterward, so kids know they can get away with it.”
—Dr. Oscar A. Alea, pediatric pulmonologist at Golisano Children’s Hospital of Southwest Florida