By a few measures, the recent vaping crisis is unique among other US epidemics. Not the least of these metrics is how quickly the crisis – characterized by widespread lung injuries that likely stem from the use of e-cigarettes – affected young Americans. This is summarized in a statement by the US Department of Health & Human Services Secretary Alex Azar, who said the country has “never seen an epidemic of substance use arise as quickly as our current epidemic of youth use of e-cigarettes.”
A 2019 survey by a pair of federal entities found 5 million middle and high school students are current e-cigarette users, and nearly 1 million use them daily. Use of a vape product has been strongly linked to health concerns, and at the crisis’ peak in September, 2019, emergency room visits for injuries related to vape products topped out at 215 a week.
Since then, hospitalizations have fallen. Nonetheless, e-cigarettes continue to pose health risks, which prompted multiple actions by US federal, state and local governments. Vape products are still on the market, and to understand where we’re headed as a country, we first need to have a working knowledge of the issues and the market as a whole. So, let’s examine the components of the vaping crisis and the different factors that contribute to it.
What Exactly is Vaping?
The vaporizer market began in 2003 with the invention of the e-cigarette in its current form by Hon Lik, a Chinese pharmacist. The devices go by different names – electronic cigarettes, e-cigarettes, vapes and vape pens, among others – but they all do much the same: heat a liquid into a vapor that’s inhaled by the user. Lik, an avid smoker, told Reuters he wanted to invent a device that would “mimic smoking” but without the “deadly smoke” that comes with it. With that, the modern vape was born.
In most cases, the vape liquid contains nicotine – an addictive drug that affects the body’s brain – flavoring, cancer-causing chemicals and heavy metals, such as nickel, tin and lead. Nicotine can be harmful to an adolescent’s brain, which continues to develop until age 25, and can affect the parts of the brain that control attention, learning, mood and impulse control. Diacetyl, an ingredient found in some vape flavorings, has been linked to serious – and potentially fatal – lung disease.
Flavors and Low Price Lure Young Users
Vape liquid flavors come in fruit, candy and other kid-friendly varieties, and a 2019 survey found 81 percent of youth e-cigarette users said their use of vapes was due in part to the availability of appealing flavors. Likewise, the CDC said the lower cost of vaping products, versus traditional cigarettes, is another factor of the spike in young e-cigarette users.
Government Response to the Vaping Illness
In August 2019, the US Food and Drug Administration (FDA) put out a statement that it and the Center for Disease Control and Prevention (CDC) were investigating “distressing incidents of severe respiratory disease associated with the use of e-cigarette products.” Often, the patients said they experienced gradual symptoms, such as difficulty breathing, shortness of breath and chest pain. Additionally, some said they had mild to moderate vomiting and diarrhea, as well as fevers or fatigue.
The CDC uses the label e-cigarette/vape use-associated lung injury (EVALI) to address these cases. Data suggests that a major factor of EVALI are products that contain tetrahydrocannabinol (THC), the primary active ingredient in cannabis. These particular products are said to be obtained from informal sources, such as friends, family, and in-person or online dealers.
Likewise, Vitamin E acetate, which was found in vaping products and patient lungs, has also been linked to the outbreak. It was not found in the lungs of patients who do not have EVALI. Finally, the CDC notes, there is not yet enough evidence that other chemicals can be completely ruled out as causes of these lung injuries.
In an effort to curb the use of e-cigarettes among young people, the New York Times reports that the federal government will take steps to ban the sale of some flavors, excluding menthol and tobacco. This exclusion also includes some types of vape tank systems. Federal officials told reporters that the ban is designed to target products that are most often used by children.
What Parents Can Do
There’s evidence that young people who use e-cigarettes may be more likely to smoke cigarettes in the future. While they’re often advertised as an alternative to traditional cigarettes, they’re still unsafe, especially for young people. The CDC suggests the following actions for parents:
- No one should use e-cigarette products that contain THC
- Vape products should not be used by children, young adults or women who are pregnant
- If you’re a parent, educate yourself on e-cigarettes and how they can affect young people
- Talk to your children about these products, the risks they carry and to stress the importance that children not use them
- Remember that it is harder to smell vape products on clothes and so it is important to have a dialog with your children to find out if they have tried, or are regularly using, vapes
- Parents can set an example by not using tobacco products
Your healthcare providers can be a great resource for parents when it comes to learning about e-cigarettes and the associated risks. At Premier Medical Group, there are practitioners who specialize in Cardiology, Pulmonology and Pediatrics and can help families address issues related to vape products. Your primary care provider should be alerted if you or your child are using vaping products.
- United States Food and Drug Administration: Press Release
- United States Food and Drug Administration: Vaporizers, E-Cigarettes, and other Electronic Nicotine Delivery Systems (ENDS)
- United States Center for Disease Control and Prevention: Characteristics of a Nationwide Outbreak of E-cigarette, or Vaping, Product Use-Associated Lung Injury
- Reuters: E-cigs a ‘consumer-driven’ revolution born from a bad dream
- United States Center for Disease Control and Prevention Quick Facts on the Risks of E-cigarettes for Young People
- New York Times: With Partial Flavor Ban, Trump Splits the Difference on Vaping