The Rise and Fall of Vaping

Lauren Middlebrooks, MD Pediatric Emergency Medicine Physician

Vaping-Related illness has plagued over 2,000 people this year alone, and has claimed the lives of now 47 innocent victims.  Several deaths have been linked to the explosion of vape pen devices, however of greater concern is a “mysterious respiratory illness” that the CDC is now calling EVALI—e-cigarette or vaping-related lung injury.  

While vape pens are void of tobacco, its main ingredient (nicotine) is still a powerful and highly addictive drug. Nicotine reaches the brain in roughly 20 seconds, resulting in tachycardia, GI upset, hypertension and can often interfere with sleep.  Nicotine can make persons more prone to infection by suppressing the immune system, and can increase risks of diabetes, atherosclerosis, heart disease and stroke.

In addition to the risks persons of all ages may face, there are certainly more dangers when a child is developing their vulnerable brain is exposed to nicotine.  For one, children and adolescents progress more quickly to nicotine dependence.  Vape pens were created as smoking cessation devices—e-cigarettes would allow for a gradual cut down of nicotine, by controlling the amount of nicotine in each cartridge.  One vape pod however is equivalent to an entire pack of cigarettes, and teens in particular are unaware of these facts.  E-cigarettes were marketed as safer products, since they are void of tobacco and contain less known toxic chemicals.   The enticing flavors, discreet packaging, and celebrity ads seemed to draw adolescents right in, and in 2017, over 40% of high schoolers experimented with vaping.  Many children and adolescents go on to smoking cigarettes due to their easier access, and like most gateway drugs, nicotine can lead to use of alcohol and other illegal substances of abuse.  

In a 2012 review, many studies affirmed nicotine’s’ effect on cognitive processing, memory, and attention in adolescents, which based on the duration of nicotine intake, can progress to long term consequences.  There is also evidence that nicotine exposure during adolescence can lead to mental health disparities such as depression and anxiety.  A smaller study showed similar affects in the brain of children and adolescents who were exposed to nicotine either in utero or by way of second-hand smoke.

Aside from the behavioral and cognitive effects of vaping in adolescents, 15% of patients hospitalized from EVALI were under 18 years of age.  EVALI has been linked to Vitamin E Acetate, a thickening agent found in vape pods that when inhaled, can cause severe lung damage.  The CDC recommends that no one use vape products, and that youth and young adults in particular, avoid e-cigarettes and vape devices at all cost.  

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