By: Sarah Johnson
Vaping, all the cool kids are doing it – and therein lies the problem. What is vaping? Why do we keep smelling sweet candy flavors in the air? Should new laws be written? Especially pertaining to children? Let’s take a deeper dive into the new, “cool” thing to do!
What is Vaping?
Vaping is a relatively new fad, often said to be a replacement for smoking cigarettes and a way to transition to quitting tobacco cigarettes. Mostly, vaping involves the use of electronic cigarettes (e-cigarettes). E-cigarettes are known by many different names: e-cigs, e-hookahs, mods, vape pens, vapes, tank systems and electronic nicotine delivery systems (ENDS).
Here is a graphic of some of the top selling e-cigarettes (PAX Era is a marijuana delivery device):
E-cigarettes are comprised of a container, a battery, a heating element, a compartment that holds liquid, a wick to carry liquid from the tank to a coil, an air intake system, a mouthpiece and a charging port. Usually the heating element and the liquid share the same area, called an atomizer. Unlike “normal” cigarettes, e-cigarettes heat up a fluid (usually containing nicotine) instead of burning tobacco. The most common e-cigarette on the market, Juul, says that one pod is equivalent to one pack of cigarettes, containing 5% nicotine. It vaporizes the liquid into a mist which is inhaled, which is where the term “vaping” comes from. Because of this, many believe that these devices are safer than tobacco cigarettes.
What are Health Concerns Surrounding Vaping?
When it comes down to it, e-cigarettes are much safer than traditional cigarettes, but still are something you should avoid. Comparing them to tobacco cigarettes, they have far less dangerous chemicals and substances. Tobacco cigarettes are the number one cause of preventable death in the United States, killing 480,000 people every year. Among other things, smoking tobacco cigarettes increases the risk of stroke, heart attack, COPD, asthma, diabetes and most cancers. The smoke that is emitted from cigarettes contains tar, which gets directly inhaled into the lungs and leads to something called black lung.
Because e-cigarettes do not burn a solid substance, they expose users to less harmful chemicals than tobacco cigarettes, but that does not mean they are safe. When an e-cigarette is “smoked” it produces an aerosol. The aerosol can contain nicotine, ultrafine particles, flavoring, volatile organic compounds, cancer-causing chemicals or heavy metals (nickel, tin or lead).
The major benefit of e-cigarettes, compared to tobacco cigarettes, is that they do not produce the tar or the toxic gases found in cigarette smoke. But, like burned cigarettes, e-cigarettes contain nicotine which has negative effects, and inhaling a vapor is not good for your lungs, either. The liquid for e-cigarettes often contains diacetyl, a chemical associated with a rare lung disease called bronchiolitis obliterans (or popcorn lung). Popcorn lung is not a reversible disease, however, treatments can help it not progress as fast. Two other major components of the liquid used in e-cigarettes (propylene glycol and glycerol) are not dangerous on their own, unmodified, but, if they decompose after being heated, they can transform into toxic compounds (like formaldehyde).
All this being said, a recent study of 900 patients said that e-cigarettes were more effective than nicotine gums and patches to help them quit smoking. Half of the patients received e-cigarettes while the other half got other, traditional treatments: patches, gum, lozenges, nicotine inhalers or whatever other kind of oral nicotine they preferred. “The e-cigarettes were significantly more effective than nicotine replacement treatment,” Peter Hajek, a public health researcher at Queen Mary University of London, says. Juul Labs published this study, showing smoking Juul reduced smokers’ risk to cigarette toxins (studying the biomarkers of carcinogens that are present in combustible (tobacco) cigarettes that are recognized to contribute to cancer) at similar levels to quitting entirely. The report and data could possibly help Juul establish their credibility as a smoking cessation tool for adults and help their case against their spotlight as a primary role in the epidemic of teen e-cigarette use. Here is a graph of the findings from the report:
What Does this Have to do with Kids?
Many believe vaping is becoming an epidemic with kids. There are two main reasons for this: one, most of the liquid for vaping is candy or fruit flavored making it attractive to kids, and two, it is perceived as cool and has a huge presence online. Online popularity of e-cigarettes ranges from making cool videos manipulating the vapor to it being a trend at weddings.
Over the last few years, nicotine poisoning from the liquid used in e-cigarettes has skyrocketed. Accidental ingestion by children has rose by 1,500% over the past three years. The rate of young people vaping has almost doubled from last year to this year (from 8 to 16 percent for 10th-graders and from 11 to 21 percent for seniors). A major concern is the impact nicotine has on developing brains. Your brain is developing until about the age of 25, so starting smoking at 15 years old could have severe effects. Nicotine is also viewed by many as a gateway drug, which most people are always concerned of young people engaging in.
The FDA is Cracking Down.
Outgoing FDA commissioner, Scott Gottlieb, has publicly stated his concern surrounding e-cigarettes marketing to teens, and is now acting upon that before he departs. He primarily has called out Juul as one of the main culprits appealing to young people with their fruit punch and mango flavored pods. On March 13, Gottlieb announced a new proposal aimed at tightening sales and eventually removing fruity e-cigarette flavors from the market (a key contributor to the teen epidemic). Gottlieb published a blog explaining the policy, stating, “We’re putting all manufacturers and retailers on notice: You may be subject to FDA enforcement for selling certain flavored … products without authorization.” The proposal moves up the FDA’s deadline to review and reject or approve flavored nicotine products. This will most likely lead to some of these flavored products getting pulled from the market. The proposal also addresses the sale of these products online – a common practice now brick and mortar stores are facing a shortage of the popular flavors.
Gottlieb’s interim replacement, Ned Sharpless, is said to have “deep scientific background and expertise” by HHS Secretary Alex Azar. Azar also added that “There will be no let-up in the agency’s focus, from ongoing efforts on drug approvals and combating the opioid crisis to modernizing food safety and addressing the rapid rise in youth use of e-cigarettes.”
What is Happening Surrounding Legislation Related to Vaping?
On top of this new proposal, many states are taking the vaping epidemic into their own hands. Take a look at the current legislation relating to vaping below.
These bills vary in the items they address, ranging from advertising to age restrictions to location restrictions to research.
Many of the bills specifically address the children epidemic. Two federal bills have been proposed: the Stopping Appealing Flavors in E-Cigarettes for Kids Act (died last year) and Youth Vaping Prevention Act of 2019 (in committee since January). Some states like New Jersey and Rhode Island are tackling the issue by imposing a high tax on the e-cigarette products. Other states, like North Dakota and Alaska, are raising the smoking age to 19 in an attempt to make people of age less accessible in high schools. Massachusetts is working to address the addiction (to nicotine and oral fixation) that vaping plays a pivotal role in, while also trying to limit youth vaping.
Other bills address vaping in general. Maryland proposed an act to prohibit the sale and distribution of flavored tobacco products (e-cigarettes and cigars) all together. Colorado has a bill to add e-cigarettes to the Colorado Clean Indoor Air Act. Arizona proposed a bill to increase taxes allocate 5 cents from every sale to a research fund for research on preventing and treating tobacco-related disease and addiction and alzheimer’s disease.
It is worth bringing up, again, that vaping is proven to help people quit smoking tobacco cigarettes, which have much worse health effects than vaping. There are many organizations, like the American Vaping Association, that are working to ensure these types of reduced harm products can and will stay on the market. I believe it is important we figure out how to reduce teen participation in vaping while also working to allow adults trying to quit smoking the option to use vaping products.
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