By Michael Lasalandra – Tufts Medical Center Correspondent
Vaping, the smoking alternative that has become a teenage craze, may not be the beneficial tool that some thought could help people quit smoking. The practice has been linked to serious lung illnesses in more than 2,000 vapers, including dozens of deaths.
As a result, the Centers for Disease Control has recommended against the use of e-cigarettes and other methods of vaping nicotine until more information is known. The warning applies also to vape products that contain tetrahydrocannabinol (THC) or cannabidiol (CBD), compounds found in the cannabis or marijuana plant.
Ban on vape sales
Gov. Charlie Baker imposed an emergency ban on the sale of all e-cigarettes and vape products in late September, saying it would remain in place for four months until studies are conducted to determine what in the products might be causing the lung illnesses.
The ban was challenged in court. On Nov. 21, the state legislature passed a ban on the sale of flavored tobacco and vaping products, including menthol and mint flavored products. After that, the governor lifted the total ban Dec. 11. But the ban on flavored products remains. The state ban on THC and CBD vaping products will be lifted as soon as products are checked and found to be free of additives.
“This all snuck up on us,” said Sucharita Kher, MD, Medical Director of the Adult Pulmonary Clinic at Tufts Medical Center, who has consulted with state public health officials on the issue. “We are playing catch up.”
She noted that e-cigarettes were initially marketed as a way for people to quit smoking. While they contain nicotine, they do not burn tobacco.
Smoking in young adults
But the products have become incredibly popular among teens and young adults who did not necessarily start using them to quit cigarettes. The e-cigarettes and cartridges are marketed in dozens of fruit flavors that seem to appeal to young people, such as mango, strawberry and banana.
Studies show that nearly one-third of high school students have vaped in the past 30 days.
Dr. Kher urges doctors to ask patients about their vaping habits as well as smoking habits. She noted that this has not been the practice. “It was not even on our radar to ask.”
She also urged parents to counsel their teen children on the dangers of vaping. “It is important to have a frank discussion,” she said. “Parents should be aware of the dangers.”
Dr. Kher noted that vaping has been linked to a number of lung issues, including shortness of breath and/or chest pain that in some cases has led to severe breathing difficulties. Coughing, nausea, diarrhea and fatigue have also been reported, she said.
Case study results
Federal and state health officials are now studying the reported cases to see what in the products may be causing the issues. Additives that have been included in the oil that is vaped may be the culprits. One that has been mentioned most is vitamin E acetate, a synthetic form of vitamin E. It is used as a thickening agent or to dilute the oil.
One problem with the safety of these products is that they are not regulated by the Food and Drug Administration, Dr. Kher said, urging that they be regulated.
In addition to the risk of lung injury, there are numerous other problems associated with vaping, she noted. For example, studies looking at vaping as a tool to quit smoking have not consistently shown that they work, she said. “And people who vape have a higher risk of becoming smokers,” she added.
For another thing, young people who ingest nicotine may have problems controlling their behavior. “Nicotine can make kids more impulsive,” she said. And nicotine may affect brain development in young people, according to Dr. Kher. “The human brain continues to develop into the mid-20s,” she said.
In addition, it is unknown what, if any, issues may develop over the years. “If it is affecting their brains today, what happens in 20 years? These things haven’t been around for 20 years.”
Until the matter is investigated fully and more data is available, Dr. Kher says nobody — teens or adults — should be vaping, not even vape products that contain THC or CBD rather than nicotine.
If people want to quit smoking, she noted, there are FDA-approved products to help with that.
“People should talk to their doctors about these products,” she said.
To learn more about the dangers of vaping, request an appointment with our Pulmonary care team.
Published January 2020
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