With flavors like “cinna-mmm” and “what-a-melon” and new products that look like USB flash drives and highlighters, it’s perhaps not surprising that a large number of teens are trying out e-cigarettes. Use of e-cigarettes, also known as vaping or juuling, is gaining in popularity among high schoolers, who are not just vaping outside of school, but also in school bathrooms and, increasingly, even in the classroom.
The Monitoring the Future survey conducted by the University of Michigan found that approximately one third of school seniors used a vape or e-cigarette in the past year, and one in six high school seniors did so in the month prior to the survey. More than one in 10 students surveyed said they use nicotine. Around 5 percent of respondents said they used marijuana in the device.
Vaping was once thought to be rather harmless, and many teens tell their parents that it is, but the findings of recent studies indicate otherwise.
“There’s a false sense of security that it is not harmful and that it’s innocuous,” says Dr. Sklyer Kalady, a staff physician in the Department of General Pediatrics at the Cleveland Clinic.
Here’s what parents need to know about this dangerous replacement for smoking.
1. Vaping can expose users to metals and harmful toxins.
Vaping may expose users to harmful toxins, including toxic metals like chromium and lead, according to a study by researchers at Johns Hopkins published in the scientific journal Environmental Health Perspectives.
E-cigarettes involve heating a flavored solution through a metallic coil. That coil heats the solution and the aerosols, which looks like water vapor but actually contain chemicals and tiny metal particles. The user inhales the aerosol into the lungs, then exhales it.
In addition to dangers that come with the inhalation of metal particles, the chemicals used to flavor e-cigarettes to make them taste almost candy-like could have potential negative respiratory health effects, according to a 2016 study, also published in Environmental Health Perspectives.
E-cigarettes can contain diacetyl, which can lead to chronic lung disease and a respiratory condition called “popcorn lung,” a possibility Dr. Timothy Sanborn, cardiologist and chairman-elect of the American Heart Association’s advocacy committee in Illinois, finds particularly concerning.
“The vapor produced by e-cigarettes can contain harmful byproducts that can be carcinogens, like formaldehyde. It’s small quantities, but it’s not healthy,” says Kalady. A study from the NYU School of Medicine determined that it is also “possible that e-cigarette smoke may contribute to lung and bladder cancer, as well as heart disease, in humans.”
“Ultimately, we don’t know for sure, but these chemicals can lead to more inflammation or irritation in the lungs. This may be a source of asthma, breathing difficulty, lung disease, and even lung cancer. The slowing of gas exchange in the lung of someone who uses an e-cigarette is concerning for the development of lung disease and breathing difficulty,” says Dr. Michael Vercillo, a thoracic surgeon at Advocate Lutheran General Hospital in Park Ridge.
2. E-cigarettes may prompt teens to try regular cigarettes.
Using e-cigarettes can function as a “gateway” to regular cigarettes, according to Sanborn. Indeed, a recent report by the National Academies of Sciences, Engineering and Medicine found evidence that vaping may lead to teenagers or young adults trying regular cigarettes, and that places them at higher risk for addiction. The negative health effects that result from an addiction to regular tobacco cigarettes are well-documented.
“If we are introducing our teens to nicotine thru vaping, we increase likelihood of them using other cigarettes, and that’s not helpful from a public health standpoint,” says Kalady. She adds that 90 percent of adult smokers started before age 18.
Sanborn has led lobbying efforts in the state to raise the age to buy all tobacco products including e-cigarettes to age 21, noting that “if you can stop someone from smoking in the first place, it’s much more effective.” He notes that stopping smoking is very difficult, with smoking cessation rates are at just 6 percent. Many of his patients dealing with heart attacks and strokes are smokers and their smoking contributes to their conditions. “Knowing it could have been avoided is one of the more frustrating parts of my practice,” says Sanborn.
3. Many e-cigarettes expose kids to dangerous doses of nicotine.
“Most e-cigarettes contain nicotine, which is highly addictive, and the developing brain is even more susceptible to it,” says Kalady. She notes that the amount of nicotine in the products is not well regulated, so teens don’t know how much nicotine they are getting. “At times it could be a large amount and almost as much as 20 cigarettes at once,” she says. She adds that while many teens will say, “I use the ones that don’t have nicotine,” that’s probably not true.
Vercillo is concerned by the negative cardiovascular effects of nicotine in e-cigarettes, noting that it is as harmful as smoking tobacco.
4. E-cigarettes can be used to vaporize cannabis.
Teenagers are also using e-cigarettes for marijuana or hash oil, according to the Monitoring the Future survey. Another study of high school students in Connecticut published in Pediatrics found that 18 percent of e-cigarette users who took the study’s survey had vaped marijuana.
Hash oils can reach 95 percent pure THC, the psychoactive component in marijuana, and that can have a big impact, particularly on those new to smoking weed. Marijuana impacts the developing brain very differently than it impacts adults and using it can lead to permanent changes. You can read more about that here.
5. There is no data on the long-term effects of vaping.
Because e-cigarettes and vaping are quite new, little is known about the long-term effects of e-cigarette use. “This unknown is concerning, especially with more and more people using e-cigarettes. More use by teens and young adults may lead to more severe effects later on in life and may also lead to longer use,” says Vercillo.
Also, Kalady notes that while there are risks for healthy kids, “there are even bigger concerns for anyone with an underlying health conditions, particularly a lung disease like asthma.”
How to talk with kids about vaping and e-cigarettes
Risky behavior by adolescents is certainly not a new phenomenon, and Kalady says that she views vaping as the latest iteration of teens pushing the limits.
“While smoking in the bathroom may not be new, we can still provide education and guidance and hopefully decrease the use in teens and young adults,” says Vercillo.
Parents should engage in dialogue with their kids and find out what they know. Instead of dictating, Kalady encourages parents to be curious and she suggests asking lots of questions to start conversation, including:
- What do you think? What do you see?
- Why do you think kids do this?
- This is a tough issue. How can I help you negotiate this?
- How do you feel about inhaling metal particles?
As part of the conversation, the doctors all stressed making sure that teens are informed about the possible health consequences of vaping. “There’s a lot of fake news,” says Sanborn. He says the marketing isn’t always truthful and kids are happy to believe a peer who says that it’s harmless.
“They need to know e-cigarettes are not benign.”
Sanborn says that teens who understand the dangers associated with e-cigarettes have joined in the lobbying efforts to increase the age for purchase of vaping products, in large part because “they understand the dangers.” Some municipalities have also raised the age to 21. Oregon, Hawaii, and California have raised the legal age to 21 for vaping and smoking products. Check out Tobacco21.org to see what the law is in your state.
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Shannan Younger is a writer living in the western suburbs of Chicago with her husband and teen daughter. Originally from Ohio, she received her undergraduate and law degrees from the University of Notre Dame. Her essays have been published in several anthologies and her work has been featured on a wide range of websites, from the Erma Bombeck Humor Writers Workshopto the BBC. She also blogs about parenting at Between Us Parents.
Shannan is the Illinois Champion Leader for Shot@Life, a campaign of the United Nations Foundation that supports vaccination efforts in developing countries to ensure life-saving vaccines reach the hardest to reach children. “Vaccines are one of the most effective ways to save the lives of children in developing countries and I’d love nothing more than to see diseases eradicated,” Shannan says. “We are so close to getting rid of polio for good!”
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