“E-cigarette” use (“vaping”) is increasing dramatically among middle and high schoolers in recent years.  E-cigarettes are hollow tubes with a battery, heating element, and cartridge that can be filled with “vape juice”–a concoction of nicotine, chemicals like ethylene glycol and vegetable glycerin, and various flavorings.  The heating element burns the fluid which is inhaled.  Keep in mind 2 important facts about “vape juice”–no testing is required and no standards to meet, and nicotine liquids are unregulated.  So its completely “buyer beware”–for chemicals our children might breath into their lungs.

Another point to note about e-cigs: websites promoting vaping and vape juice stress that these chemicals are approved as “food grade” by various very official sounding regulatory agencies.  The important thing to remember is that these approvals are for foods to be taken into the GI tract, not the respiratory tract.  Now, I drink cranberry juice and most studies consider it to be quite healthful.  But I don’t want it in my lungs.

According to the Food and Drug Administration, ecig use in high schoolers increased from 4.5% in 2013 to 13.4% in 2014 (from 600,000 to 2 million teens) and in middle schoolers from 1.1% 5o 3.9% (120,000 to 350,000).  Currently, more students vape (13.4%) than use hookah(9.4.%) or tobacco cigarettes (9.2%); as a result there has been no overall decrease in the rate of nicotine product use in the adolescent population during this time.

Ecig enthusiasts stress that vaping is safer than regular tobacco cigarettes.  Given the list of dangerous chemicals in tobacco smoke this is technically true; but its a very low bar.  The nicotine in both substances has a variety of effects on the developing adolescent central nervous system, and in particular the prefrontal cortex where ‘executive functioning”–higher thinking –occurs.  So “safer” is relative and, at best, overstated.

Another assertion from vape enthusiasts is that it can be a useful “interim” step on the way to cigarette smoking cessation.  Again, probably true as far as it goes.  But, firstly, most middle and high schoolers do not have a perhaps decades long nicotine habit with which to contend.  So I think that the focus in this age group should be on avoidance rather than withdrawal/quitting these products.  I think that dilutes that important message.  Furthermore, from nicotine gums and patches, drugs(chantix or zyban), even acupuncture and hypnosis–there are so many other methods to quit that do not employ sucking noxious chemicals into one’s lungs that I cannot see vaping  as such an important option.

A recent study from Hong Kong of 45,000 adolescents divided subjects into – “negative” “experimenters” “ex” or “current” users.  The e-smokers were more likely to have respiratory symptoms compared to nonusers (“experimenters” using only occasionally had no greater risk).  So–“safer?” I suppose.  But I still vote “no.”  That is why I now make a point of asking my adolescents both if they “smoke” or “vape.” And I encourage all of my parents to be informed and vigilant about both of these risky behaviors.

Questions?  Comments?  Thanks for following.


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