With increasing evidence mounting about e-cigarette- or vaping-product-use-associated lung injury (EVALI), many doctors and scientists are urging people to reconsider vaping as a smoking cessation technique and to be aware of the dangers it poses.
According to the CDC, as of mid-February 2020, over 2,807 hospitalized EVALI cases had been reported across the United States, and 68 of these led to the death of the patient.
The twin culprits for the disease have been identified as “tetrahydrocannabinol (THC)-containing e-cigarette, or vaping, products, particularly from informal sources like friends, family, or in-person or online dealers,” per CDC, along with the compound vitamin E acetate, which “has been found in product samples tested by FDA and state laboratories and in patient lung fluid samples tested by CDC from geographically diverse states.”
Today we’ll look at the rise in popularity of vaping and devastating health consequences it can have.
What Is Vaping?
Vaping is the use of electronic cigarettes, which feature mouthpieces, cartridges for liquid nicotine, often flavored, along with batteries powering a heating device that is activated when the smoker inhales. Center for Addiction notes, “[E]-cigarettes do not produce tobacco smoke, but rather an aerosol, often mistaken for water vapor, that actually consists of fine particles.”
It is the harmful chemicals contained in this aerosol that can damage both the vaper’s health and that of the people around them. Due to the perception of vaping as a safe alternative to smoking, its popularity has skyrocketed in recent years, especially among youth.
Dr. Nora Volkow, director of the NIH’s National Institute on Drug Abuse, told News in Health that “it is urgent that teens understand the possible effects of vaping on overall health, the development of the teen brain, and the potential for addiction.”
1. E-cigarettes are Linked to Increased Risk of Cardiac Arrest and Stroke
Research presented at the 2019 American Stroke Association’s International Stroke Conference showed that e-cigarette use increases vapers’ chances of getting a stroke or having a heart attack, per a news release by the ASA. The researchers pored over data from 400,000 respondents across all 50 states before reaching their conclusions.
According to the study, e-cigarette users surveyed had 71 percent higher risk of stroke, 59 percent higher risk of heart attack or angina, 40 percent higher risk of coronary heart disease, and double the rate of cigarette smoking.
Even more disturbing is that these numbers were not offset by the fact that “compared with non-users, e-cigarette users were younger, had a lower body mass index and a lower rate of diabetes,” per the study’s author, Dr. Paul M. Ndunda.
2. CDC Recommends Stopping Vaping After Deaths Related to E-Cigarettes
The CDC’s recommendations on vaping are clear. “Adults who do not currently use tobacco products should not start using e-cigarette, or vaping, products,” the organization states on its website. Given the deaths that have been connected to EVALI, this advice is especially important.
Moreover, the CDC specifically recommends, “E-cigarette, or vaping, products (nicotine- or THC-containing) should never be used by youths, young adults, or women who are pregnant.” For current traditional cigarette smokers, given that there are alternative methods for cessation, it’s best to avoid vaping altogether.
3. The Dangers of “Popcorn Lung” for Vapers Who Smoke Flavored E-Cigarettes
As an editorial by the American Lung Association noted, the term “popcorn lung” originated from the disease bronchiolitis obliterans, which affected workers in factories that manufactured microwave popcorn. One of the chemical flavoring ingredients for artificial butter, diacetyl, while banned from food products because of its lung-damaging properties, has made a comeback in the poorly regulated and informal e-cigarette-flavoring market.
A 2015 Harvard School of Health press release revealed that of the dozens of e-cigarette cartridges tested there, nearly three-quarters contained diacetyl. The harmful agent isn’t just used to make butter popcorn-flavored vaping products, per professor Joseph Allen, the study’s lead author. Others that tested positive for diacetyl were “fruit flavors, alcohol flavors, and, we learned in our study, candy flavored e-cigarettes,” Allen said.
4. Nicotine Is Still Dangerous However It’s Consumed
While e-cigarettes don’t always have the same concentration of nicotine that traditional cigarettes do, nicotine remains a dangerous, addictive substance. As a study in the Indian Journal of Medicine and Paediatric Oncology noted, “Nicotine poses several health hazards [including] increased risk of cardiovascular, respiratory, gastrointestinal disorders.”
Beyond the well-documented negative effects of nicotine on the body, it is highly addictive whether in cigarettes or e-cigarettes. As Dr. Michael Blaha, director of clinical research at the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, explained on the center’s website, “It’s one thing if you convert from cigarette smoking to vaping. It’s quite another thing to start up nicotine use with vaping.” Blaha noted that teen vaping “often leads to using traditional tobacco products down the road.”
5. Vaping Without Nicotine Is Still Bad for the Lungs
While many vapers might imagine that they are avoiding most of the harmful effects of e-cigarettes by using flavor cartridges that don’t contain nicotine, a 2019 study in the journal Radiology suggests otherwise. The study found that “[n]icotine-free e-cigarette aerosol inhalation in young, healthy nonsmokers resulted in transient impairment of vascular reactivity and endothelial function.” The endothelium is a thin membrane that lines the inside of the heart and blood vessels, which seem to be impacted by the use of e-cigarettes.
6. E-Cigarette Products May Contain Chemicals That Can Damage DNA
Research presented at the American Chemical Society‘s 2018 annual meeting revealed that saliva samples of people who had vaped contained dangerous chemicals such as acrolein. They found that compared to non-vapers, 80 percent of e-cigarette users were exposed to acrolein, which can react with DNA in a toxic and potentially carcinogenic way.
7. Vaping May Harm Brain Function
A 2019 study in the European Heart Journal not only confirmed that e-cigarette use damages lung function but also that it could be connected to brain damage. The study demonstrated that “acute e-cigarette vapour exposure causes endothelial dysfunction in chronic smokers, induces inflammation and oxidative stress in vascular and cerebral tissue, and increases blood pressure in experimental animals.”
8. Vaping Is Addictive
Because most vaping products contain some nicotine, they are still physiologically habit-forming. As Dr. Lawrence Weinstein, chief medical officer of American Addiction Centers, told CNET, “Inhalation of nicotine will increase dopamine production regardless of the vessel used.” Weinstein elaborated that “[t]he up and down of dopamine levels is what motivates an individual to smoke.”
The other problem is that younger people’s bodies are most sensitive to nicotine, leading to a much longer and harder fight to beat addiction. “The age of exposure is a critical determinant of dependence and ability to cease use,” Dr. Weinstein said. Given all the information, the FDA announced sanctions on companies who continue selling “unauthorized flavored cartridge-based e-cigarettes” on Jan. 2, 2020, per a statement.
The race is on to prevent young people getting hooked before it’s too late.