Written by John Ferrari
Vaping. You’ve seen people vaping, seen the smoke exhaled out car
windows, seen the ads—but you may not know exactly what it is or
how harmful it may be. You’re not alone.
“That’s the most terrifying thing about it,” says Torrance
Memorial Physician Network family and sports medicine physician Jason
Alvarado, MD. “We don’t know its effects.”
The e-cigarettes you see today were introduced to the U.S. in 2007, just
13 years ago. Electronic nicotine delivery systems (ENDS) became so popular
so quickly—especially among teens and young adults—that last
year FDA commissioner Scott Gottlieb, MD, declared e-cigarette use an
epidemic of addiction among teenagers.
Originally developed as an alternative to smoking, e-cigarettes work by
heating a liquid containing nicotine and other chemicals. E-cigarette
users (called vapers) inhale (vape) this aerosol or vapor. They’re
often marketed as a way to stop smoking, but that’s not accurate,
says psychologist Moe Gelbart, PhD, executive director of the Thelma McMillen
Recovery Center—Torrance Memorial’s outpatient alcohol and
drug treatment center.
“Vaping was not a smoking cessation tool,” he explains. “It
was a tool to reduce, theoretically, some of the negative effects of smoking.
Vaping supposedly reduces some of the harmful effects of actual smoke,
but it’s still an addiction to nicotine and still has carcinogenic
effects. Nicotine is one of the most addicting substances we’re
aware of. In some ways it’s as addicting as cocaine or heroin. We’re
only eight to 10 years into vaping, so we don’t know what the long-term
effects are.”
E-cigarette use may be most harmful to teenagers and young adults—precisely
those who are using e-cigarettes the most. The brain continues to develop
until about age 25, Dr. Gelbart explains, and is more susceptible to addiction.
Nicotine also can cause emotional swings, including depression and anxiety,
which young people are less equipped to handle than mature adults.
“Vaping is getting a whole generation of kids ready for nicotine
addiction—and a lifetime of problems,” Dr. Gelbart says, explaining
the problems include an increased chance they’ll use other drugs.
“Vaping is a gateway drug to marijuana, and marijuana is a gateway
to other drugs.”
Nicotine has immediate effects that include increasing the heart rate and
triggering the fight-or-flight hyper-alert response, Dr. Alvarado says.
Children and teenagers, he adds, haven’t yet learned how to control
those kinds of reactions. The ups and downs caused by nicotine can affect
a user’s learning abilities and attention span too—critical
in a developing brain.
Add to that the reason vaping has been in the news lately: the emergence
of e-cigarette, or vaping, product use-associated lung injury (EVALI)
last August. As of late January, the Centers for Disease Control and Prevention
was tracking more than 2,700 hospitalized EVALI cases nationwide, and
60 deaths. All EVALI patients have reported a history of e-cigarette use.
Although a single ingredient hasn’t been labeled the cause—and
EVALI may have more than one cause—the chemical additive vitamin
E acetate has been strongly linked to the EVALI outbreak. Used in vaping
liquid as a thickening agent and to magnify the high-inducing effects
of THC (present in some vape products), vitamin E acetate is safe when
taken as a vitamin supplement or applied to the skin, but previous research
has suggested when inhaled it may interfere with lung functioning.
This exposes one of the dangers of e-cigarette use, Dr. Alvarado says:
the ingredients are not regulated and may not be labeled. “There
are additives we’re not aware of,” he explains. “Even
flavoring can have its own problems; it can decompose into carcinogens.”
In early January, the Trump administration announced a ban on some flavored
e-cigarette products. Under the new policy, companies cannot sell e-cigarette
cartridges in fruit, dessert or mint flavors. Only menthol and tobacco
flavors are allowed. However, the new rules do not apply to larger, tank-style
e-cigarettes which users can refill themselves.
Since e-cigarettes were put on the market, “there’s been an
explosion of access to something that could be very dangerous,”
Dr. Alvarado says. “The best recommendation we have is just to stay
away. It’s a nerve-wracking moment.”
Dr. Jason Alvarado practices at 824 E. Carson St, Suite 101 in Carson.
He can be reached at (310) 233-3203.
Moe Gelbart, PhD, of the Thelma McMillen Recovery Center can be reached
at (310) 784-4879.