What’s up with Vaping?

The term “vaping” is used to differentiate between smoking an electronic cigarette versus the conventional cigarette.  The electronic cigarettes were initially introduced in 2003 in China, and later in the US and European markets in 2006 as a method to help individuals to stop smoking.  Unfortunately, there isn’t any clear data to suggest that the e-cigarette truly helps break the habit of smoking.  Instead, there has been a trend among our teens to start using these e-cigarettes recreationally.  If so, what exactly are the teens doing when they are “vaping,” and is there a concern?

The traditional e-cigarette consist of a cartridge containing a liquid, a heating element, and a battery.  Newer models are now called “Juul,” and resemble a flash drive that can be plugged into an electronic device to be charged.   When in use, the teen activates the device by either inhaling or by pressing a button.  The heating unit then converts the liquid into a “vapor” that is inhaled by the user.

What’s in the liquid for an e-cigarette?

The main ingredient is nicotine, and is packaged in vials that range between 6mg/ml – 36mg/ml.  A typical vial size will contain 5ml of liquid, which means it can deliver 30mg – 180mg of nicotine per vial.  If the vial is ingested by a child under the age of 6yrs, the lethal dose of nicotine can be as small as 10mg.  With even as little as 1-2mg of nicotine, there may be nausea, vomiting, increased heart rate, and eye irritation.

Secondary ingredients are propylene glycol or glycerol.  At high temperatures, both propylene glycol and glycerol decompose to form cancer-causing toxins such as propylene oxide, acrolein, formaldehyde and acetaldehyde.

Some e-cigarettes are also being sold with a flavoring to appeal to our youth.  Long-term effects of inhaling flavoring on respiratory function is uncertain; but several flavoring by-products such as diacetyl and benzaldehyde have been associated with respiratory irritation and respiratory disease.

Although e-cigarettes are marketed as a method for smoking cessation, multiple studies have found that e-cigarette use is NOT associated with higher rates of quitting or reducing smoking.  In contrast, one study (with over 17,000 adolescents) showed that users of e-cigarettes had a higher probability of initiating conventional cigarette smoking.  Furthermore, the FDA has not approved e-cigarettes for smoking cessation.

What’s the concern with vaping?

The current packing and flavorings offered with e-cigarettes are targeted to appeal to the younger adolescent population, which may lead to nicotine addiction and subsequent conventional cigarette smoking.  Once an adolescent tries and uses legal drugs, there is evidence suggesting that nicotine may prime the brain for illicit drug use.  Most worrisome is the lack of regulation on the production of e-cigarettes and the potential harm from inhalation and/or ingestion of nicotine and its toxic by-products.