What Parents Need to Know About E-Cigarettes and Vaping
It's hard to turn on the news and not see a story about the dangers of e-cigarettes or vaping.
As of Aug. 28, 2019, there have been nearly 200 reported incidents of vaping-related illness in 22 states, resulting in at least one death.
Earlier this summer, 17-year-old Tryston spent 18 days in Cook Children's ICU, needing machines to keep him alive. He lost 30 pounds, and had to re-learn to walk normally again because he had no muscle mass in his legs anymore from being bedridden for almost three weeks. He is still coughing at times and feels tired. A clear answer for why his lungs failed him was never found, but doctors believe it was because of his vaping.
“We don't know for sure. But there are literature reports of hypersensitivity pneumonitis from vaping. I told him no inhaling anything again, ever. We still don't know for sure what the trigger was. But it is very plausible that it could be due to his vaping,” Suzanne Whitworth, M.D., medical director of Infectious Disease at Cook Children's said.
Tryston was one of a growing number of teens who are vaping. Statistics show 45% of U.S. teens have tried it.
While the Centers for Disease Control and Prevention (CDC) says E-Cigarettes may have the potential to benefit adult smokers if used as a complete substitute for regular cigarettes and other smokeless tobacco products, they are not safe for youth, young adults, pregnant women or adults who are currently using tobacco products.
The CDC adds there is "a lot to learn about whether e-cigarettes are effective for quiting smoking" and "if you've never smoked or used other tobacco products or e-cigarettes, don't start."
Diane Arnaout, M.D., a Cook Children's pediatrician in Fort Worth, wrote the first story about Tryston. He was her patient and he asked Dr. Arnaout to get the word out about the potential dangers of vaping.
"And though they claim to be a “healthier option” to regular cigarettes, I beg to differ. Inhaling chemicals is inhaling chemicals. There are over 40 different chemicals in vaping liquids. And they can cause some major damage," Dr. Arnaout wrote. "They can hurt delicate lung tissue. We are seeing more and more reports of teenagers and young adults suffering severe lung injuries and seizures coming out in the news lately.
"I’m really worried about how addictive these things are. Kids who want to quit are finding it more difficult to do so than if they’d smoked a pack a day."
Don Wilson, M.D., an endocrinologist at Cook Children's, has been speaking out about the dangers of e-cigarettes for quite some time. Dr. Wilson, who is an an Endowed Chair of Cardiovascular Health and Risk Prevention, offers this basic information for parents:
What do e-cigarettes do?
E-cigarettes are designed to simulate the act of smoking and deliver nicotine without the toxic chemicals produced by burning tobacco. The use of nicotine, however, is highly addictive. Recent research suggested nicotine exposure may also cause the brain to become addicted to other substances. Vapor from some e-cigarettes has also been shown to contain known cancer producing and toxic chemicals, such as diethylene glycol and nitrosamines, as well as small particles of toxic metals. Although not well studied, there is the potential for second hand exposure by others in the environment.
How do e-cigarettes work?
E-cigarettes are smokeless, battery operated devices designed to deliver nicotine mixed with a variety of flavorings (fruit, mint, chocolate, etc.) and other chemicals via an inhaled aerosol. They typically resemble regular tobacco cigarettes, cigars, pipes or everyday items like pins or USB memory sticks.
Most e-cigarettes generally contain three components: a cartridge that contains a liquid solution containing various amounts of nicotine, flavoring and other chemicals, a heating device or vaporizer, and a rechargeable battery. Puffing on the e-cigarette activates the battery powered heating device causing the liquid to vaporize. The vapor is inhaled by the user. E-cigarette vapor may include metals, rubber and ceramics which may be aerosolized and have adverse health effects.
Are e-cigarettes safe?
Although a limited number of studies have been conducted, the safety of e-cigarettes has not thoroughly been evaluated in scientific studies.
Here are a few points to consider:
- Nicotine is highly addictive and has negative effects on brain development from infancy to teens.
- Potential consequences of using e-cigarettes among youth include nicotine addiction, withdrawal and the potential for overdose.
- The use of a variety of flavoring in the liquid solution of e-cigarettes has created concern for accidental ingestion by smaller children.
- With the rapid increase in use of electronic nicotine delivery systems (ENDS), users and nonusers are exposed to the aerosol product. While e-cigarette aerosol may contain fewer toxins than cigarette smoke, studies evaluating whether e-cigarettes are less harmful than cigarettes are inconclusive.
Bottom line: e-cigarettes are often promoted as safer alternatives to cigarette smoking. Although very little is known about their safety, they are increasingly being used by youth and young adults.
What about second hand exposure?
The potential exists for secondhand nicotine and other tobacco-related toxin exposures to others. Studies have shown that e-cigarettes are a source of secondhand exposure to nicotine but not to combustion toxins. Thus, while use of e-cigarettes in indoor environments may involuntarily expose nonsmokers to nicotine, it does not seem to expose them to toxic, tobacco-specific combustion products.
What does the American Academy of Pediatrics recommend?
To protect the health of youth, the American Academy of Pediatrics has made the following recommendations:
- Sales of e-cigarettes to minors (under 18 years of age) should be prohibited.
- Candy and fruit flavored e-cigarettes, which encouraged youth smoking initiation, should be banned.
- To avoid exposing others to potential harm, laws should mandate smoke-free environments which include e-cigarette vapor.
- To prevent poisoning, all e-liquids should be required to be sold in child-proof packaging.
*Image from CDC
- The use of e-cigarettes is unsafe for kids, teens, and young adults.
- Most e-cigarettes contain nicotine. Nicotine is highly addictive and can harm adolescent brain development, which continues into the early to mid-20s.
- E-cigarettes can contain other harmful substances besides nicotine.
- Young people who use e-cigarettes may be more likely to smoke cigarettes in the future
What Are E-Cigarettes?
- E-cigarettes are electronic devices that heat a liquid and produce an aerosol, or mix of small particles in the air.
- E-cigarettes come in many shapes and sizes. Most have a battery, a heating element, and a place to hold a liquid.
- Some e-cigarettes look like regular cigarettes, cigars, or pipes. Some look like USB flash drives, pens, and other everyday items. Larger devices such as tank systems, or “mods,” do not look like other tobacco products.
- E-cigarettes are known by many different names. They are sometimes called “e-cigs,” “e-hookahs,” “mods,” “vape pens,” “vapes,” “tank systems,” and “electronic nicotine delivery systems (ENDS).”
- Using an e-cigarette is sometimes called “vaping” or “JUULing.”
How Do E-cigarettes work?
- E-cigarettes produce an aerosol by heating a liquid that usually contains nicotine, flavorings, and other chemicals that help to make the aerosol.
- The liquid used in e-cigarettes often contains nicotine and flavorings. This liquid is sometimes called “e-juice,” “e-liquid,” “vape juice,” or “vape liquid.”
- Users inhale e-cigarette aerosol into their lungs. Bystanders can also breathe in this aerosol when the user exhales it into the air.
- E-cigarette devices can be used to deliver marijuana and other drugs.
What Are the Other Risks of E-Cigarettes for Kids, Teens and Young Adults?
- Scientists are still learning about the long-term health effects of e-cigarettes.
- Some of the ingredients in e-cigarette aerosol could also be harmful to the lungs in the long-term. For example, some e-cigarette flavorings may be safe to eat but not to inhale because the gut can process more substances than the lungs.
- Defective e-cigarette batteries have caused some fires and explosions, a few of which have resulted in serious injuries.
- Children and adults have been poisoned by swallowing, breathing, or absorbing e-cigarette liquid through their skin or eyes.
What Can I Do To Prevent My Child from Using E-Cigarettes or To Help Them Stop?
- Set a good example by being tobacco-free. If you use tobacco, it’s never too late to quit. For free help, visit smokefree.govexternal icon or call 1-800-QUIT-NOW.
- Talk to your child or teen about why e-cigarettes are harmful for them. It’s never too late.
- Get the Talk With Your Teen About E-cigarettespdf iconexternal icon tip sheet for parents. Start the conversation early with children about why e-cigarettes are harmful for them.
- Let your child know that you want them to stay away from all tobacco products, including e-cigarettes, because they are not safe for them. Seek help and get involved.
- Set up an appointment with your child’s health care provider so that they can hear from a medical professional about the health risks of tobacco products, including e-cigarettes.
- Speak with your child’s teacher and school administrator about enforcement of tobacco-free school grounds policies and tobacco prevention curriculum.
- Encourage your child to learn the facts and get tips for quitting tobacco products at Teen.smokefree.govexternal icon.
- Why Doctors Believe Vaping Landed 17 Year Old In ICU
- Surgeon General’s Advisory on E-cigarette Use Among Youth
- E-cigarettes Shaped Like Flash Drives: Information for Parents, Educators, and Health Care Providers
- Teachers and Parents: That USB Stick Might Be an E-cigarette
- E-cigarettes.surgeongeneral.govexternal icon
- Information from the Surgeon General on the risks of e-cigarettes for young people, and includes free tools such as a parent tip sheet for talking to teens about e-cigarettespdf iconexternal icon [PDF – 5.2MB].
- Teen.smokefree.govexternal icon
- Information for teens who use tobacco products, including tips on how to quit.
- Electronic Cigarettes
- Basic information about e-cigarettes from CDC’s Office on Smoking and Health.