Clearing the Air on ‘Vaping’

Earlier in my medical career, I was a retained expert to testify against RJ Reynolds, Philip Morris and the American Tobacco Corporation in a federal lawsuit on the subject of the effects of cigarette smoking. In other words, this is a topic for which I have more than a passing familiarity.

Now, I find myself concerned with the prevalence of “vaping,” particularly among young people.

For those unfamiliar, "vaping" or "JUULing" are slang terms for the use of electronic or e-cigarettes; JUUL™ simply being one popular brand. An e-cigarette is a slender, flameless battery-powered device appearing much like a pen, which contains a heated liquid. It produces a vapor which, like a cigarette, can be inhaled.

As a physician, I find there are many misconceptions about vaping and about the significance of the problem.

These devices can be legally obtained anywhere tobacco is sold; Wal-Mart, liquor stores, gas stations, and more. They can be purchased online.

Manufacturers' advertisements are very clever in targeting youth -- a practice banned by conventional cigarette manufacturers. Thus, e-cigarettes are often packaged with cute cartoon characters and fun flavorful names like Sour Apple, Sweet Banana, Chocolate Espresso, Miami Blast, and even Angelic. The packaging is void of the usual warnings required for tobacco products. No warning labels to pregnant women are found on vaping products.

When e-cigarettes came onto the market, manufacturers did a masterful job of conveying the impression of their safety. What harm can there possibly be inhaling water vapor? The suggestion was that e-cigarettes were as innocuous as a party favor. Others said they were useful in weaning people off tobacco. Certainly, advertisements showed glamorous people using them. e-Cigarettes were sleek, cool and sexy -- just like the old days of tobacco advertising.

When there is a dearth of public awareness on the dangers of e-cigarettes, is it any wonder many of our most vulnerable, our children, have fallen prey to these devices? Many physicians are unaware of their dangers, as are many parents, and I suspect many schools.

Though not all e-cigarettes utilize tobacco, that does not mean the sweet oil inside does not hide cytotoxins, carcinogens, and other addictive agents. At least 4,000 toxic poisons have been identified, not the least of which are nicotine, carbon monoxide, formaldehyde, and hydrogen cyanide. And just as with cigarettes, second-hand smoke from e-cigarettes contains these same poisons.

As a physician, the notion that the use of e-cigarettes is harmless and non-addictive is absurd to me. Electronic cigarettes do not allow an addict to slowly withdraw from some other substance addiction; it merely transfers the addiction. E-cigarette users most commonly become dual-users. I believe e-cigarettes are a gateway "drug" leading to using of other even more addictive, physically destructive and illegal drugs.

It is no coincidence that as tobacco usage among our youth has fallen, the use of e-cigarettes has skyrocketed. According to U.S. Surgeon General Jerome Adams, 21 percent of 12th graders report vaping nicotine during the past 30 days. That is double the rate reported in 2017. Similar increases were seen in kids as young as 6th grade.

What we have is an “epidemic.” Those are not my words, but the Surgeon General's assessment. All of the dramatic gains made during the past 20 years in preventing youth tobacco addiction are being

reversed. The developing brains of our youth are most susceptible to the damages of these products; including cognition, reasoning, and attention.

As the parent of a teenager, and member of the Santa Ynez Valley Union High School Board of Education, I have first-hand awareness of the problem of youth vaping.

Here is some of what I’ve heard from students:

• If you look for it, there is vaping going on everywhere.
• Everybody knows it is happening. I guess it's no big deal.
• Even if you are caught, what are they going to do?
• I try never to go to the restroom during the day. Too much vaping.

This is horrible. We cannot be complacent on this issue.

To learn more, and get tips about how to speak with young people – and others --about e-cigarette use, go to https://e-cigarettes.surgeongeneral.gov/knowtherisks.html