UPDATE: This article was updated with new information on Nov. 1, 2019.
Vaping has been making national news lately for some pretty alarming reasons. According to the CDC, 1,888 cases of vaping-related respiratory illnesses in 49 states (all, expcept Alaska, D.C., and the U.S. Virgin Islands were reported since the summer. And now, a total of 37 people have died from vaping-related illnesses. E-cigarettes were once thought of as a safer alternative to cigarettes, but as new research comes out, doctors are growing concerned with its lasting impact — especially among young people, who are particularly drawn to them. So how bad is vaping for you really? DoctorOz.com spoke with multiple doctors to get the scoop.
According to a statement released by Globe News Wire in May of 2019, e-cigs are gaining popularity by the day. In fact, the global e-cigarette market is expected to be worth 53.4 billion dollars by 2024, the statement reports, with vape mods being the highest demand in the category. Evidently, “the awareness regarding the health hazards of cigarettes” has played a role in the sales of e-cigarettes, according to the report. The idea is that, to “quit cigarettes and adopt less harmful e-cigarettes” is to choose the “healthier” alternative. But if cig-a-likes, vaporizers, and vape mods are the lesser of two evils, aren’t they still evil all the same?
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At this time, experts have gathered little information regarding both the short- and long-term effects of vaping on a person’s health. However, during a July 2019 study published in the American Journal of Preventive Medicine, it was discovered that certain types of e-cigarettes are forming irritating chemicals before they’re even in the hands of the consumer. These are chemicals that research indicates might irritate the airways.
For the study, Hanno Erythropel, an associate research scientist at Yale's chemical and environmental engineering department, and her team analyzed eight flavors of a popular e-cigarette brand's e-liquids. The researchers paid close attention to not only the liquid itself, but also the vapor each flavor produced when the e-cigarette was heated. After reviewing their data, the researchers found that alcohol and aldehyde molecules found in some e-cigarettes are reacting to one another and forming acetals, chemicals used to flavor food and products, while they’re sitting on shelves, according to NPR.
Although the extent of the effects of vaping on the human body are still largely unknown, there are some working theories as to why so many people are being hospitalized all of a sudden. Dr. Oz points out a popular theory among researchers that revolves around the way oil from the vape interacts with your lungs. Once it cools down, it can form a grease-like coating on the cells in your lungs, which ultimately causes damage to those cells. Dr. Sanjay Gupta adds that some cannabis-containing vaping cartridges are very high in vitamin E acetate. The working theory scientists have is that vitamin E could be clogging the lungs in some way, causing these illnesses.
“The ultimate diagnosis was an inhalation injury in all eight cases," Louella Amos, a pediatric pulmonologist at Children’s Hospital of Wisconsin, the facility where the teenagers are currently being treated, said in a Facebook Live on July 26, 2019. “It was alarming to have over a short period of time eight previously healthy teens come in very sick, unable to breathe, with weight loss, looking as if they had some sort of chronic lung disease when they didn't,” she said.
According to the CDC, youth “are more likely than adults to use e-cigarettes in the United States.” They may also be smoking e-cigarettes in conjunction with other tobacco products. In other words, young teens and twenty-somethings using e-cigarettes are inhaling a mixture of different chemicals, without really knowing what sort of effects they might have over their body.
Is vaping safe?
As of Sept. 18, 2019, Dr. Oz officially took a stance on vaping: stop until the FDA knows more on what's causing these illnesses.
According to Dr. Niket Sonpal, a NYC-based internist, gastroenterologist, and faculty member at Touro College of Osteopathic Medicine, it would be incorrect to say that vaping is “safer” or “better” for your health than traditional cigarettes. The liquid in vapes might contain levels of carcinogens and toxic chemicals — many of which can potentially cause lung disease. One of the things that makes vaping so dangerous is that we don’t actually know the long-term effects it can have over our bodies.
“There is no concrete understanding of the long-term effects,” Dr. Sonpal tells DoctorOz.com. “[But] we do know, the vapor produced in e-cigarettes contain harmful chemicals that irritate the lungs. You may be fine to smoke once a day, but ultimately your lungs were built to breathe in oxygen, not aerosols.”
A study that came out in Radiology on Aug. 20, 2019 confirmed that "vaping temporarily impacts blood vessel function in healthy people," according to CNN. Though infrequent users' blood vessels did return to normal after stopping use, researchers pointed out that over time, it's possible that they will take longer to return to normal or fail to return to normal at all.
What are you inhaling when you vape?
E-cigarettes might not contain tar and other chemicals found in cigarettes, but an e-cigarette cartridge has the same amount of nicotine as a pack of cigarettes, says Dr. Caesar Djavaherian, co-founder and Chief Medical Officer at Carbon Health. And unlike a pack of cigarettes that take a while to smoke over time, e-cigarette cartridges are more convenient and quicker to use. So not only are you potentially consuming the same amount of nicotine as a pack of cigarettes, but vaping gives you an opportunity to get the addictive chemical into your system faster than a traditional pack of cigarettes.
While some level of nicotine is a given, the other ingredients in e-cigarettes can vary, depending on the brand. Generally speaking, most vaping juices contain “propylene glycol, glycerin, and other flavoring additives,” like mango, mint, fruit, creme brulee, and more, Dr. Sonpal adds.
“[Vape juice flavors are] all made to sound alluring,” however, “these are toxic chemicals that are linked to causing cancer and other chronic diseases,” Dr. Sonpal warns. “If the e-liquid happens to get on your skin or accidentally ingested, high amounts of nicotine are being absorbed, putting you at risk for overdose.”
Is vaping ever recommended by doctors?
Dr. Tania Elliott, an attending physician at NYU Langone Health, tells DoctorOz.com that while, generally, doctors are against vaping for people who are non-smokers (especially adolescents and teens), some physicians believe vaping can be an effective way to quit smoking.
“[Personally,] I’d rather someone vape than use smoke tobacco cigarettes,” Elliot says, and Maurice Chianese, M.D., Chair of Pediatrics at ProHEALTH Care, agrees.
“[To] a pulmonologist or an internist treating a patient that has failed using other methods for smoking cessation, as a step down device, vaping has a role. But it has a role as transient device,” Chianese says. The goal would be to start a regular smoker on an amount of e-cigarette cartridges that would more or less equal the same amount of cigarettes they smoke, and reduce the amount of cartridges overtime to gradually kick the nicotine addiction.
As for teens and adolescents, Chianese says pediatricians are “uniformly against it.” “The concern has been that the vast majority of teens use vaping as an entree into the world of tobacco, so there is not a safe level for teens,” Chianese explains. “Teens are more susceptible to the biological effect of nicotine, both the adverse cardiovascular effects of nicotine and their brains are more susceptible to addictive effects of nicotine.”
How can you talk to someone in your life who is using e-cigarettes?
According to Mayra Mendez, Ph.D., LMFT, a licensed psychotherapist and program coordinator for intellectual and developmental disabilities and mental health services at Providence Saint John's Child and Family Development Center in Santa Monica, Calif., the best way to approach teens and adolescents about vaping, is by discussing, not lecturing on the subject.
“[Youths] are most likely to listen and take in the information when interacted with in an open manner and engaged at a level in which they feel respected and valued, rather than infantilized,” Dr. Medez tells DoctorOz.com. So rather than approaching the subject with assumptions, or in a way that points a finger, ask them questions about smoking and e-cigarettes. Get a better feel for how much they already know. This way, you have an idea of where to fill in the blanks.
Next, try to understand why they are vaping in the first place. Ask them to identify that “why,” encourages Dr. Sonpal, so that, from there, you’re able to see the appeal of vaping from their perspective. Are they vaping to cope with anxiety, to curb hunger in order to stay on track with a diet, to fit in? Once you’ve identified that “why” factor you can discuss alternative solutions to their root problems.
Cap off the conversation by leaning into the reality that while experts know for a fact that smoking cigarettes is bad for your health, there isn’t enough concrete evidence to say for sure what kinds of effects e-cigarettes and vaping can have on the body. What experts do know, Laren Tan, MD, FCCP, a pulmonologist at Loma Linda University Health, tells DoctorOz.com, is that our lunges need clean air to thrive. And “if the only thing their lungs need is clean air,” she says, “why would you put anything else in them?”