By Kim Robson:
Use of smokeless electronic cigarettes, commonly called “e-cigarettes” or “vaping pens,” is on the rise among the general public, particularly among young people. Juul markets their product as a “satisfying alternative to cigarettes,” and now stresses in its advertising that it contains nicotine, an addictive chemical. The come-on is compelling: e-cigarettes get you away from the harmful tar, nasty smell, messy ashes and the social stigma of cigarette smoking. E-cigarette “smoke” actually is quickly-dissipated water vapor with pleasant non-lingering flavors, making it far less offensive to bystanders. They are even touted to help bridge the gap from smoking to quitting nicotine altogether.
Occasionally, we see a sensational news report of e-cigarettes’ lithium batteries overheating and even exploding in users’ pockets or mouths. A vaping pen exploded in a teenager’s mouth, shattering his jaw and requiring reconstructive surgery. And of course, recently there have been reports of serious lung injuries related to e-cigarettes. So, let’s get past the clever and misleading marketing tropes and delve into the facts and dangers of e-cigarettes.
A 2018 study found that 63 percent of JUUL users between 15- and 24-years-old had no idea they were ingesting nicotine. They thought it was just water vapor and yummy flavors, which the makers of vaping products insist are not aimed toward children. But fruit and candy flavorings with names like Strawberry Watermelon, Meteor Milk Space Jam, or Cotton Candy clearly are made to be attractive to kids.
The most popular brand, Juul, happens to have the highest concentration of nicotine in their pods, about 5 percent, compared to the 1 to 2.4 percent of other e-cigarette manufacturers. One Juul pod contains about the same amount of nicotine as a pack of traditional cigarettes, or about 200 puffs. The company boasts that its nicotine salt formulation has the highest blood delivery rate and level of nicotine, compared to the competition, and that Juul delivers nicotine up to 2.7 times faster.
In addition to the nicotine, e-cigarette vapor contains fine and ultrafine particulate matter made up of propylene glycol, glycerin, chemical flavors, and trace amounts of toxicants, carcinogens, heavy metals, and metal nanoparticles. It is not merely “harmless water vapor.” In fact, many of the establishments that ban smoking also ban vaping.
Even more alarming, in recent weeks there has been an increasing number of users with severe respiratory damage landing in the ICU (450 cases as of this writing) or the morgue (five deaths to date). Their lungs appear to have been ravaged by disease or exposed to some caustic industrial chemical. All the patients have one thing in common — they all used e-cigarettes. “They are having fevers, drenching night sweats, they feel like they can’t breathe and their chest hurts. It is just a miserable, miserable condition to be in,” says Scott Aberegg, a pulmonary and critical-care specialist at the University of Utah Health.
While harder for minors to find, e-cigarette pods containing THC, the psychoactive compound in marijuana that produces a “high” are also possible to obtain. According to the Centers for Disease Control (CDC), while some patients ingested nicotine, and some others ingested THC, by far, the highest number of cases involve the 61 percent of users who ingested BOTH nicotine and THC products. The most popular THC pods are from the company Dank Vapes, and were used by more than half of the patients who gave extensive interviews to epidemiologists. Some of these pods also may have been purchased on the black market. New York state health officials are looking at Vitamin E acetate used as a carrier — harmless as a nutritional supplement, but never meant to be inhaled.
In response, several states have banned the sale of tobacco, including e-cigarettes and their associated products, to anyone under the age of 21. Some of the more reputable brands claim their cartridges don’t use cutting agents like glycerine or Vitamin E acetate, but others cut corners or target the black market to keep costs down, using unknown and untested chemicals to dilute the oil, which can be dangerous when heated and inhaled.
Additionally, the Food and Drug Administration (FDA) proposed a planin November 2018 to curb the epidemic of e-cigarette use by children and teens. It limits the sale of flavored pods to adult-only stores and online sales, but sadly, e-cigarettes will be allowed to stay on the market through August 2022, unchecked by FDA oversight. And determined kids who want their fix will always find a way.
The CDC is recommending that consumers discontinue use of e-cigarette products until more studies have been conducted and the risks are better known. They certainly never should be used by minor children, whose developing brains react differently to nicotine, worsening anxiety, learning disabilities and headaches. Adults who still choose to vape should exercise extreme caution by purchasing vaping products from a trusted, well-established company only. Don’t try to save a few bucks by using questionable or inexpensive products or, even worse, something bought off the street.