The potential health hazards of vaping for teens

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vaping WFewer teens are picking up smoking these days, but what they are doing instead could be even more dangerous and toxic than cigarettes.

Nationally and locally, teens are “vaping” or using “e-cigarettes,” which deliver nicotine and other chemicals in vapor form through a battery-operated device. And manufacturer-added flavors, such as chocolate and strawberry, contribute to the appeal.

According to a 2016 report from the Office of the Surgeon General, e-cigarette use among high school students grew 900 percent between 2011 and 2015, making it the most commonly used form of tobacco among youth in the U.S. That means more teens are using e-cigarettes than tobacco products like cigarettes, cigars and chewing tobacco.

In Anne Arundel County alone, more than 42 percent of high school students surveyed in the 2014 Youth Risk Behavior Study said they had tried an “electronic vapor product” (e-cigarettes, e-cigars, vaping pens, e-hookahs, etc.), and more than 22 percent said they were currently using one, says Mariah Fortman, a health educator with the Anne Arundel County Department of Health. That same survey revealed only 10.7 percent of teens were current cigarette users.

The nicotine in e-cigarettes can lead to addiction and harm teens’ developing brains, causing problems with attention, memory and hyperactivity. In addition, not much is known about the possible negative effects of other e-cigarette chemicals, such as solvents and flavors, experts say.
Unfortunately, e-cigarettes are just another way young people are using nicotine, says Joanne Ebner, a nurse and supervisor of cancer prevention at Anne Arundel Medical Center.

“It kind of re-normalizes smoking,” she says.

According to experts, it’s important for parents to know what e-cigarettes are, how they impact teens’ health, and what area schools and government agencies are doing to slow use and educate teens about the risks.

What are e-cigarettes?

Electronic Nicotine Delivery Systems (ENDS) is a broad term used to describe products using a liquid that contains nicotine, as well as a mix of flavorings and other chemicals. These systems come in many forms, ranging from pipe- and cigar-like devices to rechargeable and disposable cigarette-like devices. They can even resemble common items like pens and USB memory sticks.

More often, they are referred to as e-cigarettes. Most e-cigarettes have a cartridge, which holds the nicotine, flavor and chemical mix (e-liquid); a heating device, also known as a vaporizer; and a power source.

According to the National Institute on Drug Abuse, there are more than 250 different e-cigarette brands on the market. Tobacco companies, which own many of the larger brands, are using similar advertising techniques as they did with traditional cigarettes to market toward youth, Fortman says.

“Companies are trying to entice use through flavorings, celebrity endorsements,” she says, adding common marketing messages include rebellion and glamour.

The flavors contribute to the misconception that e-cigarettes are not as dangerous as regular cigarettes, says Maiya Lyons, 18, a Severn resident and senior at Meade High School. Lyons and fellow senior Faben Henok, 17, are members of the school’s Students Against Destructive Decisions (SADD) organization. Neither has used e-cigarettes, citing the potential health effects. But they say they have seen students outside of school using them, including friends who tried them as young as age 16.

“I don’t see the point in it,” Henok says. “I feel like people do this because they’re bored and have nothing else to do after school.”

The devices are cheap, costing as little as $10, and they’re easier than they should be to get, she says.

“You can buy the pens online, and (they) can be shipped to your house without your parents even knowing,” Henok says.


Health hazard

Regardless of the form they come in, electronic nicotine delivery systems are detrimental to teens’ health, experts stress.

Aside from the known issues with attention, memory and hyperactivity that nicotine can cause, e-cigarette use can lead to other addictions, Ebner says. Nicotine also can raise blood pressure and heart rate and, in high doses, is toxic, according to U.S. Department of Health and Human Services studies. Eventually, use can lead to heart disease, blood clots and stomach ulcers.

While some e-liquids are labeled “nicotine-free,” lab tests conducted by the U.S. Food and Drug Administration in 2009 found some still had traceable levels of nicotine. FDA tests also found detectable levels of cancer-causing chemicals — such as an ingredient used in anti-freeze — in two e-cigarette brands and 18 cartridges. The devices themselves, once used, can have residue buildup that can contain carcinogens and other harmful chemicals linked to lung irritation and damage, Ebner says.

“Although research is still being done, that almost makes it more scary because the long-term risks are not yet known,” Fortman says. “We still don’t know what exactly you’re inhaling. You don’t know, so why are you taking the risk?”

Some experts say e-cigarettes are even a “gateway” to smoking traditional cigarettes. A study published in the November 2015 Journal of the American Medical Association found young people who use e-cigarettes are more likely to use traditional cigarettes within a year compared to those who do not use e-cigarettes.

“We know e-cigarettes are increasingly popular among youth, so we are concerned that young people who never would have tried tobacco products now think it’s perfectly safe and even ‘sexy’ to puff away on e-cigarettes,” says Joan Webb Scornaienchi, executive director of HC DrugFree in Howard County.

Young children are also at risk. Ebner says poison control centers nationwide are reporting an increase in calls because of exposure to e-liquids. A U.S. Centers for Disease Control and Prevention report found e-cigarette exposure calls per month jumped from one in September 2010 to 215 in February 2014. A majority of the calls were for children ages 5 and younger. And in 2014, a 1-year-old died in New York after ingesting liquid nicotine.

“People don’t realize how powerful a drug nicotine is and how toxic it is,” Ebner says.

Vaping Lyons Henok WEducating and regulating e-cigs

Recognizing the risks and growing use of e-cigarettes, area schools and organizations are increasing awareness efforts while government agencies are beefing up regulation.

Last August, the U.S. Food and Drug Administration began regulating e-cigarettes and banned e-cigarette sales to people younger than 18. (E-cigarette sales to minors were already banned in Maryland.)

“It was one step in making the new product regulated,” Fortman says. “It started the process of trying to figure out what exactly is in these products and how to regulate them and monitor what these manufacturers are doing.”

Still, current Maryland and federal laws do not restrict the sale of non-nicotine e-liquid, experts say.

Three years ago, Howard County Public Schools began including the health implications of e-cigarette use in its health curriculum for students in second through ninth grades, says Joan Fox, county schools spokesperson.

HC DrugFree regularly communicates with local teens about the facts behind e-cigarettes at community events.

“Students are very receptive to our warnings about e-cigarettes,” Scornaienchi says. “Teens don't trust what they read on the internet, and they know others are ‘out to make a buck’ off youth.”

Anne Arundel Medical Center educators visit county schools with programs like “Teen Tobacco Road Show” and “Tar Wars” — both of which incorporate the dangers of e-cigarettes.

The Anne Arundel County Department of Health recently produced a video called “No Smoking or Vaping: Join the Movement” with SADD groups at area schools. The video features several Anne Arundel County students, including Lyons and Henok, challenging their peers to end smoking and vaping. The video played from December through February at area movie theaters.

If students aren’t going to listen to their parents and teachers about the dangers, Lyons says she hopes they will listen to their peers.

“I don’t think teens always listen when the message is coming from adults,” Lyons says. “When they’re hearing it from teens, they know there’s another side to the story... and (realize) the long-term and short-term effects of some of the things you’re doing can put a damper on your future.”

By Allison Eatough

Photo above: Meade High School seniors Faben Henok and Maiya Lyons were in a video called "No Smoking or Vaping: Join the Movement."

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