No doubt, most students are familiar
with vaping or e-cigarettes, an
alternative to conventional tobacco
cigarettes. Although once touted as a
product to help adult tobacco smokers
quit, e-cigarettes containing nicotine are
now believed to entice, and ultimately
hook, younger smokers with attractive
flavors – candy, bubble gum, mint,
fruit. In fact, since e-cigarettes were
introduced in the U.S. in the mid-2000s,
they have become the most common
tobacco product used among middle
and high school students.
Unfortunately, these novel products
are much more difficult for parents and
teachers to recognize – and equally
difficult to know if children or students
are using them. We asked board-certified
oncologist
Dr. Arati Patel, Medical
Director of the Thoracic Oncology
Program at CH, and board-certified
pediatrician
Dr. Bhargesh Mehta, to
discuss some of the most frequently
asked questions about e-cigarettes and
the new phenomenon: JUUL.
Q. What are e-cigarettes?
E-cigarettes are the
digital
equivalent to the conventional tobacco
cigarettes in delivering nicotine.
E-cigarettes contain a heating element
that produces an aerosol from a liquid that
users can inhale through a mouthpiece.
According to the Centers for Disease
Control and Prevention, 99 percent of
e-cigarettes sold in the U.S. in 2015
contained nicotine. E-cigarettes include a
range of devices including a new type of
e-cigarette on the market called a JUUL.
Q. What is a JUUL?
JUUL is a top-selling, brand
name e-cigarette that came on the market
for adult smokers in 2015 but is now
popular among middle, high school and
college students. A JUUL looks just like
a USB flash drive or thumb drive and can
be easily concealed. It is charged through
a laptop or computer USB port. What
concerns medical professionals who treat young people is that one JUUL pod
contains as much nicotine as one pack
of cigarettes and currently the package
is not labeled with this information.
“Teens and young adults who use these
devices can become extremely addicted
to the nicotine and are ultimately
much more likely to use other tobacco-related
products such as traditional
cigarettes,” said Patel.
Q. Are there dangerous
chemicals in
e-cigarettes? Do they result
in cancer?
E-cigarette devices contain more
than just harmless water vapor and
flavorings. According to a new report
from the National Academies of
Sciences, Engineering and Medicine,
there is
conclusive evidence that in
addition to nicotine, most e-cigarettes
contain and emit numerous potentially
toxic substances. The liquids used
in e-cigarettes are primarily made of
substances generally safe for ingestion.
The question that researchers are
studying is what happens when these
substances are heated up, vaporized
and inhaled.
A study published in the medical
journal Pediatrics in March 2018 found
at least five cancer causing toxins in
the urine of 16-year-olds who inhaled
e-cigarette vapor, according to Mehta.
“Currently, there is no evidence of
short-term carcinogenic impact.
However, it will require years of
research to understand the long-term
impact of these chemicals, especially
given the extreme popularity and the
young age of the users,” said Patel.
Q. Why is nicotine
especially harmful
to teens?
Nicotine is a stimulant, so it speeds up
the heart and constricts blood vessels
which increases blood pressure—it also
gives younger users a buzz or ‘high.’
Scientific evidence suggests that nicotine exposure during adolescence, a critical
window for brain development, may
have adverse consequences on decision making
and impulse control, according
to Patel. Nicotine also activates areas
of the brain affected by alcohol and
marijuana.
Minors may be telling their
parents that vaping or using
e-cigarettes is okay—it’s just water
vapor. “The presumption with teens
and parents is that e-cigarettes are
safe but it is my belief that these
electronic devices are the gateway to
real cigarettes,” said Mehta.
A study published in the American
Journal of Medicine found that young
adults who use e-cigarettes are more
than four times as likely to begin
smoking tobacco cigarettes within 18
months as their peers who do not use
e-cigarettes, said Mehta.
This trend is already impacting
our community. According to a
2016 survey provided by the Calvert
County Health Department, prior to
the popularity of JUULs and other
e-cigarettes, 34.2 percent of high school students and 18.4 percent of middle
school students responded that they had
smoked an e-cigarette product at least
one day during the 30 days before the
survey. Department officials expect those
numbers to go up in the next survey.
“Nearly 90 percent of cigarette
smoking starts before the age of 18, and
these nicotine-containing devices being
used by young people have the potential
to result in lifelong addiction to tobacco-related
products,” said Patel.
At a time when traditional tobacco
cigarette smokers are on the decline, and
only 9.9 percent of Calvert County high
school students and 1 percent of middle
school students surveyed identified
as smokers, e-cigarette and JUUL use
by young people today may lead to an
increase in tobacco cigarette smokers
and, potentially, an increase in health-related
consequences of smoking such as
cancer, lung disease and heart disease in
the future.
