As of this past week, the Center for Disease Control are advising the public to not use e-ciagrettes due to the outbreak of lung injury associated with “vaping” (Science, 2019). According to the CDC, there have been about 805 lung injury incidences, including twelve deaths (2019).
Vaping is intended to help smokers quit smoking traditional cigarettes. The liquid used for vaping contains nicotine which is the addictive drug found in cigarettes and tobacco products making smoking hard to quit (CDC, 2019). By putting nicotine in vape liquid it can get the smoker to start smoking vape instead of traditional cigarettes that contain harmful toxins (Blaha).
Now, there are vape pens, also called E-cigarettes, that contain other drugs such as tetrahydrocannabinol (THC) and cannabinoid (CBD) oils found in marijuana. Out of the 805 lung injury cases, about 77% involved vape containing THC (CDC, 2019). NBC news did an investigation to find that black market THC vape contained vitamin E acetate and hydrogen cyanide which could be the cause for these lung injuries (Ferguson et. Al., 2019).
However, more information is needed to determine which exact product or substances is responsible for this outbreak. In Colorado, where marijuana is legal, THC based vape is widely used. As a public service announcement, I suggest getting your THC vape cartridges through legitimate dispensaries and not from the black market (well, duh).
Another crucial problem is that there have been an increase in teenage vaping where it is now a national epidemic (Huey & Granitto, 2019). What is alarming about this is that many of these teenagers start vaping without any smoking history and then become addicted due to the nicotine intake. This situation contradicts the intended use for vaping and now there are teenagers who start traditional smoking because of initial vape usage.
What are your thoughts on "vaping"? How should "vaping" be portrayed in our society today, especially in a state where marijuana usage is widely accepted?
References:
Blaha, M. J. (n.d.). 5 Vaping Facts You Need to Know. Retrieved from https://www.hopkinsmedicine.org/health/wellness-and-prevention/5-truths-you-need-to-know-about-vaping.
Ferguson, C., McFadden, C., Dong, S., & Schapiro, R. (2019, September 27). Tests show bootleg marijuana vape tainted with hydrogen cyanide. NBC News. Retrieved from https://www.nbcnews.com/health/vaping/tests-show-bootleg-marijuana-vapes-tainted-hydrogen-cyanide-n1059356
Huey, S. W., & Granitto, M. H. (2019). Smoke screen. Journal of the American Association of Nurse Practitioners, 1. doi: 10.1097/jxx.0000000000000234
News at a glance. (2019, September 13). Science , 365(6458), 1062–1063. doi: 10.1126/science.365.6458.1062
Outbreak of Lung Injury Associated with E-Cigarette Use, or Vaping. Center for Disease Control and Prevention (2019, September 27). Retrieved from https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html.
Vaping is indeed a hot topic in the current new environment. Vaping (e-cigarettes) and smoking combustable tobacco products is a controversial topic which is why it warrants an objective critique. In comparison, e-cigarettes are nicotine based products whereas combustable tobacco products contain polynuclear aromatic hydrocarbons (aka toxins which lead to cancer). But that is not to say that smoking e-cigarettes is healthy or to be encouraged. This especially applies to individuals who are under the age of 25 (because the human brain is still in its crucial stage of development). As the brain develops, on its to-do list is making synapses and neuronal pathways for information transmission amongst other things. However, over time nicotine latches itself within the development of new neural networks and addiction become far more unlikely to be overcome if the individual continues to smoke. The effects are known to lead to developmental disorders, learning disabilities, mood changes, and more. For this to be of significant concern of course depends on the amount of nicotine exposure over time. On the other hand, individuals who elect to smoke combustable tobacco products are effected by both the nicotine dependency and the toxic substances to which they are exposed (eventually leading to lung and/or bladder cancers). So, in summary, both substances have been scientifically proven to be very addictive, dangerous, and have negative implications on quality of life. It is important the effects of vaping be well-known to all users and potential users as well as be well regulated on a federal and state level.
ReplyDeleteThe CDC & FDA reviewed a 2016 National Youth Tobacco Survey and found the top 3 reasons why middle and high school students elected to vape (James et al., 2017):
1) seen being used by family/friends (39%)
2) popular flavors (31%)
3) believed to be less harmful than traditional cigarettes (17.1%)
To conclude, based on the evidence brought forth thus far, I would not personally nor recommend to anyone to use vaping products. I think vaping should be portrayed as the science-based data portrays it, an addictive substance that is known to have neurological consequences as well as a deficit in ones bank account.
Super last note because we have to be fair and objective towards both sides... the e-cigarettes companies are very careful to not market their products as to "help smokers quit smoking" because if they were to do so, the FDA will immediately have legal authority to intervene with its full regulatory might. Clever marketing strategy... e-cigarettes companies do not explicitly say their products will facilitate in the quitting process, yet we somehow manage to say it for them.
Reference:
Jamal A, Gentzke A, Hu SS, et al. Tobacco Use Among Middle and High School Students — United States, 2011–2016. MMWR Morb Mortal Wkly Rep 2017; 66: 597 – 603.
The most interesting part of the vaping conversation, to me, is how a generation that was unlikely to ever smoke cigarettes is now hooked on nicotine. A product that in theory is specifically made for smokers to ween off cigarettes is now most popular among our nation's youth. It is beyond accessible and socially more acceptable. Some might think it looks sleek, there's no pungent smell, and for some reason it seems like there are no consequences compared to smoking cigarettes. But now we know that smoking still kills.
ReplyDeleteAnother form of nicotine is relatively popular as well: Nicotine pouches and other smokeless tobacco. You might think that because there is no smoke/vapor inhalation that there are little side effects. But it turns out that smokeless tobacco still can lead to hypopharyngeal cancers (Sapkota et al., 2007).
Because these products are easier to hide than cigarettes, younger demographics are more drawn to them. Hopefully one day we will not need this chemical stimulation just to get through our days. But it seems as though this is not the case :/
Sapkota, A., Smokeless tobacco and increased risk of hypopharyngeal and laryngeal cancers: A multicentric case–control study from India (2007). International Journal of Cancer, 121, 8.
A nation-wide survey conducted by the National Institute on Drug Abuse found that the increase in e-cigarette use among college students between 2017 and 2018 was 6.1% to 15.5%, and this was the largest increase for any substance abuse recorded since they started the survey 40 years go (Schulenberg et al., 2019). What's concerning is that, as Carter0618 mentioned above, our nation's youth has become the target consumers of these e-cigarette companies. The addictive properties of nicotine and the increasing use of these products is not up for debate.
ReplyDeleteHowever, as someone that started vaping at the age of 18 and still continues to Juul, I wanted to share some of my experiences. Currently, I am trying to quit e-cigarettes by slowly decreasing the amount of use each week. I noticed that when I stopped Juul-ing completely, I was faced with some withdrawal symptoms including irritation, anxiety, and lethargy (addiction component). I noticed that I am more inclined to use my e-cigarette before exams or any upcoming stressful events, and by introducing nicotine into my system I feel better equipped to handle those situations (dependence). As for my dad, he was a cigarette smoker for 30 years and about a year ago I introduced an e-cigarette (Juul) to him. He hasn't smoked since. This isn't to say Juuls are the for-sure way to quit smoking, but it CAN be a safer alternative to cigarettes in my opinion. It just depends on how the individual uses it. So what's my personal take on e-cigarettes? Is it addictive? Yes, but I believe that e-cigarettes (sold by legitimate companies) are healthier than combustible cigarettes. Can it be used in moderation? Yes, like any other substances with addictive properties, e-cigarette use can be moderated by the person using it. It just depends on their self-control and susceptibility.
Fun fact: A Juul cartridge does NOT contain the same amount of nicotine as a pack of cigarettes, it's actually 12 cigarettes. (Math done by me).
Schulenberg J, Johnston L, O'Malley P, Bachman J, Miech R, & Patrick M. (2019). Monitoring the Future national survey results on drug use, 1975-2018: Volume II, college students and adults ages 19-60.
A randomized trail, involving 886 participants, showed that e-cigarettes are a more effective for smoking cessation than nicotine-replacement therapy(Hajek, Peter, Phillips-Waller, Anna, Przulj, Dunja et al., 2019). The study also found that the one year abstinence rate was 18% in the e-cigarettes groups vs the 9.9% nicotine-replacement group(Hajek et al., 2019). The results demonstrated that vaping could be an effective tool in smoking cessation for those who really want to quit.
ReplyDeleteCarter brought up a good point saying how a generation that is unlikely to have smoked cigarettes are now inseparable from their juuls. I think social pressures also play a big role on how the younger generation is gravitating towards nicotine. I have a friend that have never smoked cigarettes, who now owns a juul. A big part to why he brought a juul was due to his "brothers" owning a juul( he was in a frat).
Hajek, Peter, Phillips-Waller, Anna, Przulj, Dunja et al. (11 more authors) (2019) A Randomized Trial of E-Cigarettes versus Nicotine-Replacement Therapy. New England Journal of Medicine. ISSN 1533-4406
Following this, Colorado has decided to try and increase the age of purchasing tobacco/nicotine from 18 to 21. However, it's interesting, because as both Ji and Carter have pointed out, e-cigarette use is more popular in younger populations. So, will raising the age to buy these types of products prevent younger people from buying the e-cigarettes? Furthermore, Donald Trump is trying to ban all types of e-cigarettes. However, are either of these changes in laws going to truly change who ends up smoking? And why only ban e-cigarettes and not all types of cigarettes if both are inherently harmful?
ReplyDeleteDuring a research survey, they found that a variety of reasons as to why 12th graders wanted to vape. Some of the reasons included: experimentation, the taste, boredom, it's a "good time", it "looks cool", and it helped them quit. However, almost 55% of the students vaped because they wanted to experiment. And as Georgi already stated, many people also will prefer to use e-cigarettes because it is believed that they are a safer alternative. So, the question is: are e-cigarettes actually a safer alternative? Also, how can we know that it's a safer alternative if we don't understand the long-term effects of e-cigarettes?
After doing other research, it seems that in a lot of scenarios, e-cigarettes are better. One research article states that e-cigarette use caused no changes in systolic and diastolic velocities as well as relaxation time, while traditional tobacco use does cause an increase all three of these categories. So, based on this article, it might be safe to conclude that e-cigarettes might be healthier with regards to heart function. However, the article emphasizes e-cigarettes still need to be studied extensively to ensure they have a long-term benefit for smokers.
On the flip side, another research article shows a correlation between use of e-cigarettes and asthma. The article emphasizes that there are toxins in e-cigarettes that are not usually in regular cigarettes which could lead to lung disease including asthma. While both articles seem to be valid, they both show that electronic cigarettes can be both harmful and helpful when comparing them to cigarette smoke.
So, what type of conversations should doctors be having with their patient? Should they be recommending them over traditional tobacco use or should they say to not use e-cigarettes at all? I think it's extremely difficult to have this conversation and to have clear arguments when the research shows both positive and negative effects of vaping. I think non-malfeasance comes to play when it comes to this topic. One could argue that e-cigarettes can prevent harm if it prevents people from using traditional cigarettes which may be "more harmful". Another might argue that e-cigarettes do not prevent harm because they still cause issues such as asthma.
It will be interesting to see over the course of time how the research will expand. Currently, it's difficult to come up with a full discussion because e-cigarettes are new and therefore, scientists and clinicians do not fully understand the long-term effects of vaping.
References:
Evans-Polce, R. J., Patrick, M. E., Lanza, S. T., Miech, R. A., O'Malley, P. M., & Johnston, L. D. (2018). Reasons for Vaping Among U.S. 12th Graders. The Journal of adolescent
health : official publication of the Society for Adolescent Medicine, 62(4), 457–462. doi:10.1016/j.jadohealth.2017.10.009
Farsalinos, K. E., Tsiapras, D., Kyrzopoulos, S., Savvopoulou, M., & Voudris, V. (2014). Acute effects of using an electronic nicotine-delivery device (electronic cigarette) on myocardial function: comparison with the effects of regular cigarettes. BMC cardiovascular disorders, 14, 78. doi:10.1186/1471-2261-14-78
Clapp, P. W., & Jaspers, I. (2017). Electronic Cigarettes: Their Constituents and Potential Links to Asthma. Current allergy and asthma reports, 17(11), 79. doi:10.1007/s11882-017-0747-5
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