Vaping and Nicotine Addiction

Booming popularity of e-cigarettes, ‘vaping’ raises major concerns
By Kimberly A. Kelly, B.A., C.H.E.C. 

The rapidly expanding use of electronic cigarettes and other ‘vaping’ devices, among adults but particularly within the teenager and young adult group, is an alarming reminder of the powerfully addictive nature of nicotine and the serious lifelong health risks that come with it.  

More than 9 million adults vape regularly in the U.S., according to the latest statistics from Centers for Disease Control. At least 38 percent of high schoolers and 13 percent of middle schoolers have experimented with vaping — and there’s reason to think those figures are low, as they’re based on self-reporting.  Vaping is big business and getting bigger – already a $5.5 billion a year industry, trending toward $25 billion over the next five years.

E-cigarettes produce an aerosol by using a built-in battery to heat up and vaporize a liquid that contains nicotine, flavorings and other additives. Users inhale this aerosol into their lungs and exhale a small plume of nearly odorless vapor.  E-cigarettes come in a variety of forms, often concealable in the palm or pocket and resembling everyday items like pens or USB flash drives that are plugged it into a laptop to be recharged.

Introduced in 2004, touted as a ‘safer’ alternative to regular cigarettes and even as a tool to quit smoking, e-cigarettes have been loosely regulated for much of that time. It wasn’t until 2008 that the agencies like the World Health Organization – and later the U.S. Food and Drug Administration – began seriously challenging such claims. The FDA’s official stance today is that e-cigarettes are not an approved smoking cessation tool and can pose health dangers just as serious as cigarettes.

Due to its highly addictive nature, nicotine in all forms, whether it’s smoked, chewed or vaped, presents acute health risks. The power grip of nicotine is strongest when a person starts young. Ninety percent of tobacco users begin smoking before age 18 at a vulnerable stage of their brain development, when they are literally, physiologically primed for dependency.

Aside from those brain effects, inhaled vapor from e-cigarettes can cause inflammation in the mouth, potentially leading to gum disease. It has been shown to interfere with wound healing, by destroying organisms that provide energy to cells as they work to close up injuries. Inhaled particles also can cause persistent coughing similar to a smoker’s cough.  The metal coils which heat up the fluid can cause trace chemicals to become toxic, even carcinogenic.

While e-cigarettes generally contain fewer harmful chemicals than smoke from burned tobacco, they are far from harmless. They contain a host of chemicals, including nicotine itself; volatile organic compounds such as benzene, which is found in car exhaust; a range of heavy metals, such as nickel, tin, and lead; and various ultrafine particles that are inhaled deep into the lungs.

The FDA recently announced a crackdown on e-cigarette sales to minors. An undercover sting was targeting convenience stores, gas stations and online retailers.  The FDA also ordered manufacturers to turn over documents on their marketing targets and health research.  At issue is whether companies are intentionally appealing to the youth market, despite claims to the contrary, and are doing so knowing the harmful effects.

For smokers looking to curb or quit the cigarette habit, e-cigarettes are not the answer. The only legitimate smoking cessation products approved by the FDA are nicotine-based patches, gums, lozenges, nasal spray and a variety of prescription medications to help smokers quit. All of those products should be used in conjunction with a behavioral or support program. 

The public health challenge is dispelling the notion that e-cigarettes and vaping are a safe alternative to cigarettes.  They are not.  They are simply a different vehicle, a modern-day gateway to a lifetime of nicotine addiction.

Kimberly A. Kelly, B.A., C.H.E.C., is the Director of Community Health and Public Health Initiatives with Berkshire Health Systems