Vaping 101: Understanding the Risks

The topic of vaping has been in the media recently, particularly with the FDA launching its ”The Real Cost” Youth E-Cigarette Prevention Campaign in July. We reached out to Dr. Richard A. Hogan, who specializes in both pulmonary and sleep medicine at Door County Medical Center (DCMC), to help us understand the facts and risks surrounding this important subject. 

What is vaping?  

Vaping is using an electronic cigarette or other device to inhale a vapor created by the device.  E-cigarettes are known by many different names. They are sometimes called “e-cigs,” “e-hookahs,” “mods,” “vape pens,” “vapes,” “tank systems” and “electronic nicotine delivery systems (ENDS)”.

“Electronically generated aerosols release the chemicals in the vaping cartridges,” explains Dr. Hogan. “Many of these devices use nicotine as the agent and some contain chemicals that are attempting to flavor the inhaled product. Some devices vape THC which is the psychoactive chemical in marijuana.” According to the Centers for Disease Control and Prevention: 

  • E-cigarettes come in many shapes and sizes. Most have a battery, a heating element, and a place to hold a liquid.

  • Some e-cigarettes look like regular cigarettes, cigars, or pipes. Some look like USB flash drives, pens, and other everyday items. Larger devices such as tank systems, or “mods,” do not look like other tobacco products.

  • Using an e-cigarette is sometimes called “JUULing.” JUUL is the name of a brand of vaping cartridges.

What are the physiological similarities and differences between smoking cigarettes and vaping e-cigarettes?  

Both smoking cigarettes and vaping use the lungs as a port of entry for the psychoactive chemical. Cigarettes generally have tobacco with nicotine as the psychotropic drug—the nicotine is in with the smoke. With vaping the chemical in the cartridge is aerosolized or vaporized so that one can inhale the chemical; there is no smoke. 

What health concerns come with vaping nicotine?  

Scientists are still learning about the long-term health effects of e-cigarettes. Any product that is inhaled into the lungs could have potential damaging effects on the bronchial walls and the lung tissue itself. According to Dr. Hogan, lung tissue does not have the ability to regenerate itself. 

“Beyond that, we have no idea whether the various chemicals in the vaping cartridges might have ill effects on other organs such as the brain, nervous system, heart, kidneys, liver, muscles or reproductive systems. Because the FDA does not regulate these products as drugs, there is no safety information on the products being sold. So we are in a ‘buyer beware’ situation. We do not recommend that anyone puts their health at risk with these products. Simply put…it’s not worth it.” 

According to the FDA, e-cigarettes can, among other things, contain dangerous chemicals such as: acrolein, a chemical that can cause irreversible lung damage; formaldehyde, a cancer-causing chemical; and toxic metal particles, like chromium, lead and nickel.

“Most importantly, nicotine is an addictive substance whether it is vaped or it is smoked,” says Dr. Hogan. Nicotine can also rewire the brain to crave more nicotine, particularly in adolescent brains that are still developing. 

What are some misconceptions people may have about the safety of vaping?  

“The huge misconception is that it is safe,” says Dr. Hogan. There has been a recent rash of young people in the Midwest states, including Wisconsin and Door County, who developed severe, diffuse lung disease from vaping. 

“The lung issue presents as severe chest wall pain and shortness of breath,” reports Dr. Hogan. There is a risk that the lung healing may occur with scarring and diminished lung power. He says it seems likely that there will be some residual deficit in the lung function of the people that have developed vaping related lung disease.The scientific community has not yet discovered what material in the vaping product has caused the lung issue.

“There is very clear information that these products are risky.” He suggests that because these products are sold in various locations which seem legitimate, people may assume that they are safe to use.

What can I do to stop using nicotine? 

If you are vaping nicotine products you could switch to readily available nicotine patches, lozenges or gum (all regulated by the FDA) and wean down from there. If you want advice or help with nicotine cessation, please contact your DCMC Primary Health Care Provider at (920) 743-5566. The State of Wisconsin has a “Quit Line” 1-800-QUIT-NOW.

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