The Dangers of Vaping

Dr. Andre Fallot, director of Saint Francis Pediatric Intensive Care Unit, answers important questions about teens and vaping.

Q: How popular is vaping among teens?

A: More popular than you might think. In Oklahoma, about 20% of high school students are using some form of e-cigarettes or vaping. That’s more than double the national average.

Q:  What are the health risks associated with vaping, and what do you see in the intensive care unit?

A: Thankfully, most kids don’t make it to me because you have to be pretty sick to be in the intensive care unit. But those that do are kids who already have an underlying condition like asthma. For whatever reason, whether it be peer pressure or trying to fit in, they try vaping and wind up having a horrible asthma exacerbation. We’ve even had a few children who’ve had to be intubated and placed on a breathing machine for a few days.

Most kids wind up getting what looks like a pneumonia on an X-ray, a fair bit of coughing, but not typically leading to hospitalization. However, there are certainly reports across the nation of kids who have developed vaping-associated lung injury, or VALI, where lung disease develops quickly. No one is certain what it is about those children and exactly which chemicals in vaping cause VALI. But we do know that vape pens that have THC in them usually also have vitamin E, and that’s been linked to quickly developing severe lung disease.

Long-term use of vaping leads to having a much higher likelihood — at least three times the average — of developing bad asthma, or over time, something even worse called bronchiolitis obliterans, which is similar to bad emphysema in somebody who’s been smoking a long time.

The risk may double because most e-cigarettes and vape pens also have nicotine. You wind up having an addictive cycle where folks can’t stop. They may combine it with smoking cigarettes, or graduate to smoking cigarettes, which have even more carcinogens.

Q: Is vaping addictive, and do you feel that young people are thinking that because it’s not smoking, it’s less dangerous or that it’s not dangerous?

A: Absolutely. Yes, vaping is definitely addictive. E-cigarettes contain enough nicotine that if a small child found a vial of vape fluid and ingested it, it could be fatal.

Overall, vaping is typically touted as being safer than smoking cigarettes and not as addictive. E-cigarettes are fairly easy to hide because they are small devices and don’t have the obvious, visible smoke that cigarettes have, so it’s a little bit easier to be casual about it.

A lot of folks think that because they’re flavored, which many of them are, that they can’t be bad for you. While there’s slightly less of the components that are in cigarettes, there are still some pretty ugly chemicals in it, such as formaldehyde, which can be a carcinogen. The flavoring chemicals that have a fruity smell or anything like that, has diacetyl, which can lead to long-term lung effects that are not reversible. The more you vape and the longer you do it, the less reversible it is.

Q: What would you want parents to know about the risks of vaping and what they can tell their kids?

A: First and foremost, I would say that, if your child is not vaping, they certainly know people that are. Again, at least 20% of high school students in the state are doing it. But if you suspect that your child could be, there are things to look for. Increased irritability, changing sleep cycles — often because of the nicotine – and smelling funny, fruity smells in the room or hallway are all potential signs that your child could be vaping.

But, generally, have an open discussion without yelling or being accusatory. Say, “Hey, what do you know about vaping? Are any of your friends doing it? We know that there’s a fair bit of peer pressure that friends can exert to have you fit in…” are ways to open up the discussion. Of course, if you find anything, confiscate it. Every family is different in their approach, but try to make it more of an open and informational discussion.

Even though it seems as though vaping is safer than smoking, we know that there are long-term health effects, and we do know that e-cigarettes are addictive. Many kids, just like adults, have trouble stopping on their own and need some assistance. There are some programs out there for that. You can ask a family medicine provider or your pediatric provider for resources. There are some online. Smoke-free Teen is a website and resource where kids can be texted reminders and to have them check in to make sure they haven’t resorted to vaping that day. And there are certainly other counseling services as well as medications that have been shown to be helpful in reducing and eventually quitting nicotine use.

Q:  Why is Oklahoma’s e-cigarette use so much higher than the national average?

A: It’s available pretty much anywhere. Even though businesses are not allowed to sell e-cigarettes to anyone under 21, they seem to be easily available. There are lots of smoke shops here in Tulsa as opposed to a rural area where access is more limited.

It also doesn’t help that popular shows such as “The Lowdown” right here in Tulsa show the main characters vaping constantly. It doesn’t add to the storyline. Yeah, it shows that you’re jittery, anxious, and Ethan Hawke’s an amazing actor, and it’s a great show, but come on, guys, you don’t need to be doing that.

It’s an interesting reset from the ’50s and  ’60s, where there’s smoking in every scene. Now that’s all been banned, but there’s a whole new cycle of showing characters smoking e-cigarettes, since there’s no regulation.

Q: Are there things that lawmakers or the community could do, in your opinion, that could decrease teen vaping?

A: I think increasing overall awareness, whether it be in schools, or having some mandatory signage in stores, just like the mandatory labeling on cigarettes warning of the carcinogenic effects. It’s important to ensue that folks are very aware of both the addictive properties and the negative health effects that vaping has on the lungs and heart over time.

Q: Do you think teens are more susceptible to vaping?

A: The way I think of it is that what you breathe in is one of the very few things that you don’t have a whole lot of control over in terms of air quality. But you do have control over things like vaping or cigarette smoking. You only get one body, so if you start sooner and create some irreversible effects, then that’s something you have to live with. I would encourage everybody to think twice and to recognize that they have to protect themselves. There are probably better things to do with your time and better ways to relieve stress than by directly inhaling harmful chemicals.