Vaping – a danger at any age

November saw the passing of Robert C. Norris, one of several actors to portray the iconic Marlboro Man, at 90 years of age. While Norris was never a smoker, his rugged and masculine branding in cigarette advertising enticed many folks to smoke. Like much of the Old West, the habit of cigarette smoking has faded from a high of 45 percent of adults in 1965 to a much improved 14 percent in 2017. This laudable public health accomplishment was achieved by widespread taxation, legislation, and education making it expensive, inconvenient, and “uncool” to smoke in America. However, this success also created a void in the market, which has recently been filled by vaping.

Vaping, synonymous with e-cigarette use, describes the act of inhaling aerosolized nicotine and flavoring from a small handheld battery-powered device with a liquid chamber. The liquid is propylene glycol or glycerol (used as smoke in model trains and Christmas or Halloween decorations). The nicotine content in each pod, while variable, is usually equal to one pack of cigarettes.

Use of these devices has skyrocketed as the percentage of adults who vaped at least once increased from 3.3 percent to 15 percent between 2010 and 2016. Unfortunately, illegal use among adolescents has risen even faster, with 28 percent of high schoolers and even 11 percent of middle schoolers vaping in 2017. Many misconceptions exist about vaping: for example, two-thirds of adolescent vapers don’t realize they are inhaling nicotine. Even among adults, many begin vaping as a strategy to quit smoking despite recent studies demonstrating no evidence that it helps.

Controversy surrounds the vaping trend as the marketing of these products appear to directly target youths with flavors like “bubble gum” and “unicorn poop.” The sleek design of these devices, making them look like a cell phone attachment or USB drive, gives them a discreet appearance that youths desire. Despite vaping products being illegal for adolescents, studies show that 87 percent of daily vapers started before 18 years of age. Thankfully, many legislative efforts to curb juvenile marketing are underway.

The most disturbing news regarding vaping is the growing reports of EVALI (E-cigarette/Vaping product-use Associated Lung Injury), which has caused 52 deaths and 2,409 hospitalizations in 26 states through 2019. The exact cause of this condition is unknown but is frequently related to aftermarket adaptations of the vaping liquid, especially the addition of marijuana. Patients who suffer from EVALI can become gravely ill and frequently require mechanical ventilation, antibiotics, and systemic steroids.

Vaping’s addictive nature, marketing to the youth, and demonstrably grave health outcomes should cause all, particularly parents, to oppose its rising trend. “Unicorn poop” is best left as an unspoken detail of fairy tales rather than a contaminant in the lungs of our children.

ANDREW J. MULLALLY, M.D., is a family physician who co-hosts the Doctor, Doctor program on EWTN Radio, and practices at Credo Family Medicine in Fort Wayne, IN.