A 2018 Kentucky state poll indicated that 27 percent of high school seniors reported using e-cigarettes. This represented a 100 percent increase in use among high school seniors compared to a 2016 poll.
Perhaps even more disturbing is that 20 percent of all high school students and one in 20 middle school students used e-cigarettes, according to the 2018 data. This represented a 78 percent increase among all high school students from the previous poll and a 48 percent jump for middle school students.
Despite the association of e-cigarettes with the term "vaping," these devices do not release harmless vapors, but instead contain substances such as ultrafine particles, which can be inhaled deep into the lungs. These particles are the same as those used to convince local policy makers to pass smoke-free laws to protect those who do not smoke from the ill effects of secondhand tobacco smoke. According to the Centers for Disease Control, some flavorings contain compounds such as diacetyl, a chemical linked to serious, irreversible lung disease; volatile organic compounds, which are known to be carcinogenic; other cancer-causing chemicals; and heavy metals, including nickel, tin and lead.
E-cigs can contain high levels of nicotine, which is a highly-addictive drug. One popular form, Juul, is easy to conceal since it resembles a computer flash drive. One Juul pod can contain the same amount of nicotine in an entire pack of cigarettes. Studies indicate that young people who vape are at a significantly increased risk of smoking cigarettes within six months. Nicotine has the potential to impair young people's brain development and can reduce attention span and impulse control.
Recently in the U.S. there have been 1,080 cases of vaping-related lung illness, including 18 deaths, according to the CDC in Atlanta. Symptoms have included difficulty breathing, cough, fever, nausea, and/or vomiting. While most patients have reported using cannabinoids (THC) or cannabidiol (CBD), some have also reported using only nicotine. No single e-cigarette product or substance to date has been consistently connected to the lung illness and no vaping or e-cigarette device has been associated with the outbreak.
Most of the patients with this vaping illness have been young and otherwise healthy. Roughly 94 percent of the affected individuals reported e-cigarette use within the previous week before symptom onset and 88 percent reported daily use. Treatment for this malady has included antibiotics, steroids, supplemental oxygen therapy and at times even intubation with mechanical ventilation. The spectrum of disease has included acute lung injury, adult respiratory distress syndrome (ARDS), lipoid pneumonia, diffuse alveolar damage, acute necrotizing pneumonitis and hypersensitivity pneumonitis.
In addition to the deaths which have occurred, some patients have had persistent reduced lung function on outpatient follow-up subsequently.
Because of the severity of the disease and its potential impact on youths, e-cigarette products should not be used at all by youth and young adults, pregnant women or adults who do not currently use tobacco products. Regardless, these products should not be purchased off the streets. Vaping products should also not be modified or have other substances added to them which are not intended by the manufacturer.
If you have any symptoms or believe you may be suffering from a vaping related illness, please contact a physician immediately, and/or call the local poison control center at 1-800-222-1222.
Vaping is not cool, because being unable to breathe is not cool and irreversible lung disease is totally uncool. Make sure your children and their friends know that. It could save their lungs, if not their life.
Dr. Shawn Jones is a board-certified otolaryngologist in Paducah, past president of the Kentucky Medical Association, and current president of the Kentucky Foundation for Medical Care.