Just Blowing Smoke?

In the last handful of years, we have seen vape pens and e-cigarettes become the new “thing,” almost rabidly fast. Most concerning to some is the fact that vaping has drawn in a young demographic, sometimes as young as middle school students. Despite all the years of “Just Say No” campaigns and Red Ribbon Weeks, young people, who spent their entire childhood being told smoking was harmful and breathing in cigarette smoke could lead to lung cancer, have been willingly turning to vaping as an alternative to smoking cigarettes. The substance is marketed almost as a sort of treat or candy, with new and unique flavors released all the time. 

Since this form of smoking came about, it has also been portrayed to the public most often as the “safe” way to smoke – a way to smoke without breathing in more than 7,000 chemical components (more than 250 of which are harmful to the human body) that the Centers for Disease Control and Prevention (CDC) has found to exist in cigarette smoke. But, recently, these claims that have been believed or at least accepted for the past few years are being questioned as horrifying reports of injuries, lung disease, health issues and tragic reports of deaths across the country have surfaced. As of September 2019, the CDC reports 805 confirmed and probable cases of injury and health issues related to vaping. The problem has skyrocketed over just the past six months, sending people into panic. Many of these cases involve the development of acute respiratory distress syndrome, which can be life-threatening as it involves fluid buildup in the lungs and the prevention of properly-oxygenated blood flowing through the bloodstream. The first death reported occurred in August of this year in Ill., and the list has sadly grown to include eight other states and 11 other deaths as of September 2019. 

People are frightened and even beginning to panic. Why is it that all of a sudden there has been a spike in disease, deteriorating health and even death? The answer is almost just as unsettling: no one is sure yet. There has not been any conclusive data or verdict as to what is causing these deaths and why they are occurring at such a rate, but the CDC continues to tirelessly investigate all reports they receive of these cases in order to find the answers. Until they do, we are all just as much in the dark as the next person. There are now only speculations as to what exactly is inside these vape pens may be causing issues. Some people believe the pens that hold THC are the ones causing deaths. There has been a common element, vitamin E acetate, that has been found in nearly all cannabis samples across the country and which people think could be causing harm in this form. Though vitamin E acetate is something found naturally in some foods, there still is not any evidence that it is a substance that can be inhaled safely. It has oil-like properties that, when inhaled, could cause some of the symptoms patients experience, like shortness of breath and coughing. 

So, there are theories, but no conclusive evidence or explanation. Well then, what do we know? We know how they work: vape pens produce an aerosol by heating a liquid inside the pen mechanism. This liquid usually contains nicotine and some sort of flavoring chemical, but recently, there have been more developments in what you can smoke through these pens. These aerosols could contain tiny particles of metals such as tin, nickel and lead, and other chemicals and fine particles that could be harmful when inhaled. They are, however, less toxic and less loaded with chemicals and harmful elements than the aforementioned cigarettes. 

We also know vape pens and e-cigarettes are a fairly new product, and they are still not approved by the U.S. Food and Drug Administration, nor are there any policies in place to regulate the production of what goes inside the pens. This means there are companies out there, possibly marketing their product as “organic” or “natural,” who offer products that are in fact neither of these things. Without regulation, there is potential for immoral and unsafe production, which could lead to you inhaling something very dangerous. We know there are components of these aerosols that are easily digestible, but we do not know whether they are safely inhalable. 

We also know that, like with cigarettes, there is an element of second-hand inhalation that make potentially harmful to bystanders, as well as the user. 

So, what about the assertions that vaping is a safe way for smokers to wean themselves off smoking tobacco products? Pulmonologist Dr. Ayass of Ayass Lung Clinic in Frisco says, “I never have and never will recommend using vape pens as a way to help someone quit smoking tobacco–not even before all these terrible reports came out. The reason is that tobacco and nicotine are not addictive substances. In pulmonary medicine, we refer to what people experience with tobacco and nicotine as dependency syndrome, not addiction. With addiction, to quit using is to experience withdrawal – a sometimes life-threatening state, and the reason why we have rehab programs for drug and alcohol addictions. The same is not true with nicotine and tobacco. Someone could quit ‘cold turkey,’ and it would not be life-threatening–and people do! It is definitely difficult to do so, but it can be done.”

We also know that vape pens, even before this mysterious outbreak of issues and debates over harmful substances came about, cause harm to the lungs. “They decrease macrophages in the alveoli in the lungs, which affects lung functionality and immunity negatively, and increases the lung’s susceptibility to infection and inflammation,” says Dr. Ayass.

There have been voices against vape pens for years now, especially because they seem to be most popular with young people who are still growing and developing. For example, in 2018, 3.6 million junior high and high school students used vape pens in the U.S. With no true proven “pros” to smoking e-cigarettes, and with confirmed and suspected “cons,” it is important to remember, especially in light of recent tragic events, that e-cigarettes may be less harmful than tobacco products, but that does not make them harmless.