#e-cigs

A lot of recent news stories are saying 25% of teenagers vape daily. This is a false and egregious distortion of a completely different statistic! In fact, only 3-4% of teenagers vape daily!

Don't believe the sensationalism. This is journalistic malpractice and a moral panic.

Sure! 

Article 1: Metal Concentrations in e-Cigarette Liquid and Aerosol Samples: The Contribution of Metallic Coils

Article 2: E-cigarettes as a source of toxic and potentially carcinogenic metals

Article 3: Crowned jewel of e-cigarette industry halts flavor sales

Article 4: FDA Says a ‘Public Health Tragedy’ Is Underway as Teen E-Cigarette Use Remains Popular

Old-timey photograph from the 1930s of Broadhurst Avenue in Drumbridge, Michigan, featuring the busy sidewalk just outside the lobby of Fenneman Hall, at the time one of the last surviving squirrelesque variety houses - actually a “split house,” as it had to share the space with a bawdy burlesque operation.

When somebody asks me which came first, burlesque or squirrlesque, I tell them that there was a time when burlesque was described as “squirrelesque without the squirrels.”

Though Baby Gruenwald thoroughly enjoyed the comical rodents of squirrelesque, he never really understood the double entendres of burlesque, and only appeared in the more family friendly milieu of vaudeville.

Kristen Lewis is the assistant principal at Boulder High School in Colorado. A large cardboard box sits in her office. It’s where she tosses the spoils of her ongoing battle with the newest student addiction: vaping. “This is what I call the Box of Death,” she explains. Inside it “is everything that we’ve confiscated.”

There are vape pens, such as JUULs (the leading brand of e-cigarettes). You also can see dozens of disposable pods that once were full of flavored, nicotine-rich liquids. There is even a lonely box of Marlboros.

Students aren’t allowed to smoke or vape on school grounds. But Lewis and other school employees still regularly pluck e-cigs from students’ hands or find vape-related trash littering the halls and restrooms.

In the school parking lot, Lewis spots discarded packaging. “This one,” she says, is from “an Orion vape device, it looks like.” A little further on, she spots a pile of JUUL pods. More vaping trash shows up in the yards of homes across from the school and along the edge of nearby Boulder Creek.

This trash reveals “how much [vaping] has become a part of our students’ lives,” Lewis says. “And that’s what’s scary… It really has become an epidemic.” She notes, “every high school in the nation is really dealing with this.”

Colorado recently topped the national list for teen vaping. That’s based on data reported in June 2018 by the U.S. Centers for Disease Control and Prevention. Boulder, it turns out, is a Colorado hot spot. The surge in vaping here, as elsewhere, has led to health problems. Less obvious, this new teen obsession is creating a new environmental problem. Discarded vape pens and pods now litter city streets and schools across the nation.

Parents may not recognize on sight a JUUL or similar pod-type electronic cigarette, but many of today’s tweens and teens will. These have quickly become the leading vapes of choice for the legions of U.S. e-cig users 18 and under. Vaping isn’t a healthy choice for anyone. And, new data show, these pod-type e-cigs might just be the worst choice of all for kids who have decided to experiment with tobacco products.

U.S. minors cannot legally buy vapes. And that’s one reason the majority of them find these pod-like devices so appealing, says Bonnie Halpern-Felsher. She’s a developmental psychologist at Stanford University in California. These pod vapes have a deceptively large amount of nicotine, she notes.

That nicotine can harm the developing brain, adds Suchitra Krishnan-Sarin. Whether kids know it or not, their brains will undergo a lot of developmental changes between the ages of 10 and 25. Krishnan-Sarin works at the Yale University School of Medicine, in New Haven, Conn. There, she studies how nicotine affects smokers and vapers.

Most nicotine research has taken place in rodents. “In adolescent animals,” she notes, “nicotine is a neurotoxin.” It keeps the brain from maturing normally during adolescence. This can harm the ability to learn, to make memories and to maintain attention, she explains. It can even lead to hyperactivity.

Krishnan-Sarin spoke at a news briefing for reporters earlier this year. Adolescent animals, she noted, “are very sensitive to even low levels of nicotine.” And that, she explained, “means they get addicted very easily.” The same, she added, is likely true for human teens.

Yet some kids aren’t aware that pod-like e-cigs contain any nicotine. That was one finding of a new survey. At an October workshop at the National Institutes of Health in Bethesda, Md., Halpern-Felsher and her Stanford colleague Karma McKelvey shared data from their survey of 445 teens and young adults. Each had been asked whether they knew about — or used — pod-like e-cigarettes. The researchers focused on such devices, they said, because JUUL now accounts for between 70 and 85 percent of e-cigarettes vaped in the United States.

Nearly one-quarter of the students said they had vaped. Of those, more than half said they had used JUUL or other pod-like e-cigs. These devices all are really small. And they don’t look like earlier types of e-cigs. Those had resembled mechanical cigarettes or were clunky. JUUL’s sleek pods look a bit like thumb drives. What’s more, they release a relatively small cloud of the vapors from which vaping takes its name.

But these devices hold more nicotine than most earlier e-cigarettes, says Halpern-Felsher. Each JUUL pod, for instance, contains 41.3 milligrams. That’s as much nicotine, she notes, as someone can get smoking 26 to 40 conventional cigarettes (depending on how they are puffed).

Moreover, the salt-based form of nicotine in the pods feels less harsh than the nicotine in true cigarettes and earlier e-cigs. So the pods’ nicotine is less likely to turn off a new user, Halpern-Felsher says. And that may encourage kids to overdo it as they experiment.

Bonnie Halpern-Felsher’s team at Stanford developed this visual illustration of the high quantity of nicotine in several types of pod-based e-cigs — shown in terms of their cigarette equivalence.

CREDIT: TOBACCO PREVENTION TOOLKIT, STANFORD UNIV.

Some kids are already paying a high price for their covert vaping. Data released Dec. 18 by a federally funded study — Monitoring the Future — finds that 8.1 percent of U.S. 12th graders say they are hooked on vaping. That’s more than twice the 2018 number. What’s more, Halpern-Felsher has found, most teens “don’t recognize how addicted they are.” Some nicotine addicts she surveyed didn’t realize they were hooked at all.

Health experts have been growing increasingly concerned about the rising rate of teen vaping. Too many kids see e-cigarettes as cool and harmless, they note. And it’s that last part that’s especially worrisome, they say. Study after study has shown vaping does pose risks. One of the newer and more concerning symptoms: seizures.

Last April, the U.S. Center for Tobacco Products issued a special announcement. Over the past nine years, people have filed reports on 35 cases of vaping-related seizures. Most took place in the previous year. Especially worrying, it noted, most of the cases involved teens or young adults.

The center, based in Silver Spring, Md., is part of the U.S. Food and Drug Administration. “Detailed information is currently limited,” its report notes. But emerging data are so worrying, it adds, that FDA wanted to get the word out on “this important and potentially serious health issue.”

Seizures are essentially electrical storms in the brain. Little is known about the molecular changes that can trigger them. But at least in animals, nicotine can turn on such storms.

CREDIT: PETERSCHREIBER.MEDIA/ISTOCK/GETTY IMAGES PLUS

Seizures are electrical storms in the brain. They can be accompanied by convulsions, where the body shakes uncontrollably. However, the new report notes, “not all seizures show full-body shaking.” Some people just show “a lapse in awareness or consciousness.” This might leave someone “staring blankly into space for a few seconds,” the FDA report explains. Affected people might simply stop what they’re doing, briefly. If this happens while someone is standing, they might collapse.

The share of U.S. teens and tweens vaping in school bathrooms and nearly every other place continues to grow. These new data worry health officials. One in every four high-school seniors reported recent vaping, according to an annual survey of teen behaviors. Among sophomores, one in five reported vaping. For 8th-graders, one in every 11 had vaped. And a growing number of studies show vaping can be harmful, in some cases very harmful.

Explainer: What are e-cigarettes?

This growth in teen vaping comes as health officials are witnessing a growing outbreak of severe vaping-related illnesses and deaths. As of October 10, the Centers for Disease Control and Prevention, or CDC, reports 1,299 cases of lung injury linked to vaping since this summer. Of these, 15 percent of cases were under 18 years old. Another 21 percent were between 18 and 20. The cases come from 49 states, the District of Columbia and one U.S. territory. Of these, 26 people have died. Officials don’t yet know what substance or product is fueling the lung injuries.

The new student vaping stats come from Monitoring the Future. It’s a nationally representative survey of U.S. teens that is conducted by the Institute for Social Research. That’s at the University of Michigan. The survey is funded by the U.S. government. It asked vaping-related questions of more than 4,500 students in each of the three grades.

The new vaping data mark a 4.5-percentage-point rise among 12th graders. The rate is up 4.1 percentage points among 10th graders. Among 8th graders, there has been a rise of 2.8 percentage points over the past year. Richard Miech of the University of Michigan in Ann Arbor and his team reported their findings September 18 in a letter to the New England Journal of Medicine.

The popularity of vaping continues to increase, as more 8th graders and high school sophomores and seniors report using e-cigarettes each year from 2017 to 2019. CREDIT: E. Otwell, Source: R. Miech et al/New England Journal of Medicine 2019

“Unfortunately, I am not at all surprised by these increases,” says Susanne Tanski. She’s a pediatrician at the Dartmouth Geisel School of Medicine in Hanover, N.H. “Use [of e-cigs] among teens and young adults is incredibly common, frequent and leading to addiction,” she notes.

Most e-cigarettes vaporize a liquid that contains nicotine, an addictive drug. So this year’s survey for the first time attempted to quantify how many teens might be addicted to e-cigs. To get at that, it asked if students were vaping daily, or at least on 20 of the 30 days before taking the survey. Nearly one in every eight 12th graders had. So had roughly one in every 14 10th graders. Among 8th graders, one in every 50 said they had vaped.

Nicotine can alter how a teen’s brain develops. It can harm its ability to learn, to pay attention and to control impulses.