Nick started smoking cigarettes when he was 11, maybe 12, and he kept at it for years.
“Until my parents got fed up with it,” says Nick, now 18, a high school senior who lives near Helen, GA. “Also, it got to the point where I couldn’t taste or smell anything.”
So he stopped smoking and started “vaping” -- he gave up traditional cigarettes and for the past year he’s used electronic cigarettes (e-cigarettes).
“It’s the lesser of two evils,” Nick says.
But is it, really?
More and more organizations are concerned about their health effects. Although there have been studies showing they are less harmful, there are many that point out serious harm.
“Safer is not the same as safe,” says Brian King, deputy director for research translation in the CDC’s Office on Smoking and Health.
“Nicotine is a prime ingredient in these devices,” he says. “Studies show nicotine is more addictive than heroin and cocaine. And there’s a growing body of evidence that nicotine can harm the developing adolescent brain.”
At the same time, the number of teens using e-cigarettes has soared.
“High school students are using e-cigarettes at a greater rate than adults,” King says.
In response to this trend, the FDA has rewritten its tobacco rulebook. It now regulates electronic nicotine delivery systems, or ENDS.
Some examples of ENDS include:
- Hookah pens
- Vape pens
These products use a flavored liquid that typically contains a third to half the nicotine found in a regular cigarette. The fluid heats into a vapor that the user inhales, simulating the act of smoking.
While smoking has gone down among teens, overall tobacco use has remained steady. It’s because vaping has become common.
More than 3 million middle and high school students used e-cigarettes in 2015, up from 2.46 million in 2014.
In 2015, e-cigarettes were the most commonly used tobacco product among students in middle and high school for the second straight year.
In 2011, less than 2 in 100 high school students said they used e-cigarettes. By 2015, 16 out of 100 had.
The sale of vaping supplies to minors is banned across the country. But teens have no trouble buying the stuff online.
'A Huge Concern'
A lot of kids experiment with or use vaping products because they believe it’s harmless. For most, the flavors are the lure.
Vaping liquids can be made to taste like candy, fruit, ice cream, or other foods and drinks. Many contain nicotine, which is bad enough on a body because it’s addictive. But some of the chemicals used for e-liquid flavoring also put your health at risk.
For example, Harvard University researchers found diacetyl, a flavoring chemical, in most of the e-cigarettes and e-liquids tested.
Diacetyl has been linked to a respiratory disease called bronchiolitis obliterans. Also known as “popcorn lung,” it first appeared in workers who inhaled artificial butter flavor in microwave popcorn processing facilities.
“This is potentially volatile stuff,” King says. “The flavorings in these products are a concern. The bottom line here is, e-cigarette aerosol is not harmless.”
Nick, the high school student in Georgia, agrees. “You’ve got companies using chemicals like diacetyl to make them taste better. That’s not right.”
There are other issues linked e-cigarette use. They can irritate your lungs or make asthma worse. They may also make a teen more likely to take up smoking.
“They may not be burning carcinogens when they use an e-cigarette,” says Jonathan Popler, MD, a pediatrician with Children’s Healthcare of Atlanta, “but are delivering nicotine to the body.”
The evidence is clear, Popler says: “Teens who use these products are more likely to become smokers later on.”
“From a public health standpoint, that’s a huge concern,” King says.
When It’s Not Tobacco
There have been media reports of teens vaping other drugs, such as alcohol. Popler hasn’t seen any signs that his patients do that. But Nick has heard about it, and he’s not impressed.
“It’s like chugging alcohol and it’s just as stupid,” Nick says. “You’re skipping the filtration system in your body and that can lead to alcohol poisoning much faster than drinking.”
Pot is also part of the trend. “We do hear a lot about people vaping marijuana,” Popler says. That’s illegal and unsafe, too.
Risks Down the Road
The e-cigarette trend in the U.S. is only about 10 years old, so there’s still a lot of data to collect.
As for Nick, he’s now old enough legally buy his own vaping supplies.
“These e-cigarettes don’t work off combustion, so at least I’m not getting all that tar,” he says. “I know it’s not good for me, but it’s not as bad as regular cigarettes. Right now, I’m OK with that.”
He knows he’s taking a chance.
“We still don’t know the long-term effects of e-cigarettes on the human body,” he says. “The unknown is what scares me most.”