E-cigs: Healthy alternative or gateway to addiction?

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E-cigarettes – a.k.a. vapes or e-cigs – are all the rage these days.

Vape shops have popped up all around town and big white clouds waft out of cars at traffic lights or from pedestrians as they walk the downtown streets. And memes about Juul – a popular type of vape – are taking over Twitter.

But the FDA is cracking down on e-cigarette companies, requiring them to make a plan to prevent sales to minors or face penalties. On the latter, vaping advocates + manufacturers say e-cigs can help people quit traditional tobacco products.

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Why is this topic coming up now?

In September, the FDA gave manufacturers 60 days to restrict sales to people under the age of 18 – issuing 1,300+ warning letters + fines to retailers illegally selling products to minors (mostly products manufactured by Vuse, Blu, JUUL, MarkTen XL + Logic). And earlier this month, Juul Labs announced its plan to suspend sales of most of its flavored e-cigarette pods in retail stores, discontinue its social media promotions, ban sales of flavored e-cigarettes in convenience stores + gas stations, as well as strengthen the requirements for age verification on online purchases.

We want to hear your perspectives on vaping – we’ve included info from a doctor at Lexington Medical Center in Columbia, S.C. and are giving you the 411 on vaping laws. Join the conversation here.

Doctor’s take

Our friends at COLAtoday consulted with M. Christopher Marshall, MD, FCCP, of Carolina Pulmonary, a Lexington Medical Center physician practice, to give you the 411:

“Vaping can be viewed by the younger generation as a less dangerous habit when really it is just as dangerous as smoking regular cigarettes. This misconception has led to a 900% increase in vaping among high school students from 2011 to 2015 [according to the American Lung Association].”

ICYMI: E-cigarettes are devices that contain a liquid that is heated at a low degree and turns into vapor – or “e-liquid.” The e-cigarette liquids come with or without nicotine (extracted from tobacco) and mixed with a base like propylene glycol, plus additives like vegetable glycerin + food flavoring. (Dr. Marshall says the flavorings, colorings + chemicals that are also added are somewhat unknown since e-cigarettes just came under FDA review a few years ago.)

Many e-cigarettes manufacturers market their products to look like kid-friendly products – resembling food + candy making them more enticing to teens. Some products look like USB drives and are popular among college students.

2+ million middle and high school students used e-cigarettes in 2017, according to the FDA. And teens who smoke e-cigarettes are more likely to use regular cigarettes as they get older. (In, S.C., 83% of people who smoke started before they turned 18.) Within six months 31% of teen e-cigarettes users will then turn into regular smokers.

So, are e-cigs a gateway to smoking cigarettes?

A better alternative?

Not in Dr. Marshall’s book. He says e-cigarettes are a gateway to smoking regular cigarettes.

But despite some officials’ concerns, advocates argue that e-cigs are a healthier alternative to smoking – in the sense that they help adults kick a tobacco-smoking habit. Research shows they do still negatively affect your health with the Surgeon General stating they are a “significant public health concern” in 2016.

“I always encourage my patients to stop smoking altogether,” said Dr. Marshall. “If vaping is absolutely needed to wean off regular cigarettes, then it would be fine for a short period of time – no more than 2-3 months. However, it is never the long-term solution. I encourage my patients to try all other methods to quit smoking before resorting to vaping. Some very effective methods include the patch, gum, nicotine receptor blockers (i.e. Chantix), and smoking cessation classes or counseling.”

Because of e-cigs, youth tobacco smoking is at an all-time low (something that for years with existing tobacco control was never achieved). From 2011 to 2017, tobacco product use among teens dropped from 4.5 million to 3.6 million. The percentage of students who use e-cigarettes (13%) has now passed the percentage who smoke traditional cigarettes.

However, the lack of industry regulation also means it’s difficult to know what ingredients are included because manufacturers don’t have to report the ingredients in an e-cigarette – and anytime you inhale a toxin, it has potential to cause smoking-related lung diseases (like COPD and emphysema).

“As mentioned above, the ingredients that make up the “flavorings, colorings, and chemicals” are usually not disclosed and can be widely unknown. Any heated and inhaled chemicals can produce a lasting effects on the lungs,” said Dr. Marshall. “One common chemical in e-cigarettes can cause bronchiolitis obliterans, also known as popcorn lung. Popcorn lung is caused when the same chemical found in popcorn, diacetyl, is heated and inhaled. The chemical scars the small airways in your lungs and can result in permanent reduced lung capacity and efficiency.”

N.C. passed a law making it illegal to sell these products to anyone under 18 in 2013, and nearly every school in the state bans the use of tobacco on campus – but many schools don’t have a policy in place banning the use of e-cigs.

So, the question remains – to vape or not to vape?

Tell us what you think. Reply to the email or comment below here.

–Audra

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