Electronic cigarettes – The new smoking

Just a decade ago, electronic cigarettes claimed to be the answer for any smoker who was trying to quit tobacco cigarettes. They quickly became popular with teenagers who saw them as a risk-free alternative to smoking. However, these devices pose real health issues and those who “vape” can easily get hooked on the nicotine found in the fruit and candy-flavored products, especially children and adolescents.

Thomas Ferkol, MD, director, division of pediatric allergy, immunology and pulmonary medicine at St. Louis Children’s Hospital says, “Known by many names — vapes, vape pens, mechanical mods, Juuls, and others — electronic cigarettes are a new and rapidly growing threat to the health of children and adolescents.

Juuls are the newest electronic nicotine delivery device. It resembles a flash drive, allowing the young users to hide it in plain sight. ”

According to the U.S. surgeon general, electronic cigarette use in high school students increased 900% from 2011 to 2015. A growing number of children in middle schools have tried or regularly use electronic cigarettes.

Nicotine is poisonous and highly addictive – in some brands, one electronic cigarette may have as much nicotine as an entire pack of conventional cigarettes. The United States Food and Drug Administration has even found nicotine in electronic cigarettes marketed as nicotine-free.

The teenage brain gets hooked faster than the adult brain on electronic cigarettes.  Teenagers become addicted to nicotine and suffer withdrawal symptoms when they try to quit. Studies have shown nicotine is more addictive than heroin and cocaine. And there’s a growing body of evidence that nicotine can harm the developing adolescent brain.

In addition to nicotine, electronic cigarettes vapors may also contain cancer-causing chemicals such as propylene glycol, toxic metals, solvents and flavors, though at lower concentrations than tobacco cigarettes. Flavors are one of the main reasons children and adolescents are drawn to electronic cigarettes. 

Electronic cigarettes are considered a tobacco product by the US Food and Drug Administration. The American Lung Association remains concerned about their impact on the public health, given the dramatic increase in use among youth. Studies have shown that teens who vape are more likely to try cigarette smoking.

Dr. Ferkol adds, “The bottom line is that electronic cigarettes are not a safe alternative.  Exposure to electronic cigarette aerosol in adolescence and early adulthood is not risk-free and can result in pulmonary toxicity. 

More to the point, adolescents do not use electronic cigarettes to quit tobacco products.  Instead, most surveys of middle and high school student indicate that the primary reasons why they use electronic cigarettes are curiosity, flavoring or taste, and low-perceived harm compared to other tobacco products.  Teens who use electronic cigarettes are potentially putting themselves at risk for future health issues – some we already know about and others we don’t.”

Dr. Ferkol is convinced that electronic cigarette use in youths is underestimated. “As a clinician, I have to specifically ask my patients whether they use electronic cigarettes. Most teenagers do not equate vaping with smoking. 

Research concerning the biological effects of electronic cigarette vapors in humans is relatively recent, which is not surprising, since they have only been available outside of China for a decade.  But most of the results indicate that electronic cigarettes have harmful effects on the lung. The prime suspect appears to be the fluid vehicle (propylene glycol) for the added nicotine and flavorings.

What this means long-term is uncertain, but there is enough emerging evidence to be concerned. All I can say is that inhaling something other than air is never good for a child’s lung.”

For more information visit Vaping; Dangerous, Available & Addicting from the American Academy of Pediatrics. To make an appointment with Dr. Ferkol or any other pediatric pulmonary specialist, please call 314-454-2694.

St. Louis Children’s Hospital
1 Children’s Place, Second floor, Suite C
St. Louis, MO 63110

St. Louis Children’s Specialty Care Center
13001 North Outer Forty, Suite 2E
St. Louis, MO 63017