Hidden Dangers of Vaping - KIM THOMPSON, M.D.
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Current Trends in Youth: • 90% of smokers have their first cigarette before they are 18 (US Preventive Services Task Force). • E-cigarettes surpassed combustible cigarettes as the most commonly used tobacco product among U.S. middle and high school students in 2014.1 • In 2018, more than 3.6 million middle and high school students reported they currently use e-cigarettes.2
The “Cost-Free” Mentality: Public Misperceptions • Very alarming considering that harm perceptions influence tobacco use behaviors. • Many young people don't see e-cigarettes as harmful, so prevention is especially important. (Thomas Houston, M.D., former chair of the AAFP Commission on Health of the Public) • 80 percent of youth do not see great risk of harm from regular use of e-cigarettes.3
The “Cost-Free” Mentality: Real Risk • As of August 27, 2019, at least 215 possible cases in 25 states of progressive, severe pulmonary disease related to the use of e-cigarettes or “vaping” have been reported to the U.S. Centers for Disease Control and Prevention (CDC). • And as of September 6, 2019, that number jumped to more than 450 cases of vaping-related illness in 33 states and 3 more deaths. • One death each has been reported in Illinois, Oregon, California, Indiana and Minnesota. • These pulmonary injuries are particularly seen among adolescents and young adults. Patients are experiencing respiratory symptoms including cough, shortness of breath, and fatigue, and symptoms typically worsen over a period of days or weeks before admission to the hospital.
The “Cost-Free” Mentality: Real Risk Myth: E-cigarettes assist in smoking Myth: E-cigarettes do not carry the cessation risk associated with conventional cigarette use • Study published in the American Journal of Preventive Medicine involved 9,352 • E-cigarettes deliver lower levels of carcinogens than conventional current and former e-cigarette users. 4 cigarettes, but both products still deliver • E-cigarette use actually reduces the particles and toxins that increase the risk likelihood of successfully quitting of cardiovascular disease and acute MI smoking for most smokers. • Both inhibit endothelial functioning/dilation of arteries, and shift cardiac autonomic balance to sympathetic predominance/increased oxidative stress, increasing cardiac risk
The “Cost-Free” Mentality: Real Risk Myth: e-cigarette use decreases risk of Myth: e-cigarette users tend not to having and MI smoke other traditional tobacco products • Using e-cigarettes every day almost • Concurrent use is the most common doubles the risk of MI. usage pattern and far more dangerous • 3.6% of the current and former than using either on its own. smokers had h/o MI at some point • Using both e-cigarettes and vs. 6.1% of daily e-cigarette users. conventional cigarettes at same time increased the odds of an MI almost five-fold.
Current Efforts to Curb the Trend: • FDA expanded its award-winning “The Real Cost” campaign to educate the nearly 10.7 million youth aged 12-17 who have ever used e-cigarettes or are open to trying them about the potential risks of e-cigarette use.5 • Campaign messages focus on educating youth that using e-cigarettes, just like cigarettes, puts them at risk for addiction and other health consequences. • UK group Tobacco-free Take Action (“TFTA”) messages for youth by youth to combat e-cigarette use in KY.
References: • 1. Centers for Disease Control and Prevention (CDC). Tobacco product use among middle and high school students – United States, 2011-2015. Morbidity and Mortality Weekly Report. 2016; 65(14):361-367. • 2. Cullen KA, Ambrose BK, Gentzke AS, Apelberg BJ, Jamal A, King BA. Notes from the Field: Use of Electronic Cigarettes and Any Tobacco Product Among Middle and High School Students — United States, 2011–2018. MMWR Morb Mortal Wkly Rep 2018;67:1276–1277. (Original Data Source: NYTS 2018) • 3. Johnston, L. D., Miech, R. A., O’Malley, P. M., Bachman, J. G., Schulenberg, J. E., & Patrick, M. E. (2018). Monitoring the Future national survey results on drug use: 1975-2017: Overview, key findings on adolescent drug use. Ann Arbor: Institute for Social Research, The University of Michigan. • 4. Talal Alzahrani, Ivan Pena, Nardos Temesgen,Stanton A. Glantz. Association Between Electronic Cigarette Use and Myocardial Infarction. Am J Prev Med 2018; August 22, 2018. • 5. Substance Abuse and Mental Health Services Administration (SAMHSA). 2017 National Survey on Drug Use and Health: Detailed Tables. Rockville, MD: U.S. Department of Health and Human Services, SAMHSA, Center for Behavioral Health Statistics and Quality; 2018. https://www.samhsa.gov/data/sites/default/files/cbhsq- reports/NSDUHDetailedTabs2017/NSDUHDetailedTabs2017.pdf. Accessed October 12, 2018.
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