Hidden Dangers of Vaping - KIM THOMPSON, M.D.

Hidden Dangers of Vaping
       KIM THOMPSON, M.D.

Pervasive Problem in Schools:
• It is taking over our school restrooms

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

Current
Trends in
 Youth

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:
Public Misperceptions

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.