The use of e-cigarettes or other ‘vaping’ devices has become the new fashionable habit not only amongst adults but also teens and young adults. Vaping is extremely rampant globally and in the United States of America,
1 in 4 high school students and 1 in 25 middle school students were found to have used a vaping device.
This is alarming as not only vaping exposes people to high levels of nicotine and other harmful substances that cause lung damage, it is habit forming and extent of lung damage is still unknown.

Vaping involves inhalation of aerosols produced by heating a liquid called “vape juice” or e-liquid in electronic devices. This liquid contains nicotine and other chemicals like tetrahydrocannabinol (THC), diacetyl-Vitamin E and sometimes marijuana. They contain various fruity and menthol flavours which are more appealing to the young generation. All these chemicals are habit forming with potential harmful effects on the lungs, gut, blood cells as well as the heart. Various devices that are used for vaping are e-cigarettes, vape pen, e-hookah, mods etc.

Nicotine, which is extracted from tobacco, is a habit-forming chemical that mainly affects the adolescent brain leading to cognitive impairment and behavioral disturbances. It causes lung damage and is a potential carcinogenic agent. It can also affect the heart and cause blood clots, stomach ulcers. Usually, nicotine content in an e-cigarette is 1/3rd of that in a cigarette. Though, manufacturing of the vaping devices is unregulated and different devices may contain variable concentrations of nicotine.

Effects of vaping on Lungs

The Centre for Disease Control (CDC) has termed lung damage caused by vaping as EVALI (e-cigarette or vaping use associated lung injury). Common symptoms are cough, wheezing, shortness of breath and chest pain. Abdominal symptoms and neurological symptoms have also been reported. In the lungs it can lead to chronic obstructive airway disease like bronchiolitis obliterans. The small airway become narrow due to inflammation and decrease lung function. Over a period of time with prolonged vaping, there is permanent lung damage leading to difficulty breathing and dependency on oxygen. Reduced life expectancy and poor quality of life has both social and economic implication on individual and on families. Adolescent exposed to nicotine and marijuana are known to have reduced attention span, anxiety, depression along with permanent lung damage.

In a study conducted in Wilmington, USA, 25 teenagers were evaluated for EVALI and 24 of them required hospitalization in ICU with average length of stay being one week. Most disturbing result was that 4 of them i.e. 16% required oxygen support at discharge and had signs of permanent lung damage. 10 teenagers had ongoing mental health issues and some of them were vaping marijuana and nicotine. These results are alarming and need to be seriously addressed by parents and school authorities.

What can be done?

• Open communication with your teenager is important without being judgmental or accusing.
• Look for new symptoms like coughing, shortness of breath, lethargy etc. – CONTACT A PULMONARY PULMONOLOGIST for evaluation
• Watch out for any new smells or any new behavior change in your teenager
• Awareness programs for adolescents in schools and community centres
• Strict prohibition of vaping devices in schools
• Regulation of production and sale of these devices by the government