VAPING UNVEILED: Understanding the epidemic

Vaping Unveiled

Smoking and vaping researcher offers insight into why vaping has become so popular as well as why it may be so dangerous

BLUFFTON, S.C. (WSAV) – Vape pens and Juuls have become a part of our everyday lexicon in the past few years as more people have turned away from cigarettes and turned to the simpler, supposedly safer products.

Its something the Centers for Disease Control and Prevention (CDC) calls an epidemic.

News 3 went to find out more from smoking and vaping researchers at the Medical University of South Carolina (MUSC) about the product, the trend, and its future.

“E-cigarettes are battery-operated devices that heat a liquid onto a metal coil and then that liquid is turned into an aerosol,” explained Dr. Tracy Smith, MUSC Smoking researcher. “You hear e-cigarette companies call it water vapor but it’s not really water vapor — its an aerosol and it’s delivered to the user.”

“The liquid is actually a mix of propylene glycol and vegetable glycerine usually in different concentrations,” she added.

Dr. Smith was once focused on smoking research but now dedicates almost all of her time to the e-cigarette epidemic.

“It looks like a flash drive so its small and discreet,” said Dr. Smith. “It doesn’t produce a lot of vapor, you don’t see a huge cloud, so kids are able to use it in class, in the bathroom. They can do it without parents and teachers noticing.”

The key to all e-cigarettes is simple: nicotine. The addictive chemical is delivered through these mechanical devices, many times in fun fruit flavors.

“They come in different shapes and sizes, and we hear from kids, sometimes they say ‘I don’t use e-cigarettes but I vape,’ or ‘I don’t vape, I Juul.’ It’s important to know from a medical and scientific perspective all those products are the same,” Dr. Smith said. “They all carry the same potential health consequences and unknown risks”

The fastest-growing group of users is young adults — 18 to 24 years olds — and teens.

“We are seeing it among middle school students, that’s where its really starting and that’s where the numbers have continued to rise,” said Dr. Smith. “It’s not as prevalent in middle school as it is in high school, but it is increasing every year like we see it increasing every year for high school students so that’s what’s really scary.”

FILE – In this April 23, 2014 file photo, a man smokes an electronic cigarette in Chicago. (AP Photo/Nam Y. Huh, File)

“We don’t want these products to be cool or accessible to use, we want it to continue to be something you wouldn’t normally do, so you wont be attracted to any type of tobacco,” she added.

According to the CDC, 3.6 million teens vape.

Twenty-one percent of high school seniors said they vaped in the last 30 days in 2018. That number is already at 27 percent and rising in 2019.

“If you look back on [Juul] marketing, they were using it was a lot of fun, vibrant colors, people, a party atmosphere,” Dr. Smith explained.

“It looks like they really took a page out of the tobacco industry handbook,” she said. “They marketed to youth and marketed to non-smokers. They used techniques that were really appealing to people who didn’t use cigarettes.”

The fun without that cigarette smoke and smell is what teens say they like.

In addition, many are attracted to the flavors offered which Dr. Smith says is typically what people start out using.

“These e-cigarettes can also deliver very high levels of nicotine very quickly,” she added. “That’s especially true for the Juul product, for example, delivers very high levels fo nicotine that is comparable to a combustible cigarette.

“Youth can obtain the same levels of nicotine they can get from smoking with an e-cigarette.”

Dr. Smith said those high levels of nicotine are what can be the hook.

“When you ask kids ‘Do you feel addicted?’…you get roughly 30-40% saying either, ‘Yes, I feel a little addicted’ or ‘I feel very addicted.'”

Kids could be swayed by the vaping related deaths; now at more than 50 with 2,400 injuries reported. The majority of those come from “illicit sources” like THC vapes.

Eighty-three percent of the people who were injured of killed used THC vapes — most of which were not regulated or even legal.

“Don’t add anything to your e-cigarettes, or e-liquid that wasn’t in there when you bought it,” Dr. Smith warned. “Don’t buy it from friends or other sources and don’t use vaping products that contain THC.”

The only connection so far between all injuries: vitamin E acetate.

“We don’t know for sure that there’s not something else involved or its not the vitamin E acetate plus something else; a particular device for example,” Dr. Smith said. “But it does seem like that vitamin E acetate is playing a role.”

She explained that vitamin E acetate is used to thicken the e-liquid.

“So maybe they are using it to cut the product, make it stretch further and then use the vitamin E acetate to thicken it up,” Dr. Smith said.

“We hear from people all the time that the ingredients in their liquids are declared as safe by the FDA or FDA approved,” she said. “They may be safe when you eat them because they are typically used as food additives, but we don’t know what the impact will be of inhaling them, especially inhaling them over 30 to 40 years.”

Concerning also is the fact that vaping teens are three times as likely to start smoking as everyone else.

“For a non-smoker or for a kid, when they try an e-cigarette or they try vaping, they are becoming addicted to a tobacco product that they wouldn’t have had in their lives otherwise,” Dr. Smith said. “So they are potentially starting a lifelong addiction.”

She added that while bans on certain flavors could prevent first time users, it might not do much for those already using.

“The concern is you have a bunch of kids who did start because those flavors were out there and were attractive and their friends were using them, but now they are addicted to those products,” Dr. Smith explained.

Juul has the majority of the market share: 78 percent, worth $16 billion dollars.

Seventy percent of that came from their mint flavor, which they took off the market just this month.

FILE – In this Dec. 20, 2018, file photo a woman buys refills for her Juul at a smoke shop in New York. California is suing the nation’s biggest e-cigarette maker, alleging Juul Labs deliberately targeted teenagers with its early marketing campaigns. (AP Photo/Seth Wenig, File)

Altria, the company which used to be Phillip Morris, the cigarette maker with a history of running campaigns targeted to youth and minorities, bought a majority stake in the Juul brand for $12.8 billion in 2018.

Juul Labs CEO Kevin Burns said back in November that it was “Never an intent on our company’s part to target youth to grow our business.”

Soon after Burns said that on camera, he stepped down as CEO.

Reacting to the pressure, the company has now shut down its Instagram and Facebook pages and changed it’s marketing to darker colors, and more adults.

This comes as the campaigns against e-cigarettes from organizations like the Truth Initiative, especially targeted at kids, ramps up.

The first goal of anti-vape groups is making the tobacco buying age 21 instead of 18, simply to make it harder for kids to get.

The second is treating these electronic devices just like cigarettes have been treated.

“We know what worked for cigarettes,” Dr. Smith said. “We have years of data that shows work policy steps, what regulatory steps worked for cigarettes.”

She pointed to taxation, smoke-free air laws and better education campaigns.

“Taking those steps and applying them in the same ways for e-cigarettes could go a long way to the initiation of kids,” Dr. Smith said.

She added that talking to kids in general terms about addiction typically does not make a big impact, but approaching the specifics surrounding addiction could help.

“Addiction means that you are going to crave, addiction means you are going to have to use your e-cigarette when you don’t want to; when it’s not convenient,” Dr. Smith said. “You will be spending your money on it. And you are becoming independent you are growing up and by using an e-cigarette and becoming addicted to nicotine you are giving away that independence, you are letting someone else control how you behave and how you spend your money.”

Researchers say the confusing part of the epidemic is that the news is not all bad when it comes to vaping.

There is still a belief that switching to an e-cigarette can help many people kick the smoking habit.

“Nicotine is the primary addictive component of tobacco — but it’s not where most of the harm comes from,” explained Dr. Smith. “When you are substituting one type of nicotine addiction for another, it still may be beneficial to you if that new nicotine and type of tobacco deliver less harms and lower levels or the other chemicals than cigarettes do.”

“One of our messages as researchers is it may be safer than smoking, but it’s not safe,” she said.

For more information on the epidemic and ways to approach conversations surrounding e-cigarettes with young people, visit the CDC’s website here.

The Truth Initiative also has additional information on the health effects and much more associated with usage.

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