The recent vaping-related lung injury and deaths are alarming and the providers at the Wellness Center felt that it was necessary to address this topic. You may not be surprised to know that there are many students on campus who use electronic cigarettes (e-cigarettes) or vape. Granted, the vape store planted directly across campus does not help. This blog will give you a quick background on e-cigarettes and vaping products, why these devices are unhealthy, and give you an update on the outbreak of lung injury/deaths.
Vaping is the popular shorthand for using e-cigarettes to “vaporize” nicotine.1 These devices were marketed as a “safer” way to inhale nicotine as it removed the risks associated with burning tobacco or cigarettes. These devices rapidly evolved into products with hundreds of flavor combinations and chemical compounds, including THC, the psychoactive ingredient in marijuana, and other marijuana extracts.1 The components of the liquid substance in e-cigarettes vary among brands. Many of these chemicals can cause toxic effects on the body, not due to the nicotine, but rather from the number and concentration of chemicals used to flavor the liquid.2,3 The base liquid of e-cigarettes is a blend of water, vegetable glycerine, and propylene glycol.2 When propylene glycol and glycerol (commercial name for glycerine) is heated in e-cigarettes, it creates compounds that release formaldehyde.2,4 Formaldehyde is a Group 1 carcinogen which means that it has the potential to cause cancer.2
"This risk for cancer is 5 to 15 times as high as the risk associated with long-term smoking."4
When inhaled, most of the formaldehyde quickly breaks down in the cells lining your respiratory tract and is breathed out.5 Even with low concentrations of formaldehyde, rapid onset of nose and throat irritation, cough, chest pain, shortness of breath, and wheezing can occur.5 “Higher exposures can cause significant inflammation of the lower respiratory tract, resulting in swelling of the throat, inflammation of the windpipe and bronchi, narrowing of the bronchi, inflammation of the lungs and accumulation of fluid in the lungs.”5 Also, high levels of formaldehyde will cause it to enter your blood. Once in your body, formaldehyde is rapidly broken down into other chemicals, most of which leave your body in the urine.5 A recent study with adolescents showed that although vaping may be less hazardous than tobacco smoke, those who used e-cigarettes had higher quantities of toxic chemicals in their urine compared to the control group (non-tobacco users).6
As of October 29, 2019, there have been 1,888 confirmed cases of lung injury associated with the use of e-cigarettes or vaping products, a rise from 1,604 cases reported the week prior.7 37 deaths have been confirmed with their age ranging from 17 to 75 years old.7 THC is present in most of the samples tested by the Food Drug Administration (FDA).7 At this time, the FDA and Centers of Disease Control and Prevention (CDC) have not identified the cause(s) of the lung injury with the only commonality among all cases being the use of e-cigarette or vaping products.7 The products containing THC, particularly those purchased from the street or informal sources such as friends, family members, illicit deals, are linked to most of the lung injury cases.7 Due this data and the continued ambiguity of the cause of lung injury, the CDC recommends that you DO NOT use e-cigarettes, vape, or use products that contain THC.
Also, for those who may not have heard, beginning October 1, 2019, the legal age to buy ANY tobacco product including e-cigarettes is now 21 in Maryland unless you are active duty military personnel.
If you are interested in information on vaping or smoking cessation, please contact the Wellness Center at (443)352-4200. You can also call the Maryland Tobacco Quitline, 1-800-QUIT-NOW, a FREE evidence-based counseling program available 24/7. Visit www.smokingstopshere.com for more information.
By: Sudin Thomas, MSN, FNP-BC
1Rowan, H. (2019). Vaping by the numbers. Kaiser Health News. Retrieved from https://khn.org/news/vaping-by-the-numbers/
2Johnson, J. (2019). Does vaping without nicotine have any side effects? Medical News Today. Retrieved https://www.medicalnewstoday.com/articles/326489.php
3Bahl, V., Lin, S., Xu, N., Davis, B., Wang-Y., & Talbot, P. (2012). Comparison of electronic cigarette refill fluid cytotoxicity using embryonic and adult models. Reproductive Toxicology, 34(4), 529-537. Retrieved from https://www.sciencedirect.com/science/article/pii/S0890623812002833
4Jenson, R.P., Luo, W., Pankow, J.F., Strongin, R.M., & Peyton, D.H. Hidden formaldehyde in e-cigarette aerosols. (2015). New England Journal of Medicine, 372, 392-394. Retrieved from https://www.nejm.org/doi/10.1056/NEJMc1413069
5Agency for Toxic Substances & Disease Registry (ATSDR). (2008). Toxic substances portal – Formaldehyde. Retrieved from https://www.atsdr.cdc.gov/mmg/mmg.asp?id=216&tid=39
6Rubinstein, M.L., Delucchi, K., Benowitz, N.L., & Ramo, D.E. (2018). Adolescent exposure to toxic volatile organic chemicals from e-cigarettes. Pediatrics, 141(4). Retrieved from https://pediatrics.aappublications.org/content/pediatrics/141/4/e20173557.full.pdf
7Center for Disease Control and Prevention (CDC). 2019). Outbreak of lung injury associated with the use of e-cigarette, or vaping, products. Retrieved from https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html#what-we-know