The rise of e-cigarettes use among youth and young adults in our country has been declared a major public health concern by the US Surgeon General. E-cigarettes first entered the US market in 2006 and since then, it has been increasing in popularity.
The National Youth Tobacco Survey (NYTS) data showed a steep increase in e-cigarette use in high school students from 1.1% in 2011 to 16.0% in 2015.
What are e-Cigarettes and Juul Devices?
E-cigarettes are battery powered devices that when turned on, heat a liquid, ‘e-juice’ or ‘e-liquid’, turning it into an aerosol that is then inhaled into the lungs. The aerosol can contain different substances which deliver fine particles of nicotine and other chemicals into the lungs. There are multiple different types of delivery devices, and the e-liquid components can be highly variable depending on the type and/or brand of device.
There are proprietary devices such as the ‘Juul’ device, which is known for its sleek design that resembles a USB drive and can be concealed in the palm of a teenager’s hand quite easily. Juul has also manufactured a variety of flavors for their e-liquids which are marketed to youth.
Controversy Surrounding E-Cigarettes
There is much controversy surrounding use of e-cigarettes. The spectrum of arguments ranges on one side from the perspective that they are a health benefit as a substitute for combustible or traditional tobacco cigarettes, to those who believe they are a gateway to substance abuse.
There are many studies citing a decline in combustible cigarette use among adolescents and young adults over the past decades, to be only met with a more recent trend back to increasing tobacco use with combined e-cigarette and other tobacco product use.
Due to the novelty of the e-cigarette trends and the variety of devices, there are few studies able to publicize long term health effects of e-cigarettes.
Misinformation About E-Cigarettes
There are a few common misconceptions regarding e-cigarettes.
Myth#1 – E-Cigarettes do not contain nicotine.
This is not only inaccurate, but the amount of nicotine in one Juul pod is the equivalent of 20 traditional combustible cigarettes. Studies suggest that there are biologic effects of nicotine from e-cigarettes on teenagers who use them, and it may also be harmful to adolescent development.
Myth #2 – The vapor from e-cigarettes is ‘water vapor.’
This could not be further from the truth. In fact, depending on the device and the contents of the liquid, the vapor can contain fine particles and chemicals from both the substances in the liquid and the flavoring, which can be very harmful to the lungs and potentially carcinogenic.
Dangerous Long Term Effects of Vaping Among Youth
As a thoracic surgeon, I have seen a shift in my practice within the adolescent age group as it relates to e-cigarette use/vaping.
There is limited data or published studies on the effects of vaping on the development of spontaneous lung collapse, or “pneumothorax.” This is a phenomenon that is currently being studied and anecdotally, in my practice, appears to represent a complication of vaping. This remains to be verified but it is logical that the vapor and aerosolized particles from the e-cigarettes could potentially have damaging effects with inhalation into the small air sacs in the lungs called ‘alveoli,’ with resultant release of air outside the lungs.
Unfortunately, because we are born with all the lung function we will have in our lifetime, each air sac or section of our lungs that becomes damaged will subtract from our ability to use our lungs to bring oxygen into our bloodstream efficiently. Our lungs do not regenerate when damaged or lost, and damaged lung tissue cannot be regained.
Whether vaping is leading to collapsed lungs that do not expand when we breathe, or damaging lung tissue that an adolescent will never regain – the potential detrimental effects on the lungs of an entire generation of our youth is being jeopardized by these devices.
About Alden Maier, MD
Dr. Alden Maier specializes in minimally invasive thoracic surgery, which mainly involves surgical procedures of the lungs and esophagus, as well as other types of surgical procedures within the chest. Request an appointment with Dr. Maier today.
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