Monmouth's Ask the Doctor January-February 2020

Can Vaping Be Deadly? Your Questions Answered By Nirav N. Shah, DO, FACCP

D O C T O R A D V I C E Is it safer than smoking cigarettes? While initially vaping was marketed to consumers as a safer option than cigarettes, it does still deliver nicotine to the lungs and can cause lung inflammation. Vaping should not be used as a substitute for smoking. In fact, research shows that e-cigs encourage people to smoke, not help them quit. There is no solid evidence to suggest that vaping is safer than smoking cigarettes. What is THC? THC, or tetrahydrocannabinol, is a natural compound found in cannabis plants. It is the main psychoactive compound in marijuana. While THC can be accessed by smoking marijuana, the compound also is available in oil form, which can be used in vapes or e-cigarettes. The substance causes a chemical inflammatory reaction in the lungs. Most people who have experienced vaping-related illnesses used vap- ing liquid that contained THC oil. We aren’t sure why THC seems to affect the lungs more severely. How does flavored vaping liquids affect the lungs? The base of all vaping liquids is a combination of propylene glycol and vegetable glycerin. To this base, liquid manufacturers add flavors that while deemed safe for food, aren’t meant to be smoked and inhaled. We simply don’t have enough information about how the body reacts when flavoring chemicals are inhaled instead of ingested in smaller quantities in a food product as originally intended. What are the symptoms of a vaping-related illness? Vaping can cause a variety of health issues, including: • Coughing • Shortness of breath Some patients develop symptoms over a few days, while others notice symptoms over the course of several weeks. A lung infection does not appear to be the cause of these symptoms. How are these illnesses treated? Unfortunately, many of these cases are being misdiagnosed as pneumonia and patients are being prescribed antibiotics, which won’t help the condition. The recommended first course of treatment for a vaping-related illness is steroids, which suppress the immune reaction taking place in the lungs. If you vape and are having health issues, contact your primary care physician, who can determine if you need to see a specialist, such as a pulmonologist, for treatment. Your primary care physician also can refer you to smoking cessation services to help you quit. Are teens more at risk of developing a vaping-related illness? The brain keeps developing until about age 25. Using nicotine in adolescence can harm the areas of the brain that control learning, at- tention, mood, and impulse control. According to JUUL, an e-cig manufacturer, a single JUUL pod contains as much nicotine as 20 regular cigarettes. About 37 percent of high school seniors say that they vape, up from 28 percent in 2017. An estimated 3.6 million middle school and high school students reported using e-cigarettes in 2018. This is particularly troubling because the lungs and brains of adolescents are still ma- turing, meaning that nicotine and THC can affect brain and lung development. A secondary concern is that according to research, adolescents who use e-cigarettes may be more likely to smoke cigarettes in the future. As a parent, should I be concerned? Vaping is popular with adolescents because it’s easy for teens to buy vaping products. Vapes, particularly those that are marketed to teens like JUUL, look like USB cartridges, so they are small, easy to hide – and easy to use. Additionally, children have been poisoned by swallow- ing, breathing, or absorbing vaping liquid through their skin or eyes. I’ve seen about seven patients so far with vaping-induced lung disease. All of those patients were under age 30 and about half came into the emergency room without a parent. I advise parents to discuss these products with their children. Let them know that vaping can be addicting. And while we don’t know that vaping causes cancer, we don’t know for sure that it doesn’t. Until the U.S. Food and Drug Admin- istration rules on the safety of vaping, we need to get the word out to adolescents about the dangers before this trend becomes an epidemic. Nirav N. Shah, DO, FACCP, is board-certified in pulmonary medicine and critical care, and is on staff at CentraState Medical Center. He can be reached by calling 866-CENTRA7. • Chest pain • Nausea • Vomiting • Diarrhea • Fatigue • Fever • Abdominal pain What is vaping? Vaping is when a person uses a vape or e-cigarette to inhale nicotine. Vapes are battery-powered devices that heat a nicotine-containing liquid to produce an aerosol that is inhaled. The liquid is usually flavored with fruit or other sweet flavorings. Is vaping safe? No, vaping is not safe as it has been shown to cause inflammation of the lungs. In fact, as Oct. 1, 2019, 1,080 patients have sought treatment for vaping-induced illnesses in the United States. Nearly 20 people have died in 15 states, and in 80 percent of those deaths, the person was under the age of 35.

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JANUARY/FEBRUARY 2020