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July 23, 2020

What You Need to Know About E-Cigarettes & Vaping: Your Guide to the Latest Facts

What You Need to Know About E-Cigarettes & Vaping: Your Guide to the Latest Facts

Much to tobacco companies' delight, electronic cigarettes and vaping have caught on since they hit the U.S. market in full force in 2006. While smoking rates have been on the decline, the number of people vaping has surged to the millions, with the biggest jump among youth.

Along the way, the debate about vaping has ramped up too. On one side, supporters advocate e-cigarettes as a safer alternative to smoking or a way to quit smoking. On the other side, opponents point to a surge in vaping-related illnesses and deaths as proof of vaping's health dangers. It's hard to know what's true and what's not.

Maybe you're thinking about trying vaping or making the switch to e-cigarettes from smoking. Or on the flip side, maybe you're worried your teen may be vaping, or you're wondering if you should break the vaping habit. Whatever side you're on, here are the latest facts.

First, e-cigarette and vaping basics

E-cigarettes, e-cigs, vapes, e-hookahs, mods, vape pens, JUUL. They're all different names for battery-operated devices used to vape (sometimes also called juuling, after the most popular brand of e-cigarettes).

They hold a container (either a replaceable pod or a refillable tank) filled with liquid that usually contains nicotine, flavorings and other chemicals. They can also accommodate THC, the chemical in marijuana that makes you high.

The device heats the liquid, turning it into an aerosol, which you inhale. It's called "vaping" because the aerosol looks like a vapor.

Vaping and e-cigarette regulations and laws

Until 2016 when the U.S. Food & Drug Administration (FDA) began regulating the production and marketing of e-cigarette products, the e-cigarette industry was an unchecked Wild West. There were no standards for devices or products and ingredients.

Initially, the FDA deemed it illegal to sell these products to anyone under age 18. In December 2019, the federal government raised the minimum age to buy all tobacco products, including electronic smoking devices, to 21, effective immediately.

What health officials have learned about vaping:

The recent spike in vaping-related illnesses and deaths made it clear the tobacco industry can't rightfully claim vaping is as safe as their marketing campaigns claimed.

With national and state health officials mobilizing to determine what's behind the outbreak, the Centers for Disease Control (CDC) updates its website weekly with the latest information. Here's what officials know:

E-cigarettes are just as addictive as traditional cigarettes

Nicotine is addictive no matter what way it's delivered. Almost all vaping liquids contain nicotine and studies have shown many of the few that claim they don't actually do.

Most people don't realize one JUUL pod contains the same amount of nicotine as a pack of cigarettes. And e-cigarettes can deliver nicotine at different rates, too. A more concentrated dose of nicotine means becoming addicted quicker and needing more to satisfy cravings.

Vaping causes lung damage

It took decades of research to show how smoking causes deadly diseases. Research on vaping's impact is in early stages. What researchers have learned is vaping's harmless-looking cloud holds dangerous chemicals that damage the lungs and cause life-changing and sometimes life-threatening conditions.

Yes, it's true the aerosol from vaping has fewer toxins than the 7,000 found in smoke from regular cigarettes. But that doesn't make e-cigarettes safe. Far from it. As of Feb. 4, 2020, the CDC reports that there have been 2,758 hospitalized cases of vaping-related illnesses and 64 deaths in the U.S.

Experts still don't know how the chemicals and the vaping process damage the lungs. Products that contain flavorings, vitamin E acetate or THC have been involved in cases during the recent outbreak. The number of cases peaked in September 2019. Although there's been a gradual decline in reported cases, new cases continue to develop.

More kids are getting hooked on nicotine

The brain continues to grow until about age 25. Nicotine changes the way connections in the brain are formed, which can harm the way the brain develops. Nicotine can prime younger brains for addiction to other drugs, too.

Efforts to keep the next generation from becoming addicted to nicotine by reducing smoking in youth worked. Cigarette use among high school students is at an all-time low. But e-cigarettes are making up the gap—and worse. Kids who may never have gotten addicted to nicotine through smoking are now vaping.

The number of kids who admit to vaping is staggering. Skyrocketing numbers led the U.S. Surgeon General to declare youth vaping an epidemic in 2018. According to data from Indiana's and the federal government's latest Youth Tobacco Surveys:

  • 3.6 million kids were vaping in 2018, a 78% increase in just one year
  • From 2012 to 2018, vaping increased more than 300% among Indiana youth
  • In 2019 more than 5 million middle and high school students reported using e-cigarettes in the last 30 days, and nearly 1 million were using e-cigarettes daily
  • Teens who vape are more likely to begin smoking cigarettes

Many teens are drawn to vaping because they believe it's safer than smoking. Until 2018, JUUL's fruit- and candy-flavored products were also enticing. That's when under pressure, JUUL stopped selling the flavored pods popular with youth. A new federal policy prohibits the production and sale of all flavored products except menthol and tobacco flavors after Feb. 6, 2020.

Vaping Illustration. "The number of kids who admit to vaping is staggering."

Vaping hasn't been proven to help quit smoking

Sure, there are success stories of people who've used e-cigs to quit a long-time smoking habit. But according to the U.S. Preventive Services Task Force, a group of health experts that makes recommendations about preventive health care, there's not enough hard evidence to prove it works.

In fact, many people who take up vaping to quit smoking continue to smoke, known as dual use. That can lead to higher risks. Smoking any number of cigarettes is harmful.

The bottom line

Health officials and researchers have learned a lot about vaping and e-cigarettes, including there's a lot they still don't know. They don't have years of use to study to determine vaping's long-term impact.

Most experts say e-cigarettes aren't as safe as they're promoted to be but agree they're less dangerous than traditional cigarettes. That's not enough to justify using them. These are the latest CDC and FDA recommendations about vaping and using e-cigarettes:

  • Youth, young adults or pregnant women should never use e-cigarette or vaping products.
  • Do not add other substances, especially vitamin E acetate and THC, to vaping products.
  • Adults using e-cigarettes as an alternative to smoking should not go back to smoking. If you vape, don't smoke too.
  • If you're not using e-cigarettes or vaping products, don't start. If you are, stop.

Quitting nicotine is tough, whether you've become addicted through smoking or vaping. But it's the best thing you can do to protect your health. Talk with your doctor about how FDA-approved medications can help.

All Hoosiers also have access to support through the Indiana Tobacco QuitLine. The program provides free phone, online and text access to a Quit Coach® and the resources you need to quit nicotine for good.

Read more: Are you a tobacco user? Do you vape? Risk factors with the COVID-19 pandemic

IU Health social worker and tobacco cessation counselor Danielle Barwise offers help to patients who vape or are tobacco users. They could be at a higher risk for COVID-19 symptoms. Read full story.

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