It’s September, and I think that most parents agree at this point that all of the extra moments of relaxation and downtime this summer are now in the past.  The adjustment period as our children advance a year in school, sometimes moving up to new “bigger” schools all-together, is also over, and with homework, sports practices, instrument lessons, tournaments and playdates, there is no turning back.  In order to ensure that our children will have a healthy year of growth and development, I think it is important to pause and take note of an important recent story in the news.  As of the date of this publication, there have been six deaths in the country attributed to vaping or electronic-cigarette use.  As a pediatrician, I need to change the tone of the advice I give to teenagers in my office.  We once urged teenagers to avoid the use of electronic cigarettes as the actual risks were unknown.  With the recent news updates, pediatricians will be taking the strongest stand to stop the use of electronic-cigarette use in their patients. 

Here’s what you need to know about the recent developments on electronic-cigarettes:

  • As of the time of this letter more than 450 possible cases of lung illness associated with using e-cigarettes have been reported to the CDC across 33 states and the US Virgin Islands. The numbers have been on the rise every day.  Six deaths have been reported in Kansas, California, Illinois, Indiana, Minnesota and Oregon, the first death being in August 2019.  High Vitamin E Acetate seems to be a common factor linking these cases together, which was found in e-cigarettes containing THC, but also as a thickener in flavored products.  It is important to remember that although the recent illnesses and deaths are under investigation, it was already well known that e-cigarette use poses health risks to not only those using the e-cigarettes but also to those with secondary exposure to toxic exhaled vapor.
  • E-Cigarettes are the most commonly-used tobacco products among youth, and use is rising at an alarming rate. In 2018, 21% of high school students and 5% of middle school students reported having used e-cigarettes in the last 30 days. This represents an increase of 1.5 million youths from 2017-2018.
  • E-Cigarette devices are meant to mimic conventional cigarette use, however, many teenagers are well aware that traditional cigarettes are harmful, and associate the risks with the inhaled smoke and the resulting lung disease.  The tobacco companies have created devices that have caused children to re-normalize nicotine use, and because vapors are directly inhaled without smoke, it is common for teenagers to vape at home and in school. 
  • Nicotine (found in most e-cigarettes) is a dangerous substance that spikes your blood pressure and causes a surge in adrenaline, which down the road can lead to strokes and heart disease.  It can also have long-term detrimental effects on memory, learning, self-control and mood.  Nicotine is highly addictive and may be as addictive as heroin or cocaine.
  • E-Cigarettes contain a liquid solution that is flavored in order to appeal to children, giving them the impression that the product is less harmful than it actually is. Fruit flavors, candy, bubble gum and chocolate are common flavors.  Aside from these liquid flavors that contain Vitamin E, a possible cause of the recent reported illnesses and deaths, there are other harmful substances in e-cigarettes such as anti-freeze, diethylene glycol, and a known carcinogen, nitrosamine.  Tobacco companies have a long history of developing flavored products that attract kids.  The flavors improve the taste for the new users starting before the age of 18 and are a known strategy in the industry’s marketing playbook.

In summary, no one should be using vaping products, especially given the recent updates in the number of associated cases of lung disease, and recent deaths.  Pediatricians across the country are calling on the FDA to immediately ban flavors, as well as marketing practices, that enhance the appeal of e-cigarette products to youth.  Because current federal regulations are insufficient to protect youth from e-cigarette use, and proposed changes in legislation will take time to implement, please talk to your teenagers about the dangers of e-cigarettes.  It’s a new school year, and even though this topic was previously well-known and addressed in our schools, the importance of taking a stronger stance today has drastically changed with the recent news.

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Stacey Tavel, MD

Pediatrician practicing at the Summit Medical Group, Short Hills and Livingston offices