Electronic Cigarettes and Teen Health
New Drug, New Risks
Emerging Health Risks
The 2015 Monitoring the Future survey results tell us that
among United States students, approximately 10% of 8th graders and 15% of 9th
through 12th graders use e-cigarettes monthly6.
If such rapid growth in use in the U.S. is any indicator
of teen use throughout the rest of the world, we all must be concerned, as
e-cigarettes pose cancer, addiction, and intoxication risks.
Unknown Quantities of
Addictive Nicotine
Students are generally unclear about the contents of their
e-cigarettes. Among 12th-grade students who used e-cigarettes in 2015, 65%
reported their e-cigs contained only flavoring, while 22% believed they
contained nicotine, 6% thought they were vaping marijuana or hash oil, and a
final 6% had no idea what they were vaping6.
Unfortunately, this confusion among students is
understandable. E-cigs marketed as "nicotine free" often do contain
nicotine. Even if not marketed as nicotine free, many brands do not specify how
much nicotine or other chemicals their e-cigarettes contain. E-cigarette
companies have not been obligated by any governing body to regulate or monitor
the amount of each substance that goes into their products.
To highlight the inconsistency of nicotine concentration
in e-cigarettes, researchers in the United Kingdom tested 16 different
e-cigarettes7. They found wide
variations in nicotine levels per puff. Their findings suggested that nicotine
concentration not only varies by brand, but also between inhalations of the
same product!
More startling, nicotine levels per puff ranged from 0.5mg
to 15.4mg in the study. The typical nicotine concentration in a puff of a
tobacco cigarette is 1.54mg to 2.60mg. This means that e-cigarettes may deliver
nearly six times the amount of nicotine a tobacco cigarette would.
Nicotine is widely known to be an extremely addictive
chemical. Biological studies show that teens are much more susceptible to the
development of nicotine addiction than are adults. Adolescents may develop
nicotine dependency within just a day of use8.
Alcohol in E-cigarettes
The FCD Student Attitudes and Behavior Survey has found
that in some communities, students are exposed to e-cigarettes sooner than they
are to alcohol9. Even more disturbing,
new research suggests that students may be exposed to alcohol for the first
time through their early use of e-cigarettes.
Many e-vaporizer liquid solutions contain alcohol to
extract their flavors from base ingredients. Yale School of Medicine found that
some commercially available electronic cigarette liquids contain enough alcohol
concentrations to significantly impair users' motor skills10. When study participants
were asked to perform a motor task, those under the influence of higher alcohol
concentration e-cigarettes performed more poorly than those not under this
influence.
Exposure to alcohol through e-cigarettes puts students at
a long-term risk for addiction and a short-term risk for intoxication and
impairment. Students who do not know that e-cigarettes can contain alcohol may
unwittingly put themselves at risk not only for an addiction to nicotine, but
also for an addiction to alcohol through vaping. Students using e-cigs may also
drive under the influence of alcohol unknowingly or otherwise put themselves at
risk for accidents and physical harm as a result of motor impairment.
Out of the dozens of e-liquids tested in the Yale study,
one-third did not contain measurable alcohol, while 40% of e-liquids registered
at 0.75% or less alcohol content, and another 23% contained 1-3% alcohol
levels. Some e-liquid brands have been measured to contain over 23% alcohol
content. As prior research has demonstrated, the concentration of such
chemicals in e-cigarettes has not historically been regulated by manufacturers
nor made known to consumers.
Cancer
If we have heard any messaging about e-cigarettes, it
likely includes the notion that e-cigarettes don't cause cancer. However,
studies attempting to classify the contents of e-cigarettes have revealed a
number of troubling substances known to be carcinogenic within the products.
For instance, a New England Journal of Medicine study
reported that some e-cigarettes release formaldehyde when heated by high
voltage batteries7. A Cleveland Clinic study
found that the liquid in many e-cigs contain propylene glycol7. While considered safe to
eat in food in small quantities, propylene glycol as a carcinogen has not yet
been longitudinally studied in a context where it is deeply and repeatedly
inhaled by children and teens.
E-pens, too, marketed as "nicotine-free"
e-solutions have been found by a San Diego Veterans Affairs lab investigation
to damage cells in ways that could lead to cancer7. The researchers exposed
cells in petri dishes to an extract of e-cigarette vapor and found that the
cells showed breaks in DNA strands and a greater tendency towards cell death.
Other Health Risks
Respiratory damage, burns, and poisonings are among the
additional risks of e-cigarette use.
A flavoring chemical in some e-cigarettes called diacetyl is
associated with a disease called bronchiolitis obliterans or "popcorn
lung," so named because the illness was found among plant workers exposed
to airborne diacetyl from the artificial butter flavoring of microwave popcorn
production11. Popcorn lung is a
condition similar to chronic obstructive pulmonary disease (COPD), marked by
cough, shortness of breath, and irreversible scarring of the lungs. A study of
51 e-cigarette varieties found higher than normal diacetyl levels in 39 of its
tested flavors.11
An outcome of inconsistent manufacturing quality among
e-cigs is the risk of burn injuries related to their use. In January 2016, The
Canadian Press reported on a 16-year old student who sustained significant
facial and dental injury as a result of an e-cigarette explosion during use12. The teen has had
multiple surgeries for first- and second-degree burns and two root canals
resultant from the incident.
In addition to burns and other external injury,
e-cigarette toxicity is a concern too. The number of calls to U.S. Poison
Control Centers involving e-cigarette liquids containing nicotine rose from one
per month in September 2010 to 215 per month in February 2014, according to the
CDC13.
The Impact on Students
In some school communities, a young person's first
exposure to a drug, including alcohol, will be an electronic cigarette. This
means that lower and middle school communities must work to educate their
students about the risks of electronic cigarettes before first use or exposure
occurs, and that middle and upper school communities must have initiatives in
place to prevent use as students grow.
June 14,
2018 • 7:OOpm
Stonehill College Book Award
TECHNICAL STUDIES AWARDS
Mrs. Potter, Science Department Head
