American Heart Association Calls for Action on Teen Vaping

A new scientific statement issued by the American Heart Association is calling on decision-makers at the local, state, and national levels to take action to reduce or prevent youth use of e-cigarettes in order to lower their risk of developing lifelong cardiovascular disease.

According to a statement led by Dr. Loren Wold, a professor and associate dean responsible for research, operations, and compliance at Ohio State University's College of Medicine, current scientific evidence suggests that e-cigarettes may have negative effects on users' cardiovascular and respiratory systems.

Since electronic cigarettes were introduced to the US market at the beginning of the 21st century, they have become a popular trend, especially among teenagers. This has reversed the decreasing trend in tobacco use among young people and has also resulted in a decrease in nicotine dependency among users of combustible cigarettes. According to a statement published online today in the journal Circulation Research, young people who start smoking now may become lifelong tobacco or nicotine users.

Dr. Lauren Walden stated that most research on the use of electronic cigarettes has been conducted on adults or animals. It is crucial to understand how the organ systems of young e-cigarette users are affected, especially the long-term impact into adulthood. Dr. Walden's recent study on mice revealed that smoking has significant long-term effects on cardiovascular health in adolescent males that persist into adulthood.

According to the statement, there is still a lot unknown about the toxicity of electronic cigarettes, partly due to many manufacturers not disclosing a full list of ingredients. Without knowledge of the exact composition of the products within these devices, it is difficult to predict or determine the health impact on the lungs and heart. Besides nicotine or tetrahydrocannabinol, electronic liquid also contains vegetable glycerin and propylene glycol, both of which are considered safe by the US Food and Drug Administration. However, these compounds are not intended for inhalation and have not been tested for their effects on users when inhaled. When heated, these compounds often break down into other chemicals such as formaldehyde, a known carcinogen.

Inhaling any foreign substance can have an impact on the respiratory and cardiovascular systems," said Wald, who is also the Assistant Dean of Biological Health Research at the nursing school.

Furthermore, an individual's lung development continues into their early 20s, which means that teenagers who use drugs may experience delayed or altered lung development, which can result in an inability to achieve full lung function.

Previous research has found that using electronic cigarettes increases the risk of respiratory health problems, including wheezing, coughing, asthma, and lung infections. Furthermore, studies have also found that young adults who use electronic cigarettes experience arterial stiffness, impaired vascular function, and elevated blood pressure and heart rate. This evidence suggests that long-term electronic cigarette use may lead to the development of cardiovascular diseases.

While teenagers who use e-cigarettes may not currently think that smoking is affecting them, it is becoming increasingly clear that the chemicals found in e-cigarette aerosols are damaging cardiovascular cells, leading to long-term changes that facilitate the development of heart disease, "says Walde. "People who smoke combustible cigarettes usually take decades to develop cardiovascular disease and/or chronic obstructive pulmonary disease. The same may be true for e-cigarette users. Reducing the smoking rates among teenagers may help improve their long-term cardiopulmonary function.

A new study has found that many people who use electronic cigarettes as an aid to stop smoking combustible cigarettes end up using both products regularly. The study emphasizes the importance of distinguishing between tobacco cessation and nicotine cessation. An investigation conducted in the UK discovered that e-cigarettes contain significantly less nicotine than in the US. In terms of giving up combustible tobacco cigarettes, e-cigarettes may be more effective than nicotine patches (18% vs 10%). However, the study found that e-cigarettes were four times less successful at reducing nicotine consumption (20% for e-cigarettes compared to 81% for nicotine patches).

The customizability of vaping, including power levels, e-liquid content, and a variety of flavors, has attracted young people, making regulation of these products difficult, according to Walda. While the FDA has released a policy opposing e-liquid flavors like mint and fruit that are known to attract young people, there are still mint-flavored products on the market for certain product types. Additionally, the US does not have regulatory standards limiting the nicotine concentration in e-liquids, and some devices have been found to contain as much as 59 milligrams per milliliter. In contrast, the EU limits nicotine concentrations in e-liquids to below 20 milligrams per milliliter, which is similar to the concentration in standard combustible cigarettes.

The statement suggests taking measures to clear all flavored e-cigarettes, including mint-flavored ones, from the market. Other public health and policy recommendations are also included.

Implement better measures to reduce the access of electronic cigarettes for teenagers, including strict age verification in sales venues and banning marketing of e-cigarettes targeted towards teenagers.

Provide more education for teenagers and their parents regarding the use of e-cigarettes and their potential health risks.

A course on electronic cigarettes is being introduced for medical students to provide information to the next generation of healthcare professionals.

Ensure the provision of hospital-based smoking cessation programs for both adolescents and adults.

Regulating the marketing of electronic cigarettes on traditional, online, and social media platforms that are popular among young people.

Include electronic cigarettes in smoke-free air policies.

Source: Wexner Medical Center