Rising Rates of Teenage E-cigarette Use in the US

The proportion of teenagers using e-cigarettes has increased once again, according to a report released by the US Centers for Disease Control and Prevention. The National Youth Tobacco Survey, led by the US Food and Drug Administration and the CDC, showed that 14.1% of high school students and 3.3% of middle school students reported using e-cigarettes or other vaping products in the recent past. These figures suggest that approximately 2.5 million middle and high school students in the US are now vaping. Experts are particularly concerned that over a quarter of students are using e-cigarettes on a daily basis.

Dr. Ramiro Fernandez, Assistant Professor at the Division of Thoracic Surgery under Dr. David J. Sugarbaker at the Michael E. DeBakey College of Medicine, states that while extensive long-term data on the effects of electronic cigarettes are lacking, we are aware of acute lung injuries associated with their use, known as EVALI or electronic cigarette-associated lung injury.

Patients with EVALI experience respiratory symptoms and signs, including shortness of breath and decreased oxygen levels. They may also develop severe diffuse inflammation in their lungs, which can lead to death," said Fernandez. As of February 2020, there have been 2,807 reported cases of hospitalization or death due to EVALI, with 68 confirmed deaths.

Most e-cigarettes contain nicotine. In fact, a study by the Centers for Disease Control and Prevention found that 99% of e-cigarettes sold in assessment locations in the US contained nicotine. Nicotine can harm the developing brains of adolescents, which do not fully mature until around age 25. Additionally, research shows that teenagers who use e-cigarettes are more likely to start smoking traditional cigarettes in the future.

Electronic cigarettes also contain other harmful substances, such as ultrafine particles that can be inhaled deep into the lungs, flavorings associated with serious lung diseases, heavy metals like nickel, tin, and lead, as well as other carcinogens.

According to the American Cancer Society, the aerosol in e-cigarettes contains addictive substances that can lead to lung disease, heart disease, and cancer. A study by Johns Hopkins University in October 2021 on the components of e-cigarettes shows that there are thousands of chemical components in e-cigarette products, many of which have not been identified. The research team identified a pesticide, three chemicals never before found in e-cigarettes, and two flavorings associated with respiratory irritation and potential toxicity.

Although some people believe that electronic cigarettes can help people quit smoking, they have not been approved by the Food and Drug Administration as an aid. To quit smoking, seek help from your doctor or other support services, such as the smoking cessation program at the Baylor College of Medicine's Chest Clinic. It is important to note that electronic cigarettes are harmful not only to young people but also to adults.

People need to know that electronic cigarettes are harmful to your health," Dr. Fernandez stated. "Although the long-term effects are still unclear, data shows noticeable risks to cardiovascular and lung health.

For more information and resources, please see Baylor College of Medicine's position paper on taking action to address the issue of youth smoking and vaping.

Author: Tiffany Harston, Assistant to the Michael E. DeBakey Surgical Communications at Baylor College of Medicine.

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