OpEds
Vaping – the Venus flytrap of our youth
It’s a drug, it’s expensive, and it’s highly addictive. Worse, it’s turning our children into liars.
The challenge with vaping is that it sounds innocuous. Drug companies have been brilliant at marketing it, and have made the concept seem so appealing. Modern vaping tools look like USB flash drives. They’re odourless, and so easy to hide. They put up stalls at shopping centres and staff them with good-looking young people. They are vibey, and have made it look trendy to walk around with an e-cigarette. The colours of the sales stands are bright and eye catching, even “healthy” looking. A modern day Venus flytrap baiting its victim.
A quick look around the world shows that vaping is now the most commonly-used tobacco product among teens in the United States, putting them at risk of smoking and a life-time addiction.
Australia has recently restricted the use of vaping, making it illegal for those under the age of 18 and, with new legislation, it will be available by prescription only.
In June 2022, the US Food and Drug Administration banned the sale of the JUUL e-cigarette.
In South Africa, the finance minister announced in the 2022 Budget on 23 February 2022 that excise duty on vaping tobacco products would be introduced.
This week, on Tuesday 6 June, New Zealand has now announced a ban on disposable vapes and new vape shops will not be allowed near schools or meeting grounds.
So, what’s all the fuss about?
The consequences of vaping are becoming more apparent to me in my practice over time. Whereas last year, I saw a few teens and adolescents with respiratory issues related to vaping, in the past six months, the numbers have spiralled three-fold, with many presenting with asthma, chronic coughs, and chronic respiratory issues. I have dealt with at least 50 patients during this time.
As innocuous as it may seem, vaping devices contain nicotine. Nicotine is a stimulant. This causes an increase in heart rate, headaches, dry mouth, as well as blood pressure. There’s a causal link between vaping and asthma, heart attacks, recurrent coughing, increased phlegm, chronic bronchitis, and sinusitis.
More than 7 000 different flavours are added to vaping mixtures including cotton candy, chocolate, strawberry muffin, and many others. These additives are also linked to increased dental cavities as well as halitosis (bad breath).
One of the main reasons why vaping is so bad for teens and adolescents is the fact that the human brain is the last organ in the body to develop fully, a process that takes until their early 20s. Vaping affects the central nervous system causing mood disorders, attention deficit hyperactivity disorder, irritability, memory problems, as well as poor impulse control. With a major risk to the youth of dependence and addiction.
Nicotine causes the brain to release a hormone called dopamine, causing feelings of pleasure and happiness, which in turn encourages more nicotine use and leads to addiction, especially in teens who are much more vulnerable due to their ongoing brain development.
Vaping isn’t safe. The aerosols that are inhaled in the vape contain many toxins including acetaldehyde/formaldehyde, which are carcinogenic. All vaping liquids contain mixtures of chemicals including lead, nickel, propylene glycol, chromium, and most importantly, nicotine. A JUUL pod in a device contains as much nicotine as a pack of 20 cigarettes.
Vaping is now an epidemic among high school users. Once they start, almost all move over to smoking cigarettes, which is far worse.
A favourite act of teens and adolescents is to add THC (tetrahydrocannabinol, which is the primary psychoactive cannabinoid extracted from the marijuana plant) and vitamin E acetate to the vaping liquids. These have been associated with EVALI, which is the term used for e-cigarette or vaping-associated lung injury. Patients present with shortness of breath, a cough, vomiting, diarrhoea, headaches, chest pain, and a rapid heart rate. Vaping-related lipoid pneumonia develops due to inhalation of the oily substances found in intense liquid cartridges. Vaping can cause an acute, progressive form of life-threatening respiratory failure leading to intensive-care admission and being placed on life support.
Breathing in the harmful chemicals from vaping products can cause irreversible lung damage as well as heart disease, and lead to biological changes that are associated with cancer development.
I have done many talks and podcasts on the vaping epidemic. The question I’m often asked is: is vaping worse than smoking cigarettes? The answer is simple. If a pedestrian gets hit by a speeding car or by a motorbike, are they still going to get injured? The answer is obvious. Though vaping is less severe than smoking, it still has detrimental effects on our bodies, our central nervous systems, and the environment.
So why hasn’t the government banned vaping in public, just like it has smoking? That will come soon enough.
The environmental impacts of vaping also need to be addressed. Most vaping devices contain metals and plastics that can take many years to decompose. Plastic never fully decomposes, and lands up polluting our food and drinking water.
Another common question is: surely it’s better to use vaping to help stop smoking? This, too, is a myth. No official health guidelines include vaping in smoking cessation guidelines. The simple answer is that vaping is bad for you regardless of your age.
We live in a society that’s always looking for a new kick or something to help build our self-esteem among our peers. Be sure – vaping isn’t it.
Vaping is a dangerous habit. It’s an addictive drug and lands up causing many medical and psychological issues. It’s critical for parents and educators to be informed and empowered and stop this epidemic before it spirals further out of control.
- Dr Anton Meyberg is a specialist physician and pulmonologist in private practice, which is largely responsible for the Intensive-Care Unit at Linksfield Clinic in Johannesburg. He is passionate about healthcare and education.
Kurt Yeo
June 13, 2023 at 5:30 pm
Very disappointing article from a doctor I keenly followed during the pandemic. Some points need to be corrected here as I am afraid Dr Meyberg might not be up to speed or simply jumping into the moral panic gripping the world. We would hate to see the good doctor fall into the trap of sharing misinformation, as it will have serious consequences for the community and dissuade adult smokers from making informed choices.
1. June 2022, the US FDA banned the sale of the JUUL. Yes, BUT on 5 July 2022 they stayed the marketing denial order, stating: “The agency has determined that there are scientific issues unique to the JUUL application that warrant additional review”. Dr Meyberg should review The Reagan Udall Foundation – A Critical Evaluation of FDA’s Center for Tobacco Products. This will provide some insight as to how the FDA has dropped the ball on this matter.
2. “Vaping affects the central nervous system causing mood disorders, attention deficit hyperactivity disorder, irritability, memory problems, as well as poor impulse control”. Reviewing the scientific essay “Balancing Consideration of the Risks and Benefits of E-Cigarettes” written by 15 past presidents of the Society for Research on Nicotine & Tobacco (SRNT) arguably the experts in the field of nicotine, the following was stated: “Whether impaired brain development with behavioral consequences occurs in young nicotine consumers is difficult to determine because of potential confounding of genetic and socioeconomic factors, the influence of other substance abuse, and the role of preexisting neuropsychiatric problems associated with youth smoking. Research has yet to isolate nicotine use in the adolescent years and then examine later sequelae.” It also needs to be noted that these observations were made by reviewing changes in rodents, notoriously unreliable.
3. “vape contain many toxins including acetaldehyde/formaldehyde”. To this, the good doctor should rely on the well-known adage and a foundation of pharmacology, “The dose makes the poison”. Both these chemicals are found in everyday foods and household products, and there are acceptable levels as set forth by varying standards bodies, including the FDA. Their mere existence doesn’t make them dangerous, which should always be made clear by a health professional.
4. EVALI. Pure fear-mongering here and doesn’t pass the sniff test. 101 epidemiology! EVALI occurred between Jun 2019 and Feb 2020. It has never occurred prior nor since, and the unfortunate event primarily occurred in the USA. It was related to black-market THC products containing Vitamin-E acetate produced by drug dealers. If this was in any way related to vaping we would witness these acute reactions in all parts of the world consistently, given that there are an estimated 85 million vapers around the world and vaping has been commercially available since 2006. I suggest further research on this and a good place to start https://www.qeios.com/read/ZGVHM7.2
5. “No official health guidelines include vaping in smoking cessation guidelines” I suggest Dr Meyberg refer to Public Health England under its new name OHID as well as the NHS on recommended ways to quit smoking. It also needs to be noted that just recently UK Health Minister Neil O’Brien announced the “Swop to Stop” campaign which will see 1 million vape starter kits being given to smokers wishing to quit via their smoking cessation services. Also, look and the New Zealand Health Ministry’s vaping facts website where vaping is endorsed as a smoking cessation aid. Then there is Health Canada which is also slowly warming up to the importance of these products. If these products were as harmful as being “hit by a motorbike”, do you honestly believe these countries would endorse, promote and even provide them to their citizens?