Vaping: What Is It and What Are the Risks
Before COVID-19 took over the news cycle, there were a string of initially mysterious deaths that were eventually attributed to the use of vaping or e-cigarettes. The Centers for Disease Control has confirmed 68 deaths as of February 2020 due to what is now known as “EVALI,” e-cigarette, or vaping product use associated lung injury.
Vaping using e-cigarettes was introduced as an alternative to smoking tobacco, known to be addictive and cancer causing, in the early 2000s. For most e-cigarettes, a user puffs on it, which activates a battery-operated heating mechanism that vaporizes the liquid in the attached cartridge, releasing a nicotine vapor. It is often referred to as “JUULing,” though JUUL is a particular brand of e-cigarette that operates in essentially the same way.
To date, there is no known research suggesting the practice of vaping definitively causes cancer in humans. There are, though, findings from New York University researchers that suggest the smoke from vaping and e-cigarettes does cause cancer in mice, as published in the Proceedings of the National Academy of Sciences in October 2019. While mice and people are different, clearly, these findings are a cause for concern.
Originally marketed to be a safer alternative to tobacco cigarettes that emit tar, a known carcinogen, e-cigarettes have been characterized as the possible “lesser of evils” for tobacco smokers by Harvard Medical School faculty member Robert H. Shmerling, MD. Of greatest concern seems to be the additives found in commonly used flavorings for vaping, those same flavorings that appeal to younger users. These include chemicals like formaldehyde and acetate.
Srilata Gundala, MD, a hematologist/oncologist and founder of Hope & Healing Care in Hinsdale and Lombard, Illinois, wants her patients to be aware of the risks associated with vaping and the lack of understanding about the long-term impact of using e-cigarettes, “Decades passed before medical professionals understood that smoking cigarettes caused cancer, most typically in people over age 65. While some research exists about the risks of vaping, not enough is understood about the impact it may have on the lungs, particularly young lungs over a longer period.” Dr. Gundala works with her patients to assess risks associated with smoking and smoking cessation.
As of 2016, the Food & Drug Administration gained regulatory control over ENDS (electronic nicotine delivery systems) and the Acting Commissioner of the FDA is the former Director of the National Cancer Institute, Ned Sharpless, MD. On the FDA website, Dr. Sharpless states, “ . . . while ENDS products appear to hold some promise in helping addicted adult smokers transition away from combustible tobacco to a potentially less harmful form of nicotine delivery, these products are not safe, and we cannot allow the next generation of young people to become addicted to nicotine.”
After the overwhelming negative attention on vaping in 2019, one thing that all researchers can agree upon is that more research is required to understand the risks associated with vaping and e-cigarettes. Because it is a newer product and delivery device, there is no long-term data available to learn from and direct policy or regulation. More will be understood in time, but until then, vaping must be understood as a risky habit.
Written By: Sheila Quirke, MSW
Reviewed By: Srilata Gundala, MD
