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Teen vaping is growing at a staggering rate. A December 2018 study found that 37.3% of 12th graders had vaped in the previous year, up from 27.8% in 2017. Half of Colorado teens have tried vaping — the highest rate for any state. Unfortunately, teens are using electronic cigarettes (e-cigarettes) at a rate that research and caregivers are struggling to keep up with.

Vaping rates are surging and we don’t yet know the full effects of vaping. While some perceive vaping and e-cigarettes as safer than tobacco, we don’t yet know if that is true. Public health officials with the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) reported a spike in lung illnesses and one death linked to vaping in August 2019. These cases occurred across a number of states, including Colorado, and are likely the result of a condition known as vaping-associated pulmonary injury, or VAPI.

Health hazards of teen vaping

In the following video, Robin Deterding, MD, Chief of Pediatric Pulmonary Medicine at Children's Colorado, explains what vaping is, what the symptoms of VAPI are, what parents can do to help and more.

What is vaping?

Vaping refers to using an e-cigarette or other vaping device to inhale vapor, which may contain a number of toxic chemicals and nicotine. A battery heats the nicotine solution, which is typically flavored, and users inhale the resulting vapor. Some teens also use e-cigarettes to inhale THC, which is the compound in marijuana that creates a high.

Can vaping cause lung disease?

While we don’t have a definitive answer yet on the link between vaping and lung disease, the rise of VAPI is a troubling sign and proof that vaping can cause severe, life-threatening lung injury. Symptoms for VAPI tend to resemble lung infection: trouble breathing, cough and fatigue, as well as chest pain, fever, low oxygen and coughing up blood in some cases.

Parents, healthcare professionals and educators should check for a history of vaping in all kids, particularly if they have any of these symptoms. If symptoms persist, they need to see their doctor or a pediatric lung specialist. Correct and early identification is key. The treatment for VAPI is different from the treatment for lung infection, and early treatment may be important to stopping progression.

We do know that vaping devices and e-cigarettes contain a disturbing amount of chemicals that are released when heated. Vape liquid can contain high levels of nicotine and chemicals, some that can cause cancer, also known as carcinogens, and oils — all of which are bad for kids and their lungs.

Some vaping products can contain substances known to cause cancer and lung injury. Research shows that vaping increases the production of inflammatory chemicals and disables immune cells in the lungs. Vaping likely has a number of consequences we have yet to discover and it provides no benefits to teens.

Is vaping addictive?

The vast majority of e-cigarettes and vaping products contain nicotine and teens don’t always know this. JUUL, the most popular vaping product, doesn’t offer a nicotine-free option and one cartridge alone contains roughly the same amount of nicotine as an entire pack of cigarettes.

Nicotine has a particularly potent effect on the teenage brain due to how it is growing and reorganizing. The teenage brain is especially vulnerable to nicotine and it can have lasting effects into adulthood. Teens who use nicotine show lower cognitive function, shorter attention spans and increased impulsivity, depression and anxiety in adulthood. Nicotine addiction can also increase the risk for other addictions in the future. Pregnant women definitely should not vape.

Why is vaping appealing to kids and teens?

Vaping is appealing to teens for multiple reasons. Vaping companies have created flavors like bubblegum and cotton candy, which are clearly intended to entice teens. Some e-cigarette companies have positioned themselves as a safer alternative to tobacco products. Also, vaping products are not taxed at the rate that traditional tobacco products are, so they are cheaper. And like all tobacco products, teens can legally buy e-cigarettes at 18.

Vaping products are also very present on social media. While some companies have stopped promoting their vaping products on social media, e-cigarette advertising is unregulated and may influence teens online. Kids can also buy products that hide vaping accessories like sweatshirts and watches.

How can parents prevent their kids from vaping?

The greatest tool parents have to keep their kids from vaping is open communication. Talk with your kids about the dangers of vaping and emphasize that we don’t yet know just how bad it might be. Make sure that they know e-cigarettes contain nicotine, which can have lasting effects on their brain and behavior. Remind them that their brains develop until early adulthood. The CDC offers a tip sheet for starting a conversation with your teen about e-cigarettes.

Take advantage of teachable moments. You may find an opportunity to talk to your child about vaping when you see a character on TV vaping or someone vaping on the street while driving to school. Use these moments when the conversation can arise naturally.

You should also think about other people who can influence your child’s decisions:

  • Set up an appointment with your child’s doctor if you think they are more likely to listen to a medical professional about the dangers of vaping.
  • Talk to your child’s teachers and school administrators about how they are preventing vaping at school.
  • Remind your child that tobacco cigarettes are not an alternative to vaping.
  • Talk to other parents about their children and how they are preventing them from using e-cigarettes.
  • Be aware of what your child is doing online and set limits on their social media use.

And finally, think about actions you can take. Be a good role model by not vaping or smoking. It’s never too late to quit smoking and your child is more likely to listen to you if you are modeling the behaviors you want your children to show. Become an advocate and tell your politicians that you support legislation that limits teens’ access to vaping products.

Vaping-associated pulmonary injury (VAPI)

Charting Pediatrics is a weekly podcast covering a number of pediatric health issues. In this series, specialists from Children's Hospital Colorado examine the latest treatments for the most common complaints in pediatric medicine. Listen and subscribe on Spotify, iTunes, Google Podcasts and Google Play.

In this episode, Dr. Deterding discusses VAPI, including symptoms and what steps parents should take.

Teens and e-cigarettes

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Children's Colorado in the news

  • CBS4
    Impact of child and teen vaping in Colorado
    August 29, 2019

    Public health agencies have identified hundreds of vaping-related respiratory illnesses across the country. Pediatric pulmonologist Robin Deterding, MD, explains the common symptoms in these cases and what all kids should know about the risks of e-cigarettes.

  • 9News
    Colorado lawmakers want stricter limits on where you can vape
    January 15, 2019

    There are many places in Colorado where cigarette smoking is not allowed. State lawmakers want to add the same restrictions to vaping and e-cigarettes.