Vaping, the use of electronic cigarettes (e-cigarettes) or other Electronic Nicotine Delivery Systems (ENDS), has increased in recent years compared to the use of traditional cigarettes. Like traditional cigarettes, vaping has multiple harmful effects, including special concerns for young people. Despite recent regulations by the FDA, loopholes still exist that allow the sale of flavored ENDS devices to youth.
ENDS are battery-fueled devices that heat and vaporize liquid chemicals for inhalation. They are not combustion activated like regular cigarettes, but explosions and burn injuries have occurred from the lithium batteries that power the ENDS heating element. The enclosure around the battery, improper charging in the USB port, and expanding gas within the case are believed to be the most common triggers for explosions that can result in severe injuries including substantial facial burns, fractures, and/or loss of vision.
A September 2020 Centers for Disease Control and Prevention (CDC) study reported, “During September 2014–May 2020, e-cigarette sales increased by 122.2%. Sales of prefilled cartridges increased during September 2014–August 2019; since then, sales of disposable products have increased. Prefilled mint cartridge e-cigarette sales increased from September 2014 to August 2019, then decreased, as menthol sales increased during August 2019–May 2020.”
Poisoning has occurred in children from ingesting the highly concentrated nicotine found in the ENDS chamber and refill containers. These products are often marketed with colorful, attractive packaging and flavors (e.g., fruit, candy, and mint), which can be tempting to children. Nicotine poisoning in young people can result in coma, seizures, heart attack, cancer, and death.
The “e-liquids” in ENDS, even in absence of nicotine, have been shown to harm middle ear function, and e-cigarette use increases the risk of asthma attacks in youth. Furthermore, the recent (2020) use of e-cigarettes is associated with a five-fold higher risk of COVID-19 infection in a survey of adolescents and young adults, possibly due to respiratory poisoning and frequent hand-to-face touching in users.
Use of e-cigarettes in pregnancy can have multiple harmful effects on the fetus, and the harm may occur before the mother knows she is pregnant. Smoking of all types increases the risk of congenital heart defects. Nicotine exposure in utero can increase the risk of childhood and adult high blood pressure, impair the development of normal brain circuits, and is associated with pre-term births and still births.
Nicotine in e-cigarettes may affect the maturing brains of adolescents, leading to emotional disorders and increasing impulsive reactions. Nicotine is an addictive drug and may lead to addiction to other “hard” drugs.