Vaping and Teens

September 13, 2019

The nation has seen a rise in teen vaping, and many pediatricians are seeing patients from elementary and high schools who vape, according to Arthur Atlas, MD, director of pediatric pulmonology at Goryeb Children’s Hospital in Morristown, New Jersey. Here, he answers questions about the consequences of vaping and its impact on the body.

Are you seeing a rise in younger patients who vape?

We are definitely seeing a rise in younger patients who vape, but I think we are only seeing the tip of the iceberg because most young patients don’t admit to vaping – especially if a parent is present. We think vaping is being underreported in pediatric patients. Vaping is not limited to high school students, it’s also occurs in elementary school. When we know about it, we try to discuss the dangers with the child and their family.

To what do you attribute the rise in teen vaping?

One of the reasons vaping is so popular is that there’s no odor, so kids can be vaping in their rooms or at school and their parents and teachers don’t know it. When vaping first came out, there was an idea that it is safer than cigarettes. That may be true, but that doesn’t mean it’s without risk.

Is vaping dangerous?

The only thing that should be inhaled is air. The reason vaping is dangerous is two-fold. Our lungs are designed only to be exposed to the air we breathe, so whenever you introduce things into the lungs other than air, there’s always a concern. The second is that there are side effects of inhaling chemicals, especially nicotine. I don’t think we have enough long-term data in vaping like we didn’t in cigarettes initially to know if there are other long-term consequences, but the short-term risk is nicotine addiction.

Why is vaping especially bad for children?

In children, the biggest concern is that kids who are vaping become addicted to nicotine. Vaping turns into a nicotine delivery system, and many products are flavored, which encourages more frequent use. Over time, nicotine addiction occurs and it becomes difficult to kick the habit. Some people are concerned vaping is a gateway to marijuana use, but that has not been correlated by research.

The American Academy of Pediatrics issued a strong statement against vaping based on the limited evidence we have. Simply put, vaping is not a safe activity for health maintenance.

Is vaping safer than cigarettes?

In adults, there is some good evidence that vaping may be safer than actually smoking a cigarette, but in both adults and children, we’re still dealing with nicotine addiction. If someone is smoking and they want to vape to stop or change how they’re getting nicotine, it may be a better option, but if they can do without smoking and vaping, they’re going to be better off.

Does vaping harm the lungs?

I think over time, the answer is yes, based on the buildup of what’s being inhaled by the lungs. The long-term evidence of vaping is still not clear.

What are the effects of nicotine on the body?

First, is it is an addiction. If someone starts vaping in their teens, we are concerned this may become a lifelong dependency on a drug that body doesn’t need. Second, nicotine causes blood vessels to constrict. In children, they may not experience any signs or symptoms right away, but in adults, especially if they have underlying heart disease, the construction can become a serious issue.

What are the signs of nicotine dependence/addiction?

Any addiction requires a physiologic need for the product, so people who are addicted to nicotine develop a physiologic and psychological need for nicotine. In children, they may initially be attracted to the taste of the product they are vaping, but overtime may become addicted to the nicotine in the product.

If you are addicted to nicotine, and try to abstain, your body will experience physiologic changes of withdrawal, for example irritability, headaches and cold sweats. Many decades of research on the use of cigarettes has shown us that nicotine addiction is very strong physiologic and psychological addiction, and it takes a long time to break that addiction, and most people are unsuccessful.

How do you recommend people quit?

For those who want to break their nicotine addiction, a combination of medication and counseling have the best outcomes.