Q: At my son’s last well child visit, my pediatrician counseled me to not use my e-cigarette inside my home or car, and to not use it around him. Why not? I thought this was much safer than smoking regular cigarettes.
A: Electronic cigarettes, or e-cigarettes, are NOT safe and pose dangers on many fronts. E-cigarettes belong to a group of devices called Electronic Nicotine Delivery Systems, or ENDS. ENDS are also called vaping devices, personal vaporizers, vape pens, e-cigars, and e-hookahs. These devices produce an aerosolized mixture containing nicotine and flavors and is inhaled by the user. The exhaled vapor may be even more dangerous than cigarette smoke. This vapor is a toxic aerosol that contains nicotine, antifreeze, diethylene glycol, and carcinogens such as formaldehyde and nitrosamines which can cause cancer. Not only are these toxins in the vapor which can be inhaled by others, but they also become deposits on surfaces and can be absorbed through the skin upon contact.
In addition to the risk of poisoning through contact with the vapor, the liquid refills contain highly concentrated nicotine that can cause poisoning and even death. In fact, less than half a teaspoon of liquid nicotine can be fatal to a toddler. The American Association of Poison Control Centers reported a high of 4,024 cases of exposure to e-cigarettes and liquid nicotine in 2014 (most of these cases were in children under 5 years old). The total number through August, 2017, is only 1,627. The decrease in the number of cases is due to the 2016 passage of the Child Poisoning Prevention Act, which requires that liquid nicotine refills used for ENDS be sold in childproof packaging. Symptoms of nicotine poisoning include: vomiting, sweating and dizziness. This can progress to rapid heart rate, increased blood pressure, lethargy, seizures, and weakness of respiratory muscles. If you suspect your child has been exposed to liquid nicotine, call your local poison center at 1-800-222-1222. If you use liquid nicotine refills for your ENDS device, always protect your skin when handling them, keep them locked up and out of reach of children, and follow the specific instructions for disposal on the label.
There are other dangers to using ENDS. Secondhand vapor containing nicotine is harmful to growing lungs and can damage developing brains. The long-term health effects of exposure to secondhand vapor is still unknown. There have been reports of ENDS devices exploding, causing burns and fires. These devices can also be used to smoke or vape marijuana, oils, waxes, and herbs. None of these exposures is healthy for you or your child.
Proponents of using e-cigarettes as safer alternatives to traditional cigarettes state they don’t contain tar and tout them as successful options to help one quit smoking cigarettes. The problem is that it isn’t really known if they are safer, and there is little evidence to support that they help users stop smoking cigarettes. In fact, many smokers use both traditional and e-cigarettes! The best suggestion for trying to quit is to use proven smoking cessation techniques such as nicotine replacement therapy. Call 1-800-QUIT NOW or check online at www.smokefree.gov for help.
Do e-cigarettes lead kids to smoke? YES! Youth who use ENDS are more likely than non-users to smoke traditional cigarettes, and ENDS are the most commonly-used tobacco product among teens. In 2015, almost 25 percent of high school students reported using ENDS. About 90 percent of all smokers first tried cigarettes as teens, and an estimated three of every four teen smokers continue into adulthood. A 2016 study published in the journal Pediatrics reported that teens who had never smoked but used e-cigarettes were 6 times more likely to try cigarettes than teens who didn’t use e-cigarettes or vape. Kids are exposed to advertising for ENDS products on TV, in magazines, through social media, and on billboards, and the flavors produced are usually appealing to kids (bubble gum, chocolate, fruit). Although the products cannot legally be sold to kids under 18 years of age, they can be purchased online.
So how do we do what’s best for kids? Ideally, quit using nicotine products. If used, do so in the safest possible manner. Be an advocate to protect kids from exposure to nicotine products. Talk to your own kids about the real dangers associated with ENDS use. For more information on the risks of nicotine and ENDS, or to learn how to be an advocate to keep kids safe and healthy, visit: http://www2.aap.org/richmondcenter/ENDS.html.