As we head into the holiday season, most of us are anticipating spending more time with family and loved ones. Kids are wriggling with excitement at the thought of sleeping in, not doing homework and spending time with their friends. Parents are looking forward to seeing their kids more. Perhaps there will be a chance parents will talk to their kids about vaping.
Most readers are aware by now that vaping is considered a health hazard and a public health epidemic that is taking our schools by storm. The delivery devices come in smaller and less obvious packages all the time. There is one that looks like a USB flash drive. There are smokeless devices. The product inside comes in a host of tasty flavors such as caramel and spearmint. According to a 2014 survey, 81% of youth e-cigarette users stated appealing flavors as the primary reason for use.
The Centers for Disease Control has issued an official health advisory which states that e-cigarette use has been associated with severe lung disease. They are calling it E-cigarette and Vaping Associated Lung Injury (EVALI).
There have been cases reported around the country of young children, as young as 9 or 11 years old, admitted to pediatric intensive care units in acute respiratory failure.
Early symptoms include coughing, chest pain and shortness of breath, followed by a general deterioration manifested by nausea, vomiting, diarrhea, fatigue, fever and weight loss.
Some kids become quite ill, with critically low levels of oxygen in their blood, needing to be on mechanical ventilators for days and then supplemental oxygen for weeks afterward. In addition, kids may suffer the total body consequences of critical illness, which can include deconditioning, diminished lung capacity, memory loss, and setbacks in school.
Aside from a known history of vaping, there is very little to distinguish these symptoms from a severe pneumonia. Whereas the main treatment for pneumonia is antibiotics, we don’t currently have a treatment for EVALI.
We do not know enough about this entity to offer more than supportive care at this point. We have on our hands an increasing number of children with severe lung disease and respiratory failure, for which there is no specific treatment, and which is completely preventable. Kids who don’t vape, don’t get vaping related lung disease.
A recent outbreak of EVALI has led to at least 47 deaths in 25 states. Earlier this month, the CDC announced that a substance called Vitamin E Acetate deposited in the lungs may be the culprit.
So, how does Vitamin E Acetate get into your child’s lungs?
What is vaping?
Vaping is the colloquial term for the use of e-cigarettes (vaporizers). Each device is composed of a battery, an atomizer which turns nicotine liquid into vapor, a tank where the e-liquid is stored and a mouthpiece which funnels vapor from the atomizer in one’s mouth.
The liquid can contain nicotine, THC and CBD oils, propylene glycol and other additives. Vitamin E Acetate is an additive used as a thickening agent in THC-containing e-cigarette (vaping) products.
There is currently very little, if any, regulation on what e-cigarettes contain.
Public health officials, politicians, teachers, filmmakers and news sources have been trying to provide education, awareness and regulation around the subject of e-cigarettes.
A very good documentary called “Vape” was released in October. Before that, In August, the TV program New Mexico in Focus interviewed a child psychologist and a public health expert about vaping. They pointed out that children who vape on a regular basis may feel pressured by their social group, and having access to alternative social groups through organized sports and activities can be very helpful.
A program called 24/7 New Mexico works with schools on these sorts of interventions, trying to reengage kids with school and school activities. It was also mentioned that e-cigarette companies are able to market to kids via social platforms such as Snapchat and Instagram.
Therefore it is important for parents to talk with their kids about vaping. Ask them what kind of ads they are seeing and how they react to those ads. Ask them if they or their friends are vaping and why. Ask them where they get their vaping equipment.
Kids can purchase equipment and flavors online, through essentially unregulated websites. There is a cursory screening message, “Hey you really need to be 21 or over to browse or shop on this website”
Then there are two boxes to click — one that says ‘Yes, I’m over 21″ and the other that says “No.”
Any kid with access to a credit or debit card can click “Yes, I’m over 21” and start shopping.
Anjali Subbaswamy is a Pediatric Intensive Care Physician at UNM. Please send your questions to her at ASubbaswamy@salud.unm.edu.