Teens are becoming increasingly dependent on and addicted to vapes. The trendy electronic cigarettes have become a way for many kids to ‘fit in’ or relieve stress. However, the adverse effects of vaping put adolescents at a serious health risk.
Dr. Catherine Sanders, a pulmonologist at Le Bonheur Children’s Hospital, is here to discuss the dangers of the popular habit of vaping among the pediatric population.
Selected Podcast
Vaping Me Sick: An Epidemic Among Teens
Featured Speaker:
Dr. Sanders is the Director of the Primary Ciliary Dyskinesia Center and also serves as the Program Director for Pediatric Pulmonology Fellowship at The University of Tennessee Health Science Center (UTSCH) College of Medicine. She is an Assistant Professor of Pediatrics at UTHSC.
Catherine Sanders, MD
Catherine Sanders, MD is a pulmonologist at Le Bonheur with a clinical focus of primary ciliary dyskinesia, cystic fibrosis, high-risk asthma and bronchopulmonary dysplasia.Dr. Sanders is the Director of the Primary Ciliary Dyskinesia Center and also serves as the Program Director for Pediatric Pulmonology Fellowship at The University of Tennessee Health Science Center (UTSCH) College of Medicine. She is an Assistant Professor of Pediatrics at UTHSC.
Transcription:
Vaping Me Sick: An Epidemic Among Teens
Prakash Chandran: Teens are becoming increasingly dependent on and addicted to vapes. The trendy electronic cigarettes have become a way for many kids to fit in or relieve stress. However, the adverse effects of vaping put adolescents at a serious health risk. Dr. Catherine Sanders is a pediatric pulmonologist at Le Bonheur Children's Hospital, and she's here to discuss the dangers of the popular habit of vaping among the pediatric popul. This is the Peds Pod by Le Bonheur Children's Hospital. I'm your host, Prakash Chandran. So Dr. Sanders, thank you so much for joining us today. I really appreciate your time. Now, for the audience and also for me, can you just explain what a vape actually is and how it's different from, e-cigarettes and normal cigarettes?
Dr. Cathrine Sanders: Sure. So a vape is a type of product and it's, you can use it interchangeably with e-cigarette or they're sometimes called, Pods or mods or JUUL or electronic nicotine delivery systems. And these are different devices that actually aerosolize vape juice that is then inhaled by the user and they usually contain either nicotine or THC, which is the intoxicant in marijuana. And it's a little bit different from your traditional cigarette, which we sometimes call combustible cigarettes, where you actually light it on fire. And you inhale the full tobacco, which has about two different substances in it. So typically they have fewer substances in them. You're still inhaling juice, which contains many things.
Prakash Chandran: Okay, so you're saying that apart from just nicotine, that with a vape you can inhale many different types of substances, including THC, flavored THC, and other things. Is that correct?
Dr. Cathrine Sanders: Yes, and I think that's one of the appeals is you can have all these really enticing flavors that are a little. More pleasant than say your traditional cigarette. So you're sort of covering up the harmfulness of it because with a traditional cigarette you can almost feel and taste these harmful things. But with a vape, it might taste like mango or fruit punch or something really tasty and and it may come across as something that's safe and pleasant.
Prakash Chandran: Yeah, totally. I was just gonna ask you, when did vapes get so popular and why, and is it only mostly teens that are using them today?
Dr. Cathrine Sanders: So vapes became available in the United States starting in 2007, and in 2010 you really started seeing more advertising for vaping products. And that's when it really picked up, particularly among teens. And by 2014, the use of vape products had actually outnumbered use of traditional cigarettes and teenagers. And it, it is the younger groups that's really taken off with, while some older adults may use vapes to try to come off of traditional cigarettes. It's teenagers that are starting with vapes and using them more exclusively than your typical combustible cigarettes.
Prakash Chandran: Yeah it, crazy just how, fast I've seen vapes get picked up. I think a part of it, outside of the flavor and everything like that, is just the accessibility, how easy it is to like, because I, sometimes I see, my friends' kids, they'll come like put something to their mouth and then it's done. Do you find that that has fueled the adoption, just how easy it is to access?
Dr. Cathrine Sanders: Absolutely. I think they're passed along between friends. It's a lot easier to conceal from parents. Kids aren't coming home with that smoke smell on them, so parents may not even be aware. They may see things in their backpack or in their rooms and not recognize them as vape pens. Because they can come in all sorts of forms. They may look like a USB drive or something else. So I think it's very easy to conceal and they are used so prevalently among teenagers I've talked to patients and they say that as far as they, they know 80 to 90% of their school is using them. So parents really may not be aware how prevalent they are and whether their own child is using them.
Prakash Chandran: Well, and I think the general thought, certainly amongst teens is that they're relatively safe. Right. And I think that's the argument I remember. My friend's teen was having an argument with them just saying like, they're safe. And my friend was like, no, they're not. And then when questioned, he's like, well, I don't really know, but this can't be good for you. Right. So I'd love for you to explain what exactly makes vaping so harmful?
Dr. Cathrine Sanders: Absolutely. I think that comes down to looking what is actually in the vape juice. So if you look at that, there are a couple different components. So you do have your intoxicants and With nicotine products, that itself is really harmful. Nicotine is very addictive and particularly in teenagers because the teenage brain is still developing and so they are at high risk for addiction and needing more and more of that substance to get their hit. It also can impair things like learning memory and all of these things that are so important in that brain formation in the late teen years.
So that in itself is a harmful effect. If we look, further some of the other substances in the vape juice, like the actual solvent. So the substance that the liquid that it, everything's dissolved in those themselves are quite harmful. they are known to cause airway irritation, airway meaning the tubes that lead to your lungs. They're known to cause inflammation, irritation, redness, and there's been some studies actually where they looked with scopes down into the airways of people who use vape products.
And they look more like those of traditional smokers compared to non-smokers. So we can actually visualize these effects. And I think one of the scariest things is there's not a lot known about the long-term effects. We absolutely know long-term effects like cancer risks and traditional cigarettes, but we don't know about that with use of vape. We can only see some of the short term effects.
Prakash Chandran: Yeah, and one thing that's important to highlight there is, you started by talking about nicotine and how that can be addicted to teenagers. But even if you're taking in THC through the vape, the solvent still has harmful chemicals and things that will cause that airway irritation and be bad for you. Is that correct?
Dr. Cathrine Sanders: That is absolutely correct. Another thing with thc. So back starting in mid 2019, we started seeing an influx of cases of what we call e-voly, so that stands for electronic cigarette or vaping associated lung injury. And these were young people predominantly coming in very sick with respiratory failure, cough, low oxygen levels. And if you look at what they were smoking, what type of vape products, the majority of those were THC products. And it wasn't necessarily the THC itself that was causing this, but some of the additives in these products.
Another thing I like to highlight is the flavors themselves. I think a lot of people think they're harmless because these are food grade flavoring, so we could eat them, and it's not harmful to us. But eating something, ingesting something into your GI system is very different from inhaling it into your lungs. And there's a lot different effects on the cells of the lungs and they can be quite harmful. So the flavorings themselves add another layer of harm.
Prakash Chandran: Wow. It seems like kind of multifactorial and I appreciate the explanation there. Tell me how addictive are vapes and is there research around the addictiveness of them?
Dr. Cathrine Sanders: So when we think about the addictives, a lot of it has to do again with nicotine. And so I don't know that there's been specific research looking at vaping addiction, but we absolutely have. Great evidence for the addictive nature of nicotine. Again, it really especially affects the young brain because we, our brain develops up until the age of about 25. And those last several years of adolescence and into early adulthood are so formative for developing memory and learning and all of that is interrupted and affected by nicotine.
And it sets these young people up for addiction. It's a really critical time for brain development and of high risk time for addiction. So it comes down to nicotine is so addictive and we know we have generations of people addicted to cigarettes and now we're having a new generation that's not addicted to combustible cigarettes, but to vaping products.
Prakash Chandran: Yeah. I think another piece of it is just behavioral. Like sometimes even for me, I'm not addicted to caffeine or I tell myself that, but I kind of feel like I need to have my cup of coffee every day. Not just, it's like part of my routine and like everyone else is doing it. So I imagine that as a teen with all of my friends doing it and just something that you're just addicted to the habit of doing it. The behavioral component is very strong.
Dr. Cathrine Sanders: Absolutely. And think you know There's so many layers now to peer pressure. Back when I was a teenager, there was just regular peer pressure where you're hanging out with friends and you're gonna do the things that they do. Social media adds an entirely another layer onto that. So you can find so much on social media about vaping including on TikTok. I read this one study that looked at TikTok videos about vaping and think they looked at like 800 videos that had an average of, I think around a million views each. 63% of them were positive about vaping. So I mean, we know how important social media is to teenagers today.
And it's so, I think difficult to just get away from this culture of vaping. Even if maybe your immediate friends don't do it, you are absolutely seeing your classmates do it on social media and yes, I think with kids hanging out, it's just sort of something they're doing and it's just sort of part of their culture that, there's a vape pen that's being passed around and everybody's partaking of it.
Prakash Chandran: We're obviously talking about it being dangerous. What are the symptoms of vaping that parents should look out for and when is it actually time to see a pulmonologist?
Dr. Cathrine Sanders: Well, sometimes I think one of the biggest worries is that it may not be immediately apparent, but if your child has new onset respiratory symptoms like coughing or wheezing and they've never done that, that's something I always gonna ask in clinic visits and usually I ask the parent to step out because some parents may have no idea why their child all of a sudden has respiratory symptoms when they've never had asthma or anything in the past. So certainly if your child is starting to have new respiratory symptoms, they've not had with their pediatrician and they may be able to figure something out.
But if it's still a mystery, why is your child. They need to see a pulmonologist. And that's something I'm gonna dig into a little bit more is whether vaping may be part of the picture. So new onset symptoms, again, there's this entity evol. So if your child is all of a sudden developing, severe respiratory symptoms, they're in distress, they're wheezing, they're working hard to breathe, that would mean they need to go to the emergency room. Now, it can be difficult to pick apart because a serious covid infection or flu can also look like that, but we will often admit these patients and find, no, they don't have the flu, they don't have covid, they don't have any known infection.
And we find out later that it's because they've been vaping. So certainly that's, sort of a get to the emergency room. I think parents should be very open talking about this with their children. Knowing how prevalent it is, just asking what are they doing? What are their friends doing? What are their thoughts about vaping? Do they understand any of the risks? Do they think it's safe? So I think starting those conversations, even before there's any signs, is really important because you don't want to wait until they're having effects from vaping.
Prakash Chandran: Yeah. And just outta curiosity, what ages have you seen, like people come in with vaping issues. Like how early does it start in teens?
Dr. Cathrine Sanders: I think I've mostly seen older teens, probably 15 and up. But that being said, there's data that shows this is really prev like use of Vapes is quite prevalent in middle. Schools even. So, and maybe those younger kids don't have as much access and so they're doing it a little bit less, but they are still exposed in school by their peers. So starting to talk to kids even in, fifth or sixth grade is important because if they haven't come in contact with these things yet, they certainly will in the years to come.
Prakash Chandran: Yeah. I mean, with fabs just being everywhere on social media and so accessible, outside of having a conversation with your child, do you have any other recommendations around what parents can do to keep their kids safe?
Dr. Cathrine Sanders: Sure. I think. Monitoring what kids are doing online is always important for so many reasons. And so talking to kids about what are they looking at online, what sort of TikTok videos are they watching? What are they learning from TikTok? What are their friends showing online? And having open conversations so that they can ask questions if they see something they're not sure about. I there are, is a place for parental controls on certain things, and I'm not sure how that works in the setting of vaping, if there's a way to sort of limit access to this sort of thing. But I think having really honest conversations about technology use has to be a part of daily life with a teenager, regardless of whether you believe they're vaping or not.
Prakash Chandran: Yeah. Totally makes sense to me. Well, Dr. Sanders, this has been a great conversation, super informative. I really appreciate your time. Is there anything else that you would like to share with our audience before we sign off?
Dr. Cathrine Sanders: I just want to make sure everybody knows that vaping is not safe. So I think there's this thought that at least I'm not smoking cigarettes, but we gotta add vaping to the list of harmful things and not think of it as something that's a safe alternative.
Prakash Chandran: Yep. Wonderful advice, and I'm so glad that you said that. So thank you so much for your time today, Dr. Sanders.
Dr. Cathrine Sanders: Thanks, Prakash. It was great talking to you.
Prakash Chandran: That was Dr. CAtherine Sanders, a pediatric pulmonologist at Le Bonheur Children's Hospital. For more information on vaping, you can visit leboneur.org. That is L E B O N H E U R.org. Thanks for listening, and make sure to subscribe to the Peds Pod by lab, Bonner Children's Hospital, on Apple Podcast, Google Podcasts, or wherever you listen to your podcasts. You can also check out the leboneur.org podcast page for the entire podcast library. This has been the Pete's Pod by Le Bonheur Children's Hospital. I'm Prakash Chandran. Thanks and be well.
Vaping Me Sick: An Epidemic Among Teens
Prakash Chandran: Teens are becoming increasingly dependent on and addicted to vapes. The trendy electronic cigarettes have become a way for many kids to fit in or relieve stress. However, the adverse effects of vaping put adolescents at a serious health risk. Dr. Catherine Sanders is a pediatric pulmonologist at Le Bonheur Children's Hospital, and she's here to discuss the dangers of the popular habit of vaping among the pediatric popul. This is the Peds Pod by Le Bonheur Children's Hospital. I'm your host, Prakash Chandran. So Dr. Sanders, thank you so much for joining us today. I really appreciate your time. Now, for the audience and also for me, can you just explain what a vape actually is and how it's different from, e-cigarettes and normal cigarettes?
Dr. Cathrine Sanders: Sure. So a vape is a type of product and it's, you can use it interchangeably with e-cigarette or they're sometimes called, Pods or mods or JUUL or electronic nicotine delivery systems. And these are different devices that actually aerosolize vape juice that is then inhaled by the user and they usually contain either nicotine or THC, which is the intoxicant in marijuana. And it's a little bit different from your traditional cigarette, which we sometimes call combustible cigarettes, where you actually light it on fire. And you inhale the full tobacco, which has about two different substances in it. So typically they have fewer substances in them. You're still inhaling juice, which contains many things.
Prakash Chandran: Okay, so you're saying that apart from just nicotine, that with a vape you can inhale many different types of substances, including THC, flavored THC, and other things. Is that correct?
Dr. Cathrine Sanders: Yes, and I think that's one of the appeals is you can have all these really enticing flavors that are a little. More pleasant than say your traditional cigarette. So you're sort of covering up the harmfulness of it because with a traditional cigarette you can almost feel and taste these harmful things. But with a vape, it might taste like mango or fruit punch or something really tasty and and it may come across as something that's safe and pleasant.
Prakash Chandran: Yeah, totally. I was just gonna ask you, when did vapes get so popular and why, and is it only mostly teens that are using them today?
Dr. Cathrine Sanders: So vapes became available in the United States starting in 2007, and in 2010 you really started seeing more advertising for vaping products. And that's when it really picked up, particularly among teens. And by 2014, the use of vape products had actually outnumbered use of traditional cigarettes and teenagers. And it, it is the younger groups that's really taken off with, while some older adults may use vapes to try to come off of traditional cigarettes. It's teenagers that are starting with vapes and using them more exclusively than your typical combustible cigarettes.
Prakash Chandran: Yeah it, crazy just how, fast I've seen vapes get picked up. I think a part of it, outside of the flavor and everything like that, is just the accessibility, how easy it is to like, because I, sometimes I see, my friends' kids, they'll come like put something to their mouth and then it's done. Do you find that that has fueled the adoption, just how easy it is to access?
Dr. Cathrine Sanders: Absolutely. I think they're passed along between friends. It's a lot easier to conceal from parents. Kids aren't coming home with that smoke smell on them, so parents may not even be aware. They may see things in their backpack or in their rooms and not recognize them as vape pens. Because they can come in all sorts of forms. They may look like a USB drive or something else. So I think it's very easy to conceal and they are used so prevalently among teenagers I've talked to patients and they say that as far as they, they know 80 to 90% of their school is using them. So parents really may not be aware how prevalent they are and whether their own child is using them.
Prakash Chandran: Well, and I think the general thought, certainly amongst teens is that they're relatively safe. Right. And I think that's the argument I remember. My friend's teen was having an argument with them just saying like, they're safe. And my friend was like, no, they're not. And then when questioned, he's like, well, I don't really know, but this can't be good for you. Right. So I'd love for you to explain what exactly makes vaping so harmful?
Dr. Cathrine Sanders: Absolutely. I think that comes down to looking what is actually in the vape juice. So if you look at that, there are a couple different components. So you do have your intoxicants and With nicotine products, that itself is really harmful. Nicotine is very addictive and particularly in teenagers because the teenage brain is still developing and so they are at high risk for addiction and needing more and more of that substance to get their hit. It also can impair things like learning memory and all of these things that are so important in that brain formation in the late teen years.
So that in itself is a harmful effect. If we look, further some of the other substances in the vape juice, like the actual solvent. So the substance that the liquid that it, everything's dissolved in those themselves are quite harmful. they are known to cause airway irritation, airway meaning the tubes that lead to your lungs. They're known to cause inflammation, irritation, redness, and there's been some studies actually where they looked with scopes down into the airways of people who use vape products.
And they look more like those of traditional smokers compared to non-smokers. So we can actually visualize these effects. And I think one of the scariest things is there's not a lot known about the long-term effects. We absolutely know long-term effects like cancer risks and traditional cigarettes, but we don't know about that with use of vape. We can only see some of the short term effects.
Prakash Chandran: Yeah, and one thing that's important to highlight there is, you started by talking about nicotine and how that can be addicted to teenagers. But even if you're taking in THC through the vape, the solvent still has harmful chemicals and things that will cause that airway irritation and be bad for you. Is that correct?
Dr. Cathrine Sanders: That is absolutely correct. Another thing with thc. So back starting in mid 2019, we started seeing an influx of cases of what we call e-voly, so that stands for electronic cigarette or vaping associated lung injury. And these were young people predominantly coming in very sick with respiratory failure, cough, low oxygen levels. And if you look at what they were smoking, what type of vape products, the majority of those were THC products. And it wasn't necessarily the THC itself that was causing this, but some of the additives in these products.
Another thing I like to highlight is the flavors themselves. I think a lot of people think they're harmless because these are food grade flavoring, so we could eat them, and it's not harmful to us. But eating something, ingesting something into your GI system is very different from inhaling it into your lungs. And there's a lot different effects on the cells of the lungs and they can be quite harmful. So the flavorings themselves add another layer of harm.
Prakash Chandran: Wow. It seems like kind of multifactorial and I appreciate the explanation there. Tell me how addictive are vapes and is there research around the addictiveness of them?
Dr. Cathrine Sanders: So when we think about the addictives, a lot of it has to do again with nicotine. And so I don't know that there's been specific research looking at vaping addiction, but we absolutely have. Great evidence for the addictive nature of nicotine. Again, it really especially affects the young brain because we, our brain develops up until the age of about 25. And those last several years of adolescence and into early adulthood are so formative for developing memory and learning and all of that is interrupted and affected by nicotine.
And it sets these young people up for addiction. It's a really critical time for brain development and of high risk time for addiction. So it comes down to nicotine is so addictive and we know we have generations of people addicted to cigarettes and now we're having a new generation that's not addicted to combustible cigarettes, but to vaping products.
Prakash Chandran: Yeah. I think another piece of it is just behavioral. Like sometimes even for me, I'm not addicted to caffeine or I tell myself that, but I kind of feel like I need to have my cup of coffee every day. Not just, it's like part of my routine and like everyone else is doing it. So I imagine that as a teen with all of my friends doing it and just something that you're just addicted to the habit of doing it. The behavioral component is very strong.
Dr. Cathrine Sanders: Absolutely. And think you know There's so many layers now to peer pressure. Back when I was a teenager, there was just regular peer pressure where you're hanging out with friends and you're gonna do the things that they do. Social media adds an entirely another layer onto that. So you can find so much on social media about vaping including on TikTok. I read this one study that looked at TikTok videos about vaping and think they looked at like 800 videos that had an average of, I think around a million views each. 63% of them were positive about vaping. So I mean, we know how important social media is to teenagers today.
And it's so, I think difficult to just get away from this culture of vaping. Even if maybe your immediate friends don't do it, you are absolutely seeing your classmates do it on social media and yes, I think with kids hanging out, it's just sort of something they're doing and it's just sort of part of their culture that, there's a vape pen that's being passed around and everybody's partaking of it.
Prakash Chandran: We're obviously talking about it being dangerous. What are the symptoms of vaping that parents should look out for and when is it actually time to see a pulmonologist?
Dr. Cathrine Sanders: Well, sometimes I think one of the biggest worries is that it may not be immediately apparent, but if your child has new onset respiratory symptoms like coughing or wheezing and they've never done that, that's something I always gonna ask in clinic visits and usually I ask the parent to step out because some parents may have no idea why their child all of a sudden has respiratory symptoms when they've never had asthma or anything in the past. So certainly if your child is starting to have new respiratory symptoms, they've not had with their pediatrician and they may be able to figure something out.
But if it's still a mystery, why is your child. They need to see a pulmonologist. And that's something I'm gonna dig into a little bit more is whether vaping may be part of the picture. So new onset symptoms, again, there's this entity evol. So if your child is all of a sudden developing, severe respiratory symptoms, they're in distress, they're wheezing, they're working hard to breathe, that would mean they need to go to the emergency room. Now, it can be difficult to pick apart because a serious covid infection or flu can also look like that, but we will often admit these patients and find, no, they don't have the flu, they don't have covid, they don't have any known infection.
And we find out later that it's because they've been vaping. So certainly that's, sort of a get to the emergency room. I think parents should be very open talking about this with their children. Knowing how prevalent it is, just asking what are they doing? What are their friends doing? What are their thoughts about vaping? Do they understand any of the risks? Do they think it's safe? So I think starting those conversations, even before there's any signs, is really important because you don't want to wait until they're having effects from vaping.
Prakash Chandran: Yeah. And just outta curiosity, what ages have you seen, like people come in with vaping issues. Like how early does it start in teens?
Dr. Cathrine Sanders: I think I've mostly seen older teens, probably 15 and up. But that being said, there's data that shows this is really prev like use of Vapes is quite prevalent in middle. Schools even. So, and maybe those younger kids don't have as much access and so they're doing it a little bit less, but they are still exposed in school by their peers. So starting to talk to kids even in, fifth or sixth grade is important because if they haven't come in contact with these things yet, they certainly will in the years to come.
Prakash Chandran: Yeah. I mean, with fabs just being everywhere on social media and so accessible, outside of having a conversation with your child, do you have any other recommendations around what parents can do to keep their kids safe?
Dr. Cathrine Sanders: Sure. I think. Monitoring what kids are doing online is always important for so many reasons. And so talking to kids about what are they looking at online, what sort of TikTok videos are they watching? What are they learning from TikTok? What are their friends showing online? And having open conversations so that they can ask questions if they see something they're not sure about. I there are, is a place for parental controls on certain things, and I'm not sure how that works in the setting of vaping, if there's a way to sort of limit access to this sort of thing. But I think having really honest conversations about technology use has to be a part of daily life with a teenager, regardless of whether you believe they're vaping or not.
Prakash Chandran: Yeah. Totally makes sense to me. Well, Dr. Sanders, this has been a great conversation, super informative. I really appreciate your time. Is there anything else that you would like to share with our audience before we sign off?
Dr. Cathrine Sanders: I just want to make sure everybody knows that vaping is not safe. So I think there's this thought that at least I'm not smoking cigarettes, but we gotta add vaping to the list of harmful things and not think of it as something that's a safe alternative.
Prakash Chandran: Yep. Wonderful advice, and I'm so glad that you said that. So thank you so much for your time today, Dr. Sanders.
Dr. Cathrine Sanders: Thanks, Prakash. It was great talking to you.
Prakash Chandran: That was Dr. CAtherine Sanders, a pediatric pulmonologist at Le Bonheur Children's Hospital. For more information on vaping, you can visit leboneur.org. That is L E B O N H E U R.org. Thanks for listening, and make sure to subscribe to the Peds Pod by lab, Bonner Children's Hospital, on Apple Podcast, Google Podcasts, or wherever you listen to your podcasts. You can also check out the leboneur.org podcast page for the entire podcast library. This has been the Pete's Pod by Le Bonheur Children's Hospital. I'm Prakash Chandran. Thanks and be well.