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Bill Klaproth (Host):  So, let’s talk about vaping. With multiple deaths and hundreds of cases of a mysterious lung disease, many people have questions and are concerned with the growing trend of vaping. So, let’s get a better understanding of the risks and dangers of vaping with Dr. Pete Mikkelsen, Medical Director of Emergency Services and Employee Health at Pullman Regional. Dr. Mikkelsen, thank you for your time. So, first off, what does it mean to vape?

Pete Mikkelsen, MD (Guest):  Vaping is a way of inhaling an aerosol through an electronic device so it can be through an E-Cigarette or other device. What it does, these devices heat up either a liquid or a solid to a vapor and then you inhale and exhale the vapor.

Host:  So, is it that liquid that has been the problem with these acute lung diseases?

Dr. Mikkelsen:  The acute lung disease is a major concern right now. Public health concern in the United States. Primarily our states and some other countries and the cause for it is unknown. It started off in Wisconsin where there was several reports to the Wisconsin Department of Health and spread to several other states and unfortunately, there has been seven deaths across the country that are confirmed from acute lung injury associated with vaping. Over 500 Americans have been affected by this and the cause we don’t know. Some people think, some scientists feel that something in that liquid when it aerosolizes and gets into the lungs then either turns back to liquid that’s harmful to the lungs and causes these terrible illnesses in folks that have used the vaping devices.

Host:  So, overall then, what are the dangers and health risks of vaping? It was sold to us as a way to quit smoking. But it certainly hasn’t tuned into that.

Dr. Mikkelsen:  Yeah, you are absolutely right about the initial marketing of E-cigarettes and vaping. It was seen as an alternative and safer alternative to smoking. There are still some people who feel that it is a safer alternative to smoking. Interestingly, it was never approved as a way to quit smoking officially. There are lots of other ways to help to quit smoking and vaping is not an official FDA approved way to do that.

Host:  And the other factor in all of this is that vaping is really popular with teenagers and young adults.

Dr. Mikkelsen:  Very popular among younger generations. And it seems like the popularity is increasing very quickly. In 2017, when they surveyed high school seniors; 27 of them admitted to vaping nicotine in the previous year and just in one year in 2018, that jumped up to 37% of high school seniors in the United States. Unfortunately, these are new nicotine exposures. These aren’t people who used to smoke cigarettes and switching to vaping. They are starting with vaping.

Host:  And that’s exactly what we don’t want. So, I know it’s early, but the signs aren’t very promising. What is the long-term health risks of vaping? Can we determine that yet?

Dr. Mikkelsen:  It’s difficult to tell. A lot of public health experts feel that the long-term effects are less than cigarette smoking because of all of the horrible chemicals in cigarette smoke. But it turns out there’s a lot of horrible chemicals in vape as well. And it’s not controlled as well in the United States as say Great Britain. I think there is going to be some more control coming down the line. But we don’t know exactly what’s in E-cigarettes or vaping liquid that people and youth are using.

Host:  Right and it’s this liquid, especially the flavors that people put into these E-cigarettes. That’s the main culprit. Is that right?

Dr. Mikkelsen:  Well the flavors are possibly the culprit. It’s still not identified what exactly the culprit is. Some people think it’s vitamin E in the liquid. There are some other chemicals that I think may be the cause of the deaths of these now seven Americans and over 500 Americans with the significant acute lung injury. But the flavoring, the use of the flavoring is what is used to market youth and that’s the real concern. That’s why that in addition to the rapidly increased use of vaping by youth is what led to some states and now President Trump in banning the flavored E-cigarette to make it less appealing.

Host:  So, even with all the claims, there’s no way to say that vaping is safer than smoking cigarettes, right? We can’t say that.

Dr. Mikkelsen:  We can’t say that it’s a safe alternative to smoking cigarettes. That’s unfortunate that we can’t. We know that nicotine is harmful to developing brains and several major associations warn against this, American Heart Association, the CDC, Center for Disease Control. Nicotine is highly addictive. It has negative health effects such as harming the developing brains of teens, kids, fetuses in women. So, certainly, when you are pregnant, you shouldn’t vape. And there’s also other potentially harmful substances in vaping that may cause in addition to this acute lung injury, cancer or chronic lung injury as well as possibly heart disease.

Host:  Right. It sounds like at this point, there’s a lot that we don’t know about. So, would your best advice be obviously, don’t start if you are not vaping and if you are vaping, stop because ultimately, we don’t know what’s in these things and the harm that it is potentially doing to your body.

Dr. Mikkelsen:  That’s absolutely true. Especially for the youth and one of the things that some current folks who are vaping now may think that maybe they should stop vaping and start cigarette smoking and that’s really what we don’t want people to do.

Host:  No, not at all. And especially in this flavors if you are a vapor, is that how you say it a vapor? I don’t even know. A person that vapes, don’t use the flavors too, I mean that’s just another added ingredient that we really don’t know what’s happening to the body. As you said, there’s been seven deaths as of the recording of this podcast and hundreds of people suffering from this mysterious lung disease that nobody can really put their finger on yet.

Dr. Mikkelsen:  That’s absolutely true. I mean that’s what we know right now at this snapshot in time. The other thing that I might add to that too is that sometimes there are vaping products that people can get off the street that aren’t even sold in stores or manufactured and those we think are even more dangerous than the manufactured products.

Host:  And Dr. Mikkelsen, as we wrap this up, for someone that is vaping; what should they watch out for? Any symptoms they should know about and when is it time to see the doctor?

Dr. Mikkelsen:  Well in addition to stopping vaping, quitting vaping, if you are vaping and you have an acute respiratory illness, cough, shortness of breath, certainly chest pain; some people have had some gastrointestinal symptoms as well, nausea, vomiting, diarrhea. If you are especially having respiratory symptoms and believe it’s associated with vaping; then you should see a healthcare professional and maybe even report to the CDC or another organization trying to get to the bottom of this.

Host:  That’s a really, really important point. So, stop the vaping, go see your doctor, don’t delay and wait and potentially report it to the CDC and let them know what’s happening. Really good information Dr. Mikkelsen. Thank you for your time.

Dr. Mikkelsen:  Thank you very much. I appreciate it.

Host:  And for more information or to get hooked up with a provider, please visit www.pullmanregional.org, that’s www.pullmanregional.org. And if you found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you. This is the Health Podcast from Pullman Regional. I’m Bill Klaproth. Thanks for listening.