Show Notes
Vaping has recently killed several Americans and landed hundreds in hospitals with lung illness. Novant Health pulmonologist Dr. Richard Pomerantz discusses e-cigarettes, a popular, unhealthy craze sweeping the country.
Transcript:
Cliff Mehrtens
0:06 Welcome to Novant Health Health Healthy Headlines. This is Cliff Mehrtens. Vaping, the term for using electronic cigarette has exploded in popularity recently, especially among teenagers and young adults. vaping devices are sleek, high tech and they're often barely noticeable, but their dangers are undeniable. Nearly 400 people in the United States have been hospitalized recently, and seven deaths have been connected to vaping. For some insight into e-cigarettes and vaping we talked to know from health pulmonologist Dr. Richard Pomerance, he'll talk about the effects of vaping can have on you whether e-cigarettes can help you quit regular cigarettes if you're trying and the risk involved with adding ingredients to your e-cigarette, be sure to stick around to the end for list of terms, the vapers used to describe what they do, and some of the equipment they use. You can find stories like the US and hundreds of others by searching Novant Health and Healthy Headlines. Thank you for listening.
What are some of the effects you've seen and heard about with vaping?
Dr. Richard Pomerance
1:08 So with electronic cigarettes, what has been described is a syndrome where people have very common respiratory complaints, cough, shortness of breath, low grade fevers, occasionally nausea, diarrhea, those type of things, it then progresses to give more pronounced respiratory problems that actually require the person to be hospitalized, need to be placed on oxygen, sometimes on a ventilator. And we call that lung injury. A lung injury encompasses the the lung disease that we're seeing. And we see that with other things. But the CDC has just come out with guidelines as to how to describe these cases. Specifically, they call a case as either a confirmed case or probable case. So in before, they used to talk about investigating a certain number of cases, but not going to describe that anymore. It's either going to be confirmed or probable cases. And the only difference there is that if you have recently used an e-cigarette and come down with a respiratory illness, that is not explained by other things. Specifically, it's not an infection. And it's not another condition that can cause these kind of problems. They're going to call it either confirmed or probable case.
Are e-cigarettes less, we've established that they're harmful, are they less harmful than a tobacco cigarette?
Dr. Richard Pomerance
2:30 We don't know that right. Now. The other thing to keep in mind is that a lot of the case that have been described are not only with a flavoring product in there, but also for people which are using not commercially made product. So these are products, which people will take the one time use a container and actually go ahead and refill it. There's people that are selling things on the street, which have special blends, and that's particularly thought to be dangerous. So the specific CDC guidelines, which I really would like to make sure that everybody hears are that if you are, if you're a minor, you should not vape use an e cigarette or any, any form of it. That's across the line. Second one is that pregnant woman under no circumstances should use these products either. The third one is that adults that are not currently using a tobacco product should not start on using an e-cigarette or vaping. And then the last one to be any current user shouldn't buy any cigarettes or any of those products off the street.
I saw some CDC stats that said in 2018, almost 21% of middle school and high school children had tried an e-cigarette within the past month. Is that a startling number to you? And if so why?
Dr. Richard Pomerance
3:54 It is startling there's a high crossover between using these products and actually going on to smoking, which I'm much more familiar with the ill effects of as as the medical community. So it is startling to think that one in five children are already using a product with a higher incidence of leading them to actually smoking cigarettes.
Someone comes to you and they're trying to say for instance, quit smoking. What would you recommend them to say, "Hey, Doc, thinking about these e-cigarettes" for all the reasons that we hear about "...you won't see me you won't smell me, I can do it."
Dr. Richard Pomerance
4:28 It's conversation, I have 10 times a day.
There's no evidence right now that suggests that it's a good idea to do it that way. There's been some minor evidence that it might help certain people. But given the safety concerns that we have, we don't recommend it at all. We There are all sorts of great ways of actually working towards quitting smoking, it's something which might not be able to be done by that person alone, they really should seek out help. Now they're asking a medical professional, they're already on their way. The State of North Carolina for example, as do other states have resources available online, which are very good. So there are all sorts of great resources available Lung Association has resources that are available as well. The part that's that I really find troubling is people that will use these products go back and forth to cigarettes when it suits them. So they're in their workplace. And they think that they can vape, although many workplaces will now not allow that. And it's simply prolongs their effort. And they believe that that's a safer alternative, they're not smoking as much, therefore it's safe. When that's really not the case, I do want to alert you to there's other ways of using these products, which are particularly dangerous, though. There's things called heard, there's a method that people use called dripping, which is where they take an e-cigarette, the filling of it, and they'll drip it onto the hot coils of the actual e-cigarette and then vape it in gives them a particularly potent amount. So it's a really big effect that they'll have. But dripping, unfortunately is particularly dangerous they have seen that associated with some of these cases of lung injury. And there's also dabbing, in which they will just take the substance that's inside the the e-cigarette, oftentimes add other things and just heat it up alone outside of UV, even using an e-cigarette using like a lighter or something like that. And then going ahead and inhaling that really kind of dangerous activities. Clearly never a good idea. The the more worrisome trend is the THC and the CBD oil vaping. Those are associated with a higher degree of this particular lung injury that we're talking about now, which is in the news. But this has been around for a number of years.
Is that because of the intensity of it that it can get into your bloodstream or lungs quicker, I add it to my electronic cigarette. Therefore, a higher concentration is inside me quicker?
Dr. Richard Pomerance
6:55 Well, anytime in which it's being added outside the commercial manufacturing processes, is concerning. The THC or the CBD oil products. I think because it's somewhat unregulated, that might be part of it. We don't know, this, the CDC was really leading the effort. In fact, the CDC just opened up their emergency research emergency reaction center, which they've done for things like Ebola and everything. They just opened up their their center for this specifically. And they're asking physicians to always ask about e-cigarette use. And people come in with respiratory illness, which is not something that we've always been doing. If they do find somebody that's used the product within 90 days, they're actually asking them to be very specific about what kind of product they are, where they purchased it, taking a sample of it, if they have it, contacting their local health department or the state health department to be as the conduit in order to get these information of the CDC. So we are seeing greater amounts of it being reported because of that. I'll give you an example. And North Carolina now, in just august of 2019 had reported three cases of possible vaping related lung injury, then by September 11th, so not even a month later, there were 28 cases in North Carolina. So it's either greater recognition or perhaps there's more of extra occurring. It's hard to know.
What's the biggest misconception out there about vaping and electronic cigarettes?
Dr. Richard Pomerance
8:23 I think one that actually you brought up, which was that you talked about up being popular with kids in North Carolina of this 28 cases, the age group range on there was 16 to 72 years old. So it's not just necessarily used by young people. The biggest mistake misperception, I think, in general is that they're safe. Hopefully, the recent data out there and all the news information out there with tell them it's not safe,
Are electronic cigarettes vaping an effective method to wean yourself from tobacco smoking?
Dr. Richard Pomerance
8:53 So initially, there was no recommendation that using electronic cigarettes was a good way. Do you use it as a nicotine replacement product, which is one of the methods of helping people for smoking cessation. There was an article out not too long ago, suggesting that there was potentially a role for this. And so there's maybe minor evidence. I generally tell people that it's not a role that I thought a method that I want them to use. But I would suggest that if they've already been successful and quitting using an e cigarette that they might want to continue. This is before all the more recent information regarding some of the potential hazards with the cigarettes.
Close to 400 people have been hospitalized recently across the country, seven people have died, the death toll is rising. A lot of concern about vaping being dangerous because of what you mentioned, sometimes people add things to it. What are some of the long term effects of vaping electronic cigarettes?
Dr. Richard Pomerance
9:59 We don't know that yet? That's the big question that we're trying to answer. And to be specific, the CDC just a few days ago, updated 380 confirmed or suspected cases of respiratory illness associated with e cigarette use, and six deaths across six different states, not North Carolina.
Popular among children, young teens, people into their 20s, marketed with flavors and things like that, if I'm a parent, and I see that, what can I do as a parent to take steps to inform my child or possibly eliminate that from theiractivities?
Dr. Richard Pomerance
10:37 Well, the CDC specifically now recommends that people under age 18 should not use the product at all, that was not a recommendation, although it would have been illegal for them in certain states to actually obtain it at all. Certain states are actually banning it for people based on age. And that age range is going to be variable by state. The tricky thing is that the electronic cigarette may look like a USB drive, it could look like many other common devices. And it might be very hard to identify. It doesn't necessarily produce a characteristic smell less it has a flavor with it. And you might not even know they're doing it. I'm like if they were smoking a cigarette, you would be able to detect the dust, which is the smoke coming off it. And you're right, the the flavoring is the item which has been most lately concerned with being associated with the hazards with using the electronic cigarettes. problem is we don't have a lot of information. That's really just at the beginning of this. There's a there's some research that's been done that shows that different products activate different cells. In fact, there was an interesting study that was done that show that depending which flavoring you use, it activates these cells in the body that are part of the damage causing effect. And it was profoundly different if it was a bomb cherry vs. strawberry flavor. And none of us know why.
as a medical professional does that trouble you? Do you realize that that's just someone trying to market a product? I although it is a very dangerous one. How do you look at that from the medical profession?
Dr. Richard Pomerance
12:19 It's troubling that it's an unregulated product, that it's a product which has been presented as a safe alternative without medical evidence showing that and that it's now become indoctrinated into a culture in some ways, and particularly at such young ages as well.
Dr. Pomerance, how prevalent is electronic cigarette smoking among high school students in North Carolina?
Dr. Richard Pomerance
12:45 Well, there was a study done from 2011 to 2015. And among North Carolina high scores increase use 888% over that time period.
Are there any terms or phrases that parents should be aware wherever for here there are children who might be doing this behind mom and dad's back, that need to be aware of just to realize that their children are involved in vaping?
Dr. Richard Pomerance
13:10 Yeah, well, it's not a comprehensive list by all means, but vapes, e-hookahs, vape pens, tinks, mods, ends, all of those different terms that have been used. I'm sure there's going to be 20 or 30 other terms as well, but any of that kind of reference would be an alarm system for an alarm reason for a parent.
Hello, this is Cliff Mehrtens again. A few weeks back, I was discussing vaping with my college aged son, several kids and his circles began vaping as high schoolers a few years ago, I asked him what percentage of college kids he sees today who vape; he thought for a moment said 80% easy, well as a partent that certainly frightened me. But kids aren't the only vapers, it's growing in every age group, as are the lung illnesses associated with vaping. I fear that the illness and death numbers associated with vaping will only get worse before they get better. Let's hope this fad passes before too many vapors do. Thank you again for listening.