Scripps Health: What Is Vaping and Why Is It Bad for You?
18
December

By Adem Lewis / in , , , , , , , , , , , , , , , , , , , , , , , , , , , , /


– Hi, I’m Susan Taylor with Scripps Health in San Diego, California. Vaping, the use of e-cigarettes. According to the Centers for
Disease Control and Prevention, vaping has been linked to more than 40 deaths across the United States. Joining us to talk about vaping is Dr. Ni-Cheng Liang,
who is a pulmonologist, a lung doctor, at
Scripps Memorial Hospital in Encinitas, California. Thanks so much for being with us. – Happy to be here Susan. – Let’s start off with the basics, what is vaping? – So vaping is when someone chooses to use a device that basically heats a liquid into a vapor. It is usually contained in the form of liquid in a cartridge, usually these big but there are many, many different varying sizes now. When a person inhales there’s a center that triggers a heating element, within this device, to heat that liquid which then transforms that liquid into a smoke that the person then inhales. – So what ingredients are contained in these e-cigarettes? – So the e-cigarette contains many different compounds including, mariajuana derivatives such as THC, and CBD, as well as nicotine, and a whole host of different flavorings that are available now
marketed towards children. – When you talk about
the marijuana products, what is CBD? – So CBD is a chemical that’s found in the marijuana plant that does not give the
person that’s using CBD the typical high from THC. – But it does help with pain does it not? – Yes, CBD oil can be used topically and also ingested to help with pain and to help with sleep
and induce relaxation. – And then THC, that can
also be in the e-cigarette but that’s the part that gets you high? – Yes Susan. – Can you vape without having the THC? – Absolutely you can vape without having the THC, or the CBD, or the nicotine or the flavoring. – So why has vaping become so popular? – I think that with the bad press that smoking gets in general vaping was initially thought to be a possible way for people to stop smoking. But it has turned into somewhat of a fad, a novelty, for our youth. Adolescents, high schoolers, and in fact the e-cigarette
user age is much younger than that of smokers. So I think there’s a
novelty component to it and also the flavorings
unfortunately attract a much younger user population. – What kind of flavorings
are you talking about? – For instance, raspberry, candy flavors, even menthol flavors, things that are the same flavorings in candy in general. – But then, I mean, you just referenced it but e-cigarettes weren’t
they originally seen as the healthier alternative to smoking? That people could actually ween themselves off of cigarettes with this vaping. – So initially that was
the thought and the hope. But technically the FDA has never approved vaping or e-cigarettes as
a modality to quit smoking. And the literature actually suggests there’s a lot of conflicting results. Some result show that it did help people quit smoking, but a year later they were then addicted
to the e-cigarettes. Other reports show that
there’s no difference in using e-cigarettes to quit smoking compared to nicotine containing products and in terms of efficacy
in quitting smoking. – And e-cigarettes are more
popular with women, men? – So in epidemiological studies it’s about 50% it’s a pretty even split, perhaps slightly increased
among male users. – And as far as age is concerned? – Much younger population of users, so 18 to 24-year-olds consist of 40% of the e-cigarettes users. – And then another 25% of
patients are what, ages 25 to 34 I believe, according to The
Centers for Disease Control. And you’re saying that it’s popular for this younger crowd because of all of the different flavors. – Yes, I do believe so. – Do you think that vaping
is safer than smoking. – No, absolutely not. Reason being vaping contains
so many different additives. In the beginning of the
advent of the e-cigarette there were technically less chemicals found in the e-cigarette smoke that users would be inhaling
compared to smokers. And so there was a thought
that because of that e-cigarette use was
less dangerous smoking. However, we also found out later on that e-cigarette use can
also alter the immune system of the lung in dangerous ways. And now with the advent of these e-cigarette or vaping product associated lung injuries
that we’ve been seeing across the United States, it is absolutely not safer than smoking. – We want you to hold this thought, we’re gonna come back to it
in just a couple of minutes, is there a safe way to vape? To safely use these products. We’ll come back and talk about that in just a couple of minutes. You’re talking about these
horrific lung injuries, even deaths now being
cause by e-cigarettes. And the news reports are talking about this thing called vitamin E acetate. Can you explain what that is, and what that does to
the lungs when you vape? – Sure, so vitamin E acetate could be one of the culprit ingredients
that is found in the lung lavage samples of patients
who have this lung injury that has been thought
to be vaping induced. And what vitamin E acetate does is it dilutes out the e-liquid. So it is often times found with the THC, so many of the vaping
induced lung injury patients did admit to the use of THC containing e-cigarettes vaping products. And in many of those patients the vitamin E acetate
was found in their lungs. – So it’s the vitamin E acetate that comes along with THC, is there a vitamin E acetate that comes with CBD or nicotine? – Yeah, so there are still
quantities of vitamin E that can be found in any
e-cigarettes containing devices. – And what are the symptoms that you have a problem with your lungs? – So symptoms can include coughing, shortness of breath, chest pain, and in some patients we’ve also seen people coughing up blood. – Can you get vaping products
without this additive, without this vitamin E acetate? – Vitamin E acetate has
been shown to be found more in the black market e-cartridges. And less so in the e-vaping
products that are regulated. But trace amounts of vitamin E acetate have still been found in the more considered regulated
e-cigarettes products too. – Would it still put
you at risk though for severe lung injury without
this vitamin E acetate? – We don’t really know yet, because the different additives in there are known irritants to the lung and I think we’re just
beginning the story. I think a lot remains to be seen with regards to further
research on other chemicals that could be associated with
this type of lung injury. – We use vitamin E all the time though. We use it as vitamin E supplements, it’s found in food, it’s
found in cosmetic products. Why does it not cause a problem when we actually ingest it
in the food or cosmetics, or as a dietary supplement, but it causes, you know,
such incredible harm when we ingest in terms of e-cigarettes? – I think the main reason for this is because the lining of the lung is very different than
th lining of our gut and also our skin barrier. The lining of our lung
sees the vitamin E acetate as honey coating the
airways and the air sacs. So you can imagine if we took honey and put it in someone’s lungs that wouldn’t be an ideal
situation for breathing. – And when somebody
comes in with that kind of a lung injury, is it reversible? Can the lung heal? – So it’s partially reversible and steroids are the
mainstay of treatment. But we don’t even know what vitamin E acetate does to the lungs this has never come up before. What we think it might do is it causes a severe and rapid airway obstruction and it can also induce lung injury from damaging the air sacs
within the lungs themselves. – So people that you’ve treated for this are they gasping for breath? – I’ve treated people who have almost died from this type of lung injury Susan. It’s been a huge wake up call for them and currently they’re doing much better. But it takes a lot of time and completely quitting e-cigarettes and vaping all together. – And when they have these episodes can they breathe on their own, or do you have to hook
them up to a machine to breathe for them? – So it depends, my
patient actually needed to have a breathing tube
stuck down his throat and be connected to life
support to help him breathe. Other cases that I’ve seen these patients were able to take steroids
orally and they got better. – And there are other
ingredients in e-cigarettes that also might contribute
to these lung issues right? Because there’s been all
these new stories about, what is it, pesticides found
in the vaping products, and actually cyanide. I mean a deadly poison. – Yeah, Susan, unfortunately in a lot of the black markets
products there have been traces of pesticides that have been found and when this type of pesticide is heated, it can form hydrogen cyanide. – And these counterfeit products, I mean, they mimic what looks like, you know, a bonafide e-cigarette right? Because the industry’s not regulated. So how do you know you’re not getting something that’s pure as opposed to something that’s counterfeit. – Right, you really don’t
know, unfortunately. – What if you get rid of the flavors? ‘Cause you say that these
vaping products come in, you know, all kinds of sweet flavors to entice people to use the e-cigarettes. What if you got rid of, you know, the flavors in the vaping product, would that make it safer? – No, unfortunately
because it’s so unregulated what goes into these
liquids we can’t control. And even the usual substances
of propylene glycol and glycerin, which are
considered to be relatively benign are also known lung irritants as well. – So you’re a lung doctor. I suspect you treat people who have, you know, issues with regard
to smoking cigarettes, if somebody comes to you and says, “Look I wanted to stop smoking, “I wanna ween myself off
using an e-cigarette.” What advice would you give to them? – I would say to please consider some of the more recommend
ways of smoke cessation. Such as nicotine replacement products which include lozenges that
are hard sucker candies that we can put in our mouth and suck on. We can also use nicotine gum, as well as nicotine
patches and different pills that can also decrease our cravings for nicotine from smoking. – So we referenced this
a couple of minutes ago, let’s come back to this now. Is there a way to vape safely, to safely use these products? – No. – The bottom line is just absolutely no. – The bottom line is absolutely no. If someone still choose
to continue to vape and to use e-cigarettes
products I highly recommend that the source be a reliable one if they’re still choosing to continue to purchase and use these products. So not from the black market, not homemade, and not made by friends and certainly not illegally purchased. – Any final thoughts doctor? – Absolutely Susan, so if you’re interested
in quitting smoking please speak to your physician about all of the well documented ways that are safe to quit smoking. Including nicotine replacement products, that I already mentioned,
as well as pills, but really Susan, the bottom line is it’s not worth your lung health or your life to vape, or
even try e-cigarettes. The only things you need to inhale are clean air and prescribed
inhalers should you need them. That’s it, very simple recommendation. – Dr. Liang thanks so much for joining us. – Thank you so much for having me. – If you want more
information about vaping, please click on the link or
go to scripps.orgvideos. Want more critical
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Scripps health YouTube channel, and follow us on social
media, @ScrippsHealth. I’m Susan Taylor, thanks
so much for joining us. It’s our mission at
Scripps to help you heal, enhance, even safe your life.


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