Vaping and e-cigarettes: How worried should we be?

A few weeks ago, I was walking downtown with my young son.

Guest Writer

Lindsey Manfrin serves as Yamhill County’s public health administrator and deputy director of its Department of Health and Human Services. She holds a doctorate of nursing practice degree and a master’s of nursing in health systems and organizational leadership from Oregon Health and Science University. She is involved in many aspects of state and local work focused on health systems and community health. She has lived in Yamhill County since childhood, and is now raising a family of her own here.

He stopped in his tracks and made an exaggerated movement with his head smelling the air. He looked at me and said, “Mom, that smells so good. Can we get some?”

Unfortunately, what he smelled was the watermelon-flavored vape coming from an individual we had just passed. To my son’s credit, it did smell like candy.

Health officials have been working for decades to undue the harm of tobacco. We have come a long way from having to contend with ads featuring physicians and Santa Claus touting their favorite cigarette brands — pitchmen who would now seem wildly inappropriate today — but smoking is still the leading cause of preventable death in the United States.

Luckily, our work succeeded in cutting the rate of tobacco usage over the years, even among youth. However, in 2013, we began to see a sharp increase in adult and youth users of e-cigarettes and other vape products.

Initially these products marketed themselves as a way to help smokers quit.

A study published in The New England Journal of Medicine earlier this year showed 18% of individuals who used vape products to quit cigarette use were, indeed, able to stop smoking. However, that leaves us with a failure rate of 82%, and 80% of those who succeeded in kicking cigarettes through use of vape products continued afterward to feed their nicotine addiction through vaping.

If we look at a met analysis of various research on e-cigarettes as a method to quit smoking, the shortcomings become even more evident.

In a compilation of 38 studies, many of them robust control studies accompanied by clinical trials, overall results showed individuals were 28% less likely to succeed in quitting if they relied on e-cigarettes as the means. Given that information, it appears e-cigarettes may only be helping a small minority of people.

One thing we do know is that vape products are attracting new youth users, thus creating a new generation of people addicted to nicotine. Alarmingly, data shows that youth who begin vaping are also three times more likely to subsequently turn to tobacco.

And it's not just national and state rates that are rising. We are seeing the same thing in Yamhill County.

This leads to this question: Are e-cigarettes actually any safer than conventional cigarettes?

They certainly contain fewer chemicals than traditional cigarettes. However, that doesn't necessarily translate to safer.

It's also important to not that safer does not equal safe.

E-cigarette aerosol can contain a range of harmful or potentially harmful substances, including nicotine, ultrafine particles, cancer-causing chemicals and heavy metals. More study is needed to determine potential short- and long-term side effects of these products.

Whether you are supportive of the governor’s temporary ban or not, an important question we should be asking is how do we stop kids from taking up use of addictive e-cigarettes?

Many of the evidenced-based strategies to prevent youth from using tobacco products are likely transferable and should be considered. Things like retail licensing to assure sellers are following the law, increased cost through taxation and expansion of the protection afforded under the Indoor Clear Air Act are all things deserving consideration from a policy standpoint.

It's also critical that we move further upstream and support our children, families and schools in primary prevention efforts that promote and increase positive social behavioral in kids. That makes it less likely that they will engage in self-harming behaviors such as e-cigarette use.

Decades of research demonstrates positive shifts through school programs such as the PAX Good Behavioral Game, which is incorporated into classroom activities. As a community we should support things like PAX to raise up a generation that doesn’t rely on nicotine, as it has demonstrated a 68% decrease in the likelihood of youth using cigarettes.

We also need to remember the power of parents who are actively involved in their children’s lives, who ask questions and pay attention. They are more likely to catch early signs of the use of harmful substances, including nicotine through vaping.

There is support out there for those interested in quitting smoking without taking up vaping. One option is the Quit line at 1-800-QUIT-NOW (1-800-784-8669), which can also be accessed online at www.quitnow.net/oregon.

There is also a program designed to help vapers quit. Called This is Quitting, It can be accessed by texting DITCHJUUL to 88709 or visiting www.thisisquitting.com online.