'We have reason to be worried'

Not my kid? If you think e-cigarette use isn’t a problem among teens today, you may not have the full story. According to the latest data from the FDA, 3.62 million middle and high school students were current users of e-cigarettes in 2018. And for just those teens in grades 9-12, usage increased a whopping 78 percent from 2017 to 2018. Many kids, and even parents, may not fully understand the risks involved.

So, what are the medical side effects of vaping? For this first piece in our series, we turned to Dr. Kevin Gray, a Daniel Island resident and professor of addiction sciences at the Medical University of South Carolina, to ask about his experiences with vaping and the effects he’s witnessed firsthand. To put it mildly, he didn’t paint an optimistic picture of the technology.

“It is true that we don’t fully know the long-term consequences, but we have some very good information to suggest we have reason to be worried,” he began.

While there is mounting evidence that chemicals burned in e-cigarettes can have negative side effects on a smoker’s lungs, Gray showed more worry over the high doses of nicotine that are present in vaping devices.

“We have very well-established information to suggest that the teenage brain is still developing and developing into the early to mid-20s,” the doctor said. “And if somebody starts using an addictive substance during their adolescent years, they are much more likely to become addicted than if they were to start to use a substance as an older adult, and we know that nicotine is one of the most addictive compounds to humans.”

As a point of reference, 40 milligrams of nicotine (a standard JUUL pod) is said to equal approximately one pack, or 20, cigarettes. JUUL does make 23 milligram pods, as well.

Nicotine, as Gray explained, isn’t the most dangerous compound, but it is one of the most addictive substances to humans.

“It’s got a relatively short half-life, so you can feel good for a little bit, and then go back,” he added. “You feel a boost at first, then go back to feeling normal. But, the more times you get it, it’s less of a boost and more that you need it to feel normal.”

The highly addictive nature of the compound will lead to cravings, irritability, and lack of focus after a long period of time.

Because of its popularity amongst teens, e-cigarette brand JUUL is the leading receiver of ire from many. When asked about JUULs, Gray commented that their sleek and unassuming appearance is one of the dangers, but added the real concern is the concentration of substance it transfers.

“It very efficiently delivers a lot of nicotine very quickly,” he stated. “So, it has a much higher likelihood of driving someone toward being addicted to it, needing it to feel normal. That conversion can happen relatively quickly and we even see brain changes in young people who begin using nicotine.”

As a professor with a focus in adolescent psychiatry and substance abuse disorders, Gray has seen the addictive nature of nicotine in teens.

“In the best of our clinical trials, the best of our treatments, most people are not successful in quitting nicotine,” Gray said. “It’s not a surprise. It’s that way with adults, too.”

He added that there are plenty of effective treatments, despite the difficulties.

Many people who have followed the development of e-cigarettes around the country know that for adults, vaping devices are commonly used as a method to end their history of smoking. Gray believes that this is a stable strategy for traditional tobacco smokers, but it has negative implications for younger generations.

“The big complication around this is that e-cigs are probably a good harm reduction strategy for somebody who’s an adult, who’s an established cigarette smoker, and who’s trying to quit,” Gray explained. “It’s probably less harmful to vape nicotine than it is to smoke tobacco cigarettes. The unintended consequence of a product like this is that they make it appealing enough to young people who have never smoked a cigarette in their lives and don’t plan to.”

According to the National Institute on Drug Abuse, 30.7 percent of teenage e-cigarette users started smoking common tobacco products (cigarettes, cigars, hookah) within six months of starting regular vape usage.

Several questions still hang in the air about the long-term effects, and while it is true that medical professionals do not know the full extent of prolonged e-cigarette use, they do know that the short term effects are not something to take lightly.

“I’m not saying that every adolescent who tries a JUUL is going to become addicted and have this lifelong pathway in the gutter, or something like that,” Doctor Gray elaborated. “But, the idea is that the reward system in the brain is still developing and if you give your brain a highly rewarding substance at a high pharmacological dose, it hijacks that reward system. So, things that should normally be rewarding in a normal scale become less rewarding. And that’s part of our worry that you set up the brain to become more prone to addiction in the future.”

Next week, we will look at how this trend is affecting local teenagers in middle and high school, what Daniel Island and Cainhoy peninsula principals think of vaping, and programs that are employed by the schools to combat e-cigarette usage.

TEENS: WE NEED YOUR INPUT! How prevalent is vaping at your school? Do you vape? What are your thoughts on e-cigarette use? We want to hear from you! Please take our anonymous survey at the following link: https://www.surveymonkey.com/r/KSB8ZZ8.