Vaping Effects

Directions: Answer the prompt in 2 well-developed pparagraphs(no less than 7 sentences each). An effective response will incorporate information from the two attached handouts. You are also welcome to incorporate any independent knowledge you may have on the subject into your response.

Prompt: According to the CDC in 2018, more than 3.6 million US middle and high school students used e-cigarettes in the past 30 days. Does this statistic alarm you? Why or why not? What facts, arguments and/or perspectives would you present to these students in order to make them understand that the health consequences of e-cigarette use are highly detrimental to their development and Health Triangle?

11/5/2021 The Mysterious Vaping Illness That’s ‘Becoming an Epidemic’ - The New York Times https://www.nytimes.com/2019/08/31/health/vaping-marijuana-ecigarettes-sickness.html Sign in to The New York Times with Google The Mysterious Vaping Illness Thatʼs ʻBecoming an Epidemicʼ A surge of severe lung ailments has baffled doctors and public health experts. John Tan jtan@millenniumhs.org Continue as John By Sheila Kaplan and Matt Richtel Published Aug. 31, 2019 Updated Oct. 12, 2021 To create your account, Google will share your name, email address, and profile picture with The New York Times. See The New York Times's privacy policy and terms of service. An 18-year-old showed up in a Long Island emergency room, gasping for breath, vomiting and dizzy. When a doctor asked if the teenager had been vaping, he said no. The patient’s older brother, a police officer, was suspicious. He rummaged through the youth’s room and found hidden vials of marijuana for vaping. “I don’t know where he purchased it. He doesn’t know,” said Dr. Melodi Pirzada, chief pediatric pulmonologist at NYU Winthrop Hospital in Mineola, N.Y., who treated the young man. “Luckily, he survived.” Dr. Pirzada is one of the many physicians across the country treating patients — now totaling more than 215 — with mysterious and life-threatening vaping-related illnesses this summer. The outbreak is “becoming an epidemic,” she said. “Something is very wrong.” Patients, mostly otherwise healthy and in their late teens and 20s, are showing up with severe shortness of breath, often after suffering for several days with vomiting, fever and fatigue. Some have wound up in the intensive care unit or on a ventilator for weeks. Treatment has been complicated by patients’ lack of knowledge — and sometimes outright denial — about the actual substances they might have used or inhaled. Health investigators are now trying to determine whether a particular toxin or substance has sneaked into the supply of vaping products, whether some people reused cartridges containing contaminants, or whether the risk stems from a broader behavior, like heavy e-cigarette use, vaping marijuana or a combination. On Friday, the Centers for Disease Control and Prevention issued a warning to teenagers and other consumers, telling them to stop buying bootleg and street cannabis and e-cigarette products, and to stop modifying devices to vape adulterated substances. [Read more: The Trump administration is weighing a ban on some flavored e-cigarettes.] The illnesses have focused attention on a trend that has been overshadowed by the intense public concern about soaring teenage use of e-cigarettes, with its potential for hooking a new generation on nicotine: the rise of the vaping device itself. It has introduced a wholesale change in how people consume nicotine or marijuana, by inhaling vaporized ingredients. Vaping works by heating liquid and turning it into steam to be inhaled. Broadly speaking, e-cigarettes are considered less harmful than traditional cigarettes, which work through the combustion of tobacco that sends thousands of chemicals, many carcinogenic, into the lungs. But vaping has its own problems: Nicotine or THC, the high-inducing chemical in marijuana, is mixed with solvents that dissolve and deliver the drugs. The solvents, or oils, heat up during aerosolization to become vapor. But some oil droplets may be left over as the liquid cools back down, and inhaling those drops may cause breathing problems and lung inflammation. “Inhaling oil into your lungs is extremely dangerous behavior that could result in death,” said Thomas Eissenberg, who studies vaping at Virginia Commonwealth University. “That is probably the biggest message we can get out of this.” Many vaping ingredients are not listed on the products. Vitamin E oil appears to have been a common substance associated with the severe and sudden respiratory problems in some of the New York cases, according to state health officials. It is not known how it was used. Vitamin E is sometimes advertised as a supplement in cannabidiol oil, which is not designed for vaping but has been used that way. https://www.nytimes.com/2019/08/31/health/vaping-marijuana-ecigarettes-sickness.html 1/5 11/5/2021 The Mysterious Vaping Illness That’s ‘Becoming an Epidemic’ - The New York Times We'd like to hear from you. * Sign in to The New York Times with Have you ever gotten sick from vaping? Was it an e-cigarette or other substance that Google caused your illness? Please share your experience. John Tan jtan@millenniumhs.org Continue as John Continue » words Google will share your To create your 0account, name, email address, and profile picture with The New York Times. See The New York Times's privacy policy and terms of service. Dr. Scott Gottlieb, the former commissioner of the Food and Drug Administration, said he suspected a link to illicit products — perhaps related to ingredients including THC — because the main manufacturers of e-cigarettes had not suddenly altered their ingredients on a wide scale. “It’s probably something new that has been introduced into the market by an illegal manufacturer, either a new flavor or a new way to emulsify THC that is causing these injuries,” he said. https://www.nytimes.com/2019/08/31/health/vaping-marijuana-ecigarettes-sickness.html 2/5 11/5/2021 The Mysterious Vaping Illness That’s ‘Becoming an Epidemic’ - The New York Times Vaping, said Dr. Melodi Pirzada, a pediatric pulmonologist on Long Island, “is very, very dangerous. We already have one death in Illinois and we don’t need more.” Johnny Sign in toMilano The New York Times with for The New York Times Google John Tan The outbreaks have created a crisis for two emerging industries — e-cigarettes and legal cannabis — that have pitched jtan@millenniumhs.org themselves as beneficial to public health. E-cigarette supporters consider the technology a safer alternative to smoking, while cannabis has been sold politically as “medical marijuana” and as a substitute for tobacco growers. Continue as John Now some subset of these products is causing a serious lung disease that even cigarettes, while lethalGoogle in thewill long run, don’t To create your account, share your name, email and profile picture with The cause in young people. Lobbyists and company officials in both industries are scrambling to address, blame unregulated products. New York Times. See The New York Times's privacy and termsdevice of service. The spate of illnesses has made news again of Juul Labs, maker of the blockbusterpolicy e-cigarette blamed for the surge in teenage vaping. In a television interview, Kevin Burns, the company’s chief executive, said he did not know of evidence linking the recent cases to Juul’s products. On lung scans, the illnesses look at first like a serious viral or bacterial pneumonia, but tests show no infection. “We’ve run all these tests looking for bacteria, looking for viruses and coming up negative,” said Dr. Dixie Harris, a critical care pulmonologist in Salt Lake City, who has consulted on four such patients and reviewed case files of nine others in the state. On Aug. 6, Dr. Harris was working in a Salt Lake City-area hospital — she declined to provide more detail in order to protect patient privacy rights — when she was called to the intensive care unit to consult on a patient with the severe lung ailment. The patient was in his 20s and a heavy e-cigarette user who also vaped THC. She later consulted with two dozen hospitals around the state on patients with difficult pulmonary or critical care issues. “I saw a second case,” she said. “I’m like, ‘Wait a second, this is weird — two hospitals, two young people, almost identical story.’” The next morning, she called Dr. Joseph Miner, the chief medical officer for the Utah state health department, who told her he would try to figure out what was going on. In the ensuing weeks, Dr. Harris saw two other patients firsthand and reviewed nine other cases for the hospital group where she works, Intermountain Healthcare, which has 24 hospitals in Utah and Idaho. She said the first 10 cases were from eight different hospitals; over all, the state of Utah reported 21 cases. Dr. Harris said that the four patients she had been directly involved with “have been doing e-cigarettes with nicotine constantly, like round the clock. Maybe there’s some sort of accelerant effect causing inflammation in the lung caused by the THC oil.” She added that her interviews with patients suggested they were getting the marijuana liquid from friends in states with legal supplies of the drug, like California and Colorado. Some patients are suffering from another condition known as lipoid pneumonia, doctors said. When vaped oils get into the lungs, the lungs treat them as a foreign object and mount an immune response, resulting in inflammation and the buildup of liquids, which can cause lipoid pneumonia. https://www.nytimes.com/2019/08/31/health/vaping-marijuana-ecigarettes-sickness.html 3/5 11/5/2021 The Mysterious Vaping Illness That’s ‘Becoming an Epidemic’ - The New York Times A CT scan of a vaping injury patient, looking up from the patient’s feet, with theincloudy Sign to The New York Times with areas in the lungs showing damage. Intermountain Healthcare Google John Tan The surge in these illnesses comes at the start of a school year, one in which parents, teachers and administrators had already jtan@millenniumhs.org braced for the challenge of educating in the age of the vape pen, which is easy to conceal. Continue as John While educator and parental concern has focused on Juul, the reality is that the market for vaping devices and the liquids that create your account, will share your in on a fill them is vast and filled with counterfeiters and do-it-yourselfers, making it hardTofor regulators and Google scientists to home name, email address, and profile picture with The specific product. New York Times. See The New York Times's privacy policy and “public terms of service. The Vapor Technology Association, an e-cigarette and vaping industry trade group, asked officials to thoroughly investigate the circumstances which might have led to each reported hospitalization before making statements to the public as to whether certain products are implicated in these incidents.” The regulation and study of the marijuana industry is particularly complex. Even though the federal government still considers cannabis a controlled substance, 33 states now allow it to be sold for either recreational or medicinal purposes or both. Hundreds of cannabis products are sold, legally and illegally, such as THC oil, or cannabis oil with THC. The Food and Drug Administration has warned some sellers of cannabis product supplements not to make health claims, but more are doing so than the agency can keep up with. The F.D.A. oversees CBD products sold as dietary supplements, but does not regulate THC, which is illegal under federal law. Liquid nicotine and THC, sometimes sold in cartridges for use in vaping devices, can each contain oils that may be safe to swallow but can damage the lung when vaporized into a mix of unknown chemicals. Vaping devices confiscated from students at a middle school in Boulder, Colo. Nick Cote for The New York Times E-cigarettes accessories for sale in a store in Manhattan. Jeenah Moon for The New York Times While e-cigarettes have been presumed less harmful over the long run than cigarettes, the ultimate impact from years of vaping is simply not yet known. Mr. Eissenberg, director of the Center for the Study of Tobacco Products at Virginia Commonwealth University, said seven cases of similar lung injuries from e-cigarette vaping had been reported in previous years. “A common ingredient was vegetable glycerin, which is made from vegetable oil,” he said. “If there is some incomplete process, there can be oil left in the vegetable glycerin when that person is using it, and inhaling oil and getting oil into your lungs is what is causing some of the lung injuries we see.” https://www.nytimes.com/2019/08/31/health/vaping-marijuana-ecigarettes-sickness.html 4/5 11/5/2021 The Mysterious Vaping Illness That’s ‘Becoming an Epidemic’ - The New York Times “Basically what the F.D.A. should be doing is testing every one of these liquids to see if they have any oil at all and making a in to The New Yorksaid TimesMr. with regulation that would ban oil in any of these products, whether it is a THC product or aSign nicotine product,” Eissenberg, Google who is researching vaping with a grant from the agency. John Tan jtan@millenniumhs.org Continue as John To create your account, Google will share your name, email address, and profile picture with The New York Times. See The New York Times's privacy policy and terms of service. A Juul user in San Francisco. Jason Henry for The New York Times Dr. Nora D. Volkow, director of the National Institute on Drug Abuse, a part of the National Institutes of Health, said she was surprised at the severity of the lung disease involved in this summer’s cases, but not by the possibility that vaping products were causing such illnesses. “There is no oversight,” Dr. Volkow said. “No one is actually evaluating the products to see whether they are pure, or if they contain toxic substances. There has to be some way of regulating them.” The Long Island teenager, who was on a ventilator at one point, has a long road to recovery and doctors still haven’t identified the cause of his illness. “They tested for infectious diseases. They tested for bacteria. They tested for a host of issues. It all came back negative,” his father said. He requested anonymity to protect the identity of his son. “We were helpless. We didn’t know what to do. The doctors didn’t know what to do. They would treat the symptoms first and figure out what was killing him later.” In Illinois, a woman in her 30s who had recently vaped was hospitalized and died, health officials said on Aug. 23. Another recent case involves a 31-year-old Queens resident named Kevin Corrales, who in late July was in the back seat of a car heading to a Long Island beach when he started gasping for air. “It was terrifying,” he said. “I was really gasping. I should have been rushed to the hospital. They thought I was exaggerating.” He called an Uber to take him home. Too tired to climb the stairs of the home he shares with his parents, he stayed in a basement room for several days, until he felt better. That day, in the car, he had been vaping a Juul, the popular e-cigarette. But he also occasionally vapes THC oil in a separate device. “I can buy these oils like a bag of potato chips,” Mr. Corrales said. “It’s hard to say whether it was the THC or nicotine,” said Mr. Corrales, who used e-cigarettes to quit smoking. Mitch Smith contributed reporting from Chicago. https://www.nytimes.com/2019/08/31/health/vaping-marijuana-ecigarettes-sickness.html 5/5 ELECTRONIC CIGARETTES WHAT’S THE BOTTOM LINE? » E-cigarettes have the potential to benefit adult smokers who are not pregnant if used as a complete substitute for regular cigarettes and other smoked tobacco products. » E-cigarettes are not safe for youth, young adults, pregnant women, or adults who do not currently use tobacco products. » While e-cigarettes have the potential to benefit some people and harm others, scientists still have a lot to learn about whether e-cigarettes are effective for quitting smoking. » If you’ve never smoked or used other tobacco products or e-cigarettes, don’t start. WHAT ARE E-CIGARETTES? » E-cigarettes are known by many different names. They are sometimes called “e-cigs,” “e-hookahs,” “mods,” “vape pens,” “vapes,” “tank systems,” and “electronic nicotine delivery systems.” » Some e-cigarettes are made to look like regular cigarettes, cigars, or pipes. Some resemble pens, USB sticks, and other everyday items. » E-cigarettes produce an aerosol by heating a liquid that usually contains nicotine—the addictive drug in regular cigarettes, cigars, and other tobacco products—flavorings, and other chemicals that help to make the aerosol. Users inhale this aerosol into their lungs. Bystanders can also breathe in this aerosol when the user exhales into the air. » E-cigarettes can be used to deliver marijuana and other drugs. Rechargeable e-cigarette Disposable e-cigarette CS298852-A Tanks & Mods For Print Only WHAT IS IN E-CIGARETTE AEROSOL? THE E-CIGARETTE AEROSOL THAT USERS BREATHE FROM THE DEVICE AND EXHALE CAN CONTAIN HARMFUL AND POTENTIALLY HARMFUL SUBSTANCES: CANCER-CAUSING CHEMICALS VOLATILE ORGANIC COMPOUNDS ULTRAFINE PARTICLES NICOTINE HEAVY METALS SUCH AS NICKEL, TIN, AND LEAD FLAVORING SUCH AS DIACETYL, A CHEMICAL LINKED TO A SERIOUS LUNG DISEASE It is difficult for consumers to know what e-cigarette products contain. For example, some e-cigarettes marketed as containing zero percent nicotine have been found to contain nicotine. ARE E-CIGARETTES LESS HARMFUL THAN REGULAR CIGARETTES? VS YES, but that doesn’t E-cigarette aerosol generally contains fewer toxic chemicals than the deadly mix of 7,000 chemicals in smoke from regular cigarettes. However, e-cigarette aerosol is not harmless. It can contain harmful and potentially harmful substances, including nicotine, heavy metals like lead, volatile organic compounds, and cancer-causing agents. mean e-cigarettes are safe. For Print Only WHAT ARE THE HEALTH EFFECTS OF USING E-CIGARETTES? SCIENTISTS ARE STILL LEARNING ABOUT THE LONG-TERM HEALTH EFFECTS OF E-CIGARETTES. HERE IS WHAT WE KNOW NOW. 1 Most e-cigarettes contain nicotine, which has known health effects » Nicotine is highly addictive. » Nicotine is toxic to developing fetuses. » Nicotine can harm adolescent brain development, which continues into the early to mid-20s. » Nicotine is a health danger for pregnant women and their developing babies. 2 Besides nicotine, e-cigarette aerosol can contain substances that harm the body. » This includes cancer-causing chemicals and tiny particles that reach deep into lungs. However, e-cigarette aerosol generally contains fewer harmful chemicals than smoke from burned tobacco products. 3 E-cigarettes can cause unintended injuries. » Defective e-cigarette batteries have caused fires and explosions, some of which have resulted in serious injuries. » In addition, acute nicotine exposure can be toxic. Children and adults have been poisoned by swallowing, breathing, or absorbing e-cigarette liquid. For Print Only CAN E-CIGARETTES HELP ADULTS QUIT SMOKING CIGARETTES? E-CIGARETTES ARE NOT CURRENTLY APPROVED BY THE FDA AS A QUIT SMOKING AID. The U.S. Preventive Services Task Force, a group of health experts that makes recommendations about preventive health care, concluded that the evidence is insufficient to recommend e-cigarettes for smoking cessation in adults, including pregnant women. HOWEVER, e-cigarettes may help non-pregnant adult smokers if used as a complete substitute for all cigarettes and other smoked tobacco products. TO DATE, THE FEW STUDIES ON THE ISSUE ARE MIXED. Evidence from two randomized controlled trials found that e-cigarettes with nicotine can help smokers stop smoking in the long term compared with placebo (non-nicotine) e-cigarettes. A recent CDC study found that many adults are using e-cigarettes in an attempt to quit smoking. However, most adult e-cigarette users do not stop smoking cigarettes and are instead continuing to use both products (“dual use”). Because smoking even a few cigarettes a day can be dangerous, quitting smoking completely is very important to protect your health. For Print Only WHO IS USING E-CIGARETTES? E-CIGARETTES ARE THE MOST COMMONLY USED TOBACCO PRODUCT AMONG YOUTH. In 2018, more than 3.6 MILLION U.S. middle and high school students used e-cigarettes in the past 30 days, including: 4.9% MIDDLE SCHOOL STUDENTS IN THE U.S., YOUTH ARE MORE LIKELY THAN ADULTS TO USE E-CIGARETTE 20.8% HIGH SCHOOL STUDENTS AMONG CURRENT E-CIGARETTE USERS AGED 45 YEARS AND OLDER in 2015, most were either current or former regular cigarette smokers, and 1.3% had never been cigarette smokers. IN CONTRAST, AMONG CURRENT E-CIGARETTE USERS AGED 18–24 YEARS, 40.0% had NEVER BEEN regular cigarette smokers In 2017, IN 2015, AMONG ADULT E-CIGARETTE USERS OVERALL: 29.8% were former regular cigarette smokers 2.8% of U.S. adults were current e-cigarette users 58.8% were current regular cigarette smokers 11.4% had never been regular cigarette smokers For Print Only