Pharmacist Perspective on Dangers of Vaping

Blog Posts  |  21 April 2020  |  By Tom Pasquariello, PharmD, BCPS, BCMAS, PMSP

Recently I have seen a lot of commercials, television shows, advertisements, and internet articles that discuss the dangers of electronic cigarettes (e-cigarettes or vaping). An electronic cigarette is a battery-powered device that delivers nicotine, flavorings, and other ingredients that create an aerosol containing harmful chemicals.1 How big of an issue has vaping become among our youth? During 2017-2018, vaping use jumped so high that it led to the U.S. Surgeon General calling the use of these products among the young an epidemic in the U.S. In 2019, CDC and FDA data showed that more than five million U.S. youth vaped in the past 30 days (1 in 4 high schoolers and 1 in 10 middle schoolers).1

As a pharmacist, when I ask my patients why they choose to vape rather than smoke cigarettes they often say, “it’s safer.” It turns out that in 2008, the World Health Organization (WHO) deemed vaping an illegitimate cessation to nicotine replacement therapy.2 The cancer-causing chemicals, volatile organic compounds, ultra-fine particles, and heavy metals such as nickel, tin, and lead don’t come without serious risks and health concerns.1 Regrettably, there are many long-term dangers that range from cognitive impairment to permanent lung damage and even death.

According to a study published in the Center for Disease Control and Prevention (CDC) Morbidity and Mortality Weekly Report, 82% of patients hospitalized in the U.S. with e-cigarette or vaping product use-associated lung injury (EVALI) reported using tetrahydrocannabinol (THE)-containing products with and without vitamin E acetate.3 Another adverse effect is a condition called bronchiolitis obliterans, also known as “popcorn lung.” This is a permanent and sometimes fatal buildup of scarring in the lungs that destroys the small airways.2 Vaping also contains formaldehyde, or embalming fluid, a known carcinogenic when inhaled. Accidental poisoning is common if ingested, inhaled, or absorbed through the eyes or skin. Risk of pneumonia and other respiratory infections increases due to an inflammatory reaction caused by the presence of fatty deposits in the lungs and diminished gene activity that aid in immune system function.2

Unfortunately, in addition to side effects, vaping can lead to future cigarette smoking and/or other illicit drug use through nicotine’s powerful addictive properties. A 2018 National Academy of Medicine report found that there was some evidence that e-cigarette use increases the frequency and amount of cigarette smoking in the future.4 Marijuana in e-cigarettes was reportedly high in 2016 with approximately one-third of U.S. middle and high school students reporting use. Regardless of progression to cigarettes or other drugs, vaping use is extremely dangerous. Ongoing surveillance of side effects will be extremely important to better understand the long-term health consequences.

Help keep our earth’s air cleaner by spreading the message of the dangers of vaping to not only individual users, but also our environment. Even though the overall effects of second-hand vaping is less than cigarette smoking, the risk is present.5 There are plenty of free resources available to help educate on the harm and to help break the habit. Many smoking cessation products are available by prescription or over the counter such as nicotine gum or patches. I would suggest consulting with your physician to determine the best treatment for you. For prescribers, patient-specific options like insurance or cash pricing models, therapeutic alternatives, and other information are available to assist as they electronically prescribe in their Veradigm ePrescribe system.


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