Dr. Roselle Almeida explains what vaping is, the trends and statistics around vaping and the dangers associated with vaping.
Alyssa Diaz (Host): This is the Well Within Reach Podcast. I’m your host, Alyssa Diaz, and today we have with us a Riverside Medical Group provider, Dr. Roselle Almeida, a pulmonologist. Dr. Almeida, thanks for joining us. First, start with a brief introduction of you as a physician and what your role as a pulmonologist is here at Riverside
Roselle Almeida, MD (Guest): As a pulmonologist, I see and specialize in lung diseases, which range from asthma to COPD, which is emphysema and chronic bronchitis, lung cancers, and then even the intensive care side of things where we go into severe lung diseases and pulmonary fibrosis. So, I see a wide variety of cases in adults.
Host: So, with all of these respiratory care issues and topics, vaping has become a really important topic in your practice, and that’s what we’ll be covering today. So, what is vaping or the use of e-cigarettes?
Dr. Almeida: Vaping, as the name suggests, is misleading because it’s not as benign as it sounds. It’s converting e-liquids, which are solvents, into aerosols to heat. So, they come in little devices, and they come in multiple varieties of devices where you can convert these liquids and inhale them, and that’s what’s called vaping, or e-cigarettes.
Host: And, so, like you said, it is very misleading. It’s not actually water vapors; it’s aerosol in its honest truth form.
Dr. Almeida: Right. It’s whatever’s in the e-liquid, which can involve substances and solvents like propylene glycol and alcohols and nicotine in very high amounts and different kinds of flavors. There are 15,000 kinds of flavors available, and they are extremely toxic to the lung and different organs of the body.
Host: And Dr. Almeida, what are some other forms of e-cigarettes?
Dr. Almeida: So, e-cigarettes came out in 2015, and now, it’s a 26-million-dollar industry. There are different forms of it. It came out and started out as simple cigarette or cigar-like devices. The second generation are pen-like devices with rechargeable batteries and the liquids in them, and the new model and high-tech ones, like the brand Juul or MyBlu. They involve –they’re modifiable devices, also called mods, which are sleeker. They don’t even look like a cigarette, so teenagers don’t, you know, think about it as vaping. They look like USB drives. They’re rechargeable. They can be sneaked into classrooms. It can be plugged in. They’re specifically targeted to these teenagers and kids, and we need to keep a good eye on them.
Host: Yeah, and that’s a really good point that you bring up. In recent years, the popularity has just grown exponentially for products like these, especially in those certain age groups, and actually I found a statistic: according to the surgeon general that when they were surveyed in 2018, 1 in 5 high school students reported using vaping products in the previous month, and that makes it about a quarter of US youth and young adults have tried vaping or e-cigarettes. So, this is really quite an epidemic that’s hitting our society.
Dr. Almeida: It is. In fact, statistics from just a few days ago on November 15th showed it had doubled from 1.5 million to 3.6 million of our young adults. These are our kids and our teenagers that are experimenting with these products and using it for multiple different solvents and different combinations of substances.
Host: And the bottom line is, vaping is still dangerous. This is still a form of drug use, and it’s an addictive form of drug use that’s kind of sweeping our nation while individuals have tried to find it as an alternative to using cigarettes in their traditional form. This is actually having severe health impacts to those who participate.
Dr. Almeida: Exactly. The nicotine is a highly, highly addictive substance, and the nicotine levels in some of these e-liquids equals to a pack of cigarettes, and young adults and teenagers have key brain receptors that are much more sensitive to nicotine, and so they attach to these receptors and become much more addictive. They also attract them to other substances and behavioral issues. So, anxiety, depression, other drug abuse is all part of this.
Host: Right. In addition to the behavioral risks, the addictiveness, we also have respiratory health, which is something that you specialize in as a pulmonologist. So, let’s talk a little bit about the side effects in that respect.
Dr. Almeida: So, we have known that inhalation of toxic substances and solvents and some of the old flavors like diacetyl that was in popcorn butter flavoring causes lung disease, and we’ve known about these for years, and a lot of these e-liquids contain flavors—some of them like cinnamon—and mixing of the flavors that are much more toxic and can damage the lining of the lungs, and severe respiratory lung disease requiring ventilators and now eight deaths have been reported in the last year.
Host: It looks like the guidelines are a little bit fuzzy on the regulations for products like these, is that correct as well?
Dr. Almeida: That is true. So, when it came out, the FDA put a jurisdiction on its sale to adults, but there was no regulation on the solvents, the amount of nicotine, the type of devices, and we still don’t know what’s causing the specific illnesses. So, now is a time for action. Now is the time to make these regulations. I know states have already starting banning flavored e-cigarettes, and the CDC, in the interim, has put out recommendations to avoid all forms of e-cigarettes and vaping, especially in young adults and pregnant women who are most at risk, and especially if you’ve never been exposed to it, this is the time to never go back to cigarettes either. So, those are the CDC recommendations for now.
Host: And the addictive properties of this, you know, if you are recommending help for somebody who may be has started vaping, would like to get out, do you still go through the same smoking cessation protocol as you would for a regular smoker?
Dr. Almeida: Yes, we do. We see a lot of the patients, you know, who have unfortunately resorted to vaping in their efforts to quit smoking, and though it is critical to find a clean and effective way to quit smoking, we need to go through the traditional programs of smoking cessation, the counseling, and there are multiple support groups. We have eight-week programs that can help with this, and people and parents and moms need to be more aware of these dangers that are lurking in society.
Host: And what would your recommendations be as a physician? Considering these staggering statistics for our youth, as a parent, how would that topic be approached and what would your recommendation be to talk to your kids about the dangers of vaping?
Dr. Almeida: The marketing needs to be addressed at the root to explaining to kids that there are going to be plenty of fads. There’s going to be new technologies. There’s going to be a new thing for weight loss or for sleeping or for smoking or for different things that in the past, we need to just be more critical and be more aware of this, and the more we learn as parents, the more we can educate or teenagers at home of the dangers that they see each and every day.
Host: It starts at home, absolutely. And if individuals want to learn more about the dangers of vaping or the use of e-cigarettes, what is a good resource for them to look to?
Dr. Almeida: So, the CDC, the Center for Disease Control, has put out recommendations, and I think those are—is an excellent resource to get information on the statistics, what to avoid. There are videos, and there are brochures, and ways to approach this topic with your teenagers, and I think that’s an excellent resource to look up online.
Host: Very good, and Dr. Almeida, in closing, is there anything else that you would like to share on the topic of vaping to help the general public understand the dangers?
Dr. Almeida: We need to learn from our mistakes. I think we were not aware of all of this when cigarettes came out initially, and we are heading towards an epidemic where we’re making the same mistake again, and, as I said, there’s multiple new things going to come out. So, we need to tackle every new thing with a curious eye, put it under a lens, and identify it before it becomes an epidemic.
Host: All very good information and a wonderful resource here at Riverside with Riverside Pulmonology Specialists. Thank you, Dr. Almeida for joining us on the Well Within Reach Podcast. To learn more about Dr. Almeida or the Riverside Pulmonology specialist group visit riversideheathcare.org.