Transcription:

Bill Klaproth (Host):  So let’s talk about vaping. With multiple deaths and hundreds of cases of a mysterious lung disease; many people have questions and are concerned with the growing trend of vaping. So, what does an ER doctor and mom of a teen need you to know about vaping? Let’s find out with Dr. Deb Greene, Associate Chair Emergency Department at Emerson Hospital.

This is Healthworks Here, the podcast from Emerson Hospital. I’m Bill Klaproth. Dr. Greene, we know why vaping has been in the news lately with many horrific stories of lung disease and even death. So, what is it about vaping that makes it potentially dangerous and harmful?

Deborah Greene, MD, FACEP (Guest):  Well I think this is a multi-layered question. So, essentially, we’ve known for a long time that nicotine is a really powerful and addictive drug. And so vaping from a public health perspective is the new look of nicotine addiction. Nicotine is highly addictive and has some really serious ramifications for youth and young adult use. It’s highly addictive. It causes changes in brain development. And users are really at risk for permanent brain changes. Changes in their brain that control attention and learning and mood development, mood disorders and permanent lowering of impulse control.

And we know that kids who use electric cigarettes and vape are four times more likely to go on to use sort of more combustible traditional tobacco products as well as other drugs like opioids and cocaine.

Host:  it’s almost like a gateway then to smoking when it was organically designed to help people quite smoking.

Dr. Greene:  It really is. The Surgeon General has actually called these sort of flavored products starter products that help establish smoking habits in young adults that lead to long term addiction. So, it’s really this surge in use, vaping really threatens to undo decades of tobacco reduction efforts and really exposes a whole new generation to nicotine addiction. Because we know that the earlier people start using nicotine, the harder it is to quit.

Host:  Yeah, that’s really interesting what you are saying. So, basically, vaping cuts out the tobacco and the smoke which is horrible for the lungs but still includes the nicotine and that’s what’s so addictive.

Dr. Greene:  Exactly. Yeah, so I mean it is true that these products don’t expose the user to the cigarette smoke with tar and carbon monoxide and the oxidant gases that damage the lung fields, but a safer thing does not actually mean it’s truly safe. And I think that’s what’s important for people to keep in mind.

Host:  Yeah, is that the message for parents then? I mean what should parents know about vaping? It sounds like that’s the message. This is really not safe and often leads to tobacco use?

Dr. Greene:  Yes. I mean we – for one thing, the teenagers may not even really realize they are vaping nicotine. These products are not well labelled. There’s no sort of regulation on product design or safety or labelling. So, a lot of kids may not even realize that they are actually ingesting nicotine. There was a study of youth or teenaged users of the JUUL product and almost two thirds of them didn’t realize that they were actually vaping nicotine. So, and a lot of studies that have looked at the nicotine free products actually still contain nicotine. So, I think parents should be aware. Try to educate your kids that these products do contain nicotine and it can have definitely lifelong health consequences, changes in their brain development and certainly puts them at risk for this new vaping product associated lung illness that we are seeing across the country. So, it’s extremely alarming.

Host:  It is alarming. So, I would imagine part of the problem – my kids are older, so I don’t have to worry about this anymore. But I would imagine part of the problem Dr. Greene is with vaping, you don’t reek of smoke when you come in the house so how can a parent tell if their child is vaping?

Dr. Greene:  Yeah, so this is a challenge. There really isn’t that telltale odor of tobacco or marijuana. I mean people may only notice sort of a sweet scent or sort of a fruity odor. So, I would be sort of looking for that. The devices that the kids are using are very small, they are compact, they are easily concealed. This is why teachers and schools are having such a tough time, the kids can put it in their pocket of their sweatshirt and zip off to the bathroom. So, I would have parents really keep an eye out for sort of unfamiliar products, unusual or odd looking pens or batteries or USB devices. And then on another level, we know that regular vaping does dry out the nasal passages. It dries out the oral mucosal passages so sometimes people present with nosebleeds, recurrent nosebleeds, because their nasal passages have dried out.

Sometimes people are noticed to be sort of continually drinking liquids because their mouth feels so dry after vaping. And then there’s sort of this other phenomenon called vaper’s tongue where sort of regular vaping causes a sort of diminished ability to taste and so you may see your teenagers sort of reaching for the salt shaker at the dinner table or choosing unusually spicy foods or something like that. But I think that the challenge is really that it is so hard to detect. I mean kids can – kids have been known to vape in class and get away with it. So, I think it’s really hard for parents.

Host:  Yeah, what you described, it sounds really tough and I’ve never heard of vaper’s tongue but what you have just described is really important and useful. So, thank you for that Dr. Greene. So, what should a parent do then if they recognize some of these signs of vaping?

Dr. Greene:  It’s really important to get yourself educated. You really need to get the facts and there are some really great websites out there. The one I like is www.ecigarettes.surgeongeneral.gov and that has really good information for parents. A whole tip sheet for parents on how to talk to kids and sort of resources and sort of how to take it from there. But I think get yourself educated and just you really have to talk to kids and the kids themselves may not really know what they’re ingesting and what they are using. I mean these are a generation of kids that would probably abhor the thought of touching a tobacco cigarette because it’s been engrained on them since kindergarten that cigarettes are bad. But they really may not know. So, I think it’s important to really talk to them like look, this is what you’re using, this can cause changes in your brain, but also, I think it’s important to talk to kids where it might most matter to them.

Say look this may be impacting your athletic ability. I’ve heard anecdotal evidence that coaches notice decreased stamina in some of their players. You can talk to kids, look this is going to impact your finances, your after school job money is all going to these products and you’re going to need more and more of them to feed your addiction. And also just to let them know look, a lot of these companies are owned by big tobacco and big tobacco has a real history, a long history of prioritizing sales over safety and they are luring you guys in and with Instagram or has sent influencers and making this product really cool and cheap and sweet and really easily obtained. And so, kids are really being played and I think kids don’t want to feel like they are being made fools of. And so I think that may be the way to approach kids.

Host:  Those are all really good points to remember. So, what if your child is vaping and they get sick? What are the signs of a vaping related illness that needs medical attention?

Dr. Greene:  I think some symptoms may be fairly mild. Kids may just complain of a cough or feel tired or may be having nausea or vomiting. But I think if kids are feeling short of breath, or they are complaining of chest pain, severe abdominal pain seems to be a component to it. I think that’s a time to seek medical attention. Unfortunately, a lot of these symptoms overlap with influenza symptoms and so it can be really, really challenging to tell. So, I think it will be an interesting winter for sure.

Host:  Yeah, that’s for sure. So, Dr. Greene, you’re a mom of a teen; so you have first hand experience with this. It sounds like the same message that we tell our kids that smoking tobacco, smoking cigarettes is bad. The best prevention is to not start in the first place. That sounds like the same message really applies to vaping as well, is that right?

Dr. Greene:  Absolutely. Don’t start. It’s harder to quit if you start early.

Host:  That really is the message. Dr. Greene, thanks so much for your time today.

Dr. Greene:  Oh you are very welcome. It’s my pleasure.

Host:  That’s Dr. Deb Greene, Associate Chair Emergency Department at Emerson Hospital. And for more information please visit www.emersonhospital.org. And if you liked what you’ve heard please share it on your social channels and be sure to check out the full podcast library for topics of interest to you. This is Healthworks Here, from Emerson hospital. Thanks for listening.