Vaping among young adults – implications on lung health (COPD)

Vaping, or the use of electronic cigarettes, is becoming more popular in Australia, with more than 200,000 Australians vaping on a regular basis. Of particular concern is the apparent rise in the use of e-cigarettes among children, teens and young adults, thanks to their ready availability and lack of consistent regulation compared with traditional cigarettes. Research into the immediate and long-term health and safety risks of vaping is limited, as the introduction and widespread popularity of these products is relatively new. However, the evidence currently available suggests that vaping poses serious risks to health, especially for vulnerable young people and adolescents. Read on to find out more about e-cigarettes, and how to reduce the health risks associated with vaping for your child or teenager, or other cherished young people in your life.

What is vaping?

Electronic cigarettes, also known as e-cigarettes or ‘vapes’ are devices that simulate the act of smoking, without actually burning tobacco. E-cigarettes contain a liquid that is electronically heated, releasing an aerosol that resembles smoke or vapour, hence why e-cigarette use is often referred to as ‘vaping’. Vapes may contain a wide range of substances, but are most commonly used to inhale nicotine-based products. Some people also use vapes to inhale cannabis or non-nicotine based ‘e-liquids’ often containing sweeteners, flavourings and solvents.

Despite sometimes being marketed as a way to help transition people away from cigarettes or quit smoking, there is not enough evidence that vapes are effective in supporting people to quit smoking, or that they are a safe alternative to smoking combustible cigarettes. Whilst further research is required, there is increasing concern by the public that the use of e-cigarettes will have unforeseen negative health implications, especially considering the lack of consistent regulation for these products. 

Is vaping safe?

The lack of quality or safety standards for e-cigarettes, specifically those marketed as nicotine-free products, is cause for great concern about long-term health risks for regular vape users. Recent changes to legislation means that you require a prescription in order to purchase nicotine-based vape devices, however e-cigarettes that are marketed as nicotine-free are much easier to purchase, even if you are underage. 

Many vapes that claim to be nicotine free do actually contain traces of the highly addictive chemical, which can lead to impaired brain function, memory and cognitive development, especially among adolescents. Electronic cigarettes that don’t contain nicotine have frequently been found to contain other harmful compounds including formaldehyde, acetaldehyde, acrolein and other chemicals associated with some cancers and DNA damage.

More research is required to confirm some of the health risks of vaping, however based on the current knowledge, scientists do not consider vaping safe and discourage anyone from taking part. Even if it is marginally safer than smoking cigarettes, researchers continue to find a wide range of potentially toxic and carcinogenic ingredients, so it is best to avoid any cigarette use, electronic or otherwise.

Are more teens and young people vaping in Australia?

Despite the well-documented negative health effects of vaping, the use of electronic cigarettes appears to be increasing among children and young people. It is illegal to market or advertise e-cigarettes to young people in Australia, however marketers frequently use other ways to encourage young people to buy these products. Social media has been considered a key way that young people are exposed to information and advertising for vape products, such as seeing ‘influencers’ using or promoting them.

Electronic cigarette companies also use clever tactics like attractive packaging and tasty flavours to make them more appealing to young people. Designing products that look cool or fun, or have ‘sweet-sounding’ flavours have been linked with young people being more attracted or interested in trying vaping, even without any advertisement exposure. Whilst the rates of youth vaping may actually be lower than media outlets claim, the severe health risks still warrant better research, regulation, and prevention strategies to protect the lung health and neural development of young Australians.

Health implications of electronic cigarettes

There are a wide range of health risks associated with vaping. These risks appear to increase with heavier or more frequent use, and become more likely if you start vaping at a young age. Depending on your preexisting health status, genetic predisposition to certain diseases, the type of vape you use and how old you were when you started, you may be at increased risk of lung diseases, poor brain function, and a range of other serious health complications. 

Vaping, young people, and lung diseases

Medical researchers are still gathering evidence to demonstrate a direct causational relationship between vaping and lung disease, however the information currently available paints a disturbing picture.

A study conducted by John Hopkins Medicine found a strong link between people who regularly inhaled tobacco products using an e-cigarette and a higher risk of asthma and chronic obstructive pulmonary disease (COPD). These conditions have long been associated with regular smokers of traditional nicotine-based cigarettes, indicating that vaping may not be a safer choice after all. The same study suggested that people who use both cigarettes and vapes are six times more likely to develop COPD than people who don’t use any tobacco products, which contradicts the idea that using vapes is a good way to start cutting down on smoking.

Compared to smoking combustible cigarettes, the greatest new risk that vaping brings is related to the unknown cocktail of additives and chemicals used in e-liquids. Whilst smoking cigarettes is one of the greatest risk factors for a range of serious diseases, there are around six decades of research behind them to understand the effects of cigarette ingredients on the lungs. Whilst this doesn’t make cigarettes any safer, it does enable medical experts to design effective evidence-based harm reduction and treatment strategies. In contrast, there is no way to know vaping’s long-term effects on the lungs, or to be sure of the safety of the ingredients being used.

Vape e-liquids frequently contain chemicals like diacetyl, which can lead to scarring on the lung tissue causing coughing, difficulty breathing, chest pain and wheezing. E-cigarettes are also often made with oily substances that pose a risk of lipoid pneumonia due to a buildup of fatty substances on the lungs. Some anecdotal evidence from the medical field also suggests that young people who vape are reporting collapsed lungs at a higher rate, and whilst vapes have not been on the market long enough to know, it is likely that they increase the chances of developing various lung cancers.

It is important to note that the dangers of vaping and e-cigarettes do not mean that smoking regular cigarettes is a preferable alternative. Smoking is one of the biggest risk factors for a vast range of long-term health effects, and can affect the health of those you love through the effects of secondhand smoke. If you are trying to quit smoking, reach out for support from Quitline or a trusted healthcare professional before reaching for an electronic replacement cigarette. Your doctor or care team can support you to access safe, effective products to help you quit smoking, without exposing you to the health risks associated with electronic cigarettes. 

Vaping and brain development in adolescents and young people

E-cigarettes that are labeled as ‘nicotine-free’ often still contain small amounts of this toxic chemical. Consumption of nicotine can delay the brain’s development, which continues until a person reaches their mid-twenties. Using any vaping product in your adolescence or early adulthood can have serious implications for your future brain function, memory, and concentration. Whilst more research is needed on the complex relationship between e-cigarettes and brain health, some evidence suggests that inhalation of e-liquids evokes a stress response from cells in the brain stem, leading to damage or even death of the cell.

Early exposure to nicotine products can also cause the premature brain to crave higher doses of the substance, putting them at greater risk of tobacco dependency in their later life. Some research suggests that young people who use e-cigarettes are more likely to transition to smoking cigarettes in adulthood, either as a replacement for or addition to their continued vaping habit. 

Vaping and the immune system

The liquids within e-cigarettes may be damaging to your immune system when inhaled. Researchers studied the properties of the aerosol delivered to the lungs when using an electronic cigarette, and found that it increased inflammation and caused damage to vital immunity cells in the lungs and elsewhere in the body. The damage that vaping liquids cause to white blood cells, which play a significant role in immunity and fighting infection, puts vape users at a significantly higher risk of bacterial infections, pneumonia, asthma, bronchitis, and other diseases of the respiratory system. Even if vaping is slightly safer than cigarettes, vaping e-cigarettes is clearly not the risk-free alternative they are marketed to be and should be avoided. 

Other risks and dangers of e-cigarettes

Aside from the increased risk of lung and brain disease, vaping poses a range of other unique risks to health and safety. E-cigarettes have been known to explode, often as a result of the device’s batteries overheating or exploding, or because of poor manufacturing or faulty mechanisms. Whilst the rate of these vaping explosions is unknown, they pose a serious risk to the user if the device is in their pocket or near their person when it explodes. Case studies have documented incidents of serious burns, facial injuries and other traumatic incidents as a result of an electronic cigarette exploding whilst being used or stored in a clothing pocket.

Poorly designed or maintained vaping devices pose an additional risk of contact exposure to e-liquids containing unknown and potentially hazardous materials. There is conclusive evidence to suggest that ingesting the liquid within an e-cigarette can be fatal, or lead to serious, long-term health effects including brain damage. Unintentional exposure to e-liquids through the eyes, skin or mouth can also lead to injury, vomiting, brain injury and even seizures. If you or someone you know uses e-cigarettes and is not currently able or willing to cease use, it is extremely important to practice safe storage and use of your vape, including its battery or power source, to avoid serious injury.

How to protect young people from the harms of e-cigarettes

Adolescence is a time of discovering your sense of identity, which often involves some level of testing boundaries and risk taking. Supporting children, teens and young people in your life who you are worried may be vaping should begin with a non-confrontational, judgement-free conversation. Talking to young people about their behaviour must be done in a way that makes them feel safe and reassured that they will be heard and understood. 

Before you approach a young person to talk about their use of e-cigarettes, it is important to understand the basic facts about vaping. Think carefully about what you want to say, and any questions the young person may ask you so that you can provide thought-out, helpful responses. Try to raise the issue in a casual, non-confrontational way, such as when you are driving together or engaged in a shared activity. Sometimes it can be helpful to use something you have seen on television or in the news about vaping as a way of raising the subject without sounding accusatory or reprimanding. Even if you suspect your loved one has been vaping, avoid making any assumptions or accusations, and do not go through their belongings looking for evidence. This will likely only make them distrust you, and may drive them to start hiding their e-cigarettes or become more secretive about their habits. 

Even though it is perfectly natural to be concerned about your child or a beloved younger person using a potentially dangerous product, avoid lecturing or judging them for the choices they have made. Be honest about the risks without exaggerating, as this can also lead them to mistrust your intentions and the information you provide. Try to ensure the conversation remains a two-way street, and show interest in their experience and the reasons they started using an e-cigarette. People often turn to using substances to help manage other worries or concerns in their life, so this conversation may even provide an opportunity to talk through other challenges they are facing and find more constructive solutions. 

Finally, focus on the specific health concerns you have and provide them with reliable information about the long-term effects of e-cigarettes. If you feel that your message has not been received, consider linking them to support organisations such as the Alcohol and Drug Foundation (ADF) to hear the message from someone who isn’t a parental figure. You can also link them to resources to help them reduce or cut down on their use in a safe way.

Importantly, if you currently smoke cigarettes or use a vape, remember that the children and young people in your life are more likely to follow your example than obey your instructions. Seek help to quit smoking or vaping if you are a current user, and consider including your beloved young person in your quitting journey. Support is available to help you and your loved ones live a healthy, safe and smoke-free life, so reach out as soon as possible to reduce the health risks for you and the teens and young people in your life.