Ask the Pharmacist

‘Safer’ does not mean safe with e-cigarettes

By Pooja V. Patel, Pharm D.

Q: It seems like everywhere I look, more and more kids are smoking e-cigarettes (a.k.a. vaping). What are these products? I am assuming they are dangerous, especially for kids and teens, but can you highlight some important facts for me to know?


Vaping has become more and more popular with the rise of e-cigarettes. E-cigarettes were introduced to the market in the United States in 2007 and were initially intended for a good purpose: to help adults who were trying to quit smoking. Fast forward 12 years and regrettably now young people, most of whom have never smoked cigarettes before, have started vaping.


What is vaping?

Vaping, sometimes referred to as “JUULing,”—named for a brand of e-cigarettes—is the act of inhaling a vaporized liquid from an electronic device. This electronic device, commonly referred to as an e-cigarette, is a battery powered device with a mouthpiece, a cartridge for containing the e-liquid, and a heating component. Puffing into the e-cigarette activates the battery-powered heating device to vaporize the liquid in the cartridge for the user to inhale. The e-liquid that is used in these devices usually contains three ingredients: propylene glycol and/or glycerin, chemicals for flavoring, and nicotine. The e-liquid can also contain THC, the chemical found in marijuana, which can make the user feel “high.”  


Is nicotine harmful to your health?

E-cigarette use poses a significant, yet avoidable, threat to the health of kids, teens and young adults. When the nicotine from the e-liquid is inhaled, it enters the lungs and is absorbed into the bloodstream. Once in the bloodstream nicotine stimulates the body to release a hormone called epinephrine, or adrenaline. This hormone stimulates the central nervous system to raise blood pressure, breathing rate and heart rate. Additionally, nicotine also activates the brain’s reward center by causing a build-up of a chemical called dopamine. Dopamine causes the user to experience pleasure and motivates them to continue using more and more nicotine, eventually leading to an addiction.


Why is nicotine (and vaping) specifically unsafe for kids, teens and young adults?

Until about the age of 25, the brain is still growing and developing. The connections, or synapses, between each brain cell becomes stronger and stronger with every memory that is made or skill that is learned. An adolescent brain tends to build synapses faster than the adult brain, allowing them to absorb information and learn quicker. Using nicotine in adolescence can damage the part of the brain that is responsible for learning, decision-making, impulse control, and mood control. Because addiction is a form of learning, younger users can develop an addiction much quicker than adults, which can arguably lead to other illicit drug use.


Are there any regulations on the safety of e-cigarette products?

In May 2016, the Food and Drug Administration announced the agency’s authority to regulate the manufacturing, importing, packaging, labeling, advertising, promotion, sale and distribution of e-cigarettes under the Family Smoking Prevention and Tobacco Control Act. Now, before a manufacturer can market their product claiming there are lower risks of exposure to toxins or adverse health effects, it must first receive approval by the FDA to make such claims. To date, no manufacturer of e-cigarettes has received FDA approval for claims of lower health risks.

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