Teens and young men are turning to a new addictive product to satisfy their nicotine addiction: electronic cigarettes, a battery-powered vaporizer that comes in candy and fruit flavors.
But what may seem like a way to avoid the side effects of smoking real cigarettes — using a device that doesn’t contain tobacco, which is the substance in cigarettes linked to lung cancer and a host of other cancers and diseases — is actually much more harmful than people may think.
And worse, people who have never picked up a cigarette are using e-cigarettes.
“One big concern, is that while they may not start smoking tobacco, this may serve as a gateway to them smoking real cigarettes,” said Dr. Metee Comkornruecha, who works in the Division of Adolescent Medicine at Miami Children’s Hospital.
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The product, heavily marketed toward young men, comes in different flavors and is easily accessible, making it even more appealing.
A study published last month in the Center for Disease Control and Prevention’s Morbidity and Mortality Weekly Report, found that the number of calls to poison centers involving e-cigarette liquids containing nicotine increased from one per month in September 2010 to 215 per month in February 2014. More than half of those calls involved children under 5 and 42 percent included people age 20 and older.
According to the CDC, children can ingest, inhale or absorb the poison in the e-cigarettes, whereas poisoning from normal cigarettes normally just comes from children eating them.
Another study done by the CDC found that more than a quarter of a million youth who had never smoked a cigarette before used an e-cigarette in 2013. This number has gone up substantially since 2011. The same study showed that people who smoke electronic cigarettes were more likely to have intentions to smoke real cigarettes later in their life.
And more than its addictive quality, nicotine poses a long-term risk to the developing brain, particularly the frontal lobes, said Dr. Brandon Korman, chief of neuropsychology at Miami Children’s Hospital. Nicotine changes neuron activity as the brain develops, affecting people’s impulses, problem-solving and planning.
“The brain does not finish maturing until well into the 20s,” Korman said. “Especially the frontal lobes and that’s where the executive functioning is basically controlled.”
If the frontal lobes don’t develop correctly, it can cause ADHD, poor behavioral control, risk-taking and impulsive behavior. Korman said the effects also may not be discovered until later on.
He said the effects are particularly notable in young men, who already tend to be more risk-taking and are at higher risk for behavioral control.
“When they get older and the brain is supposed to have matured and these executive skills and your ability to make good decisions and to inhibit bad behaviors, negative behaviors, is supposed to have matured. You’re supposed to act like an adult,” he said, “I think that’s when the effects really kick in.”
Many people don’t even realize how bad e-cigarettes are for their health, Korman said. Although they don’t have the pesticides and other toxins present on the tobacco leaf, it doesn’t make them safe.
“From a cognitive standpoint, I don’t think it’s a very good idea at all,” he said. “I think they’re very dangerous. The way they are portrayed as a vapor rather than a tobacco product is somewhat misleading and would probably lead most people to think that there’s no danger.”
But it’s hard for people to know how bad these are for their health.
The U.S. Food and Drug Administration doesn’t regulate e-cigarettes, Comkornruecha said. So people don’t always know what kind of irritants, toxins and carcinogens are in them.
He said doctors are starting to see more emergency room visits due to overdose on e-cigarettes, which may cause nausea or vomiting. He said he hasn’t seen a lot of patients with health problems solely from e-cigarettes, but that too may change as the product becomes even more widespread.
Even though they may seem like a healthy alternative to tobacco cigarettes, Comkornruecha said taking nicotine in any form is not healthy.
“These kids can start smoking and they feel like they need more. They get tolerant to the dose that they have and they continue to smoke more and more and more,” he said. “They do see this as something that is safer. They see it as something that tastes good.”
And it doesn’t look like e-cigarettes are going anywhere anytime soon.
The products are now widely available, sold in gas stations and online. E-cigarette stores have also been popping up in Miami. There’s now even an e-cigarette with bluetooth connected to it. Supersmoker came up with the first e-cigarette that claims to also work as a Bluetooth headset and stream MP3s from a smartphone — so even more people may try it out. And Comkornruecha said advertisements for the product come on during popular TV shows, so people are constantly exposed to them.
And at the root of it: fitting in.
“Unfortunately, I think it boils down still to peer pressure and then also seeing celebrities, seeing other people do it,” he said. “They want to be in. They want to do what their idols and their role models do.”
But once you start, it’s very hard to quit, he said — and it could lead to even more harmful habits down the road.
“We need to get to the regulations,” Comkornruecha said. “We need to understand that this can be a big health problem and a big health concern and while there haven't been a lot of studies, there hasn't been a lot of time with people using these e-cigarettes. I think it’s very important that we prevent something worse from happening.”