Health Risks Vaping, Chemicals, and Addiction

Vaping is a popular hobby that skyrocketed to stardom just as tighter non-smoking laws were sweeping the country. E-cigarettes hit the market in 2007, and they became an instant hit among people who enjoyed being able to 'smoke' anywhere or smoke without the associated odors. Many people who used e-cigarettes as a tool for quitting smoking believed that the dangers of vaping were at least safer than the dangers of smoking cigarettes. The marketing of e-cigarettes as a healthy alternative to c-cigarette smoking is associated with increased use of e-cigarettes among younger adolescents and current smokers who believe that e-cigarettes are not harmful. E-cigarettes are interpreted in many societies as a safer alternative compared to combustible cigarettes (c-cigarettes) despite the fact that there is no sufficient evidence regarding e-cigarette safety and efficacy for replacing e-cigarettes1. Since the advent of e-cigarettes, vaping devices like vape pens, e-hookas and advanced personal vaporizers, known as MODS, have also become popular. A vaping device typically consists of a mouthpiece, a cartridge that contains the vaping liquid, a heating element, and a battery. When you inhale through the mouthpiece, the battery activates the heating element, which turns the liquid into an aerosol that you inhale and exhale, much like cigarette smoke. Many who vape are unaware of the dangers of vaping. Despite the dangers of vaping, this practice is gaining more popularity every year2.

What's in Your E-Cigarette?

Although the marketing materials for vaping liquids and devices would have consumers believe that they're inhaling a harmless water vapor, the truth is that only a small portion of the vapor is water. Mostly, the vapor is an aerosol produced from solvents in the liquid, according to an article in the journal Environmental Health Perspectives3. The Centers for Disease Control points out that the aerosol contains potentially harmful substances, including solvents, nicotine, flavoring agents, ultra-fine particles, volatile organic compounds, carcinogenic compounds, and heavy metals. All of these ingredients contribute to the dangers of vaping4.

VAPING LIQUID AND ASSOCIATED HAMEFUL EFFECT ON HEALTH

Solvents

E-cigarettes and vaping liquids contain propylene glycol and/or glycerin, the solvents that produce the vapor. The dangers of vaping these substances include the effects of potentially toxic carbonyls that can form when the liquid is heated at high temperatures. Carbonyls identified in a study of vaping liquids include formaldehyde, acetaldehyde, acetone, and butanol. It should be noted that Dow Chemical Company, which makes propylene glycol, recommends in its product safety assessment that individuals avoid inhaling this chemical5.

Nicotine

Some research on the dangers of vaping focuses on nicotine toxicity, which can produce nausea, vomiting, an elevated heart rate and seizures. This is a particular concern for young people, who are more sensitive to chemicals than adults. Since the amount of nicotine indicated on the refill cartridges rarely matches the true nicotine content of the liquid, it's difficult to know how much nicotine you're getting each time you inhale5.

Flavoring Agents

A study of 35 different flavorings found in vaping liquids shows that the dangers of vaping include damage to three types of cells, including human pulmonary fibroblasts, human embryonic stem cells and the neural stem cells in mice5.

Ultra-fine Particles

The dangers of vaping include damage to the body by particles produced by vaping, including ultrafine particles of water, solvent, and nicotine. These particles appear to be deposited in the lungs similarly to the ultra-fine particles found in cigarette smoke5.

Heavy Metals

A 2013 study by the University of California found that the dangers of vaping include exposure to heavy metals and silicates in the vapors produced by the liquids. These metal particles come from the heating element and are picked up by the liquid and carried to the lungs in the aerosol. Other dangers of vaping include frequent headaches, respiratory tract infections, and appetite changes5.

POPULAR VAPING SUBSTANCES

The dangers of vaping are not limited to liquids containing nicotine, although nicotine is the most popular substance for vaping. It is impossible to know what's in someone's vape pen, and according to CNN, it could be a number of dangerous or even deadly psychoactive substances. Water-soluble synthetics can easily be converted into a liquid concentrate that can be used with a vaping device. Special Agent John Scherbenske from the U.S. Drug Enforcement Administration points out that officers don't know what's in a vape pen until it's tested in a forensic laboratory, and often, the contents turn out to be dangerous drugs6.

Flakka

Flakka is a synthetic drug that's cheap and deadly. The dangers of vaping flakka include paranoid psychosis, a dangerous increase in body temperature, and insensitivity to pain, and fatigue. Overdose is one of the most important dangers of vaping flakka, since it's difficult to know how much flakka the liquid contains6.

'Legal Weeds'

K2 and Spice are synthetic versions of marijuana that can be vaped as well as smoked. The dangers of vaping these 'legal weeds,' which are up to 100 times more psychoactive than THC, include spikes in blood pressure, seizures, kidney failure and chest pain. Overdose deaths involving synthetic marijuana have been on the rise for several years, and these drugs are known to cause deep confusion and violent behaviors6.

THC

The psychoactive ingredient in marijuana, THC can be converted to an oil designed for a vape pen. In states where marijuana is legal, consumers can buy these liquids, which are available in different strengths. Cannabis oils are made with different strains, additives, and solvents. The dangers of vaping THC include harmful chemicals that are produced when thinning agents are added to the oil. Additionally, cuticle waxes, which are lipids on the outside of most plants, are commonly found in THC and hash oils. These are normally burned off when you smoke marijuana or hash, but vaping doesn't remove these waxes, which may build up in the lungs and cause respiratory problems6.

DMT

Dimethyltryptamine, or DMT, is one of the strongest hallucinogens in the world, more powerful than LSD and other hallucinogens. The dangers of vaping DMT include intense nausea, fearful agitation, and lung and throat irritation6.

THE DANGERS OF VAPING

According to an article published in the journal Addictive Behaviors, 67 percent of respondents believed the dangers of vaping to be minimal compared to the dangers of smoking cigarettes. While research into the dangers of vaping is still fairly new, and long-term studies have yet to conclude, the best research available shows that vaping is dangerous on many levels7.

Brain Health

Research into the dangers of vaping shows that vaping among youth has important implications for brain health and development. The Surgeon General reports that a developing brain is vulnerable to effects of nicotine, which include reduced impulse control, deficits in cognition and attention and mood disorders8.

Fetal Exposure to Nicotine

The dangers of vaping among pregnant women, which results in fetal exposure to nicotine, can lead to deficits in attention, cognition and auditory processing, and it increases the risk of sudden infant death syndrome, obesity and behavioral problems later on8.

Gum Disease

When bloody mouth sores became a common complaint among teenage vapers, Irfan Rahman, a toxicologist at the University of Rochester, investigated the dangers of vaping on the cells of the mouth. He found that the vapors inflame mouth cells and promote gum disease and tooth loss. Moreover, the vapors made it more difficult for these mouth sores to heal9.

Vaper's Cough

Inhaling the particles and other components of vaporized liquids has been shown to produce chronic bronchitis, or smoker's cough. A study of high school students found that current vapers were twice as likely to have chronic bronchitis as those who had never vaped. It's not yet clear whether the dangers of vaping include permanent lung damage. The hotter the liquid in a vaping device becomes, the greater the dangers of vaping. A disturbing trend among youth, called 'dripping,' involves taking the cover off of the vaping device and using an eye dropper to drip the liquid directly onto the heating coil. This gets the liquid far hotter, creating a bigger vapor cloud and a more intense throat hit. Researchers point out that even harmless chemicals that are heated up to these temperatures can become toxic, making the dangers of vaping even more concerning9.

VAPING ADDICTION AND EFFECT ON THE BRAIN

Perhaps one of the most important dangers of vaping is addiction. Some people become addicted to the nicotine in vaporizers, while others, particularly youth, can become addicted to the behavior of vaping even when nicotine isn't present in the liquid. A recent New York Times article noted that a panel of public health experts found that teens who vape have a higher risk than non-vapers of becoming addicted cigarette smokers, although the vaping industry argues that vaping isn't a gateway to smoking cigarettes or to developing an addiction10. Addiction is a chronic brain disease. It's characterized by compulsive behaviors despite the negative consequences of these behaviors. The result of changes in the brain's physical structures and chemical functions, addiction almost always requires professional help to overcome, according to the National Institute on Drug Abuse, which points out that the dangers of vaping include an increased risk of developing a nicotine addiction11.

The dangers of vaping nicotine are, in part, related to these changes in the brain. Nicotine stimulates the release of the hormone epinephrine, or adrenaline. It also increases the activity of dopamine, the neurotransmitter that is responsible for feelings of pleasure and which plays an important role in the reward, learning, and memory systems of the brain. Over time, these brain changes lead to compulsive nicotine use, driven by intense cravings. The brain changes associated with addiction affect thought and behavior patterns and can lead to dysfunctional ways of thinking and behaving that perpetuate the addiction and cause other problems, such as relationship and health problems12.

Table 1. Potential Effects of e-Cigarettes on Biological Systems13

Table 2. Chemicals Emitted in e-Cigarette Vapors and Their Potential Health Effects13

Conclusion

In conclusion, the extensive exploration of the dangers of vaping reveals a multifaceted landscape of potential health risks associated with e-cigarette use. From the composition of vaping liquids to the specific substances involved, such as nicotine, solvents, flavoring agents, and even psychoactive substances, the evidence presented underscores the complexity of the issue. The adverse effects on biological systems, including the pulmonary, immune, and central nervous systems, raise serious concerns about the long-term consequences of vaping.