10GT Omitowoju-1

Araoluwa Omitowoju
IRI/Period 1/10GT
04.23.20

Just One More Hit: The Short- and Long- Term Effects of Vaping on Youth Health

Introduction

Peer pressure and FOMO, also known as fear-of-missing-out, are two significant

phenomena plaguing America’s youth. In this age of social media where a person’s location

and actions are displayed at any given time, many are left feeling as though they are missing out

on experiences. This fear, along with peer pressure, become negative influences, often leading

teenagers to make decisions that ultimately prove harmful to their health. One of the issues that

has risen as a result of these negative influences is the use of dangerous products, which many

teenagers begin using innocently in order to fit in with others in their social communities.

Specifically, the misuse of rechargeable e-cigarettes by America’s youth has become an

epidemic resulting in detrimental health effects at extremely premature ages, including

lung damage, nicotine-related complications, developmental and reproductive injuries, and

even death. ​As of December 27 of 2019, there have been a total of 2,561 reported health cases

in the United States related to vaping from all fifty states and its territories. Fifty-five deaths

have been confirmed in twenty-seven states and the District of Columbia. These numbers

represent those who have been hospitalized and diagnosed with E​-cigarette or Vaping product

use-Associated Lung Injury or ​EVALI (CDC). In the summer of 2019, EVALI, also

synonymonized with VAPI, Vaping Associated Pulmonary Injury, and VALI, Vaping
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Associated Lung Injury, was officially recognized as “an acute or subacute respiratory illness

that can be severe and life-threatening” (Hollingsworth).

Evolution of E-Cigarette

An e-cigarette is a battery-powered device that heats up a liquid composed of chemicals

such as nicotine, a humectant to preserve, and flavorings; the vapor is then inhaled (Nat’l

Academies of Sciences, Engineering, and Medicine). The first mainstream e-cigarette was

created in 2003 by a Chinese pharmacist and inventor named Hon Lik, a heavy smoker, after his

father, also a heavy smoker, died of lung cancer. Although since then, e-cigarettes have become

more advanced while still maintaining similarities to the original form (CASAA). As they

continue to evolve, researchers have come up with a guide to classify the different forms of

e-cigarettes.

There are four general classifications of e-cigarettes. The first kind of e-cigarette are

referred to as first generation devices; these devices are intended to mimic cigarettes as closely

as possible. They act as a first step for users who want to quit smoking, or those who want an

alternative product to a cigarette. Most of these first-generation e-cigarettes are designed to

replicate and look like the original combustible cigarette whereas others are created to replicate a

pipe or cigar. Other names for these first-generation objects are cigalikes (cig-a-likes) or vape

sticks. (Nat’l Academies of Sciences, Engineering, and Medicine). The main motive of these

first-generation inventions is to be as close as possible to the original cigarette while decreasing

the overall negative impact on citizens’ health. First-generation cigalikes are slim, and they are

used with the goal of encouraging cigarette smokers to stop and seek use of a ‘healthier’ option

and were intended to be disposable.

As these devices became more evolved, the second-generation e-cigarette was created.

Unlike the first-generation, they are identified by the addition of a clearomizer, or “a trams[arent

cartridge that holds e-liquid”, an atomizer, and a slim battery. These products can be shaped like

pens and are sometimes referred to as ‘tank systems’ because of the “transparent reservoir that

holds larger amounts of e-liquid than previous cartridge-containing models” (Nat’l Academies

of Sciences, Engineering, and Medicine). With these devices, the main objective is not to help

those who once smoked to stop but rather continue reliance on the newer products. These

products are also larger than the first-generation as they contain more parts and are rechargeable.

This factor differentiates the two generations. With the addition of more pieces, the complexity

of the product increases, becoming refillable and reusable.

One of the more commonly used e-cigarettes are the third-generation devices. These

products contain a wide span and are the furthest away from the original, combustible cigarette.

They are sometimes referred to as fourth-generation devices. “Often these devices are

advertised as “vaping” products and the associated marketing makes no reference to cigarettes”

(Zhu et al.). They look almost nothing like tobacco cigarettes as they are usually more

rectangular. These devices also incorporate customizable and rebuildable batteries and atomizers.

(Nat’l Academies of Sciences, Engineering, and Medicine). As the most advanced version out

of the previous generations devices, the third-generation shares little to no similarities to normal

cigarettes, making these products more appealing and are easily marketed to teenagers. In

addition, these e-cigarettes (also known as pod-mod devices) have been increasing in popularity

amongst youth. Nowadays, one of the most popular e-cigarette companies, JuulLabs, creates
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these third-generation products. Unlike the other generations, these are sleek and way easier to

hide as they look like USB flash drives.

E-Cigarettes vs Cigarettes

In spite of the fact that they were originally created to encourage tobacco cessation,

e-cigarettes have spawned a debate on whether e-cigarettes are less harmful than normal

cigarettes. Typically, electronic cigarettes are marketed as healthier versions of tobacco

cigarettes, but they typically contain higher amounts of nicotine then their combustible

counterparts. “ JUUL (2018) indicates that each pod contains 0 mg to 59 mg of nicotine, about

the same amount as in an entire pack of cigarettes. One pod provides approximately 200 puffs”

(Selekman). As e-cigarettes continue to gain more exposure and attention by unintended users,

scientists have discovered that there are at least 60 potentially harmful chemicals, both known

and unknown in e-liquid pods and even more in e-liquid aerosol (Truth Initiative). “Metals such

as tin, lead, nickel, chromium, manganese, and arsenic have been found in e-cigarette liquids and

vapor. Other compounds detected include tobacco-specific nitrosamines, carbonyl compounds,

metals, volatile organic compounds, and phenolic compounds” (Rigotti and Kalkhoran). Many

compounds located in e-liquids are known to cause cancer and other terminal diseases.

Lung Health

As teenagers continue to vape these e-liquids, the inhaled chemicals, such as benzene

and isoprene, damage their young, developing lungs. Through continued use of e-cigarettes,

the lungs can become inflamed. When vaped, the liquid inside e-cigarettes releases several

hazardous chemicals, including aldehydes such as formaldehyde and acetaldehyde which can

cause lung disease (“The Impact of E-Cigarettes on the Lung”). Formaldehyde is “a

cancer-causing substance that may form if e-liquid overheats or not enough liquid is reaching the

heating element (known as a “dry-puff”)” (American Cancer Society). Since 1987, when the US

Envirotmental Protection Agency, also known as the E.P.A, described formaldehyde as a

carcinagen, studies have shown that there are connections between formaldehyde and certain

types of cancer (National Cancer Institute). Although not in the original e-liquid of e-cigarettes,

formaldehyde is a byproduct of vaping emitted in secondhand smoke, demonstrating that

additional harmful chemicals can be created during product use, affecting both the primary user

and those nearby him or her. Another chemical in e-cigarettes is “acetaldehyde, a chemical

found in the smoke from ​marijuana and some electronic cigarettes. Acetaldehyde also can

damage the lining of [the] ​mouth​, throat, and ​stomach​” (Chang).

It is likely that other chemicals in the e-liquid of these e-cigarettes affect various body

parts. While vaping, chemicals can enter the smallest airways of the lungs, damaging them and

making people cough and feel out of breath, causing ​bronchiolitis obliterans, also known as

popcorn lung (Chang). ​“A study published in 2015 in the ​Journal Environmental Health

Perspectives showed that harmful chemicals associated with "popcorn lung" are present in many

types of flavored ​e-cigarettes​, particularly those with flavors like fruit and candy that may appeal

to young ​smokers​” (Davis, et al.). In this study, 51 flavors of electronic cigarettes were tested.

In 47 of those samples, flavoring chemicals were found, and in 39 samples, diacetyl was found.

“This suggests a potentially dangerous level of exposure via e-cigarettes to chemicals that can

cause severe lung damage” (Davis, et al.). Popcorn lung has not been certainly proven to be

caused by vaping e-cigarettes, but from recent studies there is a very high chance that it is.

Diacetyl is thought to be one of the main chemicals causing popcorn lung, and traces of this
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chemical can be found in e-cigarettes. Therefore, the likelihood of popcorn lung being caused by

these products is extremely possible. Different flavors of e-cigarettes contain an array of

compounds, heightening the chances of these bring the origin of several diseases. “A Canadian

teenager who used e-cigarettes developed a near-fatal lung condition that does not resemble the

vaping-related illnesses [EVALI or VAPI] that have swept the United States. Doctors say the

17-year-old boy’s case looks more like ‘popcorn lung,’ an injury once seen in factory workers

who breathed in a chemical used to create a butter flavor” (Shammas). Vaping has been thought

to cause many diseases that have been classified as dormant to rise again. Unlike other

well-known diseases, scientists are still trying to figure out how to cure these medical conditions,

only furthering the danger of consuming these products.

Nicotine and E-Cigarettes

As the technology used for e-liquid delivery improves, the amount of nicotine able to be

delivered and inhaled increases. Companies, like JuulLabs, have enhanced the mechanisms in

their products so that they can deliver higher concentrations of nicotine at an accelerated rate.

“Nicotine is an addictive substance found in all tobacco products. In addition to being addictive,

it is poisonous” (Illinois Institute for Addiction Recovery). ​Continuous use of electronic

cigarettes elevates the possibility of developing a nicotine addiction, damaging the future

health and livelihood of the youth. ​“Exposure to nicotine among youth is particularly

dangerous since it has been shown to have an effect on key brain receptors, making young

people more susceptible to nicotine addiction” (Truth Initiative). The consumption of nicotine

causes the human body to release a chemical called dopamine also known as the feel-good

neurotransmitter. The deliverance of dopamine to the brain prompts it to repeatedly use the
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e-cigarette in order to feel the temporary “feel-good” moment. This process is known as

reinforcement. For every hit a person takes, the more he/she teaches the brain to continue

utilizing electronic cigarettes (“Say What? ‘Dopamine’” and “Why is Nicotine So Addictive”).

In order for the brain to work properly, it is essential that these key receptors develop and

function correctly. However, an addiction to nicotine rewires the brain, and, due to

reinforcement, creates a dependency upon nicotine which leads to adverse effects throughout the

body. “There is some evidence that the effect of nicotine on developing brains may prime not

just nicotine addiction, but greater vulnerability to addiction to other drugs as well” (Truth

Initiative). Beyond steering youth to use more nicotine-based products, nicotine wires the brain

in such a manner that it becomes more susceptible to addiction This limits the chances of one to

bounce back from addiction to alcohol and detrimental drugs such as marijuana and cocaine.As

well as this, inhaling any form of nicotine can prevent the lungs from completing their built

in-tasks. “Compared with tissues treated with a nicotine-free soluble extract, all three types of

exposures [exposure to nicotine alone, cigarette smoke, and/or e-cigarette vapors] caused lung

cells to become more permeable. The cells were no longer an effective barrier to outside

substances” (Raloff). If the cells of the lungs are not able to maintain their role as the essential

barrier between the inside of the lungs and the rest of the body, the mechanics of the body could

not run effectively. Rather than working together, these cells will act as a nuisance and an

obstacle as the body tries to function. “‘It's safe when we eat it, or when we apply it to our skin,

but inhalation is a completely different mode of exposure,’ [Maciej] Goniewicz explained.

Benzaldehyde can irritate the airways when inhaled, and vapor from the chemical also can

irritate the eyes, he said” (Thompson). This chemical causes irritation in the lungs when
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inhaled, but when added to other products that are not inhaled, it is harmless. With this known

fact, some of the chemicals being found in these e-cigarettes can start out as harmless, but when

inhaled, they become harmful.

Brain Development and Reproduction

The brains of humans are still developing from birth to the age of twenty-five.

Interrupting this maturing process can alter how the brain is expected to work, causing the

formation of disorders. The abuse of e-cigarettes by teenagers feeds into this problem. The use

of electronic cigarettes by young women and men in the reproductive age poses a risk to the

mother, father, and child. ​Using electronic cigarettes at a young age can result in brain

alterations and damage to the reproductive organs, and because a fetus shares nutrients

from its mother’s bloodstream, the use of e-cigarettes by her could result in catastrophic

deformities. ​The brain is in charge of many major aspects of people’s lives. From decision

making to controlling mood, the brain does it all. Compared to their adult counterparts, young

people have a higher chance of taking risks when it comes to their health and safety, such as

using nicotine. In addition, this nicotine usage can cause long-lasting effects because of the

exposure of this drug to the developing brain. “These risks include … mood disorders, and

permanent lowering of impulse control. Nicotine also changes the way synapses are formed,

which can harm the parts of the brain that control attention and learning” (“The Facts On

E-Cigarettes Use Among Youth and Young Adults”). The development stages in which young

people are in, including potentially clouded judgment, puts them at risk of making wrong

decisions, such as deciding to vape. As their brains are still growing at such a rapid pace, the

decision to vape can very quickly impair the ability for new developments, creating permanent
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damage to their bodies. “Potential problems include attention disorders like ADHD, impulse

control issues and susceptibility to substance abuse” (Hamilton). The development of more

diseases through continued use can make a user’s daily life miserable. When e-cigarettes are

used by women and men in the reproductive age range, it causes long term and permanent

problems similar to smoking cigarettes. “The fetus undergoes rapid organ development and

tissue growth prior to birth. Many toxins, including nicotine, can cross the maternal placental

barrier. In addition, gestational age of the fetus greatly influences susceptibility to a particular

toxicant. For example, during embryonic life certain chemical exposures can be teratogenic

while at a later gestational age, these same toxins can impair tissue and organ growth” (Eaton, et

al). Although electronic cigarettes are considered safer than normal cigarettes, they can cause

changes in the fetus. When the chemicals from e-cigarettes are inhaled into the lungs, they enter

the bloodstream and are shared with the developing baby. As the fetus grows, these chemicals

can alter the development process. Despite the effects of nicotine and additives in the

e-cigarettes, researchers at ​University College London (UCL) were able to find a connection

between the flavorings in the e-liquid and fertility. They found that a” mixture of water,

food-grade flavoring, a choice of nicotine levels or zero nicotine, and propylene glycol or

vegetable glycerin can affect sperm. The study found that vape juices greatly diminished

fertility: bubblegum flavor killed off cells in the testicles and the cinnamon-flavored vape juice

negatively impacted sperm motility (how sperm moves and swims)” (Rozensky). Vaping can

completely prevent the reproductive cycle from ever occurring. The flavors, as well as the base

chemicals, affect the ability of the reproductive organs to fulfill their purpose. The constant
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reaffirmation that e-cigarettes are not that harmful leads teenagers to making harmful decisions

that can destroy their bodies.

Conclusion

The long-term effects of vaping remain unknown, making those who currently use these

products, essentially, guinea pigs. It is proven to cause lung diseases, nicotine related issues,

developmental and reproductive injuries, and even death. On top of new information being

discovered as well as the recognition of its harmful effects, underage vaping should be restricted,

preferably by all levels of stakeholders, from local to federal regulations. In addition, education

about the negative impact of these products needs to concentrate on getting people to help lead

young people make the decision not to use these products, increasing the health of the youth of

America as a whole. With the byproducts of these products negatively impacting the youth of

America, perhaps the next generation will be motivated to put an end to this epidemic.
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Glossary

● ADHD- ​also known as attention-deficit/hyperactivity disorder; symptoms include

hyperactivity, impulsiveness, and attention difficulty

● Atomizer- ​responsible for vaporizing e-liquid; a coil that helps transform e-liquid into

mist; heating device in e-cigarettes

● Carcinogen- ​cancer causing substance in living tissue

● Clearomizer- ​the area in which the e-liquid of an e-cigarette is stored and converted into

a vapor

● Dopamine- ​neurotransmitter released by nerve cells to send signals to other nerve cells

● Embryonic- ​in relation to an embryo (after fertilization, early stage of development

process in which body structures, such as organs, are beginning to form)

● Fetus- ​the name for the unborn baby from the eighth week after conception to the birth of

the child

● Gestational age- ​used to describe how far along the mother is in the pregnancy;

measured from the last menstrual cycle to the current date

● Humectant- ​used to preserve a substance’s moisture

● Maternal placental barrier- ​between the mother and fetus; considered the “leakiest”

barrier as it poorly blocks chemicals; acts as a barrier for diffusion between the

circulatory systems of the mother and fetus

● Pulmonary- ​relating to lungs

● Teratogenic- ​substance that can cause a disturbance in the development of an embryo or

fetus
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● Tobacco-specific nitrosamine- ​formed when tobacco is grown, cured, aged, and

processed; cancer-causing chemical that is found in tobacco and tobacco smoke

● Volatile organic compounds- ​aka VOCs; emitted into the air from processes such as

smoking; can cause cancer; emitted as a gas; can react with other gases to form other air

pollutants
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