On September 20, 2005, my recurring childhood nightmare came true. Lung cancer killed my father. I knew his addiction to nicotine was so powerful that it would one day beat him because I watched this very strong and stubborn man try and try and try to quit smoking. And so it was nicotine I began to hate (and fear). Cigarettes were bad, of course, but it was the nicotine that he just couldn’t quit. What a price he, and all of us who loved him so much, paid to that horrible addiction.
This is why I’m horrified to see nicotine’s popularity rising once again. We’ve all seen those old advertisements for cigarettes, often including testimonials from physicians, claiming cigarettes are refreshing and so cosmopolitan. Today, a lot of money is going in to creating the image that vaping is a safe alternative to smoking. However, it’s not clear that it is less dangerous, and it could be even more effective at luring young people. As my own children enter middle school, a stage of development marked by a desire to try new and risky behaviors, I am worried.
Because the health risks associated with electronic nicotine delivery systems (ENDS) have not been adequately studied, the Forum for International Respiratory Societies (2014) concluded that “electronic nicotine delivery devices should be restricted or banned” (p. 612). Among these experts’ many concerns was the fact that most delivery devices contain large concentrations of propylene glycol, which is a known irritant when inhaled. Little is known about the effect of long-term inhalation of this chemical. Additionally, because these devices are unregulated, users have no idea what other chemicals they may be inhaling, nor what the short- or long-term effects of that exposure are.
What we do know is that ENDS efficiently deliver varying amounts of nicotine to the user. Nicotine causes the release of adrenaline, which elevates the heart rate, increases blood pressure, and constricts blood vessels, potentially leading to long-term heart problems. The effect of vaping is almost immediate, but it also wears off quickly and encourages the user to want to vape again and again, needing more and more to feel the same effects.
Candidly, it is hard for me to believe that this industry is truly trying to do good by helping smokers wean themselves off harmful tobacco cigarettes when they market the devices with fruity flavors and pack their juices with more nicotine than cigarettes are allowed to contain under Food and Drug Administration regulations. Nicotine is highly and quickly addicting, and addiction creates a lucrative product, especially if those users are young.
During adolescence, the brain is sensitive to novel experiences. Unfortunately, just as young people want most to experiment with new and risky behaviors, their immature brains have very different sensitivities to drugs and alcohol. Exposure to nicotine during this stage can lead to long-term changes in neurology and behavior. Chronic nicotine exposure during adolescence also alters the subsequent response of the serotonin system. Such alterations are often permanent (Yuan et al., 2015).
We should also not ignore the gateway effect nicotine has on its users. In 2012, nearly 90% of U.S. adults 18-34 years of age who had used cocaine had smoked cigarettes (i.e., used nicotine) first. Behavioral experiments have proven that nicotine “primes” the brain to enhance the effects of cocaine. So, it’s not just that one risky behavior leads to another — nicotine actually affects how the brain works, making other drugs (most commonly marijuana and cocaine) more pleasurable and desirable. And the younger a person is when beginning to use drugs and alcohol, the more likely it is that person will move on to other drugs and/or develop a serious addiction (Kandel & Kandel, 2014).
I am realistic enough to know that adolescents will always be thrill seeking and susceptible to making mistakes. However, we can and must do our best to prevent our children from developing addictions to substances we know can cause lifelong damage. In recent years, K-12 educators have grown more and more concerned about students’ abuse of opioids. And for good reason — the effects of the opioid crisis have been devastating. But let’s not ignore this additional, fast-growing public health crisis. Vaping is not just smokeless smoking — it’s a real and present danger to our students.
Forum of the International Respiratory Societies. (2014). Electronic cigarettes: A position statement. Pulmonary Perspective, 190 (6), 611-618.
Kandel, E.R. & Kandel, D.B. (2014). A molecular basis for nicotine as a gateway drug. The New England Journal of Medicine, 371 (10), 932-943.
Yuan, M., Cross, S.J., Loughlin, S.E., & Leslie, F.M. (2015). Nicotine and the adolescent brain. The Journal of Physiology, 536 (16), 3397-3412.
Citation: Leonard, S. (2018). Backtalk: What we all need to know about vaping. Phi Delta Kappan 99 (7), 80.