Sunday , June 20 2021

Why vaping is so dangerous for teenagers



Levy said he saw children addicted to his program showing what appear to be psychiatric symptoms rarely seen in traditional cigarettes or between adults. Some have anxiety and can not concentrate, for example.

On Friday, the agency will hold a public hearing to discuss the role of smoking cessation remedies for children in order to get them out of the vapes. Currently, there are no FDA-approved nicotine cessation products for users of electronic cigarettes under the age of 18.

Despite the early bragging that electronic cigarettes may offer a less damaging alternative to adult smokers, experts say that young people are being hit hard by a combination of how nicotine vapors transmit, how children's brains are connected and developing, and Exclusive appeal of gadgets for children. .

Its long-term health effects are not yet clear.

"We left this Frankenstein loose without knowing what would happen," Levy said.

Vaping teenager was a "predictable problem"

Experts say that a Juul capsule – a nicotine-rich liquid cartridge that users place in the dominant e-cig brand – contains the same amount of nicotine as a pack of cigarettes.

"That may be true, but that is not the only consideration here," Levy said, adding that it is not yet clear "how high those spikes go and how quickly they enter the bloodstream and brain."

Levy said it is not uncommon for children to report symptoms that "sound very similar to nicotine toxicity," including headaches and stomach pains. She suspects that these devices make nicotine levels in the blood reach a higher peak than with traditional cigarettes – but experts say more research is needed to better understand how vapes work in the body and brain.

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"These new generations of electronic cigarettes, like Juul … they actually deliver a really high dose of nicotine, probably even higher than tobacco cigarettes," said Maciej Goniewicz, associate professor of oncology and pharmacology at Roswell Park Comprehensive . Cancer Center, specializing in toxicology.

In a study last year, Goniewicz found higher levels of cotinine – a breakthrough product of nicotine – in the urine of teenage vapors than had been reported in previous surveys of adolescent cigarette smokers.

According to Goniewicz, vape makers may be able to store more nicotine in their products, creating "nicotine salts," which can mask the naturally unpleasant taste of nicotine and cause the drug to be absorbed by the body more quickly.

Salt is created by combining nicotine – a base in its natural form – with an organic acid, he said. Experts fear that inhaling these and other added ingredients may cause other health problems, but electronic cigarettes have not been around long enough to be known.
In addition to the nicotine chemistry itself, e-cigarette companies have been criticized for adding pleasant and often sweet flavors to their "e-liquid", which is known to attract young people. And the absence of the hardness of inhalation of combustible cigarettes may allow the vapors to take deeper or more frequent puffs, Levy added.
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FDA commissioner Dr. Scott Gottlieb proposed in November to strengthen the agency's policies against e-cigarette flavored products. These proposals can ultimately lead to their removal from the shelves and sites accessible to minors. But the proposed changes do not include mint, menthol, and tobacco flavors. Gottlieb said he wanted to leave the door open for adults who could use these products to quit smoking, "but that can not happen at the expense of addicting a generation of children with nicotine," he told CNN.

The leading e-cigarette company Juul, which holds about 75 percent of the US market, also said that flavors are a useful tool to help adult smokers switch from fuel cigarettes.

Ashley Gould, managing director of Juul Labs, told CNN last year: "We were completely surprised at how young people used the product." The company said its product is designed to convert former adult smokers into what Juul describes as a less harmful alternative, and says it is taking steps to limit the use of electronic cigarettes by children.

But Levy describes the popularity of vapes among teens as a "totally predictable problem."

The brain of adolescents may be more vulnerable to nicotine

Levy said the impact of vapes on teens is changing the way people think about nicotine products.

Smoking was seen largely as a "medical problem" that could lead to cancer and other physical ailments, she said. Vaping is now increasingly seen as a psychiatric problem because of concerns that nicotine is cultivating dependency behaviors among children and interfering with brain development.

"There is a concern that the adolescent brain may be more vulnerable to the addictive effects of nicotine," said Adam Leventhal, director of the University of Southern California's Laboratory of Health, Emotion and Addiction.

"The circuits underlying pleasure and the pursuit of new and enjoyable experiences develop much faster than circuits that promote decision-making, impulse control, and rational thinking," said Leventhal.

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We know from cigarette users that those who try nicotine products early in life are more likely to develop addiction to the drug, Leventhal said. This can also lead to the breakdown of brain circuits underlying attention and cognitive abilities, he added.

What makes children exceptionally vulnerable to vapes is not merely biological; is also psychosocial, according to Leventhal. This may come in the form of peer pressure or stress, which may increase the likelihood of addictive behaviors, he said.

More broadly, cultural and political changes that prevent many children from buying cigarettes – including FDA regulation and a "long history of prevention programs" – simply did not keep pace with the vaping expansion, Leventhal added.

Children and adults also tend to vape for different reasons, Goniewicz said. Adults tend to be ex-smokers who can handle a high dose of nicotine and want to avoid withdrawal symptoms such as inability to sleep or focus on work.

"They do not really need nicotine to feel good," he said. "They need nicotine so they do not feel bad – because they are already addicted."

But electronic cigarettes may be the first childhood experience with nicotine. "Nicotine hits the brain," he said, fixing molecules that affect mood and other avenues. And they're not used to it, he said.

"Nicotine is a potent chemical that alters our brain."

It's hard to make kids give up.

Levy said that "almost all" teens in their program have some experience with e-cigarettes, but "what's new is that now we're seeing patients in the nicotine-only substance use program."

Health experts fear that being addicted to nicotine early in life can be a gateway to cigarettes and other drugs, and there are few tried and tested resources for teenagers.

"Children are often really struggling with it, and there simply is not a lot of resources for them," said Levy, adding that many addiction programs may not be equipped to deal with some of the younger, nicotine dependent children she is seeing . Much better would be ensuring that primary care physicians are equipped to work with children in their own communities, she said.

Some parents have adopted nicotine gum and other cessation tools for their children under medical guidance. Levy said this can be tricky because some kids can use these products as a "bridge" between puffs of vapes and tobacco products.

Drugs may be important in some advanced cases, but they are not enough, she said; children also need "good and solid advice".

"We ended up having to teach kids how they can handle their desires, how they can identify high-risk situations, how they can really deal with being surrounded by people who are using those things," Levy said. "Because the reality is that for most children, we treat them and put them back in school, and then they go to the bathroom, and everyone is Juuling."

Still, she said children and their parents seem largely unaware of the potential dangers.

"To this day, I have kids saying," Well, I thought it was safe, "or" I know it's safer than cigarettes, "Levy said.

"And safer than cigarettes" is a very low bar. "


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