Vaping may boost teens' risk of heart, lung disease over lifetime, group warns

WASHINGTON, June 21 (UPI) -- The American Heart Association has issued a new warning for adolescents who use e-cigarettes: The popular pastime of vaping may increase the risk of heart and lung disease over the course of a lifetime.

The latest available scientific evidence suggests that the adverse cardiopulmonary effects from using e-cigarettes may accrue over time, the organization said in a scientific statement published Tuesday in its peer-reviewed journal, Circulation: Research.

"As a heart doctor, I believe that it is so important to find ways to prevent kids from starting to vape and support kids who need help quitting," said Dr. Naomi Hamburg, a professor of cardiovascular medicine at Boston University School of Medicine and director of Boston Medical Center's Whitaker Cardiovascular Institute. She is a co-author of the statement.

"I study the health effects of vaping in adolescents and young adults," Hamburg told UPI. "We are seeing more and more adolescents who started vaping in high school or earlier and who never used cigarettes. Adolescents often use daily suggesting that they are addicted to nicotine. Many want to quit but find it challenging to stop vaping."

Among its recommendations, the heart association urged removing flavored e-cigarettes, including menthol-flavored ones, from the market.

It also called for providing more education to youth and their parents on the product's potential health risks, getting vaping curricula into medical school training, ensuring hospital-based vaping cessation programs for adolescents and adults, and regulating the product's marketing on social media platforms.

"I am aware of local advocacy campaigns arising from parental concerns about teen vaping all over the Bay Area," Dr. Joseph C. Wu, a cardiologist who is director of Stanford Cardiovascular Institute, told UPI. He is a co-author of the group's statement.

"Parents were seeing their neighborhood smoke shops selling flavored tobacco products to underage teens and kids, said Wu, a professor of medicine and radiology at Stanford University School of Medicine.

"Some cities, including San Jose and Los Angeles, have banned the sale of flavored tobacco in their cities."

He added: "Pediatricians are also seeing more kids in clinics due to e-cigarette and vaping injuries. Due to the much higher nicotine concentration of the new formulations found in e-cigarettes such as Juuls, kids are unaware that they can quickly become addicted to nicotine."

E-cigarettes are the most common form of electronic nicotine delivery systems. Their market introduction in the early 2000s reversed years of lower rates of tobacco use, and their use has increased substantially, particularly among adolescents, the heart association said.

The latest national youth tobacco survey, which was released in March, found that roughly 34% of high school students and 11.3% of middle school students reported ever using a tobacco product in 2021. E-cigarettes were the most common product -- used by 11.3% of high school students and 2.8% of middle school students.

The heart association, which previously published a statement on adults' e-cigarette use, said in its new statement that although most new users of e-cigarettes have never smoked combustible cigarettes, adolescents who begin vaping now may become life-long nicotine or tobacco users.

The group explained that a scientific statement represents an expert analysis of current research that may impact physicians' clinical practice guidelines in the future.

In this case, the group said in a news release that "experts in basic science, cellular and vascular biology, toxicology, pharmacology and epidemiology reviewed evidence-based studies focused on the cardiopulmonary effects of e-cigarette use in adolescents" to determine short- and long-term risks and provide guidance on how to reduce vaping.

Loren E. Wold, who led the writing group for the scientific statement, explained in a news release that most studies on the use of e-cigarettes have focused on adults or animals.

"It's critical that we also understand how organ systems are affected in younger people who use e-cigarettes, and, specifically, how these effects may persist into adulthood," said Wold, a professor and associate dean for research operations and compliance at Ohio State University's College of Medicine.

The heart association said the toxicity of e-cigarettes remains poorly understood, partly because most manufacturers have not publicly disclosed the full list of ingredients of their products. And this makes it tougher to predict ill effects on the heart and lungs.

However, the group said it is known that e-liquids contain nicotine, or THC, the main psychoactive compound in cannabis, along with vegetable glycerin and propylene glycol, which are on the Food and Drug Administration's "generally regarded as safe" list.

But these compounds are not intended to be inhaled and haven't been tested in this way; and when heated they often break down into other chemicals, such as formaldehyde, a known carcinogen.

Wold said that a person's lung development continues into their early 20s, "so adolescents who vape are at risk for stunting or altering their lung development and may not reach full lung function."

The heart association also mentioned studies finding that "young adults who use e-cigarettes experience arterial stiffness, impaired blood vessel function, and increased blood pressure and heart rate."

This evidence "suggests that acute cardiovascular effects of e-cigarettes may accrue over time with prolonged use, leading to increased risk of cardiovascular disease in people who use e-cigarettes over the long-term," the group said.

Aside from cardiopulmonary consequences, e-cigarette use "impairs sleep quality, potentially affects mental health and leads to addiction through activation of certain brain pathways," the group added.