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What is vaping?

Vaping is the term used to describe smoking electronic cigarettes. It’s also called JUULing, juicing, and dabbing (the latter usually involves marijuana), among other names. No matter what you call it, youngsters using any type of vape products is dangerous.

Watch: How is vaping hurting kids?

In this episode of Boston Children’s Parentcast, host Dr. Jennifer Arnold speaks with Boston Children's pulmonologist Dr. Alicia Casey about the dangers of vaping, its effects on adolescent lung health, and what parents need to know to protect their kids.

Symptoms & Causes

What are the symptoms of vaping associated pulmonary illness (VAPI)?

Symptoms of VAPI include:

  • Shortness of breath, coughing, chest pain
  • Stomach pain, diarrhea, nausea, and vomiting
  • Fever and extreme tiredness

If your child is vaping or has vaped in the past and has any of these symptoms, be sure to call your pediatrician immediately or bring your child to the nearest emergency room. Respiratory symptoms can be quite serious and need to be evaluated quickly.

Diagnosis & Treatments

How is VAPI diagnosed?

Many people with VAPI have respiratory symptoms that look like bronchitis or pneumonia, but their condition does not respond to antibiotic treatment. Lab tests are often done to rule out influenza (the flu) and other infectious diseases. In addition, patients may require a chest X-ray or CT scans to look for lung abnormalities. Any child with respiratory symptoms who is vaping or has done this in the past should see a pulmonologist for further testing.

How is vaping associated pulmonary illness treated?

Young people with vaping-related lung illnesses will require different levels of supportive treatment, depending on the severity of their condition. In more serious cases, teens may be unable to breathe on their own and require a ventilator (a machine that helps them to breathe). Further urgent evaluation is recommended for all people who are vaping and have respiratory symptoms.

Cessation of vaping is recommended for all cases.

For adolescents addicted to nicotine, they may also need medications to help them quit. In addition, youngsters who have become addicted to nicotine, marijuana, or other drugs can benefit from working with a counselor.

Since vaping is still a relatively new phenomenon, medical experts don’t yet know the long-term consequences in people with VAPI.

Frequently Asked Questions

Vapes are battery-powered devices that contain coils used to heat up a liquid comprised of a mix of chemicals. Most vapes include nicotine, or marijuana, as the “active ingredient.” Some devices are designed with the liquid contained in a tank that can be refilled. JUUL, the most common vaping device used by kids, has the liquid in a disposable “pod.” People sometimes refill the tank or the pods with “homemade” vaping liquids, which can contain THC (the active ingredient in marijuana), other drugs, or chemicals that enhance the “buzz” that users experience.

The electronic devices heat the liquid into a fine aerosol mist or vapor that people can inhale, delivering substances into the lungs that aren’t meant to be there. This puts users at risk for serious harm to their pulmonary system. Vaping products currently aren’t regulated by the U.S. Food and Drug Administration, so there is no control on what they contain.

Vape liquids contain highly concentrated nicotine or THC. The nicotine contained in one “pod” can be as much as a whole pack (or even more) of traditional cigarettes. As a result, vaping a single pod can result in nicotine addiction and symptoms of nicotine toxicity. Similarly, the concentration of THC in dab pens can result in addiction to THC and can have acute mental health impacts.

In addition, the flavoring masks the chemical smell and allows kids to use more vape liquids faster, and exposes them to high quantities of nicotine more quickly which can lead to nicotine poisoning (commonly referred to by kids as being “nic sick”). This is typically experienced as dizziness, lightheadedness, nausea, and vomiting, though seizures have also been reported.

E-cigarettes were initially introduced as a smoking cessation aid. However, the latest research from the National Youth Tobacco Survey (NYTS) shows high school students that use vapes are more likely to smoke tobacco cigarettes. They are also more likely to use marijuana, alcohol, cocaine, and other drugs.

Vape pods come in as many as 16,000 flavors designed to appeal to young people — from buttered popcorn and gummy bears to fruit loops and bubble gum. The flavor pods are marketed with engaging images to match the flavor. Some pods are designed to be identical to candies, juice boxes, or other child-friendly items.

In addition to nicotine addiction, vaping is also linked to problems with concentration and performance in school and sports. There are also a number of health risks:

  • Nicotine stimulates the nervous system, which can speed up the user’s breathing, and increase the heart rate and blood pressure.
  • Some of the chemicals used to make the flavors in the flavor pods or cartridges are approved by the FDA for food; however, they are dangerous when inhaled into the lungs. Research has revealed that some of the chemicals can turn on the inflammatory system in the lungs, which can lead to lung disease and respiratory problems, often referred to as vaping associated pulmonary illness (VAPI).
  • Some of the chemicals in vaping liquids are known to cause cancer.

The impact of vaping on the lungs can be very serious and it can progress quickly. Therefore, if your child has breathing symptoms, contact your pediatrician right away to have your child assessed and potentially referred to Pulmonary Medicine. Parents can also call Pulmonary Medicine at Boston Children's directly to set up an appointment, but a referral may be needed from the pediatrician. However, if you are concerned about your child’s condition, or your child is having difficulty breathing, is in respiratory distress, experiences skin coloring changes, or is lethargic, please go directly to the closest Emergency Room.

Signs and symptoms of vaping can be subtle, so it’s important to be proactive by talking to your kids and asking lots of questions. The best way to treat vaping is to prevent it in the first place. Therefore, share the dangers of vaping with your children and let them know clearly that vaping isn’t allowed in your household.

If your child admits to using vapes, ask him or her to stop. Be clear that you understand how dangerous these products are and you are concerned about their health. If your child has misinformation or asks more questions, sit down and research the topic together.

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