Fall/Winter 2023 11 CDC, in the interim, has put out recommendations to avoid all forms of e-cigarettes and vaping, especially in young adults and pregnant women, who are most at risk.” Help for kicking the habit Dr. Almeida points to better, more effective ways than vaping that can help people stop smoking. Riverside offers smoking cessation programs and counseling services. She notes the need “to tackle every new thing with a curious eye, put it under a lens and identify its potential danger before it becomes an epidemic.” “We need to learn from our mistakes,” Dr. Almeida cautions. “We were not aware of all of this when traditional cigarettes came out initially, and we are heading toward an epidemic where we’re making the same mistake again.” Harmful effects Diagnoses of e-cigarette or vaping product use associated lung injury (EVALI), a severe pulmonary illness associated with the use of e-cigarettes or vaping products, peaked in 2019. Symptoms of EVALI include: ● Shortness of breath. ● Fever. ● Cough. ● Vomiting. ● Diarrhea. ● Headache. ● Dizziness. ● Chest pain. The dangers of vaping While not approved by the FDA as a smoking cessation tool, many individuals use e-cigarettes as a “safe” way to quit smoking. The evolution of the industry has seen an expansion in audience, with teens and preteens obtaining access to vaping devices. Unfortunately, these devices are anything but safe. “Vaping, as the name suggests, is misleading. It’s not as benign as it sounds. It’s converting e-liquids, which are solvents, into aerosols,” explains Roselle Almeida, MD, a pulmonologist with Riverside Medical Group. “The e-liquids involve substances and solvents like propylene glycol, alcohols and nicotine in very high amounts. There are 15,000 kinds of (flavored e-liquids) available, and they are extremely toxic to the lungs and other organs of the body.” The teen epidemic Young adults and teenagers have key brain receptors that are much more sensitive to nicotine. The nicotine level in many of the e-liquids on the market equals an entire pack of cigarettes. “The nicotine attaches to these receptors, and the habit becomes much more addictive,” Dr. Almeida notes. “It also attracts (youth) to other substances and behavioral issues. Anxiety, depression, other drug abuse—it is all part of this.” Many of the current vaping devices don’t look anything like the previous generations of e-cigarette models. Some resemble a USB drive, making it easier for teens to hide their vaping behaviors at home and school—a marketing tactic e-cigarette brands have used to sell more product. In response to the spike in vaping-related illness and death in 2019, a number of states have implemented their own regulations to prevent the sale of e-cigarette devices and liquids. Is that enough? “We still don’t know what’s causing the specific illnesses. So now is a time for action—now is the time to make these regulations,” asserts Dr. Almeida. “States have already starting banning flavored e-cigarettes, and the Roselle Almeida, MD Riverside Pulmonologist
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