LP Spring 2018 - 16


Healthy Communities

Mechanisms OF Vaping
When discussing "vaping," or the delivery
of vaporized liquid through a device such
as an electronic cigarette, it's important to
distinguish vaping devices from "heat-notburn" devices (e.g., IQOS), which take
tobacco and heat it to its smoke point.
This allows the tobacco to produce a nicotine-containing vapor but reduces the
created products of combustion. It must
also be noted that, while the majority of
devices are used primarily for the delivery
of nicotine, vaporizing devices may also be
used for the smoking of flavored liquids,
marijuana, and THC containing oils.
These various mechanisms may have a wide
range of variable implications for the user
dependent on the device itself as well as the
product to be vaporized.
In the majority of vaping products, the
chosen fluid is kept in a holding tank and
then dispensed into an atomizer, which
heats the liquid to the point of evaporation
so that it can be inhaled by the user. This
process of heating can leach trace amounts
of metals such as tin, lead, nickel, and
chromium into the vaporized liquid. Also,
vaping fluids themselves contain a wide
variety of chemicals not traditionally found
in smoking, including the solvent into which
the substances are themselves dissolved.
Most formulations consist primarily of some
combination of propylene glycol, glycerol,
or ethylene glycol, which are utilized for
their odorless and tasteless natures. While
the use of the substances, and the safety
therein, has been established in both food
and manufacturing industries, there is some
concern regarding the combustion products
of the solvents. Namely, propylene glycol
has been found at high temperatures to
decompose into propylene oxide, which is
a known carcinogen. Also, the heating of
either propylene glycol or glycerol causes
their decomposition into both formaldehyde
and acetaldehyde.

percent of persons aged 25 to 44, and 3.5
percent of persons aged 45 to 64 are regular
users of electronic cigarettes compared to
only 1.4 percent of people 65 years of age
or older. Furthermore, when we look purely
at those who have used vaping products of
any kind, we are far more likely to see a
predominance of younger users-with 21.6
percent of people between the ages of 18
and 24 identifying versus only 3.7 percent
of persons over the age of 65.
As may be expected, this trend continues
to carry forward as we extrapolate to younger
users. As of 2015, approximately 16 percent of high school students had used an
electronic cigarette or some form of vaping
product within the last 30 days. Within
that same group of high school students,
approximately 58.8 percent of those who
identified as current users of tobacco were
also current users of electronic cigarettes.
When questioned by the National Youth
Tobacco Survey, the students who were
identified as having ever used electronic
cigarettes most commonly stated that this
was because the mechanisms were used by
either a friend or peer (39 percent) or because
they were available in some flavored form
including mint, candy, fruit, or chocolate
(31 percent).
Heath Effects OF Vaping
Although the preliminary studies on the
health effects of vaping are in their infancy,
some limited amount is known regarding
the potential for health effects. First of all,
several small studies have been performed

Who is Vaping?
As may be expected by the very technological nature of vaping itself, younger and
middle-aged populations tend to favor the
use of electronic cigarettes. Approximately
5.1 percent of persons aged 18 to 24, 4.7




in both animal and human models to look
at the physical and biochemical changes
produced by vaping itself on cells of the
airway. Typically, these studies focused on
examining the specific biochemical changes
produced in the cells lining the airway,
and they have been conducted using both
vaporizing products with and without the
presence of nicotine. However, the results
of these studies have been both mixed in
results as well as limited in interpretation
due to very small sample numbers.
Moving forward, more intensive studies
are required to definitively link the process
of vaping or the mechanisms of vaping
themselves to a possible increase in pathogenic or oncogenic risk. This is because,
although we have data to prove that there
are harmful effects on cardiovascular circulation with the administration of nicotine
to naïve patients, we have neither studied
the effects of this form of vaporized liquid
on the cardiopulmonary system nor studied
the utility of vaping for tobacco cessation.


Table of Contents for the Digital Edition of LP Spring 2018

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