B. Jill McCabe, MD, Katie MacDonald, MSN, CPNP and Erin Rovelli, RN, BSN serve patients at the Children’s Emergency Room at Inova Loudoun Hospital – Loudoun County’s only emergency facility solely dedicated to caring for children and adolescents. It is also the county’s first and only sensory-friendly ER.

Katie is also a pediatric nurse practitioner for Inova Urgent Care. Specialized pediatric services are available at the Dulles South, Reston, Tyson’s Corner, and West Springfield urgent care locations.

~ Updated as of October 11, 2019.

Over the past decade, vaping and e-cigarettes have become incredibly popular. They are currently the most commonly used tobacco products among youth in our country. In 2018, more than 3.6 million youth – including one in five high school students and one in 20 middle school students – reported active use of e-cigarettes.

Vaping and e-cigarettes are not a safe alternative to cigarette smoking. As of October 8th, 1,299 cases of severe lung illness likely associated with e-cigarette products have been reported across the U.S. The Centers for Disease Control and Prevention (CDC) has linked eight deaths directly to e-cigarettes.  Most patients report a history of using THC-containing products. The latest national and regional findings suggest products containing THC play a role in the outbreak.

Here are answers to some commonly asked questions about this health epidemic:

What are e-cigarettes and what do they look like?

E-cigarettes are battery-powered smoking devices with liquid-filled cartridges that contain nicotine, popular flavors and other chemicals. The device heats the liquid into a vapor, which is then inhaled or “vaped.” E-cigarettes can also be used to smoke or “vape” marijuana, THC (the active ingredient in marijuana), herbs, waxes or oils. A bystander would not be able to tell the difference between THC and nicotine vaping.

Youth tend to use different words or slang when talking about e-cigarettes and vaping. “JUULing” is a popular word to describe a brand of e-cigarette. About one in four teens who use e-cigarettes has admitted to “dripping.” The user removes the mouthpiece and drips the liquid directly onto a heated coil. This allows the vapor to become thicker and stronger.

E-cigarette devices can resemble traditional tobacco products such as cigarettes, cigars or pipes. Or, they can look like common gadgets such as flashlights, USB flash drives or pens.

Example of ecigarette (or vaping) devices.

What are some of the other chemicals found in e-cigarettes?

Many e-cigarettes contain ultrafine particles that can be inhaled deep into the lungs. In addition to nicotine, the liquid-filled cartridges may contain chemicals such as antifreeze and heavy metals such as nickel, tin, chromium or lead. Diacetyl, a common flavoring, is a chemical linked to a serious disease, a form of bronchiolitis, commonly known as popcorn lung.

VIDEO: Watch our “Ask the Expert” presentation on youth vaping

What are some of the health effects of vaping?

Vaping is the inhalation of a vapor and chemicals created by an e-cigarette or other vaping device. 

Unfortunately, vaping has not been around long enough for us to know how it affects the body over time. However, health experts have linked serious lung damage – and even death – directly to vaping. It is important to note there is not one single product or ingredient identified as the cause of the most recent health problems and respiratory illnesses. 

Here’s what we do know and how vaping can drastically impact your child’s health:

  • The nicotine in e-cigarettes is highly addictive and can slow brain development. This can affect memory, concentration, learning, self-control, attention and mood. It will also increase your child’s risk for other types of addiction as an adult.
  • E-cigarettes can irritate the lungs, cause serious lung damage and even result in death. Second-hand smoke/vapor from e-cigarettes is also harmful to growing lungs.
  • Vaping and e-cigarettes can lead to the use of cigarettes and other forms of tobacco.
  • In some cases, e-cigarette devices have exploded, causing burns and fires.
  • Using e-cigarettes to smoke or “vape” marijuana, herbs, waxes or oils can alter your child’s thoughts, actions and feelings.
  • E-cigarette solutions can poison children and adults when consumed orally or through skin contact. Less than a half of a teaspoon of nicotine can kill a child. Symptoms of nicotine poisoning include sweating, dizziness, vomiting, increased heart rate, lethargy, seizures and difficulty breathing. Calls to poison control centers related to e-cigarette devices have skyrocketed over the past five years.

As a parent, how can I fight the e-cigarette epidemic?

You play one of the most important roles in addressing this public health epidemic. Here are some ways you can help:

  1. Know the facts. Equip yourself with credible information about e-cigarettes and the associated health risks.
  2. Set a positive example by being tobacco free. Adopt tobacco-free rules and a zero-tolerance policy. If you use tobacco, it is never too late to quit. Free help is available by visiting smokefree.gov or calling 1.800.QUIT.NOW.
  3. Start talking to children and teens early about why e-cigarettes, including JUUL, are harmful. Explain the facts. Here are some helpful tips to remember:
    • Be patient and ready to listen.
    • Avoid lecturing and criticism.
    • Strive to have a two-way conversation and encourage open dialogue. Ask your child to share feelings about certain scenarios involving e-cigarettes.
    • Find the right moment. A natural discussion will increase the likelihood your child will listen.
    • Answer your child’s questions. Be honest and factual.
    • Remember, the conversation can be ongoing and take place over time.
  4. Ask for support. Healthcare providers and other trusted adults, such as relatives, teachers, coaches and counselors, can help reinforce the message.
  5. Continue to have follow-up conversations with your child. Encourage questions as more information becomes known. 


woman reading articles on laptop

STARKID TIPS BLOG: Read more posts from Inova’s pediatric emergency medicine blog and sign up at inovachildrens.org/starkid-blog

1 Comment

  1. Brandie on October 26, 2019 at 7:57 am

    This reads more like an opinion piece from an activist organization vs. someone taking the time to actually do thoughtful research before publishing. This is ill-informed, conflates several issues, and in some cases is fear-mongering. E-cigarettes, when properly regulated, are less harmful than combustible tobacco products (ask Public Health England). Further, people who are dying are using oils and THC–not properly manufactured e-cigarettes.

    It is a sad day indeed if when articles like this are seen as facts, pushing people back to cigarettes.

Leave a Comment