Inova pediatric lung specialist cites ‘epidemic’ use of e-cigarettes among youth


As national reports continue to roll in of mysterious and severe “vaping illnesses” affecting hundreds of younger Americans who’ve used e-cigarettes, Inova’s Sunil Kapoor, MD, shares his views as part of the collective sense of alarm.

Dr. Kapoor, Chief of Pediatric Pulmonology and Medical Director of the Pediatric Lung and Allergy Center, thinks it’s only a matter of time before he sees a vaping-related case of severe lung illness among his patients. Already, several teen patients of Dr. Kapoor’s whose asthma was previously well-controlled have experienced deterioration in their lung health due to vaping.

As of mid-October 2019, 1,299 cases of “vaping illness”— and 29 deaths — had been documented in 48 states, including Virginia, according to the Centers for Disease Control and Prevention (CDC). Most of these patients are under age 30, a group particularly susceptible to using e-cigarettes laden with nicotine or marijuana-derived CBD or THC oils. Locally, four seniors at Chantilly High School have recognized the dangerous impact of vaping, and have formed ‘Teens Against Vaping’ to educate their peers and encourage them to quit. 

In the Question & Answer below, Dr. Kapoor explains the dangers of teen vaping and how parents can discourage their children from using e-cigarettes.

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

Q: You’ve said that teen vaping has crossed the line from fad to epidemic. What’s happening in Northern Virginia? 

A: I’m not the only one who sees teen vaping as an epidemic. The American Academy of Pediatrics has also described it this way. With 3.5 million to 4 million adolescents having vaped, this is a public health threat that’s significantly increasing. In Virginia, extrapolating from national numbers, it’s estimated that at least 20% to 25% of teens vape. Some estimates say 40% of kids have experienced vaping before graduating from high school, which I think is terribly frightening. I would expect these numbers to be even higher in Northern Virginia related to our socioeconomics and because access to these devices is higher in this area, compared to others.

Q: What are the symptoms of lung illness due to vaping? How does e-cigarette use cause these symptoms? 

A: If a patient is seeing me, it’s because they have a history of or a more chronic respiratory condition, such as allergies, asthma or chronic cough. In young vapers, I’ve seen increased coughing and wheezing, an increase in the use of rescue medications such as albuterol, and decreased tolerance to exercise. More severe lung illness from vaping can include nausea, vomiting and light-headedness, but it’s mainly chest tightness and coughing that progresses to lower oxygen levels and severe respiratory distress. No one really knows yet why these cases of severe lung illness are accelerating. A clear cause-and-effect hasn’t been discovered yet.

Q: What are the long-term dangers of teen vaping?

A: Because e-cigarettes have only been around for 10 years or so, there is no long-term data yet. While there is a clear association in some individuals to acute severe lung disease, we don’t know what the long-term sequela is of that yet. There have been reports of readmission to the hospital after recovery from the acute episode, but we still don’t know what degree of long-term lung damage can occur with vaping — even in the absence of the severe presentations. What scares me is, if I know there can be this rapid progression of respiratory distress leading to death, and that’s a short-term risk, then what happens four or five years down the road?

Q: What can parents and other adults do to discourage teens from vaping in the first place?

A: First, model the desired behavior. The biggest predictive factor of teen smoking is a parent who smokes, so having the right example is huge. Make sure to also discuss the dangers. Seeing these episodes of more extreme lung illness from vaping all over the news can be a lot more powerful to a teen than telling them if they keep vaping for 10 more years, they might damage their health. 

For more information on the health effects of vaping, visit Inova’s Children’s Health resource page on e-cigarettes.

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