The American Academy of Pediatrics makes a strong call for e-cig regulation to protect children.

[pnwmom]

This is unrelated to the safety of e-cigs when used by adults. Clearly, e-cigs are safer for the adult user than cigarettes. This is about protecting children and teens and their developing brains from the effects of nicotine.

The Academy’s statement primarily uses the term “e-cigarette” below but includes all “electronic nicotine delivery services” in its recommendation, including vape pens.

http://www.nytimes.com/2015/09/08/opinion/calls-for-stronger-regulation-of-e-cigarettes.html?mabReward=wR4&action=click&pgtype=Homepage®ion=CColumn&module=Recommendation&src=rechp&WT.nav=RecEngine

As a pediatrician, I couldn’t agree more about the urgent need for strong regulations to protect young people from e-cigarettes and other electronic nicotine delivery devices.

Use of e-cigarettes has risen dramatically among middle school and high school students in this country; recent data show that more teenagers use e-cigarettes than any other tobacco product. The nicotine in these products is highly addictive and toxic, and studies have shown that nicotine exposure during adolescence has longstanding harmful effects on the brain, including cell damage and both immediate and persistent behavior changes.

We also know that teenagers who try e-cigarettes are more likely to begin smoking and become addicted to traditional cigarettes. Secondhand e-cigarette vapor is not benign — it harms lung growth and function — and results in measurable nicotine exposure.

Today, in the absence of strong regulations for all tobacco products, teenagers are exposed to relentless and insidious advertising for e-cigarettes, which glamorizes their use. The American Academy of Pediatrics urges strong restrictions on marketing e-cigarettes to youths similar to those that were imposed on traditional tobacco products decades ago.

Flavors should be banned. Children and other nonsmokers should be protected from e-cigarettes’ toxic vapors. And childproof packaging should be required to protect curious children from exposure to the highly concentrated liquid nicotine, which can cause serious injuries and death.

KAREN REMLEY
Executive Director
American Academy of Pediatrics
Elk Grove Village, Ill.

[scarletwoman]

1. I want to see the study that determined that e-cig vapor "harms lung growth and function".

Seriously.

I'm all for making e-cigs unavailable to non-adults, and childproof packaging for e-cig liquids. I just get suspicious over some of these claims of harms, with never a citation to an actual study done that actually proves that those harms exist.

I certainly don't dispute that nicotime is addictive, I'd just really like to see some exact scientific proof of its negative effects beyond addiction.

I've long been suspicious that the crusade against e-cigs isn't so much based in proven harms, as it is in some old Puritan morality thing that simply can't stand granting people the right to chose using nicotine without the damage caused by smoking. Is being addicted to something that isn't otherwise harming you really that awful a thing?

Yes, I use e-cigs - it was the only way I was able to stop smoking cigarettes. I like nicotine, I like how it makes me feel. As long as I've stopped damaging my lungs with cigarettes, I don't see why I shouldn't continue to enjoy nicotine.

[pnwmom]

2. So you think the Academy made this all up? Seriously?

You really think nicotine wouldn't be harmful to developing brains, other than the obvious risk of addiction?

And that the Executive Director of the Academy is lying about the studies?

From the article:

"studies have shown that nicotine exposure during adolescence has longstanding harmful effects on the brain, including cell damage and both immediate and persistent behavior changes."


I think drugs like nicotine, pot, etc., should be legalized FOR ADULTS but regulated for children, who cannot give informed consent and are at greater risk because their bodies are still developing.

[scarletwoman]

3. I have no problem accepting that nicotine could be harmful to developing brains, it makes sense.

Although I wonder how much more harmful it is to the developing brain than, say, consuming massive amounts of sugar from drinking soda. Or consuming massive amounts of caffeine from "energy" drinks.

I simply suspect that nicotine has been given special status as a particularly demonic bête noire, when - divorced from the very real harms of cigarette smoking - it may not actually deserve it.

[pnwmom]

4. Sugar is food. Not a type of food we should eat a lot of, but it's food and can be converted

by the body to energy. Life could be supported for some time on a diet of sugar and water alone.

So it's not the same as nicotine, which is psychoactive and a toxin -- and not a food.

[scarletwoman]

5. Yes, nicotine is psychoactive. That's what makes it attractive to use.

My question is, how is it toxic? What bodily functions in a grown adult does it damage?

[pnwmom]

6. Why are you asking about adults? The OP is on the risks to developing brains

and bodies, not adult ones.

But here is some more info about risks. Were you aware, for instance, that nicotine can cause birth defects?

http://pubchem.ncbi.nlm.nih.gov/compound/nicotine#section=Top

Nicotine is a plant alkaloid, found in the tobacco plant, and addictive central nervous system (CNS) stimulant that causes either ganglionic stimulation in low doses or ganglionic blockage in high doses. Nicotine acts as an agonist at the nicotinic cholinergic receptors in the autonomic ganglia, at neuromuscular junctions, and in the adrenal medulla and the brain. Nicotine's CNS-stimulating activities may be mediated through the release of several neurotransmitters, including acetylcholine, beta-endorphin, dopamine, norepinephrine, serotonin, and ACTH. As a result, peripheral vasoconstriction, tachycardia, and elevated blood pressure may be observed with nicotine intake. This agent may also stimulate the chemoreceptor trigger zone, thereby inducing nausea and vomiting.




http://www.cdc.gov/niosh/ershdb/emergencyresponsecard_29750028.html

EFFECTS OF CHRONIC OR REPEATED EXPOSURE: Nicotine is a teratogen (capable of causing birth defects). Other developmental toxicity or reproductive toxicity risks are unknown. The information about nicotine as a carcinogen is inconclusive

[Nevernose]

7. I've NEVER seen a teenager smoke a nicotine-laced vape

Unless they already smoked. The others always vape non-nicotine "smoke," which is actually a thing.

Granted, that's entirely anecdotal, but I've known thousands of teenagers through my career as a teacher, and I specialize in the stoner kids who hang out on the corner and smoke. They are me twenty-five years ago . Kids don't graduate from non-nicotine to nicotine; they just don't. They do, however, use vapes to help quit smoking. Nicotine isn't great, but it's far better than cigarette smoke. As for the smoke from vapes (very few people use e-cigs)? Fog machine smoke. Same stuff that actors and dancers and theater techs and patrons get far, far more of in a single show than a vaper does in a day.

With all due respect for the AAP, they have an opinion with no evidence. It might very well be a valid opinion , but I view their statement more as a call for research than an actual position statement.

[pnwmom]

8. You specialize in "stoner kids who hang out on the corner and smoke."

Yes, they probably did start out with cigarettes.

However, the research shows that there are other teens who start with vape pens. Since they aren't "stoner kids" they might be starting with vape pens in the belief that they're safer. Which they are compared to cigarettes. But not compared to not smoking at all.

The CDC says that 1 in 5 middle school students who try a vape pen have never smoked a cigarette. That's not a negligible number.

http://www.cdc.gov/media/releases/2013/p0905-ecigarette-use.html

The findings from the National Youth Tobacco Survey, in today’s Morbidity and Mortality Weekly Report, show that the percentage of high school students who reported ever using an e-cigarette rose from 4.7 percent in 2011 to 10.0 percent in 2012. In the same time period, high school students using e-cigarettes within the past 30 days rose from 1.5 percent to 2.8 percent. Use also doubled among middle school students. Altogether, in 2012 more than 1.78 million middle and high school students nationwide had tried e-cigarettes.

"The increased use of e-cigarettes by teens is deeply troubling," said CDC Director Tom Frieden, M.D., M.P.H. "Nicotine is a highly addictive drug. Many teens who start with e-cigarettes may be condemned to struggling with a lifelong addiction to nicotine and conventional cigarettes."

The study also found that 76.3 percent of middle and high school students who used e-cigarettes within the past 30 days also smoked conventional cigarettes in the same period. In addition, 1 in 5 middle school students who reported ever using e-cigarettes say they have never tried conventional cigarettes. This raises concern that there may be young people for whom e-cigarettes could be an entry point to use of conventional tobacco products, including cigarettes.

“About 90 percent of all smokers begin smoking as teenagers,” said Tim McAfee, M.D., M.P.H., director of the CDC Office on Smoking and Health. “We must keep our youth from experimenting or using any tobacco product. These dramatic increases suggest that developing strategies to prevent marketing, sales, and use of e-cigarettes among youth is critical.”

[Nevernose]

9. Yes, there are other teens

I didn't deny that. One in five middle school vapers, according to your article. However, we don't know if they're smoking nicotine or non-nicotine vape pens. It's an important distinction, and one in which I'm convinced researchers haven't really considered. I'm convinced of this because I, personally, was shocked to discover how many of these kids were vaping non-nicotine "juice." So we don't really know how many middle schoolers are starting their addiction with vaporizers, nor do we know what percentage of those kids were likely to start anyway (which should actually be easy to figure out, given their parents' history, socio-economic status, neighborhood, race, etc.).

I hope that we can both agree that nicotine is the eff-ing devil and needs to go away ASAP. At best, it is unhealthy; more often than that, it is deadly. I'm just advocating for a less reactionary, more research-based approach.

If they're hanging out on the corner smoking, they count as stoner kids, whether they get stoned or not.