Senior Physicians Speaker Series : An Update on Vaping and E-cigarette Use Among Youth
Dr . Sam Yared , Senior Physicians Speaker Series Chair , introduced Dr . Michael Bricken on Tuesday , August 6 . Dr . Bricken is a pediatrician at East Louisville Pediatrics and completed both his medical degree and his residency at the University of Louisville . He also serves with the American Academy of Pediatrics Chapter 4 as the “ E-cigarette Chapter Champion ” and is an educational resource for the chapter on all things vaping .
There are many types of e-cigarettes , but all consist of heating an e-liquid inside the device , which creates an aerosol – not a vapor , as many might think – that is inhaled into the body and out into the air . One of the big concerns with aerosol delivery is that it can be highly variable due to different thermal degradation byproducts and different aerosols . For example , a low concentration nicotine product that is highly aerosolized can actually equal high nicotine content . In some cases , teens are learning how to “ hack ” their devices , making potentially dangerous modifications to save money , change flavors or nicotine content , or add cannabis . A recent study from the Yale School of Medicine shows that about 1 in 4 kids has tried some kind of modification to an electronic nicotine delivery device , and at least half were at least aware that it could be done .
One of the most impactful reasons teens are trying e-cigarettes is targeted marketing that depicts them as appealing and less harmful than regular cigarettes . Dr . Bricken compared side-by-side advertisements of today ’ s e-cigarettes to those from decades ago showing combustible cigarettes – a near carbon copy .
Social media ads for e-cigarettes are also very prevalent , with messages being delivered to them from influencers and manufacturers , right into the palms of their hands . A recent study shows that while in 2019 , Instagram banned influencers from promoting “ vaping ” products , now in 2024 , more than two-thirds of sponsored Instagram posts featuring electronic nicotine delivery systems ( ENDS ) promoted their use in a positive way . About two-thirds of those posts did not contain any warning about age restrictions or the potential of nicotine addiction , which violates FDA regulations . A study from May showed that there was a link between high social media use and increased smoking and vaping among youth . Individuals who spent at least seven hours per day on social media had a 2.5x higher likelihood of utilizing these items than those who did not .
Another major reason that e-cigarettes are so popular are flavor 28 LOUISVILLE MEDICINE by KATHRYN VANCE
options , with 31 % of teens reporting that flavors are the primary reason they use the products . Many flavors are made to invoke nostalgia and entice teens , such as Nilla Wafers , Warheads sour candy , juice boxes and Pocky sticks .
Dr . Bricken sees many patients in his practice use e-cigarettes as self-medication for an underlying problem like anxiety . While the most common reason U . S . middle and high school students gave for trying an e-cigarette was that a friend used them , the most common reason for continuing to use them was to treat anxiety , stress or depression .
The 2023 National Youth Tobacco Survey showed that 7.7 % of students ( 2.13 million ) reported current use of e-cigarettes . More than 1 in 4 current youth e-cigarette users use an e-cigarette product every day , and more than 1 in 3 e-cigarette users report using e-cigarettes at least 20 of the last 30 days . In Kentucky , despite Tobacco 21 laws , 23.6 % of kids report being sold nicotine products directly from stores . An additional 61.5 % reported that they borrow these products from someone likely too young to have been legally sold these products .
While there is evidence that shows that completely switching to e-cigarettes from cigarettes reduces exposures to toxicants and carcinogens , there are still concerns with inhalation of ultrafine particles deep into the lung , exposure to heavy metals and exposure to volatile organic compounds . A 2024 study from the Emory University School of Nursing showed that children exposed to secondhand e-cigarette aerosols showed significantly higher levels of metabolites linked to chemicals found in e-cigarette liquids compared to unexposed peers , causing a disruption in dopamine levels , inflammation and oxidative stress . One of the most concerning discoveries in the study was a focus group that revealed more than half of parents considered vaping around children a minor concern or no concern at all .
Put simply , Dr . Bricken said , “ A safer alternative does not equate to safety .”
This is a summary of the Senior Physicians Speaker Series presentation . For a link to view the full presentation , please email foundation @ glms . org .
Kathryn Vance is the Communications and Event Coordinator at the Greater Louisville Medical Society .