AHA Urges Immediate Action to Curb Vaping Among Youth

Action is needed now to reduce or prevent adolescent access to and use of electronic cigarettes, the American Heart Association (AHA) concludes in a new scientific statement.

Since their introduction to the US market in the early 2000s, e-cigarettes have become increasingly popular among adolescents.

Current scientific evidence indicates that using these vapor products has adverse health effects that may increase over time, leading to an increased risk of cardiovascular and lung disease in long-term users, the writing group says.

“Inhaling a foreign substance can have effects on the respiratory and cardiovascular systems,” said President Loren E. Wold, PhD, Ohio State University College of Medicine, Columbus, in an AHA news release.

“In addition, a person’s lung development continues into their early 20s, so adolescents who vape are at risk of impeding or altering their lung development and may not achieve full lung function,” adds Wold.

The AHA statement on the cardiopulmonary effects of vaping in adolescents was published online June 21 in Circulation study

Multiple hazards, lack of regulation

Previous work has shown that vaping increases the risk of multiple respiratory problems, including wheezing and coughing, asthma, increased susceptibility to lung infections and respiratory disease, the writing group says.

Studies in young adult vapers show acute hemodynamic changes, including increased arterial stiffness, decreased endothelial function, and increased blood pressure, heart rate and sympathetic tone. Long-term use of e-cigarettes is also associated with increased arterial stiffness and sympathetic tone.

The writing group acknowledges that most studies on the adverse health effects of vaping have been conducted in adults and animals.

“It is imperative that we determine the short- and long-term adverse effects of vaping in adolescence, as it is likely that health effects will be seen many years into the future,” they write.

For now, however, the evidence is enough to prompt the AHA to advocate for greater regulation of e-cigarettes among adolescents.

The novelty and customisability of e-cigarettes, including power levels, e-liquid content and the abundance of flavors “attracts young people, and it also makes it difficult to regulate these products,” Wold says.

Although the United States Food and Drug Administration (FDA) has banned the mint and fruit flavors of e-liquids that are popular with adolescents, menthol-flavored products remain on the market.

In addition, there are currently no limits on the allowable nicotine concentration in e-liquids in the United States. Some devices have been shown to have a nicotine level of 59mg/ml, while the European Union limits the nicotine concentration in e-liquids to no higher than 20mg/ml, which is comparable to the nicotine level in one standard (combustible) cigarette.

Key actions recommended by the AHA to help reduce or prevent youth e-cigarette use include:

  • Implement better measures to reduce young people’s access to e-cigarettes, including strict age verification at the point of sale and bans on marketing to young people.

  • Educate young people and their parents about the confirmed and potential health risks of e-cigarette use.

  • Develop vaping curricula for medical students to educate the next generation of healthcare professionals.

  • Make sure there are hospital-based programs to stop vaping for adolescents and adults.

  • Regulate the marketing of e-cigarette products on traditional, online and social media platforms that are popular among young people.

  • Include e-cigarettes in smoke-free air policies.

The Scientific Statement was prepared by the volunteer writing group on behalf of the AHA Council on Basic Cardiovascular Sciences; the Council for Arteriosclerosis, Thrombosis and Vascular Biology; the Hypertension Council; and the Stroke Council.

This research had no commercial funding. Members of the writing group did not declare any relevant financial relationships.

Circulation Res† Published online June 21, 2022. Summary

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