AHA: Vaping causes CV, respiratory adverse effects; action needed to curb teen use
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Evidence suggests vaping causes adverse CV and respiratory effects, so action must be taken to reduce or prevent access to e-cigarettes to adolescents, according to an American Heart Association scientific statement.
The scientific statement, published in Circulation Research, was undertaken because “The use of vaping products in adolescents is on the rise, and this demographic is the overwhelming majority of users,” Loren E. Wold, PhD, FAHA, associate dean for research operations and compliance in the College of Medicine and professor of physiology and cell biology at The Ohio State University and chair of the writing group for the statement, told Healio. “However, there are limited data on the long-term effects on adolescents that vape, in particular the effects on the heart and lungs.”
E-cigarettes did not become available until the early 2000s; there are not yet any long-term epidemiological studies on their use, so the group’s task was to review current evidence of CV and respiratory effects of vaping in adolescents, the authors wrote.
“Vaping can have dramatic effects on many organ systems, including the heart and lungs. However, the effects in adolescents are understudied,” Wold told Healio. “As the major users of vaping products, most adolescents are ‘novice’ users, meaning they have not smoked combustible cigarettes in the past. Therefore, the information that is available on organ-specific effects of vaping is limited. The evidence reviewed in the statement suggests that adolescents that begin vaping are setting themselves up for later-life heart and lung disease. However, there is now evidence that cessation of vaping can revert some of the damage done later in life.”
Consequences for lungs and heart
Because lung development is not complete in adolescence, vaping during the teen years can compromise it, Wold and colleagues wrote.
“The long-term consequences are not yet confirmed, but available studies indicate that humans who vape during their adolescent years will likely have lower lung function and thus will become symptomatic at a lower threshold with any additional insult such as asthma, chronic obstructive pulmonary disease, pneumonia or interstitial lung disease,” they wrote.
While long-term studies have confirmed conventional tobacco smoking in adolescence confers risk for atherosclerosis, heart disease and stroke, similar studies have not been performed for vape use. However, “evidence of systemic inflammation and endothelial dysfunction (decreased nitric oxide production) similar to that seen in smokers points toward possible increased CVD in vapers,” Wold and colleagues wrote. “In addition, changes in vascular stiffness and blood pressure and heart rate support the likelihood of increased CVD once adolescent vapers are middle-aged or beyond.”
Vaping also appears to negatively impact sleep quality and mental health and to foster addiction, they wrote.
Preclinical research has helped the medical community understand the risks of vaping in adolescents, and that will need to continue, according to Wold.
“It is very difficult to study this demographic, as they are engaging in an activity that is not legal, and most parents would not give consent to have their children be part of a clinical study,” he told Healio. “Therefore, the use of preclinical models allows us to simulate what will happen long-term if adolescents continue vaping.”
Legal, regulatory actions to take
The statement calls for reducing youth access to e-cigarettes, making e-cigarettes part of smoke-free air laws, removing flavored e-cigarettes from the market and tightening regulations on their marketing.
“New policies must be enacted to ensure that adolescents are not able to gain access to vaping products,” Wold told Healio. “In addition, new laws should be put into place to ensure that a ban on indoor smoking includes vaping. Education is also needed to ensure that everyone understands the long-term implications of vaping.”
For more information:
Loren E. Wold, PhD, FAHA, can be reached at loren.wold@osumc.edu.
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