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E-cigarettes: A Road to Many Dead ENDS

by Veronica Harrison

June 2021

Cigarettes and cigarette smoke: Both well-known for their negative impact on health. But what about vaping and the use of e-cigarettes? Though trendy, fun, and with a great fruity smell, vaping and e-cigarettes are equally a major health concern for North Dakota teens and young adults as are traditional cigarettes.

Understanding the negative health impact of e-cigarettes, also known as Electronic Nicotine Delivery Systems, or ENDS for short, starts with understanding how they work. The devices are battery-operated and include a filament that gets hot in order to turn the liquid inside a cartridge into a vapor that can be inhaled. Through a cascade of complicated chemical reactions that make the brain feel good, once inhaled the vapor mimics the feeling of smoking a traditional cigarette.

Further understanding of the risks of e-cigarettes and vaping comes from learning more about the vaping liquid ingredients. Vaping liquid ingredients can include artificial flavorings like blueberry, watermelon, or cotton candy. Additional ingredients, depending on brand, are metals, like tin and lead. Marijuana ingredients like tetrahydrocannabinol (THC) or cannabidiol (CBD) can also be delivered in newer types of ENDS. Once inhaled into the lungs, vapor ingredients move through the body's blood vessels and eventually reaches the brain.

It's important to note that nicotine is a main ingredient of vaping liquid. A popular brand used by many North Dakota teens and young adults is known to contain roughly the same amount of nicotine as a pack of cigarettes. Other brand devices contain an amount equal to consuming the nicotine present in an entire carton of cigarettes. Most cartridges, pods, or vials of vaping fluid contain enough nicotine to cause nicotine toxicity and potential death in children.

Perhaps some proof that e-cigarettes are trendy among North Dakota teens is that, according to the North Dakota State Health Department, well over half of North Dakota high school students have tried electronic cigarettes. According to another 2013-2014 survey, over 80% of young e-cigarette users did so because of “appealing flavors.” These facts have raised so much concern on a national level that the Food and Drug Administration has limited flavor choices.

Since ENDS have become so popular with teens and young adults, healthcare providers are raising an alert about several other concerns related to ENDS. First, e-cigarettes are so new their long-term effects are not known. Next, studies indicate that e-cigarette users are more likely to transition to traditional cigarettes. Reports also indicate that users are more prone to begin use of other drugs of addiction, like opioids. Additionally, experts are expressing concern that the varying amounts of metals found in vaping liquid, like tin and lead, may have negative side effects not yet completely understood. Finally, another concern is the potentially fatal condition related to vaping. EVALI, or E-cigarette or Vaping use Associated Lung Injury can result in severe, irreversible lung damage that can cause the user to essentially suffocate. Nearly 80% of victims of EVALI have been under the age of 35, the age group of many ENDS users.

Vaping and the use of e-cigarettes are just as harmful as traditional cigarettes. Their fruity or alluring smells might make them seem safe. In truth, they pose substantial health concerns for North Dakota youths. Current research shows that e-cigarettes could be more harmful than traditional cigarettes. The amount of nicotine that they can deliver in a short amount of time is not only powerfully addictive, it can also be highly toxic. With the unknown side effects of the heavy metal additives in addition to the poorly understood lung condition EVALI that currently lacks effective treatments, e-cigarettes should be avoided by teens and young adults. In short, there is a concerning path between vaping and potential death, creating an ironic link between the words “dead” and “ENDS” that should not be taken lightly. Members of the public who would like more information or want help to quit this habit can contact NDQuits at (800) QUIT-NOW.

This article also appeared in the July 18, 2021 issue of the The Jamestown Sun.

About the Author

Veronica HarrisonVeronica Harrison is a third-year medical student at the University of North Dakota School of Medicine & Health Sciences. She was selected as the Jamestown participant for the school's ROME program, or Rural Opportunities in Medical Education. The program includes teaching student doctors the importance of rural newspapers. As a future rural healthcare leader, Harrison has written this column to provide health information for her ROME community. The information is not for diagnosis or treatment and should not be used in place of previous medical advice provided by a licensed practitioner.