The editorial, “Electronic Nicotine Delivery Systems: Recommendations to Regulate Their Use,” emerged from a 2018 Policy Statement that Mamudu, a member of the Department of Health Services Management and Policy in the ETSU College of Public Health, and others wrote for the American Public Health Association.
Dr. Timothy Sanborn with the Medical College of Wisconsin and Dr. Page Dobbs with the University of Oklahoma, Norman are co-authors.
The risks of vaping have become a major news item in the past few months, with the Tennessee Department of Health reporting 76 lung injury cases associated with e-cigarette use or vaping as of Dec. 26, 2019. Sixty-four of the 76 cases have required hospitalization, and two deaths in Tennessee have been confirmed as of Dec. 26.
“Vaping is a public health crisis,” said Mamudu. “It is more of a crisis among youth and adolescents, where the prevalence of e-cigarette use is significantly higher. We have seen an uptick of use among middle and high school youth. Vaping among middle and high school students has surpassed conventional combustible cigarettes.
“In our study involving high school students in this region, about 11% of the students vaped, compared to about 8% who smoke cigarettes. About one in three of the students reported vaping before. For many of these youth who may otherwise not have smoked, vaping is a gateway to cigarette smoking.”
Of the TDH cases of reported lung injury to date, 81% of the patients are under the age of 35.
Mamudu points out that just 10 milliliters of e-liquid is equivalent to five packs of cigarettes. Second-hand inhalation of vaping smoke is also proven dangerous, he added.
“A growing body of evidence has demonstrated both the immediate and long-term damage caused by the use of and exposure to electronic nicotine delivery systems, such as potential damage to neurons in the prefrontal cortex and reduction in cell size or quantity within the cerebral cortex and hippocampus (a complex brain structure that has a major role in memory),” Mamudu said.
The editorial makes recommendations to policymakers at federal, state and local levels. It also recommends that health educators provide potential users with actual risk information, as opposed to “relative risk” information related to traditional cigarettes.
Mamudu and his co-authors list policy recommendations and further note that current projections predict more lives will be lost through electronic nicotine delivery systems than saved from those who quit smoking.
“It is imperative that the country have a rapid and timely regulatory approach to assure the safety of those who use these products,” Mamudu said.