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home : columns : ask the doctors June 26, 2019

4/26/2019 7:50:00 AM
Vaping on the rise, but risks aren't known

Dear Doctor: My grandson is always carrying around a little device that he smokes like a cigarette. It puffs smoke just like one, too. I'm a former smoker, and my lungs aren't in great shape, so I'm worried. What is he using? Is it safe?

Dear Reader: Your grandson is vaping, which means he's inhaling an aerosol produced by the device you've seen him using. It's that aerosol, or vapor, that gives the practice its name. As for the specific type of device he's using, it's difficult to say without a clearer description. It's definitely not an e-cigarette; those look just like tobacco cigarettes, and you would have recognized it.

E-cigarettes were the vanguard of vaping devices and first made an appearance in this country in 2007. They quickly gave way to vape pens, which as the name suggests, are slim devices that resemble a ballpoint pen. Larger and bulkier in size are vape mods, which are modified (again, there's the root of the name) vape pens. These are known for their abundant vapor production. More recent to the marketplace is the JUUL, a small vaping device that's about the size of a USB drive.

Whatever the specific type of device (there are many), most use disposable pods or cartridges that hold a liquid, or e-liquid, typically propylene glycol or vegetable glycerin. These liquids can contain quite a few other compounds, but at this time, manufacturers are not required to divulge them.

When heated, the liquid produces the vapor that the user is inhaling and exhaling. Most e-liquids contain nicotine, along with flavorings such as strawberry, banana, chocolate or mint. The allure of those flavorings to young people has been particularly controversial, and the outcry has resulted in a number of actions at the state and federal levels to limit their availability.

In asking whether vaping is safe, you've touched on a roiling debate. The general consensus is that vaping is safer than smoking cigarettes. That's because rather than the tens of thousands of compounds produced in the burning of tobacco and its additives, many of them toxic, the number of ingredients in e-liquids is limited. However, many teens and young adults who would not otherwise have taken up smoking are finding the tech and the flavors of vaping so alluring that the practice has become widespread. It is estimated 20 percent of high school students and 5 percent of middle school students have used vaping devices, more than a third of them unaware that the product contains nicotine.

The fact is that nicotine poses a real health risk to young people, whose brains and bodies are still developing. Likewise, the effect of regularly inhaling vaporized glycerin and propylene glycol is not yet known. The practice of vaping is so new that we have to wait in real time for the results of studies into the long-term effects. So far, studies have linked vaping to hypertension, increased heart attack risk, slow wound healing, lung inflammation and increased likelihood of moving on to smoking tobacco. The Food and Drug Administration states vaping is not safe for young people. We wholeheartedly agree, and would go even further to end the sentence after the word "safe."

Eve Glazier, M.D., MBA, is an internist and associate professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and assistant professor of medicine at UCLA Health. Send your questions to, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.

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