Tobacco Prevention

Pulmonology

Public Health

Hospital-based Medicine

Environmental Health

Critical Care

Adolescent Medicine

Vaping and E-Cigarettes 2021: The Ongoing Health Risks During an EVALI Epidemic and Global Pandemic

Chair(s)

• SW

  Susan Walley, MD, CTTP, FAAP

  Professor of Pediatrics
  Pediatrics
  University of Alabama at Birmingham
  Birmingham, Alabama, United States

E-cigarette or vaping-associated lung injury (EVALI) has focused significant attention on the short-term health harms of electronic cigarettes and vaping devices (collectively referred to as e-cigarettes). E-cigarettes are battery-operated devices which produce an aerosolized mixture from a solution of solvents, flavoring chemicals, concentrated nicotine and other substances to be inhaled by the user. Specific additional health harms associated with e-cigarette use include nicotine addiction, transition to cigarette and marijuana use, increased cough, wheeze and asthma exacerbations (for those with asthma), seizures, increased risk for cardiovascular disease, relapse to tobacco use among former quitters and renormalization and glamorization of smoking and tobacco use. New products, emerging research, clinical recommendations and policy updates are developing at an extremely rapid pace – making it difficult for the practicing pediatrician to keep up.

Youth use of e-cigarettes is a public health crisis: In 2019, one in four high school students is a current e-cigarette user and the effect of the COVID-19 pandemic on youth use is unknown. Many factors may account for the rapid rise in popularity of new tobacco products, including aggressive youth-focused marketing and advertising, particularly by newer e-cigarette companies such as JUUL and Suorin. JUUL, the e-cigarette brand with the highest market share in the US (>70%) , contains a very high (59 mg/mL) nicotine concentration. Longitudinal data shows a concerning trajectory of youth transitioning from e-cigarettes to use of conventional cigarettes one year later, and more recent anecdotal reports of youth turning to combusted tobacco to help them quit vaping high nicotine devices. E-cigarette emissions (i.e. secondhand aerosol) contain harmful constituents such as volatile organic compounds, heavy metals and ultrafine particles, posing risks to non-users.

The panel of pediatricians presenting this session have been at the forefront of the American Academy of Pediatrics’ tobacco control efforts to craft clinician-facing policy statements, educate and inform government policies regarding all aspects of e-cigarettes. This symposium will highlight the most updated current scientific evidence on electronic cigarettes and their impact on youth tobacco use, potential youth health and public health effects. In addition, this presentation will address how the global pandemic may affect rates of youth e-cigarettre use and on how vaping may affect COVID outcomes. Current recommendation for helping youth with e-cigarette cessation will be reviewed, along with resources for prevention, refusal skills, opportunities for youth engagement, and currently available resources for teens and parents. Up to date information on regulations and legislation (and anticipated impact) will be reviewed, providing participants with information necessary for advocacy at local, state and federal levels. This session will have broad appeal given the importance of this topic to our adolescent populations and their families.

Presentations:

• 1:00 PM - 1:30 PM US CT

  Overview of Session and Background of E-cigarettes
  

  Presenter: Susan C. Walley, MD, CTTP, FAAP – University of Alabama at Birmingham
• 1:30 PM - 1:50 PM US CT

  EVALI (e-cigarette or vaping associated) lung injury case and other health effects
  

  Presenter: Rachel Boykan, MD, FAAP – Stony Brook University
• 1:50 PM - 2:10 PM US CT

  The Nicotine-Addicted Teen and Treatment Recommendations
  

  Presenter: Susanne Tanski, MD, MPH – Geisel School of Medicine at Dartmouth
• 2:10 PM - 2:30 PM US CT

  The Public Health Impact and the COVID-19 Pandemic
  

  Presenter: Judith Groner, MD – Nationwide Children's Hospital
• 2:30 PM - 3:30 PM US CT

  Break
  

  Presenter: Belinda Thomas
• 3:30 PM - 4:00 PM US CT

  Click for Live Q&A: Vaping and E-Cigarettes 2021: The Ongoing Health Risks During an EVALI Epidemic and Global Pandemic
  

  Presenter: Belinda Thomas