There are lots of things that we choose to do that are not good for us. However, in many cases, we have the opportunity to make an informed decision about the potential harm versus benefit profile involved. Then, we have the free will to make our own decisions based on our desires and perceived risks.

The use of tobacco products is a great example of this process. Even though I am now a senior citizen, it has been clear since I was a child that tobacco has a negative effect on the health of everyone who uses it. Still, some people believe there is enough positive effect to cause them to spend their money and their health on tobacco.

On the other hand, many people who would use or have used tobacco products have recently chosen to switch to inhaling heated vapor (vaping) because it has been presented as a “healthier” alternative to tobacco. It is also easier to conceal in settings where smoking is prohibited. The battery-powered devices (electronic cigarettes or e-cigarettes) feature a heating element that turns liquid containing nicotine and/or flavorings and/or other drugs into a cloud of vapor that users inhale.

Researchers recently examined data on smoking and vaping by youth in Canada, England and the U.S. and found that between 2017 and 2018, the proportion of 16- to 19-year-olds who reported vaping in the past 30 days rose by almost 50% in the U.S., and nearly doubled in Canada, while remaining relatively constant in England.

In 2018, new vaping technology started to take over the market. The vapor has a different chemistry that allows delivery of very high levels of nicotine, similar to regular smoked cigarettes. However, England has set maximum limits on nicotine concentrate, which cuts the nicotine level in half compared to the same brands sold in Canada and the U.S. Also, England has more strict rules on advertising of e-cigarettes than the other two countries.

Many people think vaping is not harmful and many are unaware of the nicotine levels in the current generation of products. Everyone, young and old, should know that these products can produce addiction and may have long term health risks from exposing the lungs to chemicals from e-cigarettes.

In a statement from the folks who make a vaping product called JUUL, they said, “We don’t want any non-nicotine user to use our products, especially youth.” “We have taken aggressive action in both the U.S. and Canada to combat underage usage of our products while preserving the opportunity for adult smokers to switch from combustible cigarettes.”

Still, parents should talk to children and teens about the dangers of smoking and vaping. Parents should explain that vaping products are for adult smokers trying to quit, not teenagers who have never smoked. Teenagers’ brains are more susceptible to nicotine addiction and most nicotine addiction, regardless of product, begins in the teen years. So, those who use e-cigarettes may be setting the stage for long-standing, or even lifetime, addiction.

Last month, the first death potentially linked to e-cigarette use was reported by the Illinois Department of Public Health and U.S. Centers for Disease Control and Prevention (CDC).

The CDC also said that there have been nearly 200 potential cases of severe lung disease reported in 22 states that could have been caused by e-cigarettes and vaping. The cases have been primarily among teens and young adults.

In many cases, patients reported a gradual start of symptoms, including breathing difficulty, shortness of breath, and/or chest pain before hospitalization. Some patients reported mild to moderate gastrointestinal illness (including vomiting and diarrhea) as well as fatigue.

It was not thought that an infectious disease was the principal cause of the severe lung illness. But further investigation is ongoing.

Many patients also said they had recently used tetrahydrocannabinol (THC)-containing products, although there was no specific product in common among all cases, nor was any product conclusively linked to the illnesses.

However, according to the American Association of Poison Control Centers, U.S. Poison Control Centers have managed about 2,500 exposure cases related to e-cigarette devices and liquid nicotine this year.

This is not harmless water vapor. Research has suggested that vaping can change lung function. The U.S. Surgeon General and the National Academies of Science, Engineering, and Medicine have concluded that e-cigarettes contain and emit potentially toxic substances.

Aside from lung side effects, the U.S. Food and Drug Administration (FDA) is investigating a possible link between e-cigarettes and seizures or other neurologic symptoms. The FDA posted an initial warning in April and has now received 127 reports of seizure or other neurologic symptoms among e-cigarette users.

While I know that testing limits and risky behavior has always been part of life, I hope that this information helps you to understand that vaping is in that category of risky behavior and that your money will be better spent elsewhere.

Dr. Terry Gaff is a physician in northeast Indiana. Contact him at or on Facebook. To read past columns and to post comments go to

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