Vaping’s popcorn lung predicament

UCT recently reported that vaping by young South Africans is on the rise. The University of Cape Town Lung Institute found close to 7 000 local learners vape, starting as early as grade 9.

E-cigarettes can contain nicotine, which is known to impact adolescent brain development and serve as a gateway drug to more “severe” substances. The tobacco industry uses tactics to “ensnare” youth early for a “lifetime of profit”, according to the World Health Organisation (WHO). E-cigarettes form a big part of these measures and have long-term implications on young people’s health.

The WHO reported that, globally, children are using e-cigarettes far more than adults, with 37 million young people (aged 13-15) estimated to use tobacco worldwide. Dr Yusrah Parker, Medical Doctor at Sanlam, says vaping means inhaling a vapour via an electronic cigarette. The liquid can contain nicotine, a marijuana distillate or oil. The long-term impacts of vaping are still being determined; however, nicotine is linked to cancer, attention and mood disorders, and fertility issues.

“Starting vaping early can lead to a lifetime of addiction to nicotine and other substances. Second-hand exposure by bystanders is also an often-overlooked complication, as the exhaled aerosol clouds have cancer-linked chemicals, which put other people at risk.”

Long-term health consequences of vaping

• Irreversible lung damage: Vaping can lead to acute respiratory failure, “popcorn lung”, and cancer.
• Oral health issues:  Irreversible damage to gums and tissues supporting the teeth.
• Adolescent brain development:  Nicotine exposure can cause learning disorders, mental health issues, and adversely affect brain development.
• Addictive compounds:  Mentholated vaping products are more addictive, reducing testosterone levels and impacting fertility. Nicotine causes vasoconstriction, which can result in erectile dysfunction.

The Heart & Stroke Foundation South African also referenced a recent study showing that vaping impacts the gene expression of 358 genes that fight viruses and bacteria; in contrast, smoking impacts 53 of these. The long-term implications of this are unknown.

The Heart Foundation additionally stressed that vape juices contain solvents and metallic particles that are likely to form aldehydes when heated – aldehydes are known to cause cancer.

Parker emphasises that while short-term complications of vaping are documented, the long-term effects remain uncertain and could take decades to fully understand, similar to tobacco smoking.

Vaping as a gateway drug

Dr Parker says: “Vaping meets the classification of a ‘gateway drug’, with studies indicating that youths who vape are 3.5 times more likely to start smoking cigarettes within two years. Nicotine, which is highly addictive, is particularly harmful to the developing adolescent brain, making them susceptible to habit-forming behaviours. Furthermore, vaping is often associated with the use of other substances, such as alcohol and opiates.”

The societal costs

The societal costs of vaping are substantial, affecting healthcare expenditure, productivity, and mortality rates:

• Chronic diseases:  New research suggests that vaping is linked to chronic lung disease, asthma, cardiovascular disease, seizures, strokes, and cancer.
• Mental health:  Mental health disorders are common in vapers, especially the younger generation with developing brains. Conditions such as depression, anxiety, ADHD, irrational behaviour, PTSD, and traits of impulsivity are common. 
• Less risk protection:  From an insurance perspective, vapers are rated similarly to smokers, facing premiums two to four times higher than non-smokers. Additional substance use, or existing medical conditions, can further increase premiums or result in cover being declined. This could exacerbate the nation’s existing insurance gap crisis. 
• Productivity loss:  Chronic illnesses result in decreased workplace productivity due to prolonged sick leave.
• Premature death: Acute and chronic respiratory diseases can lead to premature deaths, compounding the public health crisis.

Helping young people quit vaping

Families play a vital role in helping young people quit vaping. Dr Parker advises:

• Open dialogue:  Discuss the risks of vaping and dispel the myth that it is safer than smoking.
• Education on effects: Explain both short-term and long-term health consequences.
• Role modelling:  Parents who smoke should consider quitting alongside their children to set a positive example.
• Legal awareness: New South African laws prohibit the sale of e-liquids and devices to those under 18. Ensure compliance and educate children on these regulations.
• Support systems: Seek help from healthcare providers and local resources dedicated to smoking cessation. Be patient and supportive, understanding that quitting is challenging, and withdrawal symptoms are likely.

Parker concludes: “Vaping presents a significant threat to the health and well-being of young people, acting as a gateway to nicotine addiction and, potentially, more dangerous substances. It’s imperative to raise awareness about these dangers and support efforts to curb this growing epidemic. Sanlam is committed to empowering young people to lead full, fulfilled lives of confidence and financial security. A lifetime addiction to nicotine is costly in terms of mental, physical, and financial health.”

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