Once touted as a safer alternative to smoking, vaping has come under increased scrutiny, particularly as reports of lung illnesses potentially linked to the practice have surged throughout both the U.S. and Minnesota.
E-cigarettes (and similar products, known as vapes, vape pens/sticks, dab pens and e-hookahs) are battery-powered devices that allow users to inhale the vapor of a heated liquid, which typically contains nicotine, flavoring and other chemicals.
Because vaping does not involve inhaling smoke from burned tobacco leaves, it has typically been assumed to be safer than smoking traditional cigarettes. But as the steady stream of recent reports of acute lung disease among regular vapers suggests, “safer” and “risk-free” are not synonymous.
As of Oct. 1, the U.S. Centers for Disease Control and Prevention had confirmed 1,080 lung injury cases associated with vaping nationwide, including 18 deaths—one of which took place in Minnesota. The Minnesota Department of Health (MDH) has reported 55 confirmed or probable cases of severe lung injuries tied to vaping.
“The cases of severe lung injuries in Minnesota and other states show how dangerous vaping can be,” Minnesota Health Commissioner Jan Malcolm said. She also said that health officials are working “aggressively” to gather information and determine the precise cause of such lung injuries.
“One death from this outbreak is one death too many. We are working with partners around the state and the nation to find out everything we can as quickly as we can to prevent additional illnesses and death,” Malcolm said.
Youth vaping rates surge
After a decades-long decline, youth tobacco use is up across the country, and survey after survey says that the prevalence of e-cigarettes and vaping are to blame.
The most recent National Youth Tobacco Survey found that almost 5 million youth reported using any tobacco product within the last year, and 3.6 million of those youth reported using e-cigarettes, easily making them the most popular product among high school and middle school students.
Minnesota isn't immune from these trends, either. According to the 2019 Minnesota Student Survey, one in four 11th graders in Minnesota reported using an e-cigarette in the past 30 days. That represents a 54% increase from 2016's survey, in which 17% of the state's 11th graders reported vaping.
The survey likewise found that Minnesota youth are ill-informed about the health risks that e-cigarettes pose. According to the MDH, 76% of 11th graders survey said that there is “either no, slight, or a moderate risk to using e-cigarettes.” However, as most e-cigarettes contain nicotine, which is highly addictive, vaping can lead to nicotine addiction, particularly among youth and young adults, whose brains are not yet fully developed.
“No amount of nicotine is safe for children, and evidence suggests that nicotine interferes with brain maturation and can have long-term effects on cognitive development and mental health,” said Melissa Mady of Tobacco-Free Alliance Minnesota, which recently held workshops in partnership with HealthPartners' White Bear Lake clinic to educate parents and teens on the dangers of vaping.
In addition to nicotine, Mady said, e-cigarette vapor can also contain carcinogenic chemicals, heavy metals and ultra-fine particles that can be inhaled deeply into the lungs. “E-cigarette aerosol generally contains fewer harmful chemicals than regular cigarettes; however, safer doesn't mean safe,” she said.
Because e-cigarettes have only been in the U.S. market for about a decade, there is little conclusive research on the dangers posed by long-term use, especially when compared to the dangers posed by traditional cigarettes, which have been studied extensively. Mady said that imbalance is a major factor in the assumption that e-cigarettes are safe.
“We just don't know if they are as dangerous as cigarettes because (they) are still being studied,” she said. “However, we do know there are chemicals and addictive properties that are dangerous.”
Leaders respond to 'public health crisis'
The surge in youth vaping rates worry local leaders, and concerns about vaping's health risks have prompted many cities and counties to pass Tobacco 21 legislation, which raises the minimum legal age for tobacco and nicotine sales from 18 to 21. ClearWay Minnesota, a nonprofit focused on tobacco cessation, reports that approximately 40 Minnesotan cities and counties have enacted such policies.
Within the northeast metro, Forest Lake is the most recent municipality to do so, joining nearby Arden Hills, Mounds View, North Oaks, Roseville and Shoreview in taking extra steps to restrict youth access to vaping products. However, the effectiveness of such policies is mitigated by the lack of similar restrictions in neighboring communities.
“Vaping is a public health crisis for young Minnesotans, and it is critical that we act now to bring the rate down. As a teacher and as a father, I know the first step is making sure our young people understand the risks,” said Gov. Tim Walz in a statement.
Walz has directed state health and education commissioners to work on an outreach campaign targeted at raising awareness of vaping's risk among students, families and school officials. Likewise, he has directed his administration to determine a set of policy options to combat the youth vaping epidemic. Such options include raising the statewide tobacco age to 21 as 18 other states have already done, prohibiting the internet sale of tobacco and related products and banning the sale of all flavored and nicotine products.
“Our goal must be to make sure young people and the adults in their lives have the information, support and resources to fight back against those profiting at the expense of our children's health and well-being,” Walz said.