COVID-19 pandemic has raised new questions about vaping

MILWAUKEE – Before COVID-19 was in the spotlight, Wisconsin was concerned about a different public health crisis affecting people’s lungs.

As e-cigarette use skyrockets among young people, a host of mysterious – and sometimes fatal – lung diseases linked to vaping triggered alarms. Milwaukee officials have urged everyone in town to stop vaping immediately; state health officials have called teenage vaping aepidemic. “

But soon that public health fear was spooked – by a pandemic that infected hundreds of thousands of Wisconsinians.

“People aren’t thinking about smoking and vaping right now,” said Dr. Megan Piper of UW-Madison, associate director of research at Tobacco Research and Intervention Center. “People are thinking of the pandemic. “

Still, some Wisconsinians are working hard to ensure that education and research on vaping doesn’t go away, even though they are no longer the biggest public health issue.

And the pandemic has only added to the list of questions about vaping – like how blockages will affect trends in e-cigarette use, and whether a history of vaping puts people at greater risk of harm. infection like COVID-19.

“Everything in the health care system has become very focused on treating COVID,” Piper said. But in the future, she said, “I hope cigarettes and e-cigarette use will be back on the preventive health agenda.”

The state of vaping

As the pandemic began, e-cigarette use was actually starting to decline among young people, said Lindsey Boehm, a recently graduated nursing student from UW-Eau Claire. Boehm worked with nursing professor Lorraine Smith on a youth awareness project on the risks of vaping.

After several years of rising, 2020 saw a drop in the number of middle and high school students who reported vaping in the past 30 days, according to the National Youth Smoking Survey. About 20% of high school students said they vaped in this latest survey, up from around 28% the year before.

“This really dangerous growth that we worried about in teens has really diminished,” Piper said.

Federal measures like raising the age to purchase tobacco products, including electronic cigarettes, and ban many flavored vape products likely played into that decline, the researchers said. But with COVID-19 disrupting the lives and school years of young people, there are still many questions about how these trends will continue.

For teens, peer pressure is a huge factor, Smith pointed out. And a big part of e-cigarette use among young people is about getting together and being social, Piper added.

Bella Le, a junior at Franklin High School, said she saw in her school how vaping can become a social norm. Le is part of his local FACT group, which helps educate teens about the risks of tobacco and other related products.

“People just think it’s part of the high school experience, that you’re supposed to try alcohol and tobacco and vape,” Le said.

While many schools turned to virtual classrooms or hybrid models during the pandemic, Smith and Piper said these social factors may not have had the same impact.

On the flip side, however, many people use e-cigarettes and other substances to deal with anxiety and other mental health issues, Boehm pointed out. In the United States, substance use increased in the early days of the pandemic, along with other mental health issues, according to CDC Research.

“Stress leads to an automatic response of reaching for a cigarette, to a vape if you’re addicted,” Piper said. With the increased levels of stress, loneliness and boredom during the pandemic – and the disappearance of other rewarding activities, such as getting together with loved ones – “you are just looking for anything to help you feel a little better during the day, ”she said.

An additional risk?

Scientifically, it is still early to draw conclusions, the researchers said. But some preliminary research has found that vaping can increase the risk of COVID-19.

A Stanford University study interviewed thousands of young people aged 13 to 24 who had been tested for coronavirus. In this group, people who said they had ever used vaping products were five times more likely to test positive than those who said they had never vaped.

There are two main theories about how vaping could lead to a higher risk of catching COVID-19, Boehm said.

The behavior itself can be a problem: a person who vapes is of course not wearing a mask. And young people tend to share devices, Boehm said, which could lead to more dissemination as well.

Plus, while vaping products don’t contain the same toxins as traditional cigarettes, they still affect the body – and could potentially make it more prone to infections.

“As we say, although electronic cigarettes are less harmful than fuels, they are not harmless,” Piper said.

The use of e-cigarettes is still a relatively new trend, Piper pointed out, so we don’t have a lot of information on how it affects the body in the long run.

But some studies have suggested that vaping could affect blood vessels in the brain, or lead to more expression of the ACE2 receptor – which the coronavirus uses to attach itself to cells. And other research has shown that nicotine can suppress parts of the immune system.

Smoking has been more clearly linked to worse COVID-19 outcomes, with a Cleveland Clinic Study heavy smokers were about twice as likely to be hospitalized or die after coronavirus infection.

While the exact links require further study, Le said the focus on health – and in particular lung health – during the pandemic may have discouraged people from purchasing vape products.

“It was just a wake-up call for people to focus on their health and how one little thing can change their lifestyle,” Le said.

Back burner

Even though these questions have been raised, much research on smoking and vaping has stalled, Piper said, making it difficult to track trends and develop new treatments. And for Boehm, Smith and Le, the work of educating and connecting with the community has largely moved online during the pandemic.

Instead of going to schools in person, Boehm and Smith connected with young people through virtual sessions. Le’s FACT group has turned a lot to social media instead of hosting events in the community.

While the online format has allowed their program to reach new audiences – like young people in a juvenile detention center – Smith said he feels vaping is really on the back burner in terms of priorities. public health.

Le said she looks forward to connecting with people and sharing information face-to-face again in the future.

“I hope we can have more outreach opportunities with the students, because I feel like it has a bigger impact on the community,” Le said. “There is so much you can do on social media. “

As the pandemic emerges, there will still be many questions about how the last year affected vaping and smoking trends, Piper said. And, of course, other pre-existing gaps – like understanding exactly how vaping affects the body in the long run – still need to be addressed, Smith said.

In the future, finding nuance in vaping messages will be critical, Piper said.

Although “the healthiest thing is not to inhale anything other than air,” she said, vaping can play an important role in helping people who are trying to quit smoking cigarettes. much more dangerous fuels. (Smoking-related diseases kill nearly 500,000 Americans each year, she pointed out – which almost rivals the assessment of the first year of COVID-19.)

Preventing young people from developing a habit, while giving smokers the opportunity to change, is a delicate balance, she said.

“Electronic cigarettes have a place in helping smokers switch to a less harmful product,” Piper said. “Electronic cigarettes have nothing to do with being in the hands of adolescents, because of the risk of potential addiction, the other problems that brain development can cause. “

Among these young people, there is still work to be done to ensure that people understand the risks of vaping, Le said. Many high school students take the attitude of “I’ll always do what I want, because it’s my life,” she said – without really thinking about the health consequences.

Boehm, who was born and raised in Eau Claire, said making these connections with young people in her hometown has been a rewarding job.

“What interests me most [in this work] is just about empowering young people to make good decisions about their health, especially here in my community, ”said Boehm. “I think teens and teens need a little support in decision making, and they need to be empowered to learn about vaping so they can make better decisions about their health.”

The Wisconsin Tobacco Quit Line offers free help to quit smoking, vaping, or other tobacco uses. You can call 800-QUIT-NOW, text READY to 200-400 or chatting on the internet.

About Margaret Shaw

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