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Doctor: Vaping among isle youth high

Viewpoint

Vaping has been in the news recently, with a number of illnesses and even deaths across the country tied to e-cigarettes. This trend is especially concerning for Maui because we have such high rates of vaping here, especially among young people, who are most at risk.

As a physician who works both on Maui and the Mainland, I’ve noticed that the number of adolescents and young adults actively using vaping for both tobacco products and THC is much higher on Maui. And the numbers are rising: I’m seeing more Maui kids vaping today than I did 18 months ago. This would be in line with statewide trends, as Hawaii now ranks second in the nation for e-cigarette use among high school students.

As this problem has grown, I’ve been fielding more and more questions about vaping, especially from parents, who are justifiably concerned. So here’s everything you need to know about vaping: It’s not safe. Nobody should be vaping, but especially not kids.

To date, there have been more than 450 cases of suspected vaping-related illnesses across 33 states, six of which have been fatal. Hawaii’s first vaping-related illness was confirmed last month, in a teenage Hawaii island girl.

New information from a New York State Department of Health investigation suggests that these illnesses may be connected to an emulsifier added to the vaping liquid in some products. When inhaled, this additive seems to be causing something called lipid pneumonia, a rare condition caused by fat or oil particles entering the lungs. This can cause chest pain, coughing, difficulty breathing and, in some cases, death.

There are a few reasons the current vaping epidemic is especially concerning for Maui. Aside from the fact that we have such high rates of vaping among young people, our islandwide shortage of primary care physicians is much greater here than on the Mainland or even on Oahu. This means we are missing the first line of defense when it comes to educating patients, helping them quit, and spotting vaping-related illness in the early stages.

At the same time, the fact that that recreational cannabis is not legal here means people are more likely to turn to those illegal THC products that may contain dangerous additives and adulterants.

But even before vaping-related illness was in the news, the evidence was already mounting that vaping was highly problematic. Vaping solution contains pure nicotine, so with vaping, you actually get more nicotine than you do from a cigarette, which is why people get hooked on vaping very, very quickly.

And while it’s true vaping doesn’t deliver the carcinogenic tars and adulterants in cigarettes, nicotine is dangerous in and of itself, increasing the risk of heart disease, heart attack, and stroke. So let’s be really clear: vaping isn’t safer than cigarettes, and if anything, it’s more addictive.

What makes vaping especially troubling is the way vape companies are marketing to youths. Most of us haven’t seen cigarettes advertised on television or radio since they were banned more than four decades ago. But now we’re seeing plenty of ads that make e-cigarettes look fun and cool. Vape companies market their products in flavors like cotton candy, bubble gum and Gummi Bears. These flavors are designed to attract kids and hook them on nicotine for life.

Vape companies also go out of their way to market their products as safe, and this leads patients to make decisions that can be unhealthy or even dangerous. Here on Maui, I treated one patient with advanced lung disease who was using an oxygen tank. This patient actually thought it would be OK to vape while they were using oxygen. The e-cigarette ignited the oxygen and caused their face mask to explode, burning their mouth, nose and face. The patient later told me they never would have smoked a cigarette while on oxygen, but thought vaping would be safe.

Maui and Hawaii should follow in the path of states like New York that are beginning to remove these products from the marketplace. I personally believe that if vaping is allowed to continue as it has been, more people will die. It’s time we ask ourselves as a community if we want one more nicotine product on the market that has not been fully studied, that is almost completely unregulated, and that we have no control over.

Until we make a change at the policy level, it’s vital for all of us on Maui, but especially parents, to arm themselves with information, and to think very hard before allowing e-cigarettes to be part of their lives.

* Lee Weiss, M.D., is the medical director and chairman of the Maui Memorial Medical Center Emergency Department.