E-cigarette vapor tied to changes in lung cells

 The vapor from e-cigarettes may boost the production of inflammatory chemicals in the lungs, while disabling key cellular defenders against infection, a new study suggests.

In a series of laboratory experiments, researchers found that e-cigarette vapor impairs the activity of cells called macrophages, which normally remove allergens, bacteria and other particles that have made their way into the lungs, according to the report published in Thorax.

For the cultured cells, exposure to e-cigarette vapor induced many of the same changes in lung macrophages that have been seen in cigarette smokers and patients with COPD, the researchers note.

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The concern is that long-term vaping might lead to breathing problems. E-cigarettes “are safer in terms of cancer risk, but if you vape for 20 or 30 years and this can cause COPD, then that’s something we need to know about,” senior study author Dr. David Thickett of the University of Birmingham in the UK, said in a statement.

Earlier studies looked just at the effect on cells of the liquid that goes into an e-cigarette rather than at the vaporized chemicals.

To determine what effect vaporizing might have, Thickett and his colleagues extracted macrophages from lung tissue samples from eight non-smokers who had never had asthma or COPD. One third of those cells were exposed to e-cigarette fluid, another third to vaporized liquid and the remaining third to nothing.

After 24 hours, the researchers saw cells dying in the groups exposed to fluid and vaporized e-cigarette liquid. But the vaporized liquid killed cells at lower doses than the unvaporized liquid.

The researchers also noted that when macrophages were exposed to doses too low to kill, the cells spewed out 50-fold higher amounts of oxygen-free radicals, the “rust” of the biological world, compared to unexposed cells. The cells exposed to vaped liquid also secreted a host of inflammation-inducing molecules.

Cells exposed to vaporized liquid also were not as good at battling bacteria, suggesting that e-cigarette users’ lungs might have more trouble fighting off infections.

The macrophages examined by the researchers are important cell defenders deep within the lungs, said Dr. Daniel Weimer, a pediatric pulmonologist at the Children’s Hospital of Pittsburgh of UPMC who was not involved in the study.

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“They do a bunch of things,” he said. “One thing they can do is eat up foreign things, whether they be bacteria or viruses or just particles that have drifted down into the lungs. They can act as scavengers that present these particles to the immune system to activate an immune response.”

It’s important to keep in mind that the study was done on cells in a culture, not in an animal or a human being, Weimer said. Things might be different in vivo.

Nevertheless, this study, taken along with some earlier ones, suggests that we may need to worry a bit more about the use of e-cigarettes, especially among the young, Weimer said.

“Many people think of COPD as an older person’s disease,” he added. “But we’re seeing younger and younger kids vaping. And that may cause a loss of long function at a more accelerated pattern because they’re starting it in their teens.”

Research on e-cigarettes has been a bit of a moving target, said Dr. Michael Blaha, a professor of medicine and director of clinical research at the Ciccarone Center for the Prevention of Heart Disease at Johns Hopkins Medicine in Lutherville, Maryland. That’s because every aspect of the devices and the fluids used in them has been changing at a rapid pace, he said.

The idea that vaporized e-cigarette liquid might be more toxic than the liquid itself, “is highly plausible,” Blaha said. “And there are some early studies that suggest that people using e-cigarettes have more respiratory symptoms, such as coughing and wheezing, than those using nothing at all.”

Initially public health experts were not that concerned about e-cigarettes because they were being marketed as a way to help smokers quit, Blaha said. “When the field was originally thinking of these as cessation devices, then some toxicity could be tolerated,” he added. “But now we’re looking probably at a couple million users in the United States who are being exposed to e-cigarette vapors who potentially wouldn’t have been exposed to any tobacco product.”

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Vaping good, bad or not clear?

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A new report from MPs has certainly generated a new talking point – not least among vapers and smokers taking a break from their desks.

It has raised again the questions of whether e-cigarettes are a positive force for public health and whether they could yet cause harm to users. Both it seems could be true.

The Commons’ science and technology committee comes down strongly in favour of vaping as a vehicle to help smokers quit.

Its report says that about 470,000 smokers are using them as an aid to help them give up the habit and tens of thousands are successfully quitting each year.

The MPs believe transport and other public places should be more sympathetic to vaping. That means not bracketing e-cig users with smokers and banishing them to the street.

One tweet on Friday morning underlined the frustration of one rail traveller: “No-one on the platform and it’s totally uncovered. I was vaping. A guard walked 100 yards and told me it’s not allowed. I said ‘but it’s open air and there’s no-one about. Rules are rules’ he said!”

On the other hand, some of those who don’t smoke or vape take exception to the idea of being in close proximity to an e-cigarette user.

To quote another tweet: “Not in public places please – I don’t want my world filled with sweet smelling clouds of vapour. All mixed together from different peoples tastes. Yuk!”

People of this persuasion might not be happy to hear that the committee advocates “non-vapers having to accommodate vapers”.

So is vaping safe?

There is no definitive answer to that.

The clinical regulator, NICE, makes the point that as e-cigarettes have only been on the market for about a decade, there is no authoritative research yet available. It may take several more years for such research to emerge which can show beyond doubt that vaping does not affect users’ lungs or other aspects of their health.

This then is a debate about whether clear gains now in terms of getting smokers off tobacco might be outweighed in future by adverse health effects which only emerge after detailed research.

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The MPs on the committee, public health authorities and many health campaigners are strongly of the view that fairly certain gains now are more important than a possible long-term risk.

Critics are adamant that it’s too soon to give a clear-cut message to consumers.

The MPs also want to see a clearer lead from the NHS in advocating e-cigarettes. They are disappointed that a third of mental health trusts in England won’t allow vaping on their premises, even though smoking among people with mental health conditions is much higher than for the general population.

At smoking cessation clinics some local authorities suggest vaping, but others don’t.

The committee also wants to see more e-cigarette brands cleared for medicinal use. This would allow GPs to recommend or even prescribe them if they wished, subject to the views of their commissioning groups.

There is one brand, eVoke, which has had such approval from the Medicines and Healthcare Products Regulatory Agency but, curiously, it has not yet been marketed to consumers.

Intriguingly, the company which owns the brand is British American Tobacco. Company sources have indicated that the brand is “not likely” to be taken any further as the vaping market has moved on since eVoke was developed and consumer preferences have changed.

This is still a debate clouded with uncertainty but the select committee report has allowed some of the fog to clear.

It has moved smoking higher up the agenda of important public health issues, with growing pressure on NHS leaders and ministers to think about a way forward.

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Vaping on buses ‘should be considered’

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Image caption Around 470,000 people are using e-cigarettes as an aid to stop smoking

Rules around e-cigarettes should be relaxed so they can be more widely used and accepted in society, says a report by MPs.

Vaping is much less harmful than normal cigarettes and e-cigarettes should be made available on prescription to help more people quit smoking, it said.

The report also asks the government to consider their use on buses and trains.

There is no evidence e-cigarettes are a gateway into smoking for young people, Public Health England said.

The report on e-cigarettes, by the science and technology MPs’ committee, said they were too often overlooked by the NHS as a tool to help people stop smoking.

For example, it said it was “unacceptable” that a third of the 50 NHS mental health trusts in England had a ban on e-cigarettes on their premises, when there was a “negligible health risk” from second hand e-cigarette vapour.

What else do the MPs say?

In the report they call for:

  • greater freedom for industry to advertise e-cigarettes
  • relaxing of regulations and tax duties on e-cigarettes to reflect their relative health benefits
  • an annual review of the health effects of e-cigarettes, as well as heat-not-burn products
  • a debate on vaping in public spaces, such as on public transport and in offices
  • e-cigarettes licensed as medical devices
  • a rethink on limits on refill strengths and tank sizes
  • an end to the ban on snus – an oral tobacco product which is illegal in the UK under EU rules

How popular has vaping become?

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Media caption“Relief my son turned to vaping” – Norman Lamb

About 2.9 million people in the UK are currently using e-cigarettes.

It is estimated that 470,000 people are using them as an aid to stop smoking and tens of thousands are successfully quitting smoking each year as a result.

Although the report recognised the long-term health effects of vaping were not yet known, it said e-cigarettes were substantially less harmful than conventional cigarettes because they contained no tar or carbon monoxide.

Norman Lamb, chairman of the science and technology committee, said: “Current policy and regulations do not sufficiently reflect this and businesses, transport providers and public places should stop viewing conventional and e-cigarettes as one and the same.

“There is no public health rationale for doing so,” he said.

“Concerns that e-cigarettes could be a gateway to conventional smoking, including for young non-smokers, have not materialised.

“If used correctly, e-cigarettes could be a key weapon in the NHS’s stop-smoking arsenal.”

Mr Lamb said medically licensed e-cigarettes “would make it easier for doctors to discuss and recommend them as a stop-smoking tool to aid those quitting smoking”.

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Image caption MPs want greater freedom for industry to advertise e-cigarettes

The debate on e-cigarettes

The report is the latest in a long-running debate about e-cigarettes and how they are used in society.

A survey in Scotland found that young people who use e-cigarettes could be more likely to later smoke tobacco.

And in Wales, concerns have been raised about young people using e-cigarettes on a regular basis.

But elsewhere, a six month trial at an Isle of Man jail found allowing inmates to smoke e-cigarettes made them calmer and helped them quit smoking.

More research is needed to better understand the long-term effects of e-cigarettes, after early research on lung cells in the lab suggested that the vapour may not be completely safe.

But there is general agreement among public health experts, doctors and scientists that e-cigarettes are significantly less harmful than normal cigarettes containing tobacco.

Where are you not allowed to vape?

E-cigarettes are not covered by the smoking legislation which bans the use of cigarettes in all enclosed public and work places.

In fact, to encourage smokers to switch to vaping, Public Health England recommends e-cigarettes should not be treated the same as regular cigarettes when it comes to workplaces devising smoking policies.

“Vaping,” the authority said, “should be made a more convenient as well as safer option”.

But some places have banned vaping. For example, Transport for London forbids the use of e-cigarettes on all buses and the Underground, including at stations.

Big cinema chains such as Cineworld, Odeon and Empire also ban smoking e-cigarettes anywhere on their premises while most theatres also forbid their use.

Most airlines and airports ban vaping, apart from in designated smoking areas.

What is the response to the MPs’ report?

Public Health England estimates that e-cigarettes are 95% less harmful than normal cigarettes.

Duncan Selbie, chief executive of PHE, said: “E-cigarettes are not without harm but are way safer than the harms of tobacco.

“There is no evidence that they are acting as a gateway into smoking for young people.

“We want to see a tobacco-free generation within 10 years and this is within sight.”

The charity Action on Smoking and Health welcomed the report but said it had some concerns over rule changes on advertising, which could mean tobacco companies being allowed to market their e-cigarettes in packs of cigarettes.

George Butterworth, from Cancer Research UK, said any changes to current e-cigarette regulations “should be aimed at helping smokers to quit whilst preventing young people from starting to use e-cigarettes”.

Prof Linda Bauld, professor of health policy at the University of Stirling, said: “This report is a welcome and evidence-based respite from all the scare stories we see about vaping.

“Its recommendations are not likely to be popular with all, and some of them may be difficult or complex to implement. But government, regulators and service providers should take note.”

What do the public say?

There are some strong opinions on Twitter in reaction to the idea of allowing vaping on public transport.

Richard Walker, 44, says vaping has helped him to give up smoking.

He smoked around 30 to 40 cigarettes a day for 23 years but gave up tobacco 12 weeks ago.

“I have used patches and lozenges to aid my attempt and I vape using oils with low nicotine content.

“I can honestly say that using a vape has helped me to stop smoking.

“During my cessation meeting with the nurse specialist, my carbon monoxide reading was 32 which classed me as a heavy smoker.

“My carbon monoxide reading is now two – non-smoker.”

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E-cigarettes ‘more harmful than we think’

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Vaping can damage vital immune system cells and may be more harmful than previously thought, a study suggests.

Researchers found e-cigarette vapour disabled important immune cells in the lung and boosted inflammation.

The researchers “caution against the widely held opinion that e-cigarettes are safe”.

However, Public Health England advises they are much less harmful than smoking and people should not hesitate to use them as an aid to giving up cigarettes.

The small experimental study, led by Prof David Thickett, at the University of Birmingham, is published online in the journal Thorax.

Previous studies have focused on the chemical composition of e-cigarette liquid before it is vaped.

In this study, the researchers devised a mechanical procedure to mimic vaping in the laboratory, using lung tissue samples provided by eight non-smokers.

They found vapour caused inflammation and impaired the activity of alveolar macrophages, cells that remove potentially damaging dust particles, bacteria and allergens.

They said some of the effects were similar to those seen in regular smokers and people with chronic lung disease.

They caution the results are only in laboratory conditions and advise further research is needed to better understand the long-term health impact – the changes recorded took place only over 48 hours.

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An independent review of the latest evidence on e-cigarettes was published by Public Health England in February.

The review concluded there was “overwhelming evidence” they were far safer than smoking and “of negligible risk to bystanders” and advised they should be available on prescription because of how successful they had been in helping people give up smoking.

Prof Thickett said while e-cigarettes were safer than traditional cigarettes, they may still be harmful in the long-term as research was in its infancy.

“In terms of cancer causing molecules in cigarette smoke, as opposed to cigarette vapour, there are certainly reduced numbers of carcinogens,” he said.

“They are safer in terms of cancer risk – but if you vape for 20 or 30 years and this can cause COPD [chronic obstructive pulmonary disease], then that’s something we need to know about.

“I don’t believe e-cigarettes are more harmful than ordinary cigarettes – but we should have a cautious scepticism that they are as safe as we are being led to believe.”

Martin Dockrell, tobacco control lead at Public Health England, said: “E-cigarettes are not 100% risk-free but they are clearly much less harmful than smoking.

“Any smoker considering e-cigarettes should switch completely without delay.”

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Juul and the vape debate: Choosing between smokers and teens

(CNN)The year was 2004, and James Monsees and Adam Bowen couldn’t stop taking smoking breaks during a brainstorming session for their joint master’s thesis at Stanford University’s design school. It was during one of these breaks that they decided: Why not create a better way to deliver nicotine?

Eleven years later, they unveiled Juul, a device that gives users a flavored nicotine fix without the smell and smoke of combustible cigarettes. It’s an e-cigarette, which means it doesn’t burn tobacco but rather generates an aerosol by heating a liquid that contains nicotine.
Juul, along with many other e-cigarette products, has found a place in a multibillion-dollar market. According to a Bloomberg report from late June, Juul controls 68% of the e-cigarette market. In 2016, 3.2% of US adults were current e-cigarette smokers while 15.5% smoked combustible cigarettes according to the National Health Interview Survey. Younger adults were more likely to vape than older ones.
    That even holds true for underage users: Youths are more likely than adults to vape, according to the US Centers for Disease Control and Prevention. For high school and middle school students who used a tobacco product in 2016, e-cigarettes were the most commonly used; 11.3% of high schoolers and 4.3% of middle schoolers used e-cigs, according to data from the 2011-2016 National Youth Tobacco Surveys.
    The act of vaping has even become a verb among youth: Juuling.
    Today, Monsees and Bowen are the chief product officers for the company. Ashley Gould, the chief administrative officer for Juul Labs, said they designed Juul for adult smokers trying to switch from combustible cigarettes, but data show the product’s startling popularity among youth.
    “It’s been devastating to us,” Gould said. “This is not a product for youth. It’s a product for adult smokers.”
    According to a 2017 national online survey by the Truth Initiative, a nonprofit tobacco control organization,7% of teens 15 to 17 reported having ever used a Juul.
    “The evidence is overwhelming today that these products appeal to kids,” said Matt Myers, president of the nonprofit organization Campaign for Tobacco-Free Kids.
    But Juul Labs argues that, by helping people give up cigarettes completely, the company provides a potentially life-saving service to current smokers, two-thirds of whom will die from smoking-related illnesses. The scientific consensus, however, is still out on the long-term health effects of vaping. And new research, combined with lawsuits against Juul Labs, threatens to undermine the company’s argument.
    “We need to talk to our kids, and at the same time, we can’t forget about the 38 million American adult smokers in our country who need and deserve our support,” Gould said.
    New research on the health effects of vaping and lawsuits against Juul Labs threaten to undermine the company’s argument.

    Juul gone viral

    At Jonathan Law High School in Milford, Connecticut, Principal Francis Thompson pulled from his pocket a sleek device resembling a USB drive. It’s the Juul, the most popular vape students used, he said.
    Vaping among teens took off so rapidly at Jonathan Law, the school had to take drastic measures.
    “Being a relatively new phenomenon, we didn’t know a lot about vaping and its impact and its danger and, quite frankly, its popularity that continues to rise among teenagers,” Thompson said. “It was causing several issues in our school bathrooms.”
    Thompson closed all but one of the school’s bathrooms. But then, kids began to brazenly vape in hallways and classrooms instead, recalls Andrew Paulus, an 18-year-old recent graduate.
    “It was a party setting. I saw everyone was doing it, so I was like, ‘Let me just try it once just to see what this fuss is about,’ ” Paulus said.
    Emma Hudd, one of Paulus’ classmates, said that teachers who didn’t know any better would allow kids to plug their vapes into classroom computers to charge them.
    Hudd, 18, likened Juul to her generation’s version of cigarettes.
    “We need to understand this more, because no usage of our product by youth is acceptable to us,” Gould said.
    “I can tell you certainly though, it was not designed to look like a USB device. It was not designed to be hid by kids,” she said. “This is a product that was designed by smokers for adult smokers, and that is the design ethos of the product.”
    Bella Kacoyannakis saw the Juul on social media sites, where people would post about how “awesome” it was, she said. The first time the 20-year-old tried it, she said she was immediately drawn to its small size, simple upkeep and fruity flavors.
    “I like the Juul better than cigarettes because the taste is so much more pleasant. And, like, the nicotine content isn’t really that much different,” Kacoyannakis said.
    The nicotine in one Juulpod, a small disposable e-liquid cartridge that’s inserted into the vaping device, is equal to that of an entire pack of cigarettes, according to the company. The rate at which a Juulpod is consumed varies among users, but can last about 200 puffs.
    Since Kacoyannakis switched from cigarettes to the Juul, she says, she vapes more than she used to smoke because of how convenient the device is.
    Gould said the company’s data do not show that Juulers who switched from cigarettes are taking in more nicotine than they did when they smoked. Independent research hasn’t yet confirmed Juul Labs’ data.
    Kacoyannakis recently picked up the box of her Juul and for the first time read the warning label.
    “This product contains chemicals known to the state of California to cause cancer and birth defects or other reproductive harm,” she read aloud. She had never noticed the California Proposition 65 warning before.
    Neither had Paulus or his friends.
    “On the front [of the packaging], it’s big letters, J-U-U-L Juul, or it has the flavoring in the color of the pod, but no one really looks at the side to see this really small writing saying, ‘Oh, caution, this is bad for you or whatever,’ ” he said.
    The Truth Initiative survey reported that 63% of young Juul users did not know that the product always contains nicotine.
    Gould said Juul Labs has added larger warning labels that now announce that the product contains nicotine across 20% of the space showing on a package.

    What’s in the vape?

    Nicotine isn’t the only ingredient in e-cigarettes, though. Studies from Harvard and Johns Hopkins researchers found that e-cigarette users wind up inhaling dangerous chemicals and toxic heavy metals along with their nicotine fix.
    “There’s a lot that’s happening with an e-cigarette besides just the nicotine and the carrier fluid. You’re also inhaling these flavoring chemicals like diacetyl or cousins of diacetyl, which have been found to be harmful,” said Joe Allen, an assistant professor at the Harvard T.H. Chan School of Public Health and the first author of a study on the presence of diacetyl in e-cigarettes.
    Much of what’s known about diacetyl’s effects on the lungs comes from studying the workers in a microwave popcorn packaging plant, Allen said. Twenty years ago, these workers developed a disease called bronchiolitis obliterans, or popcorn lung, after inhaling the fumes of artificial butter flavoring from open vats in their workplace.
    “You see a slow onset of some symptoms like wheezing, shortness of breath or coughing,” Allen said. “This is a disease that is irreversible, often requiring a lung transplant.”
    But David Abrams, a professor at the NYU College of Global Public Health who has researched smoking cessation for 40 years, doesn’t see diacetyl inhalation as much of a threat for vapers.
    “I think this whole story of diacetyl and popcorn lung, which is true only in popcorn workers who were exposed for eight to 10 hours a day has been completely exaggerated, and it’s part of what’s led the public into thinking e-cigarettes are as dangerous as cigarettes,” he said.
    Nevertheless, Abrams said the public can’t be reassured completely until the US Food and Drug Administration regulates vaping products.

    The future of regulation

    Last year, the FDA announced that it would delay regulations that could have halted the sales of many e-cigarettes. Instead, the agency gave extensions to new and existing vaping products, giving them until August 2022 to submit information to support their products’ safety and efficacy as switching devices.
    The organization decided on this timeline to “make certain that the FDA is striking an appropriate balance between regulation and encouraging development of innovative tobacco products that may be less dangerous than cigarettes,” according to the news release announcing the extensions.
    Michael Felberbaum, an FDA spokesman, said the agency does not have any additional information regarding a regulatory timeline once these applications are submitted. Meanwhile, the agency plans to propose a series of product standards to address some of the known public health risks of these products, which includes taking a close look at flavors, he said.
    Greg Conley, president of the American Vaping Association, said the question facing the American public and the FDA is not whether there should be regulations but whether they should be so strict as to wipe out competition from independent vape companies.
    “Reasonable product standards that actually help make the products better, help instill consumer confidence, that would be fine,” he said. “But what the FDA has proposed is not regulation; it is prohibition for 99% of products on the market today.”
    Gould says reasonable regulation would entail banning candy flavoring for e-cigs like cotton candy and gummy bear, cracking down on marketing to youth and restricting purchase to buyers 21 and older.

    Protecting kids

    Even as it announced the extensions last year, FDA Commissioner Dr. Scott Gottlieb said the agency would “redouble our efforts to protect kids from all nicotine-containing products.”
    Felberbaum said the agency’s goal is to balance public health concerns alongside the innovation of the e-cigarette industry, which “can’t come at the expense of kids,” he added.
    In April, after telling CNN Chief Medical Correspondent Dr. Sanjay Gupta that the organization would be taking enforcement actions “very soon” against companies believed to be marketing products to young people, Gottlieb announced a “blitz” on retailers for violations related to sales of e-cigarettes to minors. The agency said it sent Juul Labs a request to submit documents related to product marketing and research, including information about “youth initiation and use.”
    In July, the company was hit with multiple lawsuits that allege Juul Labs intentionally targets teens in its marketing. Prior to the lawsuits, Gould said the company took seriously the criticism of its 2015 launch campaign, which used young-looking models. The company had also announced that it would no longer use models on social media platforms, instead focusing on testimonials from adult smokers who switched to Juul.
    “That campaign in the end, we felt, did not help us achieve our mission of speaking to adult smokers to provide them information about an alternative to cigarettes,” she said.
    Juul uses age verification measures on its website, but Gould said 90% of the company’s sales are at the retail level, which is more difficult to regulate.
    Paulus, the recent high school graduate, says enforcing stricter age laws won’t stop underage users from getting their hands on Juuls.

    Sign up here to get The Results Are In with Dr. Sanjay Gupta every Tuesday from the CNN Health team.

    “I’m 18, and a freshman, sophomore, junior — if they really want to smoke or use a Juul, they could ask me or ask anyone in the senior class that’s over 18, and they could easily just give them money, go to a store, pick it up for them,” he said.
    Other approaches target the schools where the Juuling problem is prevalent.
    One independent organization that has developed an e-cigarette prevention program for middle and high school students is the Coordinated Approach to Child Health, or CATCH. It includes four lessons with topics that include e-cigarette ingredients, marketing techniques and skills for refusing e-cigarettes.
    Ashley Monteiro, a student at Wareham Middle School in Massachusetts, said that before taking the class, she thought e-cigarettes looked “pretty cool” and the flavors might taste good. But since learning about the use of artificial flavorings and chemicals in vapes, she’s no longer interested.
    For Hudd, a 2018 grad ofJonathan Law High School, the solution to the vaping craze is to escape its epicenter.
    “I’m happy I’m leaving high school so that I can get out of here and away from all the Juuling,” she said.

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    TSA agent praised for clearing smoking bag at Georgia airport

    One Transportation Security Administration security officer is being praised for his quick thinking during a recent scare at Savannah-Hilton Head International Airport. TSA Lead Officer Lead Officer Darrell Wade grabbed a smoking piece of luggage from a checkpoint and ran it away from the terminal, protecting everyone nearby.

    On August 8, footage was released of Wade’s brave actions at the Georgia air hub on July 20, which potentially prevented a major mishap, Fox 30 reports.

    ‘SUICIDAL’ AIRLINE EMPLOYEE WHO STOLE PLANE FROM SEATAC AIRPORT HAD BIZARRE CONVERSATION WITH AIR TRAFFIC CONTROL BEFORE CRASHING

    “I just really wanted everyone else to be safe. At that moment I can honestly say I wasn’t thinking of me getting injured, or anything else,” Wade recalled of the scene, in footage obtained by Fox News. “I just wanted everyone else at the checkpoint and all the other officers to be safe, passengers to be safe.”

    Upon examination, the cause of the smoke was revealed to be a malfunctioning vape battery, Fox 30 reports. Wade’s actions also prevented damage to the TSA security equipment, as well as a potential showdown of the airport. The checkpoint also remained open.

    As noted by the TSA’s security screening guidelines, electronic cigarettes and vaping devices are banned in checked bags.

    “Battery-powered E-cigarettes, vaporizers, vape pens, atomizers, and electronic nicotine delivery systems may only be carried in the aircraft cabin (in carry-on baggage or on your person). Check with your airline for additional restrictions,” the site states.

    Janine Puhak is an editor for Fox News Lifestyle. Follow her on Twitter at @JaninePuhak

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    Teens who vape or use hookah are more likely to use marijuana later, study finds

    (CNN)Teens who used e-cigarettes and hookah were up to four times more likely to use marijuana later, according to a study published Monday in the journal Pediatrics.

    Researchers from the University of Pennsylvania and the University of Southern California surveyed 2,668 students at 10 public high schools in Los Angeles beginning in fall 2013, when they were 14 years old and in ninth grade.
    The students answered a paper-and-pencil, phone or internet survey that asked whether they had ever used (or had used in the past 30 days) e-cigarettes, combustible cigarettes or a hookah water pipe. They were also asked whether they had used any type of marijuana product. The use of less popular tobacco products such as smokeless tobacco and cigars was not studied.
      In a followup survey in fall 2015, when the students were 16 years old and in 11th grade, the survey asked whether they had used three types of marijuana products: combustible, vaped or edible.
      The researchers found that the students who had tried e-cigarettes when they were freshmen had a more than three-fold greater likelihood of ever using marijuana and using marijuana in the past 30 days than students who hadn’t tried e-cigs.
      “When we were thinking about this topic, we were kind of just reflecting on the fact that we have more tobacco products on the market now than ever,” said Janet Audrain-McGovern, an associate professor in the Department of Psychiatry at the University of Pennsylvania’s Perelman School of Medicine and lead author of the study. “And we’ve seen cigarette smoking decline among young people, but we’ve seen increase in use of these other tobacco products. At the same time, we’ve also seen in many areas of the country a lessening of the restrictions surrounding marijuana use.”
      The researchers controlled for factors that could be associated with an increased risk of marijuana use, including family history of both tobacco and marijuana use, peer use, depression and impulsivity.
      “That doesn’t mean necessarily that the association is causal,” cautioned Dr. Ana Navas-Acien, a professor of environmental health sciences at Columbia University’s Mailman School of Public Health, who was not involved with the study. “I think we need to be very careful with interpreting these relationships. But it seems that the use of these tobacco products, including combustible cigarettes and e-cigarettes, seems to precede the use of marijuana somehow.”
      Students who had used hookah at the time of the first survey had a more than three-fold increase in the odds of having tried marijuana two years later and over a fourfold increase in the odds of using marijuana in the previous 30 days.
      One potential reason for the strong tie between hookah and marijuana use is that hookahs allow the mixing of multiple combustible products and could be used with marijuana itself, said Navas-Acien, who also studies e-cigarettes and hookah usage.
      Along with the potential of addiction to nicotine and the substances in marijuana, there are toxicants in hookah that can lead to increased health concerns, she said. Smoking hookah can result in 1.7 times more nicotine exposure than a regular cigarette, the researchers said.
      Nicotine changes the brain and enhances the pleasure experienced from subsequent drug exposures, Audrain-McGovern said. The changes in the airway from hookah smoking and e-cigarette vaping could also make smoking and vaping marijuana easier because of decreased sensitivity to irritation.
      “Once you start vaping, I think you become known as the person who vapes, who’s cool,” said Richard Miech, a professor at the University of Michigan and principal investigator of Monitoring the Future, an ongoing study of adolescent drug use. He was not involved with the new study. “You get invited to parties where people are going to smoke cigarettes and smoke marijuana because you vape already. So there’s that social component.”
      Students probably develop peer groups that they wouldn’t otherwise, and that is a possible link between vaping and future cigarette and marijuana smoking, Miech said.
      “And I think there are probably other social pathways as well, other than just friendship networks,” he added. “It probably changes your attitude. You probably vaped for a while and say ‘I don’t see any problem. I’m not dropping dead. I guess it’s not as dangerous as they’re telling me it is.’ “
      More than 11% of high schoolers use e-cigarettes, and between 5% and 11% smoke hookah, according to the authors of the study.

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      “The brain is still developing during the teen years,” Hongying Dai,an associate professor at Children’s Mercy Hospital and the University of Nebraska Medical Center, who researches tobacco use and health disparities, wrote in an email. She was not involved in the study.
      “Nicotine exposure might lead to changes in the central nervous system that predisposes teens to dependence on other drugs of abuse. Experimenting with e-cigarettes might also increase youth’s curiosity about marijuana, reduce perceived harm of marijuana use, and increase the social access to marijuana from peers and friends.”
      Teens had about 3.5 times greater likelihood of using marijuana in the previous two years for each additional tobacco product used, the study found.
      “And we know that these two drugs sort of go together,” Audrain-McGovern said. “So if you smoke cigarettes and then you later try marijuana, you’re more likely to quickly progress to using marijuana again.”
      The surveys did not measure the frequency of marijuana use, so whether e-cigarette or hookah use aligns with specific levels of marijuana use is unknown, researchers said. More data demonstrating a relationship between e-cigarettes and hookah use and marijuana use would be useful in determining policies to protect teen health, they said.

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