Vaping spurs fear for next generation’s lung health

Juul pods are not a safe way to consume nicotine

VAPING IS AN EPIDEMIC. Since starting its investigation in August 2019, the Centers for Disease Control and Prevention (CDC) has documented more than 2,000 cases of vaping-related illnesses and over 40 deaths. Here in Massachusetts, there have been three vaping-related deaths and more than 200 cases of suspected vaping illnesses reported to the Massachusetts Department of Public Health (DPH).

This is what we discovered over a three-month period. With each new weekly report from the CDC the numbers continue to grow, and in an investigatory breakthrough public health officials have named vitamin E acetate as a key culprit. Vitamin E acetate is sometimes used as a thickening agent or to dilute THC oil in vape cartridges to make it go further. What is most alarming, however, is that current e-cigarette and vaping use is highest among teens with more than one in four high school students using e-cigarettes in the past 30 days.

Vaping has appealed to our youth for its offerings of fun and fruity flavors. But vaping is heavily concentrated in nicotine. One Juul pod has 40 milligrams of nicotine, while a regular cigarette doesn’t even have one milligram. This means one Juul pod is equivalent to smoking two packs of cigarettes. Teens who vape are nearly three times more likely to go on to smoke traditional cigarettes than their peers who do not use any type of tobacco product.

While the medical community has not yet been able to study the effects of high levels of nicotine on the developing brain, we do know that nicotine changes dopamine levels, leaving an individual vulnerable to depression and addiction. Additionally, carcinogens are present in the aerosol or water vapor of products containing THC, the main psychoactive compound in marijuana. There is nicotine, nickel, lead, and other cancer-causing heavy metals, such as diacetyl, which bring out the flavor of the vape and is known to cause popcorn lung. The lung injury that is commonly seen in patients, Vaping Associated Lung Toxicity, or VALT, is very similar to lung damage caused by mustard gas, a chemical agent that causes severe burning of the skin, eyes, and respiratory tract.

Studies show there is a 20-year lag between the initiation of cigarette consumption and the onset of lung cancer. By comparison, we’re starting to see vaping deaths and lung injuries occur much earlier than we ever experienced with cigarettes and traditional tobacco use. As an oncologist, it is clear that vaping products will cause lung cancer and I fear for the next generation’s lung health.

As November is Lung Cancer Awareness Month, I encourage our community to use this time to act. To help curb this epidemic, our school system, public health officials, and parents can and should take the initiative to talk to students and their children about the effects of vaping.

Meet the Author

Andrea McKee

Chair of radiation oncology, Lahey Hospital & Medical Center
There are numerous resources and guides available when establishing your community’s approach to combatting youth vaping. The most helpful include: youth anti-vaping organizations such as Halt VALT, which is dedicated to delivering the facts on the dangers of VALT through social media platforms; programs from the American Lung Association such as The Vape Talk, which offers a conversational guide for parents to discuss vaping with their kids; and the Intervention for Nicotine Dependence: Education, Prevention, Tobacco and Health (INDEPTH), a convenient alternative to suspension or citation that helps schools and communities address the teen vaping problem in a more supportive way.

Education is critical to reversing the mentality around vaping and encouraging prevention. We must start taking action now to raise awareness about the dangers of vaping so together we can save lives.
Dr. Andrea McKee is a radiation oncologist at Lahey Hospital & Medical Center and spokesperson for the American Lung Association. For additional information about lung cancer screening and access to resources, contact the American Lung Association by phone at 1-800-LUNGUSA or visit