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Mira Canali

Mr. Wyatt Lay

English 11 Section A2

May 4, 2022

Respiratory effects of e-cigarettes

Introduction

A growing number of teens who vape said they vaped 20 days or more in the past 30 days

according to a survey done by the New York Presbyterian. The teenage use of e-cigarettes is now more

commonly known as a pediatric disease because of how many teens are using them. Teenagers in high

school are unaware that they are endangering their bodies by inhaling toxic chemicals and metals into their

lungs. Young people aged 15-17 are sixteen times more likely to vape than people aged 25-34. The

population of high school students who vape keeps going up due to how easily accessible e-cigarettes are. In

2020, 19.6% of high school students (3.02 million) and 4.7% of middle school students (555,00) reported

current e-cigarette use.

A national survey found that a quarter of two million US high school students say that they vape

daily. Health Department data shows about one in three Hawai’i teens are vaping. About 31% of high

school students in Hawaii vape regularly, according to a 2019 survey report from the state Department of

health. Although Hawaii has a law that citizens must be over the age of 21 to purchase an e-cigarette,

teenagers still have easy access to obtaining them, and they are also unaware of the damage they are doing

to their respiratory system. To promote the end of the teenage use of e-cigarette's, Hawaii can focus on

ending the sale of flavored tobacco products completely. Spreading awareness about this topic is also

another factor that goes into helping teens to stop using these products.
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The Problem

According to a website titled Vaping – What You Need to Know, “the effects of smoking

on the respiratory system include, irritation of the trachea (windpipe) and larynx (voice box),

increased risk of lung infection and symptoms such as coughing and wheezing, permanent

damage to the air sacs of the lungs”. These aldehydes can cause lung disease, as well as

cardiovascular (heart) disease. E-cigarettes also contain acrolein, an herbicide primarily used to

kill weeds. It can cause acute lung injury and COPD and may cause asthma and lung cancer.

Nicotine causes inflammation of lung tissue. It also reduced that tissue’s ability to serve as a

barrier to foreign substances. Vaping coats lungs with potentially harmful chemicals. E-liquid

concoctions usually include some mix of flavorings, aromatic additives and nicotine or THC (the

chemical in marijuana that causes psychological effects), dissolved in an oily liquid base. The

substance at the center of investigation id vitamin E. It’s often used as a thickening and delivery

agent in e-liquid. And, while it’s safe when taken orally as a supplement or used on the skin, it’s

likely an irritant when inhaled (Smoking n.d.)

The authors from the website also state that “chemicals within an e-cigarette cause

impairment of the lungs’ clearance system, leading to the buildup of poisonous substances,

which results in lung irritation and damage”. It’s been found in the lungs of people with severe,

vaping-related damage. Some common substances that are contained in e-liquid are diacetyl,

formaldehyde, and acrolein. Diacetyl is a food additive, used to deepen e-cigarette flavors, it is

known to damage small passageways in the lungs. Formaldehyde is a toxic chemical that can

cause lung disease and contribute to heart disease. Acrolein is most often used as a weed killer,

this chemical can also damage the lungs (Smoking n.d.)

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According to authors from the website “Better Health”, “the use of nicotine-based e-

cigarette products reduce lung function and breathlessness due to swelling and narrowing of the

lung airways and excess mucus in the lung passages”. Vaping products (electronic cigarettes or

e-cigarettes) are devices that heat a liquid into an aerosol that is inhaled (breathe in) into the

lungs. These devices are commonly called vapes, mods, e-hookahs, sub-ohms, tank and vape

pens. They may all look a bit different, but work in similar ways. The health effects of exposure

to e-cigarettes, especially of chronic exposure, are uncertain. However, e-cigarettes emit volatile

carbonyls, reactive oxygen species, furans, and metals (nickel, lead, chromium), many of which

are toxic to the lungs (Better Health n.d.)

An article titled Vaping – What You Need to Know, “While the chemicals used in

flavored e-juices have been tested as safe for eating, they have not been tested for inhalation.

When heated, the liquids create chemicals that could cause long-term harm to the lungs. The

heating process can create chemicals like formaldehyde and other contaminants such as nickel,

tin and aluminum”. This review summarizes the rapidly expanding evidence from cell culture,

animal, and human studies on the potential pulmonary health effects of e-cigarettes. The tobacco

industry has a long history of conducting studies intended to create doubt about the health effects

of combustible tobacco and of misinterpreting data, and as tobacco companies consolidate their

control of the $11.4bn global e-cigarette market, traditional industry marketing, lobbying, and

research strategies are increasingly apparent (Vaping, 2021)

This article states that vaping can cause lung disease, “Lung disease: Vaping can make

asthma and other existing lung diseases worse. Inhaling the harmful chemicals from vaping

products can cause irreversible (cannot be cured) lung damage, lung disease and, in some cases,

death. Some chemicals in vaping products can also cause cardiovascular disease and biological
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changes that are associated with cancer development”. Smoking is a risk factor for developing

several chronic diseases (asthma, cancer, chronic obstructive pulmonary disease (COPD), and it

is thus considered a health problem; stricter laws to regulate its consumption have been

developed. Electronic cigarettes consist of. Mouthpiece, a refillable cartridge for heating a liquid

matrix or e-liquid (with or without nicotine and other substances), a lithium battery, and a

heating atomizer (Vaping, 2021)

According to authors from the website “Better Health”, “the use of nicotine-based e-

cigarette products reduce lung function and breathlessness due to swelling and narrowing of the

lung airways and excess mucus in the lung passages”. Smoking also increases the risk for

tuberculosis, certain eye diseases, and problems of the immune system, including rheumatoid

arthritis. The flavor within an e-cigarette is also a big part of the decrease in tobacco sales.

People prefer to intake the chemical with a flavor that also contains chemicals rather than

smoking the real thing. This shows that people are just finding new ways to have the chemical.

Although they may think that it is a healthier way to have the chemical, it overall isn’t because

they are still inhaling chemicals that are worse than tobacco (Better Health n.d.)

Previous efforts

Although not many people are aware of the teenage use of e-cigarettes, and although

there haven’t been many previous solutions to this problem, there are a few solutions that

previous students and Hawaii’s legislators have implemented to help solve this problem. For

example, in an interview I had with a current Maryknoll High Schol student, Noah Chang has

given me a list of solutions he has done to help with the ongoing problem. During the interview,

he mentioned a youth council that fights for ending the sale of flavored tobacco products. This is

a council that he has been a part of since middle school, and he said that this is a great resource
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and council for me to join if I am in search of something to do for this project. He also said that

he has presented a slideshow to the grade school about the damage e-cigarettes have on an

individual's respiratory system. His hope for the outcome of presenting and educating the youth

about flavored tobacco products, is that they would never have the urge or desire to try any such

product. He hopes that by educating youth about the dangers of these products. He also hopes

that the youth would spread awareness to their friends to try and help prevent them from using

such dangerous products. I hope to follow Noah and his goals by educating youth about the same

thing, and I hope to make a difference in the council.

Noah also mentioned that the youth council hosts sign waving events in front of Hawaii’s

state capitol to help pass a bill to end the sale of flavored tobacco products. Not only do these

sign waving events help pass a bill, but they also educate others in the community about what

this council plans on doing, and overall educate the public about this issue. Not many people are

aware of this topic, and the sign waving event that the council holds in front of the capitol is a

great way to spread awareness and to show that one is a strong advocate for the topic.

Along with educating the youth, joining the council, and attending sign waving events,

Noah also mentioned writing to the editors of the Star Advertiser. He wrote an opinionated piece

about his point of view on Hawaii’s youth being endangered by flavored-tobacco products. This

can be seen as an effective solution because he is voicing his opinion to the people of Hawaii,

and he is also spreading awareness about this topic. Noah did a lot of work to try and end the sale

of flavored tobacco products in Hawaii, and although he didn’t see many results from the

outcomes of his efforts, he still spread a lot of awareness and he still voiced his opinion.

In addition to Noah’s efforts of preventing teens/kids from using e-cigarettes, there is also

a law that requires an individual to be over the age of 21 to purchase an e-cigarette. The law
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states that, “It shall be unlawful for a person under 21 years of age to purchase or possess any

tobacco product or electronic smoking device” (Hawaii’s state law). Hawaii’s Clean Indoor Air

Act has been amended to prohibit the use of vapor products where smoking is prohibited.

Although this can be seen as a previous solution to teenagers using e-cigarettes, it has not been

effectful enough because teenagers and people under the age of 21 in general still have easy

access to them because everyone knows people who can get, or people just have a “plug”. This

law is not working, and the government is aware of that, but has made no other efforts into

stopping teens from using e-cigarettes.

With Hawaii having a law that restricts individuals under the age of 21 from purchasing

e-cigarettes, there are still easily accessible ways for teens to have access to them. For example,

it is very easy to order e-cigarettes online from Amazon or other online stores. These online

stores do not require any sort of identification to make sure that whoever is purchasing e-

cigarettes is under the age of 21. Teens can just go online and order whatever they want without

being asked to show any form of identification, all they need is a credit card number. There is no

solution to this online ordering problem. However, in general Hawaii and online stores could do

a better job with restricting the purchase of e-cigarettes.

The Solution

Although it may seem that there is no solution to this ongoing topic, there are a few

ways/events that one could do to help minimize the percentage of high school students that use e-

cigarettes. For example, as I mentioned earlier, Noah Chang joined a youth council that helps

spread awareness about the topic and what is included within an e-cigarette. That is one solution,

along with many other solutions that he thought of. Spreading awareness is my main goal for this

project, just to help teens make their own decision to quit. I feel that this project wouldn’t be that
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successful if they weren’t given a choice to quit, for example, if all vape shops closed, I will feel

like I made a difference if teens/high schoolers made it their decision to quit smoking from e-

cigarettes. Not only would it make me feel accomplished, I feel that the people who choose to

quit would feel accomplished too because they are doing something good that benefits them and

their respiratory health.

Recently, a permanent solution was made to this ongoing issue. Governor David Ige

banned the sale of all disposables vape products,

On May 3, the Hawaii House of Representatives passed legislation that would ban the

sale of flavored vaping products. Previously passed by the Senate, the bill now moves

to the desk of Governor David Ige, a Democrat. If he signs it, Hawaii will become the

fifth state to prohibit flavored e-cigarettes, joining Rhode Island, New Jersy, New York

and Massachusetts (Hawaii Bill, 9 May 2022).

This is a permanent solution to the use of e-cigarettes of all ages. Although this bill only bans the

sale of disposable vape products and not refillable mods, it is a start to help keep Hawaii’s youth

healthy.

However, banning the sale of vape products may cause controversy in the vape shop

industry. According to the article Hawaii Bill to Ban Flavored Vape Awaits Governor’s

Signature, the vape industry does not want the bill to get passed, “The industry and consumer

advocates, of course, oppose the bill on the grounds that it will strip from the market the flavored

products that adults prefer to help them switch from cigarettes deterring the adoption of safer

products and promoting current vapers to potentially return to smoking. According to the CDC,

Hawaii’s Hispanic and Native Hawaiian/Pacific Islander populations have historically had the
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state’s highest smoking rates, and young adults smoke more than older adults. Around 1,400

people in Hawaii die of smoking-related causes each year” (Hawaii Bill, 9 May 2022). This just

gives Governor Ige a stronger reason to pass the bill because it is causing so many death and

health problems.

The article then goes on to say that “The supporters of the flavor ban appear split over the

PMTA exemption. While some accept it as a logical compromise, public health nonprofits and

some governmental bodies, including Hawaii’s Department of Health, have argued that the

exemption would favor tobacco companies with the resources to get FDA authorization for their

vaping products. They therefore think the current bill doesn’t go far enough and want instead to

prepare legislation that permanently bans all flavors, regardless of what the FDA decides. With

the PMTA carveout, if any flavored vaping products achieve FDA authorization – a feat that

seems increasingly improbable – those could legally be sold in Hawaii” (Hawaii Bill, 9 May

2022). This shows that many are still indifferent about the bill being passed. Although it is a

great thing that Governor Ige finally decides to take action with this problem, he needs to hurry

up and enforce it before the bill gets overturned and he can’t do anything about the situation

anymore.

Looking to the future and going away from what is going on in the Government right

now, I plan to build off what Noah has already started. I will join the Youth Council that fights

against the sale of flavored tobacco products, and I will attend any sign waving events that they

hold. I will also educate the youth at Maryknoll about the dangers of using any type of e-

cigarette so they can prevent themselves and their friends from ever using them. I will also write

an opinionated article and send it to the Publishers of the Star Advertiser just to put my voice and

opinion out in the Public, and to make sure everyone knows what I am fighting for.
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Conclusion

Although my topic may seem like a hard and irrelevant topic to solve, I personally feel

that this topic is way to overlooked and people don’t know how teens are endangering their

bodies. Spreading awareness about this topic will make it easier for more people to get involved,

and eventually get the Government to hear what people have to say about this topic. By letting

the Government know about this topic, they may do something to help with the sale of these

products, and they may do something to help teens keep their bodies healthy.

Throughout this project, I rarely found myself in any setbacks. I feel that the only setback I had

was that I was trying to find a permanent solution rather than thinking about other ways to solve

this problem. However, in the end, I feel that I have made an impact in the community, and I

hope that at least one person heard the message I am trying to get across, and I hope they listened

to it and quit.

Works Cited:

“Hawaii Bill to Ban Flavored Vapes Awaits Governor's Signature.” Filter, 9 May 2022,

https://filtermag.org/hawaii-ban-flavored-

vapes/#:~:text=On%20May%203%2C%20the,Governor%20David%20Ige%2C%20a%20

Democrat.

Tarran, Robert. "What Are the Respiratory Effects of E-cigarettes?" The BMJ, 30 Sept. 2019,

www.bmj.com/content/366/bmj.l5275.long.
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Omar Andrés Bravo-Gutiérrez. "Lung damage caused by heated tobacco products and electronic

nicotine delivery systems: A systematic review." 13 Apr. 2021, www.mdpi.com/1660-

4601/18/8/4079/htm.

Herman, Melissa. "Just a Moment..." The Physiological Society - Wiley Online Library, 9 June

2020, physoc.onlinelibrary.wiley.com/doi/full/10.1113/JP278388.

"Quick Facts on the Risks of E-cigarettes for Young People." Centers for Disease Control and

Prevention, 7 Apr. 2022, www.cdc.gov/tobacco/basic_information/e-cigarettes/Quick-

Facts-on-the-Risks-of-E-cigarettes-for-Kids-Teens-and-Young-

Adults.html?s_cid=OSH_emg_GL0004&gclid=CjwKCAjwur-

SBhB6EiwA5sKtju7o0_R9c2MCLwcMXbtEmE5MdZ3RdLsDkIxPQicorQGF_wPULoub

ARoCWW8QAvD_BwE#why-is-nicotine-unsafe.

"Smoking - Effects on Your Body." Better Health Channel - Better Health Channel,

www.betterhealth.vic.gov.au/health/healthyliving/smoking-effects-on-your-body.

Vaping - What You Need to Know. the lung association, www.lung.ca/lung-health/vaping-what-

you-need-

know#:~:text=Lung%20disease%3A%20Vaping%20can%20make,%2C%20in%20some%

20cases%2C%20death. Accessed 8 Jan. 2021.

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