January 27, 2025 • 25 mins
Vaping is a popular trend, especially among young people. Many believe vaping is a safer alternative to smoking or using tobacco and use vaping as a way to quit smoking. But what exactly is involved when you vape? And is it really better for you than smoking? In this episode of Q&A with Dr. K, Dr. Tiffany Kniepkamp joins Dr. Doug Kuntzweiler to discuss what we know about vaping and how it compares to smoking when it comes to our health.
If you have a question for Dr. K, email QandAwithDrK@mpqhf.org. Your question will remain anonymous.
Additional resources for this episode
Centers for Disease Control and Prevention (CDC) E-Cigarettes (Vapes): https://www.cdc.gov/tobacco/e-cigarettes/index.html
CDC Vaping and Quitting: https://www.cdc.gov/tobacco/e-cigarettes/quitting.html
CDC Resources to Help Youth Reject or Quit Vaping: https://www.cdc.gov/tobacco/e-cigarettes/youth-quitting.html
American Lung Association E-Cigarettes and Vaping: https://www.lung.org/quit-smoking/e-cigarettes-vaping
American Lung Association Don't Just Switch, Quit Tobacco for Good: https://www.lung.org/quit-smoking/e-cigarettes-vaping/quit-dont-switch
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Beth Brown (00:09):
Welcome to Q and A with Dr. K, a podcast by
Mountain Pacific Quality Health,where we sit down with Dr. Doug
Kuntzweiler and get your healthquestions answered, because on Q
and A with Dr. K, the doctor isalways in.
(00:34):
Hello, everyone. This is BethBrown, your host, and I'm
pleased to announce we all getthe same two for one special
that we had on a previousepisode. As we are joined by two
Dr Ks. Today we have Dr. DougKuntzweiler, who is Mountain
Pacific's chief medical officerand also gives great advice,
talk to us about all thingsmedical. And joining us is Dr
(00:56):
Tiffany Kniepkamp, who consultswith Mountain Pacific and is an
emergency medicineextraordinaire doc. And so we
are so fortunate to have both ofthese experts with us today to
talk about a topic that I thinkis big and a lot of people have
confusion over, and that isvaping. So thanks so much for
being here.
Dr. Doug Kuntzweiler (01:14):
Thanks for having us.
Beth Brown (01:15):
Here's the short and sweet question for today. Is
vaping safer than smoking? Sothe question is short and sweet.
I don't know if the answer isshort and sweet, but before we
dive into that, let's talk aboutthe definitions of those two
things. So I think when we talkabout smoking, everyone knows
we're talking about cigarettesor pipes or whatever you're
using to ingest commercialtobacco. That is not just
(01:36):
tobacco, it has lots ofchemicals and other bad things
in there that we know causesgreat risks to all kinds of
issues with our health vaping,though, I'm not sure if
everybody knows what that is, orif people have been exposed or
seen vaping. So let's talk aboutthat. What is vaping?
Dr. Doug Kuntzweiler (01:54):
I can answer this one. This may be the
only one I can answer. So Ibetter jump in. Smoking means
igniting some flammable product,most commonly tobacco, and so
that's cigars and hookahs andcigarettes. And there are other
ways to get the nicotine otherthan tobacco, as in gum or a
(02:14):
patch that goes on your skin, orchewing snuff. All those are
ways of using tobacco. Butvaping is heating up a liquid of
some sort, and it varies as towhat the liquid is, and having
that create an aerosol. Aerosolis just tiny droplets that float
in the air and then you inhalethat into your lungs. So the
(02:38):
liquid usually then alsocontains some addictive
substance like nicotine, orsometimes a marijuana product,
cannabis oil, of one kind oranother.
Beth Brown (02:48):
So I'm glad you went back to talk about smoking,
because it wasn't as simple aswhat I said. There is more to it
than just cigarettes or pipes.
So I'm glad you talked aboutthat. And then vaping involves a
liquid. And so as you alreadytouched on, a lot of people just
think, Oh, it's just, it'svapor, water, but what are we
talking about? What's in thatliquid?
Dr. Tiffany Kniepkamp (03:05):
Yeah, so that's a very common
misconception. A lot of peoplethink it's just flavored water
vapor, much healthier. But inreality, what you're inhaling is
actually still a mix ofchemicals. The liquid in E
cigarettes contains nicotine,obviously, but also chemicals
like formaldehyde, which youmight associate with things like
(03:25):
smoke or wood burning, notsomething you necessarily want
in your lungs. So it looksharmless, but it's not as simple
as just water vapor.
Beth Brown (03:34):
And the other tricky part about vaping too is you
don't always recognize what thedevices look like that people
are using to vape.
Dr. Doug Kuntzweiler (03:42):
Yeah, they've they've evolved a lot.
It started back in the early2000s, I think, around 2005-2006
as an e cigarette, and it lookedlike a cigarette had a little
battery in it, had a little bitof the juice, which was usually
a propylene glycol or ethyleneglycol, and then it had the
nicotine, and the battery heateda little element that made that
(04:06):
juice vaporize, and then itwould kind of cool down as you
inhaled it and turn into a anaerosol, little droplets of
liquid. And as I said, then thatdevice evolved pretty rapidly,
and now they look like all kindsof things. Some of them are
rechargeable, some of them aredisposable. Some of them are
reusable. They all have somesort of a heating element that's
(04:30):
charged by a battery, and thenthey have a little container or
reservoir where the juice is,and then whatever they're going
to add to it, typically nicotineor marijuana oils, but what they
actually look like is all sortsof different things. I'm told
that one of the favorite ones ofteenagers is something called
(04:50):
the jewel, j-u-u-l, because itlooks like a flash drive. So
they can carry these around theschool, and the teachers look at
it and think, Oh, there's a verystudious child taking notes and
putting it on his flash drive,when, in reality, it's it's his
vaping device.
Dr. Tiffany Kniepkamp (05:07):
Exactly, Doug. That's part of the
problem. They can be really hardto spot. They're coming up with
new things all the time. Theycan look like pens, USB drives,
like you said. That's part ofthe thing that's become very
popular with teens is thatthey're very easy to carry, very
easy to hide, very discreetparents teachers may not even
recognize what it is thatthey're looking at. They're
(05:30):
designed to be very sleek andeasy to carry around so they
don't stand out. And forexample, recently, I got a call
from our school principalbecause my daughter had found
this blinking toy on theplayground, and they sent me a
picture of it, and it was thebattery from a vape pen. And it
was even hard for me to tellexactly what it was. I had to
(05:51):
look up the brand, and thenfound out it was a battery from
a vape pen. So we had a veryhonest discussion with my six
year old of what you do and donot pick up on the playground.
Yeah, but they're very discreetand made to be that way.
Beth Brown (06:07):
Yeah, when we talk about the difference between
vaping and smoking, it's whatwe're inhaling. Is that the
major difference, regardless ofthe device that we use to put
that into our lungs, or what isreally the difference between
vaping versus smoking?
Dr. Doug Kuntzweiler (06:25):
Well, I think to me, one of the biggest
differences is we've had arelationship with tobacco since
1600s and before, and weunderstand in this day and age
what the components of tobaccosmoke are and what the
consequences of tobacco smokeare. In contrast, we have a not
(06:46):
hardly even a decade and a halfof experience with vaping, and
so we don't know really what theconsequences of this are. It's
too soon for us to have goodinformation. We know that
smoking is horrible for you fromany number of standpoints,
cancer being a prominent one,but also heart disease, stroke,
vascular disease of all kindsand many other kinds of
(07:09):
problems. It's associated withalmost every kind of cancer you
can think of. We don't know yetabout vaping. There are studies
that show that it's less harmfulthan smoking, but as I said, we
don't have a lot of experience.
Those studies are usingrelatively small numbers of
patients, and I don't think wefully understand it yet at this
point, but I would say if it'ssafer than smoking, it can't be
(07:31):
by much. And I think historywill probably prove that to be
true.
Dr. Tiffany Kniepkamp (07:37):
Exactly Doug, and I think I would say
too that, so a big difference.
And I know we've kind ofhammered this already, but with
smoking, you're burning tobacco.
You're actually ignitingsomething which creates that
smoke that contains all kinds ofharmful chemicals, tar, carbon
monoxide, all of that. And withvaping, you're heating up a
liquid. So you're never actuallyburning anything. You're heating
it up and turning it into anaerosol without the burning. So
(07:59):
that means you're not gettingall those combustion related
toxins, but still, like Dougsaid, it doesn't mean it's safe.
There's still harmful substancesin the aerosol, and actually,
the flavoring, the fruitiness,the mintiness, even that, is a
chemical that your lungs are notused to inhaling, and so it
still causes a lot of issues. Sopeople think vaping is healthier
(08:21):
and it is technically thansmoking, but it's still very far
from risk free, both put badthings in your lungs that don't
belong there.
Beth Brown (08:29):
So with as relatively new as vaping is, are
we starting to see risks or thecons that come out of vaping? Or
we honestly don't know yet?
Dr. Doug Kuntzweiler (08:38):
No, we absolutely have seen risks.
We've seen people who getscarring on their lungs from it.
In 2019, you may remember, therewas a big outbreak of severe
lung disease from people whowere vaping, and it was thought
that they probably got a vapingdevice that had a toxin in it
(08:59):
that was related to vitamin E,and it caused severe scarring
and damage to the lungs thatthere were about 2800
hospitalizations, and out ofthose people, 68 of them died
that was related to oneparticular type of vaping device
that then was taken off themarket. But there are still
people who are developing apneumonia like syndrome, where
(09:19):
they get damage to their lungsand get scarring. So certainly
is not as safe as some peoplemaintain.
Dr. Tiffany Kniepkamp (09:26):
It still has nicotine. So we know a lot
about nicotine, and so you'restill getting the nicotine,
which is one of the mostaddictive substances, comparable
to like heroin and cocaine. Ithas been known to disrupt brain
development, which is why thisis such a huge concern, and the
teens that are using it a lotnow and it also it increases
your heart rate and your bloodpressure and nicotine also
(09:48):
constricts blood vessels. Sowhen you combine your heart rate
going up, your blood pressuregoing up, your blood vessel
constricting a bit, thatincreases your risk of heart
disease. And so, ot's the samein smoking or vaping, so you're
still having those risks, aswell as the respiratory
illnesses that doctor coonertalked about. It also has been
(10:09):
shown to increase anxiety anddepression and impacts your
memory and cognition and yourability to form those memories
and that brain development, andwe know that even in pregnant
women, that it affects the braindevelopment and the oxygen flow
to the fetus. And so I thinkthat's why this is such a big
concern for teens right now,because, oh, I can't remember
exactly the numbers, but highamount of teenagers are using it
(10:33):
currently, and it's going toaffect their brain. And we're
already dealing with a lot ofother concerns with depression
and suicidal ideations and allof that, and now we add this
into it, and it's just anotherstressor that is not good.
Beth Brown (10:46):
So you mentioned the nicotine, and that was a
question that I was going to askas well, because if there's
nicotine in there, then thatmeans vaping is addictive, just
like smoking is. And if peopleare trying to use vaping to quit
smoking, how effective is thatif they're still getting the
same stuff, just in a differentway? So can you talk about that
(11:07):
a little bit?
Dr. Doug Kuntzweiler (11:08):
Yeah, it's pretty much a shell game. There
was one small study reported toshow that vaping was a good way
to quit smoking, and that mightbe true. Some people who use
vaping were able to stop smokingcigarettes, but then they were
unable to stop using the vapingbecause, as Tiffany said, it's
still nicotine, and nicotine ishighly addictive. Then there are
(11:28):
people who use it, and they windup addicted to both. They smoke
cigarettes when it's convenientto do that, and they vape when
it's not. So it's it's a shellgame. We haven't really made
anything that's a superiorproduct. I've seen numbers and
this kind of goes to one of thethings that alarms me about it
is the marketing that goes on.
But I've seen numbers that up toa half a million middle
(11:50):
schoolers are vaping, and in thehigh school, it's it's more,
it's over a million, maybe oneand a half million high school
kids are vaping. Nationwide,I've read numbers like one in 20
Americans, they but themarketing is aimed especially at
young kids with all theseflavors, and they have cool
names and they have cool shapes,and if you're going to be one of
(12:12):
the cool kids, you have to vape.
Dr. Tiffany Kniepkamp (12:15):
One other thing I was going to say about
that is a big argument I hear alot from the teenagers in the
emergency department when we'retalking about vaping, is
nicotine is not a cancer-causingagent, it's the tobacco, it's
the tar, that's the carcinogen.
But is that true? Yes,technically, nicotine is not
classified as a carcinogencancer-causing agent, but it's
(12:35):
an indirect carcinogen becauseit enhances your body's response
to those cancer-causing agentsfound in either cigarette smoke
or all of the fruity smells andthe formaldehyde and all of
that, it increases your body'srate at turning those into
cancer cells. So while itdoesn't directly cause the
cancer, it makes your body morelikely to develop into cancer
(12:57):
have those cell damage, abnormalgrowth that just kind of
escalates that.
Dr. Doug Kuntzweiler (13:04):
And I recall that chewing tobacco or
dipping snuff is associated withcancers of the tongue, cancers
in the mouth and throat. Sothat's, you know, that doesn't
require burning. It's the otherelements in the tobacco as well
as the nicotine, that areleading to those cancers. So all
of this is addictive, whetherteenagers want to try to talk
(13:27):
about what's really going on inthere or not.
Beth Brown (13:29):
And so how do they how do you know if you become
addicted to vaping? Are theresymptoms that people begin to
show? Do people have withdrawalsif they try to quit? Can you
talk about the addictiveproperties there and how to
handle that?
Dr. Tiffany Kniepkamp (13:43):
It's pretty similar to all of your
other addictions. And if youfind yourself craving the vape,
using it more frequently, justescalating how often you're
using it, or if you don't haveit, frustrated, irritable,
anxious, when you don't have itand you just want to go
somewhere to use it. That's abig sign. You try to stop, and
you just can't. Also a sign, andif you're prioritizing vaping
(14:07):
over other activities, like, Oh,I could go to the basketball
game, but I'm going to stay backso that I can vape. That's also
another sign that you could beaddicted.
Dr. Doug Kuntzweiler (14:15):
How soon in the morning when you wake up
do you take your first vape ordrink your first beer or smoke
your first cigarette, that's anindicator that probably
addicted, if that's the firstthing you do in the morning.
Beth Brown (14:29):
So as far as getting people help if they do become
addicted or they find thosecravings are more than they can
handle, because this is more ofa teenager or tween issue. What
should parents be looking for?
How can they tell if their childis vaping? And then how can they
get their teen or pre teen help?
Dr. Doug Kuntzweiler (14:50):
Well, I think it's probably harder to
detect than smoking, because thesmoke tends to linger and causes
an odor lingers on your clothes.
I don't have a lot of experiencewith vaping, but my suspicion is
that it's much easier for kidsto hide. I mean, you can sit
down and have an honestdiscussion with your kids. Kind
of depends on what yourrelationship with your kid is
like to begin with, and theywill probably make the argument
(15:12):
to you that it's safer and it'snot addictive and doesn't cause
cancer and all those things thatwe have talked about, but I
think where you begin is withhaving an honest discussion with
them. And you know, if you seethem vaping, you might see them
in a crowd of their friends, andthey're all vaping, then that
would be a good point toinitiate the discussion. You've
(15:34):
got younger kids, Tiffany. Whatdo you - how are you approaching
this?
Dr. Tiffany Kniepkamp (15:39):
Well, I also remember high school and
college and my parents beingvery strict and trying to hide
certain things from them, so Imight have a slightly different
view on some of this, but thingsto really look out for, and
things that I'm going to lookout for as my kids get older is
it's a very pleasant, strongfruity smell. So if you're
(15:59):
starting to notice kind of anunusual fruity like a fruit you
can't quite place your fingeron, but it smells good. That's a
good indicator. Or minty smells,but they're tending to go more
towards the fruity smells. Inthe teens, some kids might start
using like a very sweet smellingperfume or a body spray to try
(16:20):
and hide the fact that it is ontheir breath and on their
clothes, that that root smell isthere, or lotions asking to buy,
like really fruity lotions, kindof out of the blue or shifting
might be a time to have a littlediscussion looking for those
little, small, discrete devices.
I mean, if you have a very smartchild who's, you know, studious,
it may not be unusual, but ifall of a sudden the kid who
(16:42):
really could care less aboutschool is carrying a pen
everywhere with them, might havesome questions, any changes in
behavior. And just knowing whoyour kids are hanging out with,
if all of their friends arevaping or if you smell it on
them, then it would be a time tohave a discussion. And I think
just having that open discussionwith them about the risk that,
yes, maybe they're telling youthis does not cause cancer, but
(17:03):
it's actually all of theadditives in it that can cause
cancer, and the nicotine is veryaddictive, and actually can kind
of be that gateway into smokingwhen you're an adult. There's a
few studies, one out ofAustralia, that talked about it
kind of being a gateway intosmoking, and the likelihood that
they smoke in adulthood is veryhigh if they started vaping in
their teens.
Beth Brown (17:24):
This is tough too, because in the past, when we've
talked about addictions, we'vesaid, you know, you can't stop
until you make the decisionyou're ready to stop. And even
that is hard. People tend to notbe able to quit the first time
they try, and it takes a coupleof times before they are able to
quit smoking, for example, withteens, if they're not ready, but
parents are trying to intervenewith this habit. I mean advice
(17:49):
for parents, first off of okay,maybe the teen admits, yes, I
have been vaping. What are thewhat are the next steps?
Dr. Doug Kuntzweiler (17:58):
The advice on quitting vaping is very much
the same as the advice onquitting smoking. And as we
mentioned, nicotine is is highlyaddictive, and it's not at all
easy to quit. There aremedications that help
alternative sources of nicotine,like the skin patch and the gum,
they've been shown to be prettyhelpful. And then there are some
(18:20):
new medications, Chantix beingone that helps cut down on the
craving. But it's true, you dohave to want to quit, and I
think it that's that's verydifficult to give people who
know everything at that stage intheir life. While we're
confessing things, I smoked whenI first got out of high school
and I went in the militarybecause everybody smoked. It was
(18:43):
the first privilege they gaveyou in basic training. And so I
smoked for the four years that Iwas in the military. That was a
long time ago, and there reallyweren't any good adjunctive aids
to quitting. If you wanted toquit, you either tapered off or
you quit cold turkey. And Ichose to go cold turkey. Well, I
grew up in a community where,pretty much if you didn't smoke,
(19:03):
there was something odd aboutyou. All of my parents and
grandparents smoked, and soeverybody in my generation grew
up with secondhand smoke anddidn't think a thing about it.
You smoked in restaurants. Yousmoked on airplanes. You smoked
everywhere. When the surgeongeneral's report came out,
people kind of poo-pooed it, butit stuck in the back of their
brain. And gradually people, asthey got older and they started
(19:25):
feeling the effects of tobaccosmoking, they started cutting
down. And that's another thingthat's kind of disconcerting
about this vaping. We have madeit unsociable to smoke in public
places, but vaping is sort ofcreeping back into being
socially acceptable and publiclyacceptable, and I think that's a
rather alarming trend.
Dr. Tiffany Kniepkamp (19:47):
There are several programs specifically
aimed at helping teens quitvaping, which can also go
towards adult but they do havespecific ones for teens, the CDC
and then the American LungAssociation have great support
materials. They have a quitline, some online tools, talking
to your doctor. You don't haveone, get one, but talking with
them, they can have someresources. And then, in the age
(20:10):
of technology, there's an appfor that. There's actually a
couple different apps that canhelp track your progress and
give support for quitting. So Ifeel like that's a big thing
that teens could utilize. Youdownload the app on your phone.
It has motivations. It hasreasons to quit. You can track
how many times you vaped thatday, everything on it. And so I
(20:30):
feel like that's probably thebest resource. And what I would
offer to a teenager who isaddicted or having a hard time
giving up vaping is download theapp. It's something that's very
easy, and it can track theirprogress and give a lot of more
motivational items to help themthan the adult who doesn't know
(20:51):
anything, right, right? does.
Beth Brown (20:54):
We definitely trust technology more than we trust
our parents. That's very true.
So I think we've answered thisquestion, but just to be crystal
clear, is vaping safer thansmoking?
Dr. Doug Kuntzweiler (21:07):
My answer to that is we simply don't know.
There's some early evidence thatshows it, it's probably less
harmful. You have to remember,smoking is incredibly harmful,
so there's some early evidencethat vaping is somewhat less but
neither one of them have a goodend. It still comes with
significant risks. We don't knowthem all as of yet, but the
(21:28):
research is headed towards thereare a lot of risks associated
with it that we don't know. Soin a way, yes, it's safer than
smoking, but it's like the saferof the bad. Oh, and as an added
attraction, there have beenreports of the batteries
exploding and causingsignificant burns.
Beth Brown (21:45):
Oh my gosh, yeah.
Dr. Tiffany Kniepkamp (21:47):
Yes.
Beth Brown (21:47):
So is it pretty fair to say, unless your doctor has
given it to you, maybe justdon't put stuff in your lungs?
Dr. Doug Kuntzweiler (21:54):
Yeah, exactly. I always thought how
counterintuitive it is, and Iwas a smoker, but how
counterintuitive it is if thehouse were burning down around
you and you smell smoke, you getout of the house, you don't sit
there and inhale deeply andenjoy the rush. You know, it
just is so counterintuitive,but, but again, what that really
gets to is how addictivenicotine is. Common sense would
(22:16):
tell you this is a stupid thingto do, but nicotine would tell
you, do it, do it, do it. Do itmore.
Beth Brown (22:22):
Yeah, 'cause there's so many things that people think
they get out of it withrelaxing. I need it to wind down
after the day. It helps me thinkthere's so many things that
people rely on, evenbehaviorally, because that
addiction has them.
Dr. Tiffany Kniepkamp (22:35):
Yeah, and Beth, I would say too. On that
note, it is often said, Right?
Nicotine, it's my stress relief.
It's my stress reliever. I needthis to get through my day, but
it actually worsens anxiety anddepression, because you're
constantly going through thisslight withdrawal, which
increases your stress level, andthen you start to adapt to the
nicotine, and then you needmore, and you actually have
(22:57):
difficulty experiencing pleasurenaturally anymore, because
you've kind of taken that cycleaway that feedback, and so in
the long run, it makes things alot worse and worsens depression
and anxiety. But we do hear thatargument a lot, that it helps
with it, but it's short lived.
Beth Brown (23:14):
Well, you provided some great resources. We'll make
sure we get those put with thisepisode so folks can learn more
or find some resources. Anyfinal note or message we want to
leave our listeners with today?
Tiffany, you want to start?
Dr. Tiffany Kniepkam (23:28):
Definitely check out the site for the app.
If you are addicted to vaping,know that it does have some
issues, and we're learning moreand more about them. Be involved
in your teen's life and in theirfriends and know their parents,
because that'll be very helpfulin those discussions with them,
whether they listen or not,download the app on their phone
and then they have it and theymight look into it. Those are
(23:50):
the biggest things. Is vapingsafer than smoking, kind of it
is slightly safer, but it'sstill bad, and it still leads to
a lot of long term effects. Andwe do see that in the medical
world, and it leads to so manymore effects than people
realize. It affects every systemin the body, highly addictive.
And so it's very helpful. If youcan give it up sooner than
(24:12):
later, or better yet, don'tstart.
Dr. Doug Kuntzweiler (24:16):
Our lungs were adapted to breathe fresh
air, so stick with that.
Beth Brown (24:20):
Perfect. It's short and sweet. I like it. Dr K.
Thank you very much. Thank youboth for being on today. Thank
you so much for listening. We'llput some resources with this
episode. If you would like tolearn more about vaping and how
to quit, we'll have thoseresources for you. And if you
have a question for Dr. K or Dr.
K, please email us atQandAwithDrK@mpqhf.org and we'll
make sure that email address isright along with this episode as
(24:46):
well. Send us your questions.
The doctor is always in, as welike to say, and we'd love to
help. Thanks. Be well.
Welcome to Q and A with Dr. K, a podcast by
Mountain Pacific Quality Health,where we sit down with Dr. Doug
Kuntzweiler and get your healthquestions answered, because on Q
and A with Dr. K, the doctor isalways in.
(00:34):
Hello, everyone. This is BethBrown, your host, and I'm
pleased to announce we all getthe same two for one special
that we had on a previousepisode. As we are joined by two
Dr Ks. Today we have Dr. DougKuntzweiler, who is Mountain
Pacific's chief medical officerand also gives great advice,
talk to us about all thingsmedical. And joining us is Dr
(00:56):
Tiffany Kniepkamp, who consultswith Mountain Pacific and is an
emergency medicineextraordinaire doc. And so we
are so fortunate to have both ofthese experts with us today to
talk about a topic that I thinkis big and a lot of people have
confusion over, and that isvaping. So thanks so much for
being here.
Dr. Doug Kuntzweiler (01:14):
Thanks for having us.
Beth Brown (01:15):
Here's the short and sweet question for today. Is
vaping safer than smoking? Sothe question is short and sweet.
I don't know if the answer isshort and sweet, but before we
dive into that, let's talk aboutthe definitions of those two
things. So I think when we talkabout smoking, everyone knows
we're talking about cigarettesor pipes or whatever you're
using to ingest commercialtobacco. That is not just
(01:36):
tobacco, it has lots ofchemicals and other bad things
in there that we know causesgreat risks to all kinds of
issues with our health vaping,though, I'm not sure if
everybody knows what that is, orif people have been exposed or
seen vaping. So let's talk aboutthat. What is vaping?
Dr. Doug Kuntzweiler (01:54):
I can answer this one. This may be the
only one I can answer. So Ibetter jump in. Smoking means
igniting some flammable product,most commonly tobacco, and so
that's cigars and hookahs andcigarettes. And there are other
ways to get the nicotine otherthan tobacco, as in gum or a
(02:14):
patch that goes on your skin, orchewing snuff. All those are
ways of using tobacco. Butvaping is heating up a liquid of
some sort, and it varies as towhat the liquid is, and having
that create an aerosol. Aerosolis just tiny droplets that float
in the air and then you inhalethat into your lungs. So the
(02:38):
liquid usually then alsocontains some addictive
substance like nicotine, orsometimes a marijuana product,
cannabis oil, of one kind oranother.
Beth Brown (02:48):
So I'm glad you went back to talk about smoking,
because it wasn't as simple aswhat I said. There is more to it
than just cigarettes or pipes.
So I'm glad you talked aboutthat. And then vaping involves a
liquid. And so as you alreadytouched on, a lot of people just
think, Oh, it's just, it'svapor, water, but what are we
talking about? What's in thatliquid?
Dr. Tiffany Kniepkamp (03:05):
Yeah, so that's a very common
misconception. A lot of peoplethink it's just flavored water
vapor, much healthier. But inreality, what you're inhaling is
actually still a mix ofchemicals. The liquid in E
cigarettes contains nicotine,obviously, but also chemicals
like formaldehyde, which youmight associate with things like
(03:25):
smoke or wood burning, notsomething you necessarily want
in your lungs. So it looksharmless, but it's not as simple
as just water vapor.
Beth Brown (03:34):
And the other tricky part about vaping too is you
don't always recognize what thedevices look like that people
are using to vape.
Dr. Doug Kuntzweiler (03:42):
Yeah, they've they've evolved a lot.
It started back in the early2000s, I think, around 2005-2006
as an e cigarette, and it lookedlike a cigarette had a little
battery in it, had a little bitof the juice, which was usually
a propylene glycol or ethyleneglycol, and then it had the
nicotine, and the battery heateda little element that made that
(04:06):
juice vaporize, and then itwould kind of cool down as you
inhaled it and turn into a anaerosol, little droplets of
liquid. And as I said, then thatdevice evolved pretty rapidly,
and now they look like all kindsof things. Some of them are
rechargeable, some of them aredisposable. Some of them are
reusable. They all have somesort of a heating element that's
(04:30):
charged by a battery, and thenthey have a little container or
reservoir where the juice is,and then whatever they're going
to add to it, typically nicotineor marijuana oils, but what they
actually look like is all sortsof different things. I'm told
that one of the favorite ones ofteenagers is something called
(04:50):
the jewel, j-u-u-l, because itlooks like a flash drive. So
they can carry these around theschool, and the teachers look at
it and think, Oh, there's a verystudious child taking notes and
putting it on his flash drive,when, in reality, it's it's his
vaping device.
Dr. Tiffany Kniepkamp (05:07):
Exactly, Doug. That's part of the
problem. They can be really hardto spot. They're coming up with
new things all the time. Theycan look like pens, USB drives,
like you said. That's part ofthe thing that's become very
popular with teens is thatthey're very easy to carry, very
easy to hide, very discreetparents teachers may not even
recognize what it is thatthey're looking at. They're
(05:30):
designed to be very sleek andeasy to carry around so they
don't stand out. And forexample, recently, I got a call
from our school principalbecause my daughter had found
this blinking toy on theplayground, and they sent me a
picture of it, and it was thebattery from a vape pen. And it
was even hard for me to tellexactly what it was. I had to
(05:51):
look up the brand, and thenfound out it was a battery from
a vape pen. So we had a veryhonest discussion with my six
year old of what you do and donot pick up on the playground.
Yeah, but they're very discreetand made to be that way.
Beth Brown (06:07):
Yeah, when we talk about the difference between
vaping and smoking, it's whatwe're inhaling. Is that the
major difference, regardless ofthe device that we use to put
that into our lungs, or what isreally the difference between
vaping versus smoking?
Dr. Doug Kuntzweiler (06:25):
Well, I think to me, one of the biggest
differences is we've had arelationship with tobacco since
1600s and before, and weunderstand in this day and age
what the components of tobaccosmoke are and what the
consequences of tobacco smokeare. In contrast, we have a not
(06:46):
hardly even a decade and a halfof experience with vaping, and
so we don't know really what theconsequences of this are. It's
too soon for us to have goodinformation. We know that
smoking is horrible for you fromany number of standpoints,
cancer being a prominent one,but also heart disease, stroke,
vascular disease of all kindsand many other kinds of
(07:09):
problems. It's associated withalmost every kind of cancer you
can think of. We don't know yetabout vaping. There are studies
that show that it's less harmfulthan smoking, but as I said, we
don't have a lot of experience.
Those studies are usingrelatively small numbers of
patients, and I don't think wefully understand it yet at this
point, but I would say if it'ssafer than smoking, it can't be
(07:31):
by much. And I think historywill probably prove that to be
true.
Dr. Tiffany Kniepkamp (07:37):
Exactly Doug, and I think I would say
too that, so a big difference.
And I know we've kind ofhammered this already, but with
smoking, you're burning tobacco.
You're actually ignitingsomething which creates that
smoke that contains all kinds ofharmful chemicals, tar, carbon
monoxide, all of that. And withvaping, you're heating up a
liquid. So you're never actuallyburning anything. You're heating
it up and turning it into anaerosol without the burning. So
(07:59):
that means you're not gettingall those combustion related
toxins, but still, like Dougsaid, it doesn't mean it's safe.
There's still harmful substancesin the aerosol, and actually,
the flavoring, the fruitiness,the mintiness, even that, is a
chemical that your lungs are notused to inhaling, and so it
still causes a lot of issues. Sopeople think vaping is healthier
(08:21):
and it is technically thansmoking, but it's still very far
from risk free, both put badthings in your lungs that don't
belong there.
Beth Brown (08:29):
So with as relatively new as vaping is, are
we starting to see risks or thecons that come out of vaping? Or
we honestly don't know yet?
Dr. Doug Kuntzweiler (08:38):
No, we absolutely have seen risks.
We've seen people who getscarring on their lungs from it.
In 2019, you may remember, therewas a big outbreak of severe
lung disease from people whowere vaping, and it was thought
that they probably got a vapingdevice that had a toxin in it
(08:59):
that was related to vitamin E,and it caused severe scarring
and damage to the lungs thatthere were about 2800
hospitalizations, and out ofthose people, 68 of them died
that was related to oneparticular type of vaping device
that then was taken off themarket. But there are still
people who are developing apneumonia like syndrome, where
(09:19):
they get damage to their lungsand get scarring. So certainly
is not as safe as some peoplemaintain.
Dr. Tiffany Kniepkamp (09:26):
It still has nicotine. So we know a lot
about nicotine, and so you'restill getting the nicotine,
which is one of the mostaddictive substances, comparable
to like heroin and cocaine. Ithas been known to disrupt brain
development, which is why thisis such a huge concern, and the
teens that are using it a lotnow and it also it increases
your heart rate and your bloodpressure and nicotine also
(09:48):
constricts blood vessels. Sowhen you combine your heart rate
going up, your blood pressuregoing up, your blood vessel
constricting a bit, thatincreases your risk of heart
disease. And so, ot's the samein smoking or vaping, so you're
still having those risks, aswell as the respiratory
illnesses that doctor coonertalked about. It also has been
(10:09):
shown to increase anxiety anddepression and impacts your
memory and cognition and yourability to form those memories
and that brain development, andwe know that even in pregnant
women, that it affects the braindevelopment and the oxygen flow
to the fetus. And so I thinkthat's why this is such a big
concern for teens right now,because, oh, I can't remember
exactly the numbers, but highamount of teenagers are using it
(10:33):
currently, and it's going toaffect their brain. And we're
already dealing with a lot ofother concerns with depression
and suicidal ideations and allof that, and now we add this
into it, and it's just anotherstressor that is not good.
Beth Brown (10:46):
So you mentioned the nicotine, and that was a
question that I was going to askas well, because if there's
nicotine in there, then thatmeans vaping is addictive, just
like smoking is. And if peopleare trying to use vaping to quit
smoking, how effective is thatif they're still getting the
same stuff, just in a differentway? So can you talk about that
(11:07):
a little bit?
Dr. Doug Kuntzweiler (11:08):
Yeah, it's pretty much a shell game. There
was one small study reported toshow that vaping was a good way
to quit smoking, and that mightbe true. Some people who use
vaping were able to stop smokingcigarettes, but then they were
unable to stop using the vapingbecause, as Tiffany said, it's
still nicotine, and nicotine ishighly addictive. Then there are
(11:28):
people who use it, and they windup addicted to both. They smoke
cigarettes when it's convenientto do that, and they vape when
it's not. So it's it's a shellgame. We haven't really made
anything that's a superiorproduct. I've seen numbers and
this kind of goes to one of thethings that alarms me about it
is the marketing that goes on.
But I've seen numbers that up toa half a million middle
(11:50):
schoolers are vaping, and in thehigh school, it's it's more,
it's over a million, maybe oneand a half million high school
kids are vaping. Nationwide,I've read numbers like one in 20
Americans, they but themarketing is aimed especially at
young kids with all theseflavors, and they have cool
names and they have cool shapes,and if you're going to be one of
(12:12):
the cool kids, you have to vape.
Dr. Tiffany Kniepkamp (12:15):
One other thing I was going to say about
that is a big argument I hear alot from the teenagers in the
emergency department when we'retalking about vaping, is
nicotine is not a cancer-causingagent, it's the tobacco, it's
the tar, that's the carcinogen.
But is that true? Yes,technically, nicotine is not
classified as a carcinogencancer-causing agent, but it's
(12:35):
an indirect carcinogen becauseit enhances your body's response
to those cancer-causing agentsfound in either cigarette smoke
or all of the fruity smells andthe formaldehyde and all of
that, it increases your body'srate at turning those into
cancer cells. So while itdoesn't directly cause the
cancer, it makes your body morelikely to develop into cancer
(12:57):
have those cell damage, abnormalgrowth that just kind of
escalates that.
Dr. Doug Kuntzweiler (13:04):
And I recall that chewing tobacco or
dipping snuff is associated withcancers of the tongue, cancers
in the mouth and throat. Sothat's, you know, that doesn't
require burning. It's the otherelements in the tobacco as well
as the nicotine, that areleading to those cancers. So all
of this is addictive, whetherteenagers want to try to talk
(13:27):
about what's really going on inthere or not.
Beth Brown (13:29):
And so how do they how do you know if you become
addicted to vaping? Are theresymptoms that people begin to
show? Do people have withdrawalsif they try to quit? Can you
talk about the addictiveproperties there and how to
handle that?
Dr. Tiffany Kniepkamp (13:43):
It's pretty similar to all of your
other addictions. And if youfind yourself craving the vape,
using it more frequently, justescalating how often you're
using it, or if you don't haveit, frustrated, irritable,
anxious, when you don't have itand you just want to go
somewhere to use it. That's abig sign. You try to stop, and
you just can't. Also a sign, andif you're prioritizing vaping
(14:07):
over other activities, like, Oh,I could go to the basketball
game, but I'm going to stay backso that I can vape. That's also
another sign that you could beaddicted.
Dr. Doug Kuntzweiler (14:15):
How soon in the morning when you wake up
do you take your first vape ordrink your first beer or smoke
your first cigarette, that's anindicator that probably
addicted, if that's the firstthing you do in the morning.
Beth Brown (14:29):
So as far as getting people help if they do become
addicted or they find thosecravings are more than they can
handle, because this is more ofa teenager or tween issue. What
should parents be looking for?
How can they tell if their childis vaping? And then how can they
get their teen or pre teen help?
Dr. Doug Kuntzweiler (14:50):
Well, I think it's probably harder to
detect than smoking, because thesmoke tends to linger and causes
an odor lingers on your clothes.
I don't have a lot of experiencewith vaping, but my suspicion is
that it's much easier for kidsto hide. I mean, you can sit
down and have an honestdiscussion with your kids. Kind
of depends on what yourrelationship with your kid is
like to begin with, and theywill probably make the argument
(15:12):
to you that it's safer and it'snot addictive and doesn't cause
cancer and all those things thatwe have talked about, but I
think where you begin is withhaving an honest discussion with
them. And you know, if you seethem vaping, you might see them
in a crowd of their friends, andthey're all vaping, then that
would be a good point toinitiate the discussion. You've
(15:34):
got younger kids, Tiffany. Whatdo you - how are you approaching
this?
Dr. Tiffany Kniepkamp (15:39):
Well, I also remember high school and
college and my parents beingvery strict and trying to hide
certain things from them, so Imight have a slightly different
view on some of this, but thingsto really look out for, and
things that I'm going to lookout for as my kids get older is
it's a very pleasant, strongfruity smell. So if you're
(15:59):
starting to notice kind of anunusual fruity like a fruit you
can't quite place your fingeron, but it smells good. That's a
good indicator. Or minty smells,but they're tending to go more
towards the fruity smells. Inthe teens, some kids might start
using like a very sweet smellingperfume or a body spray to try
(16:20):
and hide the fact that it is ontheir breath and on their
clothes, that that root smell isthere, or lotions asking to buy,
like really fruity lotions, kindof out of the blue or shifting
might be a time to have a littlediscussion looking for those
little, small, discrete devices.
I mean, if you have a very smartchild who's, you know, studious,
it may not be unusual, but ifall of a sudden the kid who
(16:42):
really could care less aboutschool is carrying a pen
everywhere with them, might havesome questions, any changes in
behavior. And just knowing whoyour kids are hanging out with,
if all of their friends arevaping or if you smell it on
them, then it would be a time tohave a discussion. And I think
just having that open discussionwith them about the risk that,
yes, maybe they're telling youthis does not cause cancer, but
(17:03):
it's actually all of theadditives in it that can cause
cancer, and the nicotine is veryaddictive, and actually can kind
of be that gateway into smokingwhen you're an adult. There's a
few studies, one out ofAustralia, that talked about it
kind of being a gateway intosmoking, and the likelihood that
they smoke in adulthood is veryhigh if they started vaping in
their teens.
Beth Brown (17:24):
This is tough too, because in the past, when we've
talked about addictions, we'vesaid, you know, you can't stop
until you make the decisionyou're ready to stop. And even
that is hard. People tend to notbe able to quit the first time
they try, and it takes a coupleof times before they are able to
quit smoking, for example, withteens, if they're not ready, but
parents are trying to intervenewith this habit. I mean advice
(17:49):
for parents, first off of okay,maybe the teen admits, yes, I
have been vaping. What are thewhat are the next steps?
Dr. Doug Kuntzweiler (17:58):
The advice on quitting vaping is very much
the same as the advice onquitting smoking. And as we
mentioned, nicotine is is highlyaddictive, and it's not at all
easy to quit. There aremedications that help
alternative sources of nicotine,like the skin patch and the gum,
they've been shown to be prettyhelpful. And then there are some
(18:20):
new medications, Chantix beingone that helps cut down on the
craving. But it's true, you dohave to want to quit, and I
think it that's that's verydifficult to give people who
know everything at that stage intheir life. While we're
confessing things, I smoked whenI first got out of high school
and I went in the militarybecause everybody smoked. It was
(18:43):
the first privilege they gaveyou in basic training. And so I
smoked for the four years that Iwas in the military. That was a
long time ago, and there reallyweren't any good adjunctive aids
to quitting. If you wanted toquit, you either tapered off or
you quit cold turkey. And Ichose to go cold turkey. Well, I
grew up in a community where,pretty much if you didn't smoke,
(19:03):
there was something odd aboutyou. All of my parents and
grandparents smoked, and soeverybody in my generation grew
up with secondhand smoke anddidn't think a thing about it.
You smoked in restaurants. Yousmoked on airplanes. You smoked
everywhere. When the surgeongeneral's report came out,
people kind of poo-pooed it, butit stuck in the back of their
brain. And gradually people, asthey got older and they started
(19:25):
feeling the effects of tobaccosmoking, they started cutting
down. And that's another thingthat's kind of disconcerting
about this vaping. We have madeit unsociable to smoke in public
places, but vaping is sort ofcreeping back into being
socially acceptable and publiclyacceptable, and I think that's a
rather alarming trend.
Dr. Tiffany Kniepkamp (19:47):
There are several programs specifically
aimed at helping teens quitvaping, which can also go
towards adult but they do havespecific ones for teens, the CDC
and then the American LungAssociation have great support
materials. They have a quitline, some online tools, talking
to your doctor. You don't haveone, get one, but talking with
them, they can have someresources. And then, in the age
(20:10):
of technology, there's an appfor that. There's actually a
couple different apps that canhelp track your progress and
give support for quitting. So Ifeel like that's a big thing
that teens could utilize. Youdownload the app on your phone.
It has motivations. It hasreasons to quit. You can track
how many times you vaped thatday, everything on it. And so I
(20:30):
feel like that's probably thebest resource. And what I would
offer to a teenager who isaddicted or having a hard time
giving up vaping is download theapp. It's something that's very
easy, and it can track theirprogress and give a lot of more
motivational items to help themthan the adult who doesn't know
(20:51):
anything, right, right? does.
Beth Brown (20:54):
We definitely trust technology more than we trust
our parents. That's very true.
So I think we've answered thisquestion, but just to be crystal
clear, is vaping safer thansmoking?
Dr. Doug Kuntzweiler (21:07):
My answer to that is we simply don't know.
There's some early evidence thatshows it, it's probably less
harmful. You have to remember,smoking is incredibly harmful,
so there's some early evidencethat vaping is somewhat less but
neither one of them have a goodend. It still comes with
significant risks. We don't knowthem all as of yet, but the
(21:28):
research is headed towards thereare a lot of risks associated
with it that we don't know. Soin a way, yes, it's safer than
smoking, but it's like the saferof the bad. Oh, and as an added
attraction, there have beenreports of the batteries
exploding and causingsignificant burns.
Beth Brown (21:45):
Oh my gosh, yeah.
Dr. Tiffany Kniepkamp (21:47):
Yes.
Beth Brown (21:47):
So is it pretty fair to say, unless your doctor has
given it to you, maybe justdon't put stuff in your lungs?
Dr. Doug Kuntzweiler (21:54):
Yeah, exactly. I always thought how
counterintuitive it is, and Iwas a smoker, but how
counterintuitive it is if thehouse were burning down around
you and you smell smoke, you getout of the house, you don't sit
there and inhale deeply andenjoy the rush. You know, it
just is so counterintuitive,but, but again, what that really
gets to is how addictivenicotine is. Common sense would
(22:16):
tell you this is a stupid thingto do, but nicotine would tell
you, do it, do it, do it. Do itmore.
Beth Brown (22:22):
Yeah, 'cause there's so many things that people think
they get out of it withrelaxing. I need it to wind down
after the day. It helps me thinkthere's so many things that
people rely on, evenbehaviorally, because that
addiction has them.
Dr. Tiffany Kniepkamp (22:35):
Yeah, and Beth, I would say too. On that
note, it is often said, Right?
Nicotine, it's my stress relief.
It's my stress reliever. I needthis to get through my day, but
it actually worsens anxiety anddepression, because you're
constantly going through thisslight withdrawal, which
increases your stress level, andthen you start to adapt to the
nicotine, and then you needmore, and you actually have
(22:57):
difficulty experiencing pleasurenaturally anymore, because
you've kind of taken that cycleaway that feedback, and so in
the long run, it makes things alot worse and worsens depression
and anxiety. But we do hear thatargument a lot, that it helps
with it, but it's short lived.
Beth Brown (23:14):
Well, you provided some great resources. We'll make
sure we get those put with thisepisode so folks can learn more
or find some resources. Anyfinal note or message we want to
leave our listeners with today?
Tiffany, you want to start?
Dr. Tiffany Kniepkam (23:28):
Definitely check out the site for the app.
If you are addicted to vaping,know that it does have some
issues, and we're learning moreand more about them. Be involved
in your teen's life and in theirfriends and know their parents,
because that'll be very helpfulin those discussions with them,
whether they listen or not,download the app on their phone
and then they have it and theymight look into it. Those are
(23:50):
the biggest things. Is vapingsafer than smoking, kind of it
is slightly safer, but it'sstill bad, and it still leads to
a lot of long term effects. Andwe do see that in the medical
world, and it leads to so manymore effects than people
realize. It affects every systemin the body, highly addictive.
And so it's very helpful. If youcan give it up sooner than
(24:12):
later, or better yet, don'tstart.
Dr. Doug Kuntzweiler (24:16):
Our lungs were adapted to breathe fresh
air, so stick with that.
Beth Brown (24:20):
Perfect. It's short and sweet. I like it. Dr K.
Thank you very much. Thank youboth for being on today. Thank
you so much for listening. We'llput some resources with this
episode. If you would like tolearn more about vaping and how
to quit, we'll have thoseresources for you. And if you
have a question for Dr. K or Dr.
K, please email us atQandAwithDrK@mpqhf.org and we'll
make sure that email address isright along with this episode as
(24:46):
well. Send us your questions.
The doctor is always in, as welike to say, and we'd love to
help. Thanks. Be well.
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