Despite Awareness of Outbreak, Many Vapers Misunderstand Risks

December 20, 2019 12:26 pm David Mitchell

Results of a survey commissioned by the AAFP show that consumers are following the news of vaping-related illnesses and deaths, but many young people who vape still don't understand the risks posed by e-cigarette products.

[young woman vaping]

As of Dec. 17, more than 2,500 cases of hospitalized e-cigarette, or vaping, product use-associated lung injury (EVALI) have been reported to the CDC.( Fifty-four deaths have been reported and more are under investigation.

In the online survey of 1,000 people ages 16 to 30 who vape, 93% of respondents said they were aware of the EVALI outbreak, and 65% said they were closely following news regarding the issue. More than 70% of respondents indicated they planned to be more careful about the products they buy and to reduce their use of vape products, and 86% were confident that they understood the health risks associated with vaping.

Survey results, however, showed a different reality regarding that understanding of risk. More than half of respondents said that only people who vape cannabis products were at risk of vaping-related illnesses and death. However, of 1,782 hospitalized patients with complete information in the CDC report, 20% reported not using cannabis products.

Furthermore, 60% of survey respondents said that second-hand aerosol from vape products is harmless. However, substances found in such aerosol include nicotine, ultrafine particles, flavoring chemicals like diacetyl, volatile organic compounds, heavy metals and cancer-causing chemicals.(

"What's disturbing is that people aren't aware of their risks," Natasha Bhuyan, M.D., a family physician in Phoenix, told AAFP News. "They think that people are only at risk if they are using cannabis products or black-market products. They think, 'My apple-flavored vape juice is just fine.' But it could be just as dangerous as whatever else is out there."

Bhuyan, a clinical assistant professor at the University of Arizona College of Medicine-Phoenix and West Coast regional medical director for One Medical, said family physicians are well positioned to have important conversations with patients (and parents) about the health risks associated with vaping. Although vape products have been marketed as tobacco cessation devices, only 37% of survey respondents said they used the products for that reason. Far more -- 59% -- said they used the products to relax.

"This could be an opportunity for family physicians to talk about mental health," Bhuyan said.

Other reasons cited for using vape products included socializing (26%) and trying to fit in (16%).

"We need to have real conversations about harm reduction and what is the role of vaping in quitting tobacco," Bhuyan said. "Teenagers and adolescents are not using vaping to quit tobacco; they're using it socially, and that's dangerous."

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