Jul 18, 2022 How Vaping Harms Kids

group of teams smiling and hugging each other

A study explains what happened to a group of local teens — and makes a surprising discovery. 

Vaping resembles smoking cigarettes: Users inhale and expel a smoke-like substance. But vaping devices don’t burn tobacco. Instead, they heat liquid chemicals such as nicotine to form an inhalable aerosol. These devices don’t produce a telltale smoky smell like cigarettes, so parents may not know children are vaping.

Maya Ramagopal, MD
Maya Ramagopal, MD

Research led by Maya Ramagopal, MD, a pediatric pulmonologist at The Bristol-Myers Squibb Children’s Hospital (BMSCH) at Robert Wood Johnson University Hospital and Associate Professor of Pediatrics at Rutgers Robert Wood Johnson Medical School, shows how parents can be fooled—and how vaping can harm kids.

In her study, published in Pediatric Pulmonology, parents brought teens to doctors thinking symptoms such as coughing, fever, breathing difficulty, abdominal pain and diarrhea were signs of COVID-19. “Most parents were very surprised to find out their children instead had a condition known as EVALI, or e-cigarette or vaping product use-associated lung injury,” says Dr. Ramagopal. “EVALI was essentially masquerading as COVID.” Here, Dr. Ramagopal elaborates on her findings.

What Prompted Your Study?

This cluster of teenage patients—six males, six females—had been admitted to BMSCH early in the pandemic between February and June 2020, and presented to us like COVID patients would: similar symptoms, chest X-rays that looked like COVID and inflammatory markers in their blood as with COVID. Yet repeated COVID testing was negative.

The patients did, however, test positive for tetrahydrocannabinol (THC), the psychoactive substance in marijuana. When asked, teens admitted to vaping both nicotine and THC for anywhere from one month to five years.

What’s the Significance of These Findings?

Figuring out what was causing symptoms meant we could treat these patients correctly with steroids and supplemental oxygen. It’s important for physicians and parents to know vaping can cause symptoms that look like COVID-19.

Why is Vaping Dangerous to Kids?

The Centers for Disease Control and Prevention says no vaping products should be used by children, young adults or pregnant women. Most products contain nicotine, but they also may contain THC, flavorings and other harmful ingredients.

Nicotine is addictive, causes lung inflammation and can interfere with brain development. THC makes people high and reportedly harms lungs more than nicotine. And an ingredient in some vaping products, vitamin E acetate, is toxic to lungs. Vaping products containing vitamin E surged around the time of our study, which might explain why we saw this cluster of EVALI cases.

What Red Flags Should Parents Look For?

Clues that kids may be vaping include:

  • Shortness of breath, or cough
  • Mood swings, behavior changes or declining school performance
  • Sweet-smelling fragrance around your child that may be due to fruity flavors in vaping products
  • Unexplained weight loss that may be due to appetite suppression from nicotine
  • Nausea or vomiting
  • Finding vaping device parts such as pods, coils or lithium batteries in children’s belongings

Learn more about the Pediatric Pulmonary Program at The Bristol-Myers Squibb Children’s Hospital at Robert Wood Johnson University Hospital.