The idea that the only people vaping e-cigarettes are current smokers trying to quit is not true, especially in the last several years. 

  According to the American Cancer Society (www.cancer.org/latest-news/surgeon-general-calls-e-cigarettes-dangerous-to-young-people.html), electronic cigarette use has grown a staggering 900 percent among high school students in recent years. Currently, an alarming one in six high school students admit to using e-cigarettes. Given that brain development continues into the early and mid-20s, exposure to nicotine and other harmful chemicals may impact their developing brains, lead to addiction, or even worse, lung  cancer.

  Atlanta Mayor Keisha Lance Bottoms recently signed legislation for a  broad ban on smoking and vaping in restaurants, bars, workplaces and  additional places in Atlanta that takes effect January 2. This is a  great first step, but as an oncologist, parent and member of the  American Lung Association’s Expert Medical Advisory Panel, I’m  committed to elevating the discussion about the dangers of vaping in 

order to give young people, parents and others a better understanding  of potential, negative ramifications.

  Dangers such as nicotine, chemicals abundant in e-cigarettes:

  The aerosol inhaled from vaping contains a mixture of chemicals including nicotine, formaldehyde and acrolein. In 1987, the U.S.  Environmental Protection Agency (EPA) classified formaldehyde as a probable human carcinogen under conditions of unusually high or  prolonged exposure. Since that time, studies have suggested that  formaldehyde exposure is also associated with certain types of cancer. Acrolein, which is commonly used as a weed killer, can cause  irreversible lung damage, while the aerosol in and of itself can  irritate the lungs, throat and eyes.

  But vaping is not just affecting those who partake. In 2016, the  Surgeon General (www.lung.org/ stop-smoking/smoking-facts/im pact-of-e-cigarettes-on-lung.html)  concluded that those exposed to second hand emissions, including nicotine, ultrafine particles; flavorings such as diacetyl, a chemical linked to serious lung disease; volatile compounds such as benzene, found in car exhaust; and heavy metals, such as nickel, tin and lead are at increased risk of developing lung cancer.

  Popcorn lung and flavored e-cigarettes:

  While it may seem cool to some teenagers and others to try the latest e-cigarette flavors , there are additional risks associated with  flavors, most prominently exposure to diacetyl. When inhaled, diacetyl  causes bronchiolitis obliterans – or  ‘popcorn lung’ – a scarring of  the tiny air sacs in the lungs resulting in the thickening and  narrowing of the airways. In the 1990s, many popcorn manufacturers removed diacetyl from their products due to harmful chemicals suspected to cause cancer.

  In a recent study  (www.hsph.harvard.edu/news/press-releases/e-cigarette-flavoring-chemicals-linked-to-respiratory-disease/), researchers at Harvard found that 39 of 51 e-cigarette vapors contained diacetyl. Two other harmful chemicals – pentanedione and acetoin – were also found present in 23 and 46 of 51 flavors tested respectively. Both are linked to adverse health effects.

  While diacetyl is the most discussed health risk when it comes to  flavorings, there are other risk factors that need to be considered,  notably, the FDA considers food flavorings as “generally” safe for  ingestion, but not for inhalation.

  Long and short-term ramifications:

  Health risks associated with vaping are still being evaluated, but there is a growing body of evidence that the chemicals in these products are very dangerous. Recently, the World Health Organization  (WHO) said electronic cigarettes and heated tobacco products are a real danger to public health and unequivocally do not help reduce  cancer. Like WHO, I am advocating that the regulation of these  products include:

  -Impeding the promotion of e-cigarettes and heated tobacco products

  -Minimizing potential health risks to users and non-users

  -Prohibiting unproven health claims from being made about these products

  -Protecting existing tobacco-control efforts from commercial and other vested interests of the tobacco industry.

  I’m also calling for the implementation of educational programs and additional research into potential risks associated with vaping. We  must band together to stop companies from targeting our youth. While studies show short-term effects on various physical functions, we haven’t seen enough evidence to truly understand long-term ramifications. The surest way to avoid problems is not to vape.

  Dr. Patricia Rich is the medical oncology director of the Cancer Treatment Centers of America (CTCA) Lung Cancer Institute and vice chief of staff at CTCA Atlanta in Newnan, Ga. She is a member of the American Lung Association’s Lung Cancer Expert Medical Advisory Panel.