Death by Vaping
Why did some people die from vaping? What should adolescents (and their parents) know about vaping alcohol, THC, CBD, and nicotine?

Confused about vaping, e-cigarettes, and nicotine inhalers? What’s the difference? Aren’t they the same? Let’s clear up the confusion.

I wrote this information in a way that you should be able to watch or read it once. Then use this 5 Question “Game” to teach this information to others. I wrote these questions with 4 truthful statements and one hidden FALSE statement. See if you or your students can find the false answer. Use the YouTube video I recorded if you need a little help. Use this if you are a teacher, preacher, leader, coach, or parent. If you care about kids’ brain development, help me share this information.

Let’s dive in:

Question #1:

E-cigarettes and Vaporizers / Vapes. Find the False Answer.
A – They use heat to aerosolize substances as they suck them into their lungs
B – They aerosolize substances to the lungs the same way a medical nebulizer does
C – Use aerosols that contain fewer toxic chemicals than cigarette smoke.
D – Most common aerosols are nicotine, tetrahydrocannabinol (THC), cannabidiol (CBD), and dabs (Butane hash oils)
E – Have become the most commonly used teen-tobacco products in the United States

The Answer? B:

Medical nebulizers
Medical nebulizers aerosolize medication for direct delivery into the lungs. Asthma medications offer the most common example of nebulized medication. Nebulizers save lives with the rapid, efficient delivery of chemicals to the source of the problem, your lungs. The tight tunnels whistle with the strain of limited air during an asthma attack. Within seconds of nebulizing the drug into the lungs, the wheezes disappear and the patient breathes easily.

Nebulizers launch the drug from the liquid form to a gas form. Tiny droplets of the medication suspend in the air and the patient breathes the medication into their lungs. The physics launching the molecule into the air comes from pressurized air or piezoelectricity.* The nebulizer allows only the smallest droplets suspended in the air to pass through the device and into the lungs. The brilliance of a nebulizer comes from the sorting of only the tiniest particles. Large particles never get inhaled when using a nebulizer.

Vapes
Vaporizers use a less brilliant approach. Vapes heat the substance with a coil within the device. The high temperatures vaporize the molecules into the air. The difference between a vaporized molecule and a nebulized one: size. Vaping asthma medication, as opposed to nebulizing them, delivers large particles into the back of the throat and the bigger airways of the lungs. Only the tiny nebulized particles make to the tiny tunnels of the lungs where asthma occurs. If we fail to deliver the medication deep into the patient’s lungs, we fail to treat asthma.

C. True. Tobacco smoke contains 7000 + documented chemical substances. E-cigarettes or Vapes attract naive users with the truthful fact that vape solutions have fewer toxic chemicals when compared to tobacco smoke. With over 7000 chemicals littering a cigarette, vapes easily deliver on this advertisement. They fail to mention that vapes have killed first-time users. Never has a cigarette killed the first-time smoker.

Question #2:
Vaped Substances:  Find the false answer:

• A- The teens who died from vaping did not seek medical care soon enough
• B – The heated coils in Vapes deliver large sized particles into your lungs
• C – The hotter the coil burns, the more particles are aerosolized in the vapor
• D – The massive influx of particles into the lungs pulls water into your lungs causing a drowning effect
• E – Your immune system attacks the inhaled particles because it looks like an infection or a toxin

A: Deaths from vaping swept through the headlines in 2019.  The patients who died reached out for help within a few days of feeling sick. Their treating physicians prescribed the proper antibiotics for a lung infection and sent them home. Inhaled toxins from vapes never crossed their minds. Unfortunately, more than 35 days passed before a second medical visit. Their tragic deaths swept the headlines.

N Engl J Med. 2019 Oct 10;381(15):1486-1487. doi: 10.1056/NEJMc1911995. Epub 2019 Sep 6.

D and E: True. Normal healthy lungs appear black on Xray or CT scans. Vaping drops large particles into the lungs that causes a cascade of troubles. The particles spark your immune system to attack the invading chemicals. Unlike bacteria or viruses, the immune defense can not overpower the toxic large particles. A wave of fluid infiltrates the spaces filled with air. Before long the lungs bubble over. Lungs filled with fluid appear white instead of black.

Choice C: True.  The heated coil vaporizes the solution inside the cartridges of a vape. The hotter the coil burns, the greater the number of inhaled droplets.

Question #3:
Nicotine inhalers (not  E-cigarettes). Find the false answer:

• A – Release nicotine powder when you suck on the end of the inhaler
• B – Can be bought without a prescription from your pharmacist
• C – Delivers nicotine through the membranes in the mouth and throat, not to your lungs
•  D – Are less addictive than vaping or smoking because of the slower delivery to the brain
•  E – Are effective in helping smokers quit smoking

The Answer?  B:  You do need a prescription in order to purchase a nicotine inhaler.

Nicotine Inhalers
Nicotine inhalers deliver the stimulating drug similar to a transdermal nicotine patch. Particles leave the inhaler and splatter on the back of the throat or inside of the cheeks. The nicotine gets absorbed into the bloodstream and circulates to the brain just like the nicotine patch. The large-sized particle of nicotine can only launch into an aerosolized gas by adding heat. Without the heat of a cigarette or a vaping coil, the particle travels only a short distance before gravity pulls it out of the air. Neither nebulizer nor nicotine inhalers allow this monster-sized particle into the lungs.

Physicians prescribe nicotine inhalers to help patients taper off their nicotine. The delivery of heated nicotine deep into lung tissue creates a jolt of nicotine into the brain. This rapid surge of nicotine feeds the addiction keeps patients craving their drug. The slower rate of nicotine through the skin or mouth mucosal tissue fails to deliver the dopamine known to keep brains addicted.
Question #4:

Brain swelling:  Find the false answer:

•  A – Vaped alcohol causes your brain to swell for 2 days
•  B – Vape THC and CBD causes your brain to swell for up to three months
•  C – Vape nicotine causes your brain to swell for up to two days
•  D – Teenage memory returns to normal 4 days after using alcohol
•  E – Once a teenage brain has swollen, it stops maturing for up to six months

Answer? D:  Teenage memory Does Not return to normal for days after using alcohol.

Single-photon emission computed tomography (SPECT) images patients looking at their blood flow and function to certain organs.  Brain SPECT scans after a recent concussion show swollen areas of the brain with low blood flow. Concussions swell the brain for up to 72 hours. SPECT scan showed that blood flow fails to return to normal after 6 months without proper brain health. Alcohol causes swelling to the brain just like a concussion. The swelling of a teenage brain halts the maturation of their brain for up to 6 months.  The cause of the swelling does not change the length of time for the arrested development. The teenage brain may resume normal development only after several consecutive weeks of low inflammation within the brain.

Choice E – is true

Once a teenage brain has swollen, it stops maturing for up to six months. Pruning the teenage brain resumes only after several consecutive weeks without trauma or inflammation.

Choice A – true:

Alcohol swells the brain. Regardless of the mode of delivery, that swelling lasts for up to two days. The arrested brain development sticks around for several weeks in a teenager.

Choice D – true:
15 Yr old Brain Drinker vs. Non Drinker
Brain SPECT scan of two 15-year-old males teach us about teenage memory. A heavy weekend drinker was compared to the teenage brain of a non-drinker. Both boys’ memory was tested using the SPECT scan. No alcohol was consumed for 4 days prior to the test. The difference? Striking. The teenager alcohol drinker had significantly lower brain activity when compared to the non-drinker. Both boys were alcohol-free. The working memory in the 15-year-old boy who previously consumed alcohol failed in comparison to the never-drinker.

The teenage memory took months to return to normal. Months of NO SWELLING within that teenage brain. Despite a diminished amount of chemicals from vaping, the effects deteriorate brain maturation in a profound and long-lasting manner, especially in the developing teenage brain.

Choice B – true:
THC and CBD swells the brain for up to three months. Both substances are fat-soluble. Both sink into the fatty organs of our brain and sex organs (testes and ovaries.) Once these chemicals get enveloped by these fatty organs, they take up to 12 weeks to find a way out. Once the organs have cleared the substances, it can take up to 6 more months to remove the remaining inflammation.

Important Points:
CBD and THC:

• are both fat-soluble
• binds to cannabinoid receptors
• are found in brains up to 3 months later
• significantly reduce BDNF (Brain-derived neurotrophic factor)
• shrinks the hippocampus
• shrinks the frontal cortex

Question #5:
Vaping. Find the False Answer:

• A – Vape solutions required no testing before selling it to the public
• B – The first e-cigarettes had no vapor or “smoke”  that exhaled from them, no added smells or taste
• C – Alcohol, gasoline, heavy metals, essential oils, and bacteria are commonly found in the Aerosols
•  D – Vaping surges dopamine due to the fast delivery of the chemical to the brain
•  E – Nicotine and THC have the same addictive properties whether you vape them or swallow them

Correct Answer? E: 
Nicotine and THC have less addictive properties when swallowed as opposed to vaping because less gets delivered into the blood.

Choice D? True:
When vaped, Nicotine and THC deliver large doses directly into the lungs. This results in a bolt of drug that enters the blood and then the brain. The bolus to the brain surges their dopamine and feeds their addiction. Directly injecting these into their blood allows the same principle. 

Dopamine causes more than just pleasure and euphoria. This neurotransmitter acts like gasoline on a fire when feeding an addiction. To create the most addictive pattern of use, deliver the drug in a way that zings the production of dopamine.

Choice A? True:
Vape Solutions required no testing before selling to the public. The first e-cigarettes had no vapor or smoke that exhaled from them. Vaping venders added smells and tastes to add higher pleasure. Each added strategy improved sales and widened their target audience.

Choice C? True:
Commonly found compounds include, alcohol, gasoline, heavy metals, essential oils, and bacteria.

*What is the piezoelectric effect? Click here for a simple explanation
Am J Respir Crit Care Med. 2019 Oct 15. doi: 10.1164/rccm.201910-1903ED.
Trends in Adolescent Vaping, 2017-2019. N Engl J Med. 2019 Oct 10;381(15):1490-1491. doi: 10.1056/NEJMc1910739. Epub 2019 Sep 18. Miech R1, Johnston L1, O’Malley PM1, Bachman JG1, Patrick ME2.