The Dangers of Vaping

The use of electronic cigarettes – e-cigarettes – e-cigs – vape pens – has been increasing among high school students.  Vaping in high schools rose from 1.5% of students in 2011 to 20% in 2018.  Middle schools may also be affected.  This is a serious matter, because of the dangers of vaping. Juul is the brand name for e-cigarettes. Juul has flavored e-cigs that appeal to youth.

In September of 2019 the Centers for Disease Control and Prevention, and the US Food and Drug Administration sent out a warning – urging people to consider not using e-cigarettes and also to avoid buying them off the street.  Currently there have been at least 380 cases of severe lung illness reported from vaping, and 6 deaths.  Unfortunately, more deaths are expected.

Vaporizers heat and aerosolize the nicotine or nicotine plus marijuana meant to be inhaled.  Vaping solutions consist of particles associated with toxicity to the heart and lungs, such as formaldehyde.  Vaping can irritate the lungs and lead to damage. It increases lung inflammation and paralyzes cilia – the hair-like projections in airways that remove microbes and debris. This increases the risk of pneumonia. A new finding has been lipoid pneumonia – the presence of fat in the lungs as a result of vaping. This is a relatively new illness with long term consequences.  Articles in the British Medical Journal and the New England Journal of Medicine have cited cases of hospitalized patients with vomiting, chest pain, shortness of breath, fever, and weight loss.  Recovery can be slow, and complete recovery from lipoid pneumonia may not occur. Vaping has also been linked to seizures and damage to the endothelial cells that line the blood vessels. In one case, the e-cigarette exploded in the mouth of a user.

I think the lessons here are clear.  Do not vape. If you are a cigarette smoker and want to quit, talk to your health care provider about safe methods.  Go to the website of the Mayo Clinic for their suggestions.  You can do it – many have succeeded – be safe, and keep your children safe.  

Sadja Greenwood, MD, MPH

Many Drugs have Dangerous Interactions with Alcohol – Be Aware

Information in this column is based on a newsletter called Worst Pills, Best Pills.  I suggest subscribing to this newsletter (800-289-3787) if you or members of your family take over-the- counter or prescription drugs. You do not need medical knowledge to understand the content of this newsletter, and it can be lifesaving.  

Research from the National Institute on Alcohol Abuse and Alcoholism has shown that many people, especially those over 65, may be incurring a risk by using alcohol when taking prescription drugs.  Alcohol, itself a drug, becomes more intoxicating if the drug taken will block the stomach’s ability to metabolize alcohol.  This is true of commonly used drugs for treating gastrointestinal ulcers such as ranitidine (Zantac and Tagamet), and also true for the smoking cessation drug Chantix.  

People combining alcohol and sedatives, including benzodiazepines (such as Valium or Ativan) and sleeping pills of all kinds, can experience increased sedation, impaired breathing, and be more likely to fall or have serious accidents.  Respiratory arrest can occur.  

Alcohol can impair the metabolism of drugs, resulting in risk of drug overdose.  This could happen with the drug warfarin (Coumadin), used as a blood thinner, and could result in an increased risk of bleeding. Conversely, long term heavy drinking could increase the metabolism of warfarin and increase the risk of blood clots. It is clear that people on warfarin should not drink heavily and be aware of their levels of the blood thinner.

Alcohol can interact with antibiotics, anti-fungal drugs, antidepressants, antihistamines, diabetes drugs, opioids, nonsteroidal anti-inflammatory drugs such as ibuprofen and naproxen (Advil and Aleve), and Tylenol.  

People who are used to having a glass of wine with dinner may not experience problems with medications. However, heavier drinking can cause serious problems.  Therefore, the following advice is very important: check with your pharmacist and your health care provider before using alcohol with any prescription or over-the-counter drug. Read the warning labels on the bottle or package.  If it says not to drink alcohol – don’t drink it! 

Sadja Greenwood, MD, MPH

What YOU can do about Global Warming

Speak up – to your friends, neighbors and elected officials. Tell California officials you are proud of their policies on fuel economy standards. A pushback is coming immediately from the Trump administration.  Stay tuned.

Follow Swedish teenager Greta Lundberg as she mobilizes youth to fight climate change. They want to inhabit a livable world.  She is currently at the U.N. in NYC.  I have her on Google Alert, so I can read about her every day.  

What would happen if everybody in the United States cut back on driving?It turns out that even driving just 10 percent less — if everyone did it — would have a big impact on greenhouse gas emissions. That’s because Americans drive trillions of miles every year, helping to make transportation the biggest contributor to United States greenhouse gas emissions. In 2017, light-duty vehicles in the United States (including cars, S.U.V.s, pickups and most of the vehicles used for everyday life) produced 1,098 million metric tons of carbon dioxide equivalents.  That’s about one fifth of the country's total emissions footprint. A 10 percent cut, therefore, would be roughly 110 million metric tons of carbon dioxide, or the same as taking about 28 coal-fired power plants offline for a year.  While not easy, that target is realistic for most people, said Tony Dutzik, a senior policy analyst at the Frontier Group, a nonprofit research organization. Walk, bike or take public transit when possible. Car-pool, and work from home when you can. Emissions from a full bus or train are vastly lower than a car.  Fly less – take a train or bus instead.  

Weatherize your dwelling – make sure to seal drafts and have good insulation.  There may be federal tax breaks for some of this.  Invest in energy efficient appliances – look for the Energy Star label on them.  Find power plug-in devices that are rarely used and turn them off – I found two immediately in my apartment.  

It takes energy to heat your water and make it clean.  Take shorter showers, turn off the tap when you brush your teeth, wash your clothes in cold water. 75 to 90% of the energy used by your washing machine goes to warming the water.   Set a timer to run your dishwasher at night, to save on electricity, gas and water costs.  If you have time, dry your clothes on a bamboo clothes drying rack.  

Eat less meat – there are large energy and water costs in producing meat and cleaning animal refuse.  Eat vegetable protein such as nuts, and organic soy.  Combined with wholegrains, you will get a complete protein. Consider drinking nut milk instead of milk and cream.  Follow the Monterey Bay Aquarium Guide for advice on sustainable seafood.  

Buy LED lightbulbs – they use 90% less power than incandescent bulbs and are much longer lasting. They will cost you more up-front but save money and power.  

Find a way to plant trees in your community – either on your property if feasible, or possibly through a local school where the children participate.  Contact the Arbor Day Foundation to find suitable trees for your area.  

Keep at it!   Sadja Greenwood, MD, MPH

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