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TDH updates health advisory on e-cigarettes

By Meg Dickens

Vaping has continuously grown in popularity since its introduction in 2007. Mountain City’s population falls at approximately 2,500 and has been the home of at least two vape shops: 421 Vapor and Crossroads Vapor. Now the Tennessee Department of Health (TDH) is updating its health advisory on these electronic nicotine delivery systems (ENDS) due to recent federal actions and new evidence of potential harm.

New risks cited in the new TDH Public Health Advisory include the following:
• Nicotine is highly dangerous to developing brains. Despite this, nearly 90 percent of adult smokers started before adulthood.

• Substantial evidence supports that youth ENDS use increases the risk of smoking cigarettes, etc.

• In Tennessee, nearly half of high school students have used these products, and 11.5 percent report current use.

• Those who use ENDS to quit smoking conventional tobacco products usually continue to smoke cigarettes and could be less likely to quit than nonusers.

“Growing evidence has raised the level of concern about the serious risks posed by these products to the health of everyone involved, especially children and teens,” said TDH Commissioner John Dreyzehner, MD, MPH. “Both current and potential users of all electronic nicotine delivery systems should be aware e-cigarettes may create a variety of dangers for the user and bystanders exposed to the products.”

One such danger is bronchial obliterans (BO), which is colloquially known as Popcorn Lungs. This condition causes shortness of breath and coughing by damaging the lungs’ smallest airways. Inhaling a chemical present in microwave popcorn can also cause this condition.

Public opinion is split. Locals who wish to be kept anonymous spoke about their experiences with these devices. Two locals spoke of ENDS’ bad quality causing leaks and its chemical taste. Two others spoke about how these devices have been helpful in weaning themselves off nicotine. The latter group consists of a male and female. The female no longer smokes cigarettes and is down to a low nicotine concentration vape juice. The TDH is not convinced that ENDS are as safe as others tend to believe.

“While electronic nicotine delivery systems are promoted as smoking cessation devices, their safety and effectiveness have not been demonstrated,” said TDH Chief Medical Officer David Reagan, MD, Ph.D. “ENDS have been shown to expose users and bystanders to chemicals and metals that may harm health. Their use as smoking cessation devices does not provide a clear benefit over the numerous Food and Drug Administration-approved products available to smokers who want to overcome nicotine addiction.”

New designs and flavors continue to entice the younger generations according to TDH Assistant Commissioner for Family Health and Wellness Morgan McDonald, MD. The most recent National Youth Tobacco Survey shows a large increase in ENDS uses in school-age users. High school students’ use increased by 78 percent and middle school students’ use increased by 48 percent.

For free assistance and support in ending a nicotine addiction, call the Tennessee Tobacco QuitLine, 1-800-QUIT-NOW (1-800-784-8669) or visit

The mission of the Tennessee Department of Health is to protect, promote and improve the health and prosperity of people in Tennessee. TDH has facilities in all 95 counties and provides direct services for more than one in five Tennesseans annually as well as indirect services for everyone in the state, including emergency response to health threats, licensure of health professionals, regulation of health care facilities and inspection of food service establishments. Learn more about TDH services and programs at