Season 15 | Ep. 1

From Smoking to Vaping

We’ll explore the history of nicotine use and what dangers it’s associated with today.

You may remember a time when it was common to see people smoking in their cars, on every corner, even on planes. It was just a few decades ago that smoking rates reached an all-time high. In 1964, we learned there were health risks associated with smoking and rates have been declining ever since. But there’s a new concern on the horizon and experts say it has reached epidemic proportions among young people.

“Where’s there a man, there’s a Marlboro.”

If you look at the advertising, certainly when I was kid, you had all these different tobacco companies. And it was looked at, they were in fancy cars and fancy boats and then Virginia Slims and glamorous women were all basically used to attract people to smoking, thinking it was a cool and really neat thing to do.  Smoke bel air smoke bel air smoke bel air   smoke twice as refreshing oh twice as refreshing.

The really sad part is, is that the exact same thing is being done with vaping. This is just a humongous business. And big tobacco is all about big money. They are out there for one reason, to sell to kids. I’ve been talking to a lot of different middle and high schools. When I say, “Do you have anyone in your family, a parent, do you have a friend who vapes,” and it’s staggering how many kids are raising their hands.

It has become so bad that students are doing it in the classroom.

It is definitely a problem. And it’s starting as young as elementary school. We’re trying to get in front of the kids as much as we can to educate them on the dangers of vaping.

We just want it to stop. We want the laws to change. We want the federal government to take a stand ’cause it’s impacting all of our kids, our future.

I got two little kids that — well, they’re not kids but teens. My son has a couple friends that vape. And pretty much all my daughter’s friends vape now. My daughter did vape and once I was admitted in the hospital, she stopped. When you’re a kid, you think, “things that aren’t going to hurt you — that everybody else does it so why can’t we.”

One of my main concerns is, I think the — the percentages again of people cigarettes is going to start to go up again. The more people that vape will definitely turn to cigarettes.

My advice to a young person would be not to even try it even though it looks appealing, that it’s harmful.

Today, HealthCare is about empowering people to take control of their health whether creating a fitness routine, choosing the right procedures and medications or adhering to treatment for a chronic condition. Capital BlueCross, dedicated to underwriting Transforming Health for the good health of the community.  WellSpan Health, helping patients reach their health goals through a coordinated system of physicians, hospitals and convenient healthcare services in communities across central Pennsylvania. Learn more at wellspan.org. WellSpan Health, for the journey that is life. Support also comes from viewers like you. Thank you.

Hello. And welcome to “Transforming Health: From Smoking to Vaping.” I’m Keira McGuire. Over the next half hour, we’ll look back at the history of smoking in the U.S. And forward to the latest concern known as “vaping.” We’ll hear from experts on the risks associated with vaping and young people on its appeal. First, you may remember a time when cigarette ads claimed they could help with weight and even digestion. Some tobacco companies even used doctors to sell cigarettes. It wasn’t until the 1960s that a landmark report linked smoking with dangerous health effects.

Smoking took off after World @ar II when we put a lot of cigarettes in G.I.s kits.

After the second world war, most men smoked. So, you’re no more than 70%. So, you’re a little bit of an oddity in the late 40s and early 50s if you’re a guy who didn’t smoke.

It really caused addiction to a lot of people coming out of the war.

So, it just became a normal thing. You know, we had tv advertising with the Marlboro cowboy. And you know, everybody wanted to be John Wayne and rough and tough and have a cigarette.  Where’s there a man there’s a Marlboro.

if you look at the advertising, certainly when I was kid, you had all these different tobacco companies. And it was looked at, they were in fancy cars and fancy boats and then Virginia Slims and glamorous women were all basically used to attract people to smoking, thinking it was a cool and really neat thing to do.  Smoke bel air smoke bel air smoke bel air   smoke twice as refreshing oh twice as refreshing.

So, the bottom line is it’s to get you into the fold.  In new bel air in new bel air menthol fresh bel air   menthol fresh bel air

Only bel air brings you the menthol fresh blend for clean, refreshing taste.

Once you start smoking at least even a half pack of cigarettes a day, you can become addicted to nicotine within six months.

The strongest relationship between smoke — cigarette smoking and health was in the field of lung cancer.

It was 1964 before there was a surgeon general’s report that really nailed smoking as the cause of lung cancer.

There is a very strong relationship and probably a causal relationship between heart disease and cigarette smoke.

The surgeon general’s report in 1964 was really a turning point and that led to things like bans on advertising cigarettes on tv and radio. That got a lot of publicity. It became more widely known that smoking’s bad for you in many ways. Lung cancer is the one we think of. But we’ve learned with many surgeon general’s reports since then — you know, heart disease and basically — almost every part of your body is affected by smoking. 100,000 Doctors have quit smoking cigarettes. You can too.

Hi, I’m Todd Schweitzer. I’ve been smoking roughly about 30 years. When I first started smoking, me and friend — was about 11 years old. Stealing cigarettes from my dad and running out back in the field and puffing away. They had the commercials with Marlboro and camel and the guy with them rolled up in his sleeve — his short sleeves. It was pretty much everywhere and anywhere. Thought we were cool, doing what everyone else was doing.  Everyone I knew was smoking, pretty much. Mom, dad, sisters, aunts, uncles, everyone. I noticed that it was addictive, I don’t know, couple months into it so I started smoking more, ’bout a pack or two a day. That’s — the first time I had problems with my lungs. The first time I tried to quit was in 2007 and that ended up in failure. You’re used to — first thing you have when you wake up is a cigarette. After you eat, a cigarette. Before you go to bed, cigarette.

And that point, it became, kind of, widely understood that this is something people might need help with, and we need, you know, medications and counseling and things like that.

Ever since I’ve been in practice, everything has revolved around cigarettes. And for me, the important thing about cigarettes is realizing it’s an addiction. When I first started, it was the Nancy Reagan approach, just say no. You know, “why can’t you say no? Why can’t you stop smoking?” And I’ve realized over the years, that just doesn’t fly. It’s an addiction.

Data now shows that the average middle-aged smoker has tried to quit at least 20 times. And the thing that makes it hard to quit is that they’ve become addicted to nicotine. And when you try and quit, they experience nicotine withdrawal.

And nicotine is one of, if not the most addicting substances out there. It’s more addictive than heroin, cocaine, alcohol. And the wanting, the needing and the craving go on for a long time after you stop. For some people, years and years, always wanting a cigarette.

Hi, I’m Becky. I started smoking when I was 16. Now I have end-stage COPD. And I’ve had lung surgery.

Cancer rates have come down to their lowest level ever and it’s largely because of the reduction of lung cancer. And it’s largely because people are smoking less.

That being said, a lot of those people that would be smoking have now gone to vaping.

Vaping is defined as the inhaling and exhaling of a vaper produced by an electronic cigarette. It began to pick up in popularity when traditional cigarette smokers saw them as a less harmful nicotine delivery system here’s a look at why they gained popularity, how much the devices have changed and how much we know about long-term safety.

When I first started reading about vaping devices, I really like the idea a lot because what they were originally developed for was to help older smokers who have been smoking a long-time transition as a nicotine replacement therapy to a vaper cigarette and help get them off regular cigarettes. So, I was recommending for a long time and I still do periodically recommend to the 60, 70-year-old people who come in who had been smoking for 20, 30, 40 years as a nicotine replacement.

I switched to vaping in 2013. The first time I heard about it, I think it was 2011. A lot of people I knew were doing it before I started vaping and that’s why I was like, “okay, I’ll try it. Give it a chance.” And we seem to think it was healthier for us with not having such high nicotine and all that in it. A guy gave me a free e-cigarette. It was just a little stick back then but — yeah. Gave it to me for free. And I had to do was get my own juice. So that’s how I tried it. I was able to get myself down to one cigarette a day, sometimes not even that. It’s like — living in an apartment where you can’t smoke inside so wintertime, when it’s real hot out in summertime, it’s easier to just sit back, vape ’cause it don’t leave a nicotine smell. Just smells fruity. I could go a day or so without having a cigarette as long as I was vaping. But then if I wasn’t vaping or ran out of juice, I’d need a cigarette.

Most sources really believe, and I do too, that vaping is overall a safer concept than using cigarettes. There are over 7,000 different toxic chemicals and compounds in cigarettes, many of which are carcinogenic and can cause cancer. Vaping refers to the inhalation and exhalation of a vaper. And basically, what happens is there is a device, a vaping device that has a heating element and that heating elements heats up a liquid and that liquid has certain substances in it. For most vapers, it’s nicotine is by far the most common. However, certainly, vaping devices can used to vape THC which is the psychoactive component in marijuana. It can also — people vape CBD oil. They would be about the three main things. Some people just vape flavorings. And there are over 7,000-8,000 different flavorings out there.

You know, they started off with what we call cigalikes that look very much like a cigarette. Now we have over 1,000 different kinds of electronic cigarettes.

Some of the more common ones are called mods which are modifiable devices. Pen vapes. There are vaping devices that look like magic markers, pens, USB ports.

The federal government today warned Americans not to use e-cigarettes following several mysterious deaths linked to vaping.

The biggest issue that’s come up that’s made the biggest difference is the mystery vaping illness. It’s called EVALI, E-V-A-L-I. It stands for e-cigarette or vapor product use associated lung injury. This illness that started in April and it progressively worse and peaked in September is now in all 50 states, many united states territories.    Over 1/3 of people that get this illness directly from vaping end up on life support machines in the hospital. This illness is primarily in people that are vaping THC. It’s primarily in people that are using boot-legged, or street bought vaping devices.

When I originally got sick, I was coughing up a little blood, short of breath. And I thought it was just a flu. And I put up with it for about five days so on Sunday night, I was like, “I’m just going to go to urgent care.” I went to urgent care and they admitted me right away. They said that an ambulance had to pick me up ’cause my oxygen level was down to 88%. And they admitted me to the hospital and just went on from there. Originally — at first, they thought it was heart failure ’cause it showed some symptoms of that. But then after a few tests that they ran, then they thought it was pneumonia. But once the bleeding the went away, and the shortness of breath started subsiding, that’s when they got down to putting me on steroids. And it ended up being EVALI.  We heard about it. I didn’t hear anybody around here that had it though. I was upset ’cause I thought it was just the marijuana vaping that had the EVALI and not the tobacco one. I was in the hospital for five days. And they ended up putting me on a steroid for three weeks. And now I’m just stuck with having shortness of breath. My oxygen levels gotten better but my x-rays are showing that there are some damage still there. I got to go this week and get another x-ray to see if the dark spots have gotten any better ’cause on that x-ray you can see where a normal lung lights up and on the darker one, that means that there’s damage in spots. I have to go to the doctor once a month now. But first, it was every other week until they find better x-ray. I’m hoping to get back to where I was before the — I had the EVALI. Just doing little things gets you winded and just a cool breeze will take your breath away when you have EVALI. Unfortunately, I’m smoking but no longer vaping anymore. I don’t want to take the risk of getting back into the hospital. We’re right now trying to get the approval for the Chantix to try to stop ’cause it works for some people. And my sister was able to cut down on her smoking with it. So, I’m hoping that — that’ll get approved. Now I got two little kids that — well, they’re not kids but teens that still like to do things with me and I still like to do things with them. And I’m hoping to get better for the summertime so we can do family things like the beach and the mountains.

The realization that vaping is not harmless has — has got people very concerned.

And the truth of the matter is we really don’t know. There’s been no literature. There’s been no long-term studies so it’s — it’s this open industry that we have no idea about the safety long-term.

Although e-cigarettes were originally intended as a nicotine replacement vehicle for existing smokers, there’s another group of users that have taken to vaping in eye-opening numbers. May say it’s reminiscent of when smoking was becoming popular.

So how many of you have heard of vaping?  How many of you know someone your age who vapes?

Basically, all these industries decided to figure out that they have this whole another group of people that they can addicted. They are out there for one reason, to sell to kids. They’re using the exact same ads. They’re appealing it in the same way to people, using people, again, doing activities. — In boats, fancy cars.

Why do you think young people are vaping?

They see other people doing it and they try to fit in.

I feel like they promote it for kids that are younger just to get them hooked quicker and easier. And then they’ll be long-term sucked into it.

I always see — sometimes I hear a commercial be like, “oh, try new flavor like ice cream or something sweet that normal kids would eat or love.” And then they’re trying to target us as having to be something good.

Certainly, the highest number of people vaping are between the ages of 18 and 24. And they actually found that between 60 & 70% of kids think that the only thing in Juul is flavoring. They don’t even realize that nicotine is in a Juul. And so again, by the time these people are using these things not even realizing, they’re already nicotine addicted.

It’s a whole different world nowadays with social media. They’re using all kinds of social medias to show little videos on sales. And as soon as something gets a little bit popular, it goes viral, and then everybody’s trying it. And we think partly what’s happened with the electronic cigarettes with young people.

Pretty often I will see people doing vapes trick online and stuff. Sometimes when I’m scrolling through social media, I’ll see it pop up every once and a while.

I know there’s this one called a ghost. And then you can also make Os with it.

The younger kids, the kids that 12, 13, or 14 that are doing it now because everyone is doing it. My son has a couple friends that vape and pretty much all my daughter’s friends vape now. My daughter did vape and once I was admitted in the hospital she stopped. I think it’s whatever they do with the clouds that they do. I don’t know all about that, but I’ve seen it. When you go to the vape shops, you see them blowing big clouds and stuff like that. I think it’s appealing to the kids because everyone else is doing it. The same reason as I got into it. The names: the skittles, and the nerds, and stuff like that maybe be the kids in because the kids see it as some kind of candy. But it’s really not. It’s nicotine. It’s bad for you.

There’s no doubt that social media has changed things. And it’s very hard for parents to really monitor it. The schools are concerned because they create a policy. You can’t vape in school. And then you go the bathrooms and there’s clouds.

A public nuance at a board meeting was back in December 2018 when a student or student board rep brought it up, about what’s going on at the high school and the vaping in the bathroom, and no one’s wants to go in the bathroom. They don’t want to be associated with it and they don’t want to smell it.

When a running joke within the school is that “why are there toilets in the Juul room?” I think that’s kind of a problem. If it’s so commonplace that that’s the thought.

It has become so bad that students are doing it in the classroom.  There they’re the largest, most well-known. And their marketing techniques are targeting are young people. We just want it to stop. We want the laws to change. We want the federal government to take a stand because it’s impacting all of our kids. Our future.

Our kids are great kids and often will tell us that things are happening. Bathrooms, hallways, and things like that. And more often than not, when we follow up those leads, we do find some kids that are vaping. We’ve heard about the hoodies with the ties, and the devices in the back, and the watches that they have. And you know, we’re trying to keep up with it, but they always seem to be one or two steps ahead.

And they’re like this big. So, they’re extremely easy to hide. And like, kids can get them like everywhere. I know I hear like all the time. And then pods are like this big. So, it’s extremely easy to hide something like somewhere on you when knowing the school can’t check you if it’s somewhere else.

In class I’ve seen that a girl was trying to hide a vaping device. And she actually dropped it in the middle of class and it like went across the room and she got up to get it. But the teacher didn’t even notice because she — I think she thought it was something else.

We’re trying to get in front of the kids as much as we can to educate them on the dangers of vaping. The message that we’ve been getting is that you can’t scare the kids out of this. You have to educate them. So, we hope that each time we do it, we can reach a couple more students. We’re gonna keep trying.

I’ve been talking to a lot of different middle and high schools. They’re aware of it. They are absolutely finding lots and lots of kids who are vaping on campus.

How many by a show of hands either have a parent, a caregiver, or simply known somebody who’s actively vaping? Okay. When I say do you have any one in your family, a caregiver, a parent, do you have a friend who uses Juul or who vapes and it’s staggering how many kids are raising their hands. The first thing I say to kids particularly is look, I’m not here to scare you. I’m not here — I’m only here to inform you. Kids are smart. Nothing is meant to scare people the information I’m going to present is not meant to scare. You guys are very smart. Your generation’s a lot smarter than mine. You’re quicker. It’s really about making good decisions.

I think the important thing is to let them know what vaping can do, what it’s about. So, my thought is if they understand what they’re getting into, they’re much less likely to do it.

We need to very clear with teenagers that vaping nicotine e-cigs, not harmless. Potentially addictive. But we also need to be very clear that vaping THC products could be very harmful. It could kill you. A product with chemicals that are inhaled into your lung, once it’s in there you can’t get it back out.

I wish I never would have started smoking. I was an idiot. That we should have never done it. That there was nothing cool really about it. But, when you’re a kid, you think things that aren’t gonna hurt you. That everybody else does it, so why can’t we? Hi, I’m Todd Schwartzer. Previous smoker, vaper. And a survivor or e-valley. And my advice to young children is not to start vaping at all.

I’d like to thank all of our guests for sharing their knowledge and experiences. Please join us next time as we continue to share stories and transform health. I’m Keira McGuire. Thanks for watching.

Today, healthcare is about empowering people to take control of their health whether creating a fitness routine, choosing the right procedures and medications or adhering to treatment for a chronic condition. Capital BlueCross, dedicated to underwriting “Transforming Health” for the good health of the community.  WellSpan Health, helping patients reach their health goals through a coordinated system of physicians, hospitals and convenient HealthCare services in communities across central Pennsylvania. Learn more at wellspan.org. WellSpan Health, for the journey that is life. Support also comes from viewers like you. Thank you.

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Keira McGuire
Keira McGuire/WITF

Keira McGuire is a health reporter and multimedia producer for WITF. She hosts and produces Transforming Health television programs as well as other shows and documentaries for WITF’s Original Productions. McGuire produced the Emmy Award winning series HealthSmart for the last ten years. Keira previously worked at WBFF in Baltimore and WMDT in Salisbury as a reporter and anchor. She’s a graduate of Towson University.

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