As one of the nation’s leading researchers on vaping, Ilona Jaspers, PhD, professor of pediatrics and microbiology & immunology at the University of North Carolina at Chapel Hill, has long been warning teens and young adults about the dangers of vaping. Now, in the midst of a coronavirus pandemic that has infected more than 500,000 in the U.S., her warnings have expanded to include complications from COVID-19.
“Everything we and others have shown is that vaping causes a suppression of respiratory host defense function and overall respiratory immune dysfunction,” Jaspers tells Yahoo Lifestyle. “Rodent studies have shown increased severity of respiratory viral infections in animals exposed to e-cigarettes. We now have data showing that in humans, e-cigarette use was associated with changes in respiratory immune responses that are indicative of immune suppression.”
While the majority of those dying from the coronavirus are much older, data from the Centers for Disease Control and Prevention in mid-March found that as many as 40 percent of hospitalized patients are between the ages of 20 and 54. In the midst of the continuing vaping epidemic, in which over 2 million middle and high school students are reportedly using e-cigarettes, local government officials have expressed concern about seeing young patients in intensive care units.
New York City Mayor Bill de Blasio is one of them, mentioning a 22-year-old user on March 9 who had become severely ill with COVID-19. “Why is a 22-year-old man stable but hospitalized at this point?’’ de Blasio asked reporters. “The one factor we know of is he is a vaper. We think the fact that he is a vaper is affecting this situation.’’
Jaspers, whose paper on the connection between vaping and severe coronavirus infections is pending, says there is not yet conclusive evidence. But her years of research on the topic point to a link. “Vaping may enhance susceptibility to viral infections because of decreased host defense function,” she says. “In addition, sharing vaping devices — as is common among some e-cig-using demographics — would significantly increase the risk of spreading the infection.”
Joanna Tsai, MD, a pulmonologist at the Ohio State University’s Wexner Medical Center who researches how vaping affects the body’s ability to fight off infection, agrees. “There has not been any specific research done on vaping and COVID-19, but there have been some reports that in China, many of the patients that were smokers may have had worse outcomes with COVID-19,” Tsai tells Yahoo Lifestyle.
Those studies, Tsai notes, were extremely small, suggesting that it’s “too early to tell” whether vaping has a major effect. But looking at earlier research, she agrees that it’s likely. “There has been some research in animal models that the animals that were exposed to e-cigarettes had a worse outcome when infected with influenza,” she says. “Research is still limited when dealing with humans.”
A third expert, Robert Tarran, director of the University of North Carolina’s Center for Tobacco Regulatory Science and Lung Health, reiterates that more research is needed, but says studies on tobacco smokers may be a clue. “It has been well established that cigarette smokers are more at risk of getting other viral infections (e.g., influenza) and typically have a worse outcome,” Tarran tells Yahoo Lifestyle. “And there’s epidemiological data in humans that shows an association between vaping and increased respiratory issues.” (That's similar to recent guidance from the American Lung Association, suggesting that marijuana smoking should be considered a risk factor with COVID-19.)
So what exactly may be putting teens and young adults who vape more at risk?
Panagis Galiatsatos, MD, a pulmonary and critical care doctor at the Johns Hopkins School of Medicine and spokesperson for the American Lung Association, says the answer is simple. “If you’re putting anything else that isn’t just good air into the lungs, you’re running the risk of these toxins changing the basic molecular structure of the lungs,” Galiatsatos tells Yahoo Lifestyle. “I’ve seen e-cigarette users who want to quit because they’re having dire health consequences, and the most basic [of their complaints] is ‘I get a cold and it takes me months to get rid of.’”
Given that vaping means inhaling toxins, he says, this shouldn’t be surprising. “You’re impairing your lung cells, your immune system,” says Galiatsatos.
While Jaspers can’t yet confirm with certainty that young people who vape are more in danger from the coronavirus, what she can confirm is that vaping is not protecting them — a theory floated by Fox News’ Sean Hannity, who, on March 19, described a study that he said shows vaping can actually prevent certain illnesses.
Jaspers addressed the comment in an April 9 education session for teens on vaping hosted by UNC’s Morehead Planetarium & Science Center. “I actually included Sean Hannity's quote into my [virtual seminar],” Jaspers tells Yahoo Lifestyle. “There is absolutely no evidence supporting his statement that vaping may protect against COVID-19.”
Tsai, Galiatsatos and Tarran all agree that that thinking is flawed — and even potentially dangerous. Instead, they say teens and young adults should focus on the research showing how vaping can weaken the immune system, and should try to quit. “I highly recommend not vaping during the current epidemic if at all possible, just to be on the safe side,” says Tarran. “And the same goes for smoking.”
For those still stuck on the notion that vaping is safer compared with smoking cigarettes, Galiatsatos offers an analogy. “You’re comparing it to the most lethal thing known to man, combustible cigarettes, which kills more humans than any opioid or gun violence combined,” he says. “That’s a really unfair argument because it’s like saying, ‘Well, are you a good person?’ And you say ‘Well, I’m nicer than the devil.’”
Galiatsatos says the idea that vaping is harmless — which multiple lawsuits have uncovered as a message marketed to teens nationwide — is extremely manipulative. In the time of coronavirus, it also could be deadly. “As a health care professional, in a nonjudgmental way I’ll say I’m here to help,” he says. “But these products are not safe.”
For the latest coronavirus news and updates, follow along at https://news.yahoo.com/coronavirus. According to experts, people over 60 and those who are immunocompromised continue to be the most at risk. If you have questions, please refer to the CDC’s and WHO’s resource guides.