Millions of School Children Are Vaping—and It Could Be Putting Them at Risk of COVID-19

Vaping and smoking could raise a young person’s risk of developing COVID-19 according to researchers who found 13-24-year-olds who used such products were five to seven times more likely to have the condition caused by the coronavirus.

Researchers recruited 4,351 people aged 13 to 24 from the U.S. to complete an online survey in May 2020. They answered questions related to whether they had ever vaped or smoked regular cigarettes, if they had done so in the past 30 days, and whether they had tested positive for COVID-19 or had symptoms.

Those who had only vaped and never smoked were five times more likely to be diagnosed with COVID-19. That rose to seven times more likely in those who smoked and vaped. The risk was 6.8 times higher for those who had smoked or vaped in the past 30 days.

Those who had smoked and vaped in the past 30 days were nine times more likely to be tested for the coronavirus, dropping to 2.6 among those who had only vaped in that time period. The team also found COVID-19 symptoms were 4.7 times more likely to be reported in those who had smoked and vaped in the past 30 days.

The study published in the journal Journal of Adolescent Health comes a year after a sharp rise in lung injuries linked to vaping, known as EVALI, peaking in September. According to the U.S. Centers for Disease Control and Prevention, as of February 2020 a total 2,807 EVALI cases or deaths had been reported form all 50 states, D.C., Puerto Rcio and the U.S. Virgin Islands. Vaping is not safe for children, teenagers or young adults, the CDC warns, partly because evidence suggests nicotine can affect brain development.

The authors wrote that although young people are at relatively lower risk of developing COVID-19 compared with older adults, “given the proportion of youth using e-cigarettes, youth e-cigarette and cigarette use may pose an important risk factor for COVID-19.”

According to the U.S Centers for Disease Control and Prevention, more than one in four (27.5 percent) of high school students and 10.5 percent of middle school students said they had used e-cigarettes in the past 30 days in 2019. That amounted to over 5 million U.S. middle and high school students.

Co-author Bonnie Halpern-Felsher, professor of pediatrics at Stanford University School of Medicine, said in a statement: “Teens and young adults need to know that if you use e-cigarettes, you are likely at immediate risk of COVID-19 because you are damaging your lungs.”

She told Newsweek: “These findings show yet again that e-cigarettes are harmful to youth and in particular, related to a lung illness.”

Halpern-Felsher said there are four possible explanations for the link. First, that youths and young adults who vape have a lower immune system and lung illness and therefore when exposed to the virus are more likely to get sick. Secondly, it’s possible that young people are more likely to be exposed to the virus because they share vaping devices. Alternatively, they might come into contact with the bug because vaping involves bringing one’s hand near the mouth. In addition, the aerosolized cloud could carry the virus and be breathed in.

Highlighting the limitations of the study, Halpern-Felsher said it was based on a survey so it can’t be proven that the data is reliable. “However, if anything, teens would underestimate e-cig use so likely our findings can be even stronger,” she said.

She said: “We really hope that youth see these findings as a sign to not use or stop using e-cigs. We also hope parents will use the findings to speak with their teens, and that health care providers screen and council youth about e-cigs.”

Echoing a call from the authors in the study, she said: “Finally, I want the FDA to realize that there is no place for e-cigs during a pandemic and they should be off the market.”

Dr. Deirdre Gilpin of the School of Pharmacy at Queen’s University Belfast, U.K. who did not work on the paper told Newsweek the study was limited because it didn’t show what types of e-cigarettes or flavors were being used, and how many contained substances like nicotine. It was also not clear how often participants were vaping, and if cigarette and e-cigarette users suffered worse from COVID-19 than those who never used.

Gilpin said: “There is increasing evidence that vaping and smoking damage the cells in the lung, albeit possibly by different mechanisms, including those that help protect against viral infection, and that may account for the increased COVID-19 risk observed in this study.”

Dr. Miranda Ween, a senior postdoctoral researcher in the Lung Research Laboratory at the Royal Adelaide Hospital, Australia, who also did not work on the paper told Newsweek: “This study provides a wake-up call to vapers, to consider the impacts of vaping on their lungs, and how many things we just don’t know about how e-cig vapor affects the lungs.”

FDA spokesperson Alison Hunt told Newsweekthe agency cannot comment on the specifics of this study, but will review it.

Hunt said cigarette smoking suppresses the immune system, increases the risk of respiratory infections, and causes heart and lung diseases. “People who smoke cigarettes may be at increased risk of infection with the virus that causes COVID-19, and may have worse outcomes from COVID-19.”

She said it is unknown whether exposure to toxic chemicals from e-cigarettes increase the risk of COVID-19 or the severity of COVID-19 outcomes. “However, many e-cigarette users are current or former smokers, and cigarette smoking increases the risk of respiratory infections, including pneumonia. Irrespective of COVID-19, e-cigarettes should never be used by youth, young adults, and pregnant women or adults who do not currently use tobacco products.”

Hunt said: “The FDA continues to prioritize enforcement against e-cigarette products, specifically those most appealing and accessible to youth” and is “keeping a close watch on the marketplace and will hold companies accountable.”

She said: Because there is a public health crisis of youth use of e-cigarettes in this country, our top priority remains to protect youth from products that pose the greatest risk for initiation or use by minors.”