Parents who vape may not see dangers of secondhand exposure to kids with asthma

Adults with children-especially children with asthma-are turning to electronic cigarettes (e-cigarettes) in a misguided effort to reduce secondhand smoking exposure, but they really aren’t fully aware of the risks, according to a new report.

A research letter published in JAMA Pediatrics revealed that nationwide, 4.4% of adults used e-cigarettes between 2016 and 2017. An even higher number-4.9%-of adults with children vape, the research notes. The number climbs even more for parents of children with asthma, with 5.6% admitting to e-cigarette use at home.

Researchers note that e-cigarette users often consider the aerosols released by e-cigarettes to be harmless, but in reality, they contain a number of harmful compounds.

Jenny L. Carwile, SCD, MPH, and Kirsten Young, DO, of the Maine Medical Center, Portland, Abby F. Fleisch, MD, MPH, of the Maine Medical Center Research Institute, Scarborough, and Katherine A. Ahrens, PHD, MPH, of the Muskie School of Public Health at the University of Southern Maine, Portland, all coauthored the research letter.

“Pediatricians can share that the American Academy of Pediatrics (AAP) recommends that parents do not use e-cigarettes around children, particularly in cars and homes, and that smoke-free laws be expanded to e-cigarettes,” Carwile says.

Although the study did not compare the effects of second-hand smoke in traditional cigarettes versus e-cigarettes, Carwile says there are a number of known harmful chemicals in the vapors from e-cigarettes, and more research is needed to determine the long-term effects of secondhand exposures to these chemicals.

“Other studies have shown that many people consider e-cigarette aerosols to be harmless water vapors, and in many cases do not have household rules about not using e-cigarettes in cars or homes,” Carwile says. “We hope that providers and patients will be more aware of potential health risks of secondhand e-cigarette use in children, and limit use around children as recommended by the AAP and other groups.”

The researchers used data from the 2016 and 2017 US Behavioral Risk Factor Surveillance System to survey adults on e-cigarette use,¹ but the study did not investigate what leads adults to use e-cigarettes or what effect inhaling vapors from e-cigarettes might have on children. Still, the research letter suggests that some parents might be turning to e-cigarettes in order to spare their children from being exposed to secondhand smoke from traditional cigarettes. Only about one-fifth of e-cigarette users with children limit vaping in their homes or vehicles, the paper notes.

Vaping causes harmful exposure as well

Another recent report, published in Pediatrics on e-cigarette use around children, reveals that whereas most users of both traditional and e-cigarettes have smoke-free home policies, fewer had rules about vaping in the homes. In fact, 63.8% of dual users did not smoke in the house, but only 26.3% refrained from vaping in the house,² according to the report. Dual users also were less likely than cigarette users to have a smoke-free car, a vape-free home, or a vape-free car,.

“Among enrolled parents, only 37.5% of smokers and 22.2% of dual users had strictly enforced smoke-free policies in both the home and car,” the report notes. “Given the extensive scientific knowledge that has accumulated over decades about the health consequences of exposure to tobacco smoke, these findings represent a major public health shortfall. Only 14.8% of parents who used only cigarettes said they were advised to have a smoke-free home and just 12.6% were advised to have a smoke-free car during their visit to their children’s doctor’s office.”

The report suggests that clinicians must do more to identify parents who use tobacco products and educate them on the dangers of second-hand exposure. Specifically, the Clinical Effort Against Secondhand Smoke Exposure (CEASE) interventions, designed to help providers identify and educate parents, was suggested, as well as the need for broadened tobacco control recommendations. 

References:

1. Carwile JL, Fleisch AF, Young K, Ahrens KA. Electronic cigarette use in US households with children: the “new” secondhand smoke. JAMA Pediatr. 2019;173(7):693-695. Available at: https://jamanetwork.com/journals/jamapediatrics/article-abstract/2732625 . Accessed August 2, 2019.

 2. Drehmer JE, Nabi-Burza E, Hipple Walters B, et al. Parental smoking and e-cigarette use in homes and cars. Pediatrics. 2019;143(4):e20183249.