Marijuana in E-Cigarettes: A Growing Public Health Concern Among US Youth

Popularity among youth for e-cigarette use has another dimension.  Will marijuana use with e-cigarettes increase proportionally?  Susceptible children and adolescents, including those with asthma are likely the highest risk.  Dr. Susarla

Among American students in grades 6 to 12, trying marijuana in e-cigarettes is common.1

According to new findings published in JAMA Pediatrics, the number of students who had used cannabis in e-cigarettes had reached an alarming 1 in 11 in 2016, including one-third of students who had ever tried e-cigarettes.

Moreover, approximately 1 in 3 middle-school students and about 1 in 4 high-school students identifying as e-cigarette users had experimented with cannabis in e-cigarettes at some point in their lives.

These statistics are a cause for concern, as neither cannabis nor e-cigarettes come without health hazards, said lead author Katrina Trivers, PhD, MSPH, from the Office on Smoking and Health at the Centers for Disease Control and Prevention in Atlanta, Georgia.

Dr Trivers recently shared her insights with Consultant360, explaining the effects of these substances on the young brain, factors that may perpetuate the cannabis/e-cigarette trend, and ways for physicians, parents, and policymakers to help address this issue.

Consultant360: Your study found that cannabis use in e-cigarettes is prevalent among middle and high school students. What factors do you think contributed to this finding?

Katrina Trivers: There are likely multiple factors that may be influencing the use of cannabis in e-cigarettes among our nation’s youth. The tobacco product landscape has changed in recent years, and e-cigarettes have become increasingly popular to the point where they have been the most commonly used tobacco product among youth since 2014. In recent years, many youths have also been using other psychoactive substances in e-cigarettes, including cannabinoids and other illicit drugs.

Young people may use cannabis for a variety of reasons, including curiosity, peer pressure, misperceptions that cannabis is harmless, as well as shifts in availability and opportunity as social norms and public policies related to cannabis have changed in recent years. Exposure to marijuana or other substance use through friends or family members may also cause the use of these products to be seen as more normative behavior. For example, our study found that youth who lived with a tobacco user were significantly more likely to use an e-cigarette with cannabis than those who did not live with a tobacco user.

C360: In your experience, what are some of the biggest misconceptions about the health-related effects of cannabis use, especially among youth?

KT: One of the biggest misconceptions is that cannabis use is harmless.

This is a public health concern because the use of any form of tobacco product is unsafe among youth, irrespective of whether it is smoked, smokeless, or electronic. The US Surgeon General has concluded that the aerosol emitted from e-cigarettes is not harmless. It can contain harmful ingredients, including nicotine, carbonyl compounds, and volatile organic compounds known to have adverse health effects.

The use of marijuana in these products is of particular concern because cannabis use among youth can adversely affect learning and memory and may impair later academic achievement and education.

Read article here.

World Lung Day

Awareness about chronic lung conditions can help foster education and prevention strategies for both adult and pediatric disease. Dr. Susarla.

Statement of Harold P. Wimmer, National President and CEO of the American Lung Association, in response on World Lung Day, September 25, 2018, and in response to the pending vote on the declaration on the prevention and control of non-communicable diseases by the United Nations General Assembly:

“Today marks World Lung Day, a day that recognizes a fundamental truth: that breathing is essential to life. Unfortunately, millions of people around the world, including more than 33.6 million Americans, suffer from chronic lung diseases, making the essential act of breathing much more difficult.  The American Lung Association joins with others who have signed the Charter for Lung Health and pledge to continue to work to save lives by improving lung health and preventing lung disease.

“Today, we urge the United Nations to join us in this pledge. We urge the U.N. General Assembly at their meeting this week to adopt a declaration in support of efforts to reduce the burden of non-communicable lung diseases, such as asthma, chronic obstructive pulmonary disease (COPD), and lung cancer. We urge them to fully support measures to tackle the sources that cause or worsen these diseases, especially tobacco use, indoor and outdoor air pollution, and climate change. Too many people die each year from preventable diseases that these sources cause or exacerbate.  

“We have made progress in our fight against lung diseases, but millions of people face threats to their lung health every day, making it more difficult to breathe. We at the American Lung Association urge the United Nations to join in the fight to protect their health.”

Read article here.

Impulse Oscillometry: From Bench to Clinical Practice.

Impulse Oscillometry: From Bench to Clinical Practice.

Lung function testing is one of the pillars of care in childhood asthma.  There are few substitutes to actually measuring the way the lungs perform in an objective way.  However, testing in children is often very difficult to perform, making interpretation of the results even more difficult.

Airway resistance testing as performed using a technique known as impulse oscillometry (IOS) offers a convenient alternative.  This test takes seconds to perform and allows us to measure the reactivity in a child's airway WITHOUT forceful breathing maneuvers or breath holding.  These data are invaluable in diagnosing asthma especially in young children down to 3 years of age. In addition, it has been shown to help predict risk of exacerbations in children with known asthma.

One of the many benefits of care in a pediatric pulmonology office is focus on the latest and greatest diagnostic testing.  What was previously only a research tool is now available as a state-of-the-art test available in the clinic.  Ask about our impulse oscillometry testing in our Frostwood location.

From Vyaire Medical

Asthma and migraines connected?

To complicate matters, some migraine medication (beta-blockers) can interfere with asthma rescue inhalers and may worsen the disease process.  Dr. Susarla

Adolescents who have asthma or allergic rhinitis may be at higher risk for developing migraine, according to a study published in The Clinical Respiratory Journal.

Previous studies illustrated a relationship between asthma and migraines (primarily in adult populations). This large cross-sectional study also included the classification of specialist-diagnosed asthma and migraine.

Using data from the Israel Defense Forces recruitment database, study authors identified 113,671 adolescent draftees (n=66,547 young men; n=47,124 young women; all were 17 years old) diagnosed with asthma or migraine between 1987 and 2010. Investigators examined migraine prevalence in this cohort. Certified specialists in neurology and pulmonology, respectively, confirmed the diagnoses for migraine and asthma.

Read article here.