Like many parents, LeeAnn is terrified her son will catch Covid-19. She lives in New York, near the nation’s coronavirus epicenter, but that isn’t the only issue that’s worrying her. LeeAnn is especially concerned because her teenager vapes: “This virus attacks the lungs and his lungs are most likely compromised due to vaping!!!!!!” she wrote via Facebook messenger. (WIRED is only using LeeAnn’s first name to protect her family’s privacy.)
While serious coronavirus infections are more likely in older populations, teenagers and kids aren’t immune to the virus. Now, some parents and public health experts are worried that vaping mixed with coronavirus could have terrible consequences. “The anxiety level is at an 11 out of 10 about vaping and smoking right now from parents,” says Jonathan Winickoff, a pediatrician at Massachusetts General Hospital who studies tobacco use among children. “No parent wants to see their child be placed in a higher risk category.”
Even cheerleading star and social media celebrity Gabi Butler has exhorted her 1.2 million Instagram followers to quit in a video ad for the Texas Department of State Health Services’ #VapesDown campaign, in which she warns about the toxic ingredients in many vapes. “With everything going on with the coronavirus, you guys want your lungs to be nice and healthy,” she says in the video.
Meredith Berkman and Dorian Fuhrman, who run the advocacy group Parents Against Vaping e-cigarettes (PAVe), say they are getting lots of messages from parents even more worried about their kids’ vaping habits now during the pandemic. “Trying to get my 14 year old to quit – doesn’t want to,” wrote one parent on the group’s Facebook page. “She says she needs it to help her with stress. It’s killing me.” Another parent messaged the group asking for strategies to help her husband and her teenager quit. She wrote that Covid-19 is motivating her to “get them off this crap.”
Not only are parents worried about potential health risks, but, as more families shelter in place together, more parents are finding out about their teens’ vaping habits. Berkman says that PAVe advocates have been hearing anecdotal stories of parents discovering their kids are more dependent on flavored e-cigarettes than they realized. “Now that everyone is at home together, you can’t hide that behavior anymore,” Fuhrman adds.
Carol Green, president-elect of the California State Parent Teacher Association, says she’s heard a different set of concerns from parents who are still working essential jobs at grocery stores, hospitals, and elsewhere. For these families with working parents and no school, there’s no adult supervision for their kids. “Those parents are really worried about what their kids are doing at home,” she says.
This isn’t the first—or even the greatest—panic over vaping and lung health. Fears over e-cigarettes and vaping reached a peak in the summer and fall of 2019 when a spate of related lung illnesses now known as EVALI (e-cigarette- or vaping-product-use-associated lung injury) spread across the country, killing 68 people and hospitalizing over 2,000. Many of these patients were previously healthy teenagers who arrived in emergency rooms with symptoms similar to Covid-19, including shortness of breath, fatigue, and chest pains. Many ended up on ventilators while doctors struggled to determine treatment.
Although the Centers for Disease Control ultimately linked EVALI to Vitamin E acetate, an ingredient found in some THC vapes, the illnesses spurred a series of state and city bans on nicotine e-cigarettes and flavored vapes, and moved the federal government to raise the purchasing age for tobacco products from 18 to 21.
There isn’t any published research yet that specifically addresses the Covid-19 health risk for vapers, but there is some evidence showing additional risks for tobacco smokers. Data from the Chinese Centers for Disease Control shows that smoking-related diseases like chronic obstructive pulmonary disease have raised the death rate for Covid-19 patients. Another study, published in the European Respiratory Journal, found that smokers have higher levels of the ACE2 enzyme that the novel coronavirus uses to get into lung cells. Having more of those entry points could make smokers more susceptible to infection.
Additionally, several earlier studies suggest that vaping weakens the lungs’ immune response and leaves the body more vulnerable to infection overall. For this reason, the Food and Drug Administration and the National Institute on Drug Abuse both warn Americans that vaping could cause underlying health problems that will complicate coronavirus symptoms.
In September, researchers at Baylor University published a study in the Journal of Clinical Investigation showing that, in mice, e-cigarettes disrupt an important lipid layer in the lungs that traps pathogens, leaving the mice susceptible when exposed to a normally harmless amount of flu virus. Another study by researchers at the University of North Carolina, published in July 2016 in the American Journal of Physiology, revealed that e-cigarette vapor weakens cilia, tiny hair-like projections that help clear mucus and pathogens out of the lungs. A separate UNC study published last May in Chemical Research in Toxicology found the chemicals that give e-cigarettes their cinnamon and vanilla flavoring affect neutrophils and macrophages, tiny cells that help gobble up pathogens before they cause an infection.