Morgan Howard, Corinna Trujillo Tanner, Boyd Tanner, Brandon Thatcher, Janelle Macintosh (Brigham Young University)
Faculty Advisor: Trujillo Tanner, Corinna (Nursing, Nursing)
Purpose/Aims: The purpose of this Review of Literature is to present the most current and accurate information about e-cigarette use, or vaping, with recommendations for nursing practice.
Rationale/Conceptual Basis/Background: According to the CDC, to date over 1300 individuals have developed severe lung injury, associated with vaping, including 216 fatalities. Most of these cases involved young people in their teens or twenties. There are concerns that marketing for vaping specifically targets young people and leads potential users to consider the practice relatively safe. On the contrary, vaping is associated with several serious health risks, including lipoid pneumonia, acute respiratory distress syndrome and popcorn lung. Little is known about the effects of the 60+ compounds identified in vaping aerosol, which is inhaled directly into the lungs. Nurses are often the first point of contact for patients in primary care and urgent/emergent settings. Nurses provide valuable patient education, health assessment, and referral. It is important for nurses to have access to the latest information about this developing problem.
Methods: We conducted a review of literature. We reviewed and summarized information from the Food and Drug administration, Centers for Disease Control, American Medical Association, American Academy of Pediatrics, and other reputable sources. All information reviewed had been published within the last six months. Research questions which guided this review sought to identify important considerations for nursing assessment, and nursing interventions.
Findings/Clinical Implications:
Nursing Assessment: An important part of nursing assessment should include documentation of a patient's history of vaping. When a patient presents with respiratory symptoms and has a history of vaping, a detailed vaping history covering the previous 90 days should be obtained. When acute lung injury, caused by vaping is identified, it must be reported to local and state health departments, per the new CDC guidelines.
Nursing interventions should include patient education as follows: 98.7% of "vape juice" assayed by the FDA contained the addictive substance nicotine (even if labeled "nicotine free") Nicotine is highly addictive and damages developing brain tissue in fetuses, infants, children and teens Inhaled "second hand" vape aerosol is dangerous for pregnant women, infants, children and those with lung disease The inhaled solution is not "water vapor" but rather an aerosol created by an electric heating element within the vaping device The inhaled solution contains up to 60 + chemicals including heavy metals
There is no established standard for vaping safety
Flavorings in vape juice, although considered safe for ingestion, have not been approved for inhalation and are not known to be safe
Additional information and recommendations will be forthcoming as our understanding of the risks associated with vaping is rapidly evolving.