Global youth vaping and respiratory health: epidemiology, interventions, and policies.

Introduction:
This text provides an in-depth review of the epidemiology, mechanisms, management, and policies related to global youth vaping and respiratory health. The review highlights the rising prevalence of e-cigarette use among teenagers and young adults, the associated health risks, and the potential mechanisms behind these risks. The authors also discuss various interventions and policies that can help prevent and manage youth vaping.

Key Points:

* E-cigarette use has increased significantly among teenagers and young adults, with potential health risks such as respiratory health problems, cognitive impairment, and neurodevelopmental issues.
* Nicotine, a common component in e-cigarettes, is associated with cognitive impairment and neurodevelopmental problems in teenagers and young adults.
* E-cigarette use is a risk factor for downstream substance use, including cigarettes and cannabis initiation, which compounds health risks in dual users.
* The review includes a systematic search of PubMed, Google Scholar, and primary government databases, resulting in 113 studies that met the inclusion criteria.
* E-cigarettes contain various harmful chemicals, including diacetyl, propylene glycol, carbon monoxide, formaldehyde, and other toxic chemicals, as well as heavy metals and nicotine derivatives.
* Nicotine affects the developing brain and has been linked to cognitive-related impairment in teenagers, with research suggesting that it can bind to N-acetylcholine receptors, thereby impacting signaling in the prefrontal cortex.
* The review highlights the need for stronger education on e-cigarettes in medical curricula, increased physician education on screening and nicotine tapering, and public health education campaigns to increase awareness of vaping risks and therapies.
* The authors suggest that public health campaigns and medical doctors could potentially target individuals with lower levels of education, lower SES, and racially diverse groups to minimize any potential inequities in health.

Main Message:
The main message of the text is that without stricter interventions and policies, teenagers and young adult vapers will continue to be at risk of multiple health problems associated with e-cigarettes. The authors emphasize the need for stronger public health protection policies and bans to protect youth, as well as evidence-based primary-care intervention and public health interventions that target vulnerable groups. They also stress the importance of increasing physician education on screening and nicotine tapering in the primary-care setting, and developing collaborations between physicians and public health researchers through joint efforts in education, screening, and referral.

Lyzwinski LN, Naslund Ja, Miller CJ, Eisenberg MJ. Global youth vaping and respiratory health: epidemiology, interventions, and policies. NPJ primary care respiratory medicine. 2022;32(1):14. doi:10.1038/s41533-022-00277-9