Six out of 10 people reported that they vape to relax and they'd miss the stress relief of vaping if they quit, a new survey sponsored by the American Academy of Family Physicians (AAFP) shows.
"We're hearing this narrative that people are vaping to quit smoking, and yet what we're finding -- especially in teenagers and young adults -- is they're vaping to socialize and vaping to reduce their stress," said Dr. Natasha Bhuyan, a practicing family physician in Phoenix.
This extends to former tobacco smokers. Only about half of former smokers said they vape to quit or stay off tobacco, the survey found.
"I think this narrative that vaping is out there to help people quit smoking, we aren't really seeing it pan out in reality," Bhuyan added.
The AAFP said it commissioned this survey of 1,000 vapers to help its doctors better understand the vaping habits of their patients, and how the recent outbreak of vaping-related illnesses and deaths has impacted their attitudes and behaviors.
The survey found that young vapers view vaping as a social activity, as opposed to a means of quitting tobacco.
About one-third of teens and young adults aged 16 to 23 said they vape to socialize. They also are more than twice as likely to vape to fit in with their group than slightly older adults, 21% versus 10% of vapers aged 24 to 30.
"That's important for parents to be aware of," Bhuyan said. "Parents will ask their kids about alcohol use and drug use. My advice to parents is, ask your teenager if they have any friends or classmates that are vaping. It will give you an idea of what pressure your child might be facing to vape, and it will give you an idea of the secondhand vape our children are being exposed to."
As far as the news about vaping-related illness, many e-cigarette users are struggling to understand the facts and the potential dangers that come from vaping.
There have been 54 deaths confirmed in 27 states and the District of Columbia related to vaping, as well as 2,506 cases of illness across the entire United States, according to the U.S. Centers for Disease Control and Prevention. The CDC has singled out THC-containing vape products containing vitamin E acetate as strongly linked to the outbreak. THC is the ingredient in marijuana that causes a person to get high.
The news has gotten through to vapers, the survey found.
About 93% of vapers said they are aware of the news regarding vaping-related illnesses and deaths, and about 71% said they are more careful about how they purchase vaping products.
But experts are concerned that misinformation might lead many vapers to assume that e-cigarettes are safer than they actually are.
A little more than half of vapers said only people who use e-liquids laced with marijuana are at risk of illness or death, and four out of five underestimated the number of injuries and deaths that resulted from the recent outbreak, the survey shows.
Three out of five vapers also stated that secondhand vapor is harmless.
"Many people think only cannabis-containing vape products are dangerous. Meanwhile, they're not aware of the major health risks of even their blueberry flavored e-juice," Bhuyan said.
Even people who only vape nicotine products are suffering lung problems, said Dr. Panagis Galiatsatos, an American Lung Association spokesman.
"I run the state of Maryland's only tobacco treatment clinic and I promise you, people who vape are suffering lung issues from e-cigarettes," said Galiatsatos, an assistant professor at Johns Hopkins in Baltimore. "They just aren't lung issues that are going to get the media's attention. Asthma isn't as immediately grabbing as someone who's on a mechanical ventilator in an ICU."
There are a multitude of harmful chemicals contained in the vapor beyond vitamin E acetate, said Dr. Robert Glatter, an emergency physician at Lenox Hill Hospital in New York City.
"It's vital to understand that there are harmful chemicals that are carried in the vapor that can still be inhaled as secondhand vapor that can damage the lungs," including arsenic and metals like cadmium, nickel, chromium, copper and lead, Glatter said.
About 72% of vapers said they are likely to reduce their vaping over the next six months, but "it is distressing that they have not yet done so," said Patricia Folan, director of the Center for Tobacco Control at Northwell Health in Great Neck, N.Y.
"The reason for their hesitancy may be associated with the challenges related to addressing their nicotine addiction, their fear of nicotine withdrawal and the associated discomfort, which could be overwhelming their concern about the reported vaping injuries and deaths," Folan said.
Galiatsatos said he is most concerned that 67% of vapers see no reason to strengthen the regulation of e-cigarettes.
"We have a product that's already unregulated, and that survey tells me that two-thirds of the population think we are fine where we are at, if not that we need to let go a little more," said Galiatsatos.
The lack of regulation has made it difficult for doctors to know exactly which harmful toxins are contained in vapor, Galiatsatos said.
The AAFP Vaping Survey was conducted by Wakefield Research among 1,000 e-cigarette users aged 16 to 30 between December 2 and 10, using an e-mail invitation and an online survey.