What you should know about vaping and e-cigarettes | Suchitra Krishnan-Sarin

翻译人员: psjmz mz 校对人员: Yu Xie

"It gets easier, right?"

“这变得更简单了，对吧？”

These are the words I often hear from young parents

这是我经常从为孩子殚精竭虑的

who are new to the game of worrying about their children.

年轻父母口中听到的话。

I tell them that it doesn't.

我告诉他们事情并不会变得更加容易，

It gets different,

实际上，事情只是变得不一样了，

but there's always something to worry about as parents.

为人父母总是有事情要担心。

I remember how I would lie half-awake at night

我仍记得为了留意我儿子的呼吸声 是如何保持半清醒的状态

listening to my son breathe

度过的每个夜晚，

when he was young and had asthma,

因为他小时候患有哮喘病。

and then, when he was a teen,

后来，等他十几岁的时候，

until I heard the front door chime open,

只有当我听到前门开门的铃声，

and I knew that he was home safe.

我才能确认他安全到家了。

Worrying about our kids comes with the territory.

为自己的孩子心神不定那是肯定的。

Now, many of these worries are about basic issues,

而这些担心大部分源于很平常的事情。

like what they eat, where they are, who they're with.

例如他们吃什么，他们在哪里， 他们和谁呆在一起。

But we also need to keep an eye on new behaviors and fads.

但我们还需要时刻关注 社会上流行的新行为和新潮流。

The latest craze is something that may not yet be on everyone's radar

最近很流行却没有引起广泛关注的，

as a serious health concern,

关乎到严重的健康问题的新玩意，

and that is the newfound popularity of vaping,

是一经推出就迅速流行的电子烟，

or inhaling sweet aerosols

或被称为吸入式甜味喷雾器，

produced by vaporizing e-liquids in e-cigarettes.

这种喷雾器可以 将电子烟内的烟油蒸汽化。

E-cigarettes, or "vapes," as they are commonly called,

电子烟，或者我们常说的 "蒸汽烟"，

are flying off the shelves like candy.

正在像糖果一样风靡各个商店。

This year, the e-cigarette market is expected to drive

今年，全球电子烟市场的销售额

26 billion dollars in sales worldwide.

预计将达到260亿美元。

Over the next six years,

在未来六年，

that volume is expected to double.

这个数字预计将再翻上一番。

We have a lot of serious concerns about the health impact of vaping,

我们非常担心电子烟 对于健康的影响，

and unfortunately, not nearly enough answers.

但不幸的是，我们几乎没有 得到强有力的解决方案。

This becomes even more concerning when you think of who uses e-cigarettes.

当你想到那些电子烟的使用者时 你会变得更加担心。

E-cigarette use, at least in the US,

电子烟的使用率，至少在美国，

has grown rapidly among youth and young adults --

在青少年和年轻的成年人中 正在迅速增长——

our kids,

我们的孩子

our most vulnerable population.

是最容易受影响的一代。

There was a 900 percent growth in the use of e-cigarettes by youth

2012年至2015年，电子烟的使用率

between 2012 and 2015.

在年轻人中上涨了900%。

The most recent estimates suggest

最新的数据表示，

that approximately 3.6 million high school and middle school students

大约有360万美国高中生和初中生

have used e-cigarettes in the US.

曾经使用过电子烟。

Now, e-cigarettes were originally created

电子烟的诞生本来是为了

to offer smokers a cleaner form of nicotine

给吸烟者提供一种更干净的尼古丁

to help with their cigarette addiction.

来帮助他们戒烟。

In the US, these devices come under the FDA's jurisdiction

在美国，这类设备作为一种烟草产品

as a tobacco product.

受美国食品药品管理局的监管。

But the science on these devices has not been able to keep up

但这些设备在科学方面的发展

with the rapid market growth,

却没能跟上迅速发展的市场需求，

so regulations on the components of these devices and e-liquids

因此对电子香烟和烟油的成分监管

are lagging.

是滞后的。

Current regulations do restrict sales of these devices

目前这类设备有严格的销售规定，

to anyone under the age of 18,

规定不能售卖给十八岁以下的人，

but these do not seem to have had much of an impact

但这些规定似乎并没有遏制青少年

on the explosion in the use of these devices by teens.

使用电子烟的迅猛势头。

You know, the first time I heard of and saw an e-cigarette,

我第一次听说和看见电子烟时，

I knew right away that teens would love it.

我马上就知道青少年们会喜欢上它。

These devices are technology on a stick,

电子烟将高科技和一根小棒结合在一起，

a perfect fit for the smartphone generation --

非常迎合智能手机一代的需求——

small, rechargeable, easy to use, easy to modify, nice smelling --

小巧、可重复使用，使用简单， 容易调节，味道好——

some even sync with your smartphone to let you know how much you have vaped.

有一些型号甚至可以和智能手机匹配， 让你知道你还能够使用多少时间。

Even I was very drawn to these very clever devices.

连我都被这么智能的设备吸引住了。

And since I had spent a long time researching teen and adult addictions,

当我花费了大量时间去研究 青少年和成年人对电子烟的沉迷现象后，

I immediately realized that these devices fit perfectly into the teen psyche.

我迅速意识到电子香烟的设计 非常符合青少年的心理。

Teens are impulsive, and they love to try new things.

青少年们易冲动，喜欢探索新事物。

They're also craving independence, and they love to make things their own.

同时他们渴望独立， 喜欢创造属于自己的东西。

E-cigarettes meet these needs perfectly

电子烟完美地符合了他们的需求，

by allowing them the chance to both innovate and personalize

电子烟能让他们有机会 去创新，去个性化

their vape experience.

他们的抽烟体验。

They can choose from over 15,000 different e-liquid flavors

他们可以从超过15000种 味道的烟油种类

and multiple nicotine concentrations.

和不同的尼古丁浓度中 选择自己喜欢的一款。

They can even create their own nicotine flavor combination.

他们甚至还可以创造出 属于自己的味道和浓度。

They can change how much vapor is produced from these devices

他们可以通过调整烟油的用量和成分

by modifying the puff volume and the constituents

或者烟雾的强度和温度

and the power and temperature of the devices.

来控制电子烟的蒸汽量。

They can even use these devices for "cloud chasing."

使用者还可以利用电子烟 来”追云逐雾”一番。

Cloud chasing, also called vape tricks

“追云逐雾”，也就是花式吐烟圈

or smoke tricks,

或烟雾魔术，

involves producing large vape clouds with quirky shapes and names,

即使用者吐出带有独特 图形和名字的的烟雾，

like rings, dragons, ghosts ...

比如圆环，龙，幽灵等等。

Cloud chasers can even participate in cloud competitions

花式吐烟者还可以参加吐烟圈比赛，

and win prizes for creating the most innovative shaped clouds.

创造出最具创意的 烟雾形状的人就能获奖。

Teens can also change the strength and throat hit from the vapor

蒸汽的浓厚度和击喉感也可以

by either vaporizing the e-liquid at higher temperatures

通过在高温下雾化烟油，或者直接

or dripping the e-liquid directly onto a heated coil.

将烟油滴在加热线圈上来调整实现。

They can even use these devices for marijuana vaping.

他们甚至可以使用电子烟来吸大麻。

And since the devices use lower temperatures

由于使用电子烟时温度较低，

and do not combust or burn the marijuana,

大麻不会燃烧，

they can do this very discreetly,

使用者可以在不产生 明显气味的情况下

without the distinctive smell of burnt marijuana.

悄悄地吸食大麻。

So they can really make these vape experiences their own,

因此电子烟真正满足了个性化的需求。

which may explain the astounding rise in the use of these devices by youth.

这大概也可以解释为什么 年轻人使用电子烟的数量激增。

E-cigarettes are technically a very simple device.

从技术上来讲，电子烟是 一种非常简单的设备。

There is a receptacle for the e-liquid which can be a tank, a pod or a plug.

其中包含一个储存烟油的容器， 可以是一个罐子，扁匣子或塞子。

There is a battery that charges the coil, which then vaporizes the e-liquid.

还有一块为雾化烟油提供电力的电池。

And then there is a mouthpiece,

还有一个烟嘴，

where the user can actually draw from the e-cigarette.

使用者可以从中吸取电子烟。

In 2017, there were 466 e-cigarette devices in the marketplace.

2017年，市场上有466种 不同类型的电子烟。

These range from cigarette-like devices which are also called "cigalikes"

范围从外形类似真香烟的电子烟

到被称为“钢笔”的电子烟雾化器。

to tank systems, which are also called "pens."

And then there are modified devices, which are also called "mods."

还有一款被称为”内嵌式 电子烟主机（Mods）“的改良装置。

Mods look nothing like a cigarette,

Mods的外形看起来一点也不像香烟，

and they come in various shapes and sizes,

有不同的形状和大小可供选择，

with different kinds of attachments and user adjustments.

还可以选择不同的配件和型号。

They're very popular for cloud chasing.

它们非常受花式吐烟圈者的欢迎。

The most recent entrance into the marketplace

最近才进入电子烟市场的

are the pod devices,

是一款被称为“烟弹”的产品，

which contain the e-liquid in a pod.

内部含有烟油。

These are very popular, by the way, among teens.

烟弹在青少年们中很流行。

An example of this is the Juul,

其中一个例子就是 Juul，

which not only looks like a USB device

它不仅外形酷似U盘，

but can also be plugged into a USB outlet to charge.

还可以插入USB接口进行充电。

Many teens do not even think that these are e-cigarettes,

很多青少年甚至不认为这是电子烟，

which has led to the use of terms like "juuling" instead of "vaping."

甚至选择用 “Juuling” 这个词来代替“吸烟”。

Many of these devices are so discreet and produce so little vapor

大部分电子烟使用时声音很小， 产生的烟雾量也很少，

that teens are using them in classrooms

所以青少年们可以在教室里使用，

and hiding them in objects like Sharpie pens, their clothes,

把电子烟藏在其他物件里面， 如记号笔，他们的衣服

their books.

或书本里。

Now, many teens think that these devices produce water vapor,

很多青少年们误以为 电子烟所产生的是水雾，

and therefore, they are safe to use.

认为吸电子烟是安全的。

But this could not be further from the truth.

但实际上，这离事实相差甚远。

What is produced is not even a vapor,

电子烟释放的甚至都不是蒸汽，

it's an aerosol,

而是气溶胶。

and let me tell you, the difference is quite pronounced.

让我来告诉你们这两者的明显差异。

Aerosols contain many finely suspended particles of liquids and gases

气溶胶含有大量可疑 的液体和气体微粒，

that are created from whatever is in the e-liquid.

是从烟油中产生的。

So an aerosol could contain propylene glycol and glycerin,

气溶胶内含有丙二醇和甘油，

which are solvents in the e-liquid.

它们都是烟油的溶剂。

Now, these solvents are known to be safe for edible use,

我们知道这些都是可食用溶剂，

so for use in products that you eat,

可用于制作食物，

but we know very little about their safety following long-term inhalational exposure.

但我们对长时间接触和吸入这些 溶剂是否安全则知之甚少。

The e-liquids can also contain alcohol,

烟油里还含有酒精，

sometimes in high levels,

有时候还是高浓度酒精，

and inhaling alcohol is known to have toxic effects on the brain.

而我们都知道吸入酒精 会对大脑有毒害作用。

I told you earlier that the e-liquids contain over 15,000 different flavors.

我刚才提过烟油有 超过15,000种味道。

Here are some examples,

这里有一些例子，

some with very catchy but familiar names like "Skittles" and "Fruit Loops,"

有些烟油有着非常抢眼和熟悉的名字， 例如“彩虹糖”或“水果棒棒糖”，

and others with more exotic names like "Dragon's Milk" and "Tiger's Blood"

还有一些有着稀奇古怪的名字， 像是“恐龙奶”或“老虎血”，

and "Unicorn Puke."

还有“独角兽呕吐物”。

The e-liquid or the aerosol can also contain metallic particles

烟油和气溶胶内还含有金属颗粒，

like chromium, cadmium and lead.

如铬，镉和铅。

These are generated from the heating coil in the devices

它们来自于电子烟里的加热线圈，

and are also known to have many toxic effects on vital organs.

众所周知，这些元素对于人体的 重要器官都具有毒副作用。

So no, let me make this very clear:

所以我要再次申明：

what is produced is definitely not water vapor.

电子烟产生的绝对不是水雾。

Exposure of the teen brain to nicotine through e-cigarettes

青少年的大脑通过电子烟 长期接触尼古丁

is also very concerning.

同样让人十分担心。

The teen brain is very sensitive to even low levels of nicotine

青少年的大脑即使对 低浓度尼古丁也很敏感，

and gets very easily addicted.

非常容易上瘾。

In fact, we have known for a long time

实际上，我们一直都很清楚

that 90 percent of smokers start smoking cigarettes prior to the age of 18.

90%的吸烟者都是 从18岁之前开始吸烟。

Those who start early are more addicted and have a harder time quitting smoking.

越早开始接触香烟的人越难戒烟。

In other words, and to quote a past FDA commissioner,

或者，我引用 一位前药监局专员的话，

"Nicotine addiction ... is a pediatric disease."

”尼古丁上瘾是一种儿科疾病。”

E-cigarettes can expose teens to a lot of nicotine.

电子烟使青少年能够接触大量尼古丁。

Many of these devices contain the amount of nicotine

很多电子烟的尼古丁含量

that is in a full pack of cigarettes.

可以比得上整包香烟。

The more recent pod devices contain a nicotine salt,

最新款的烟弹内还有尼古丁盐，

which has a smoother taste and is much easier to use

这可以让味道更佳清淡， 更容易入口，

and can produce rapid increases in brain nicotine levels.

还可以快速提高尼古丁入脑的速度。

Teens who use e-cigarettes regularly report symptoms of craving --

经常使用电子烟的青少年 都有一种渴望的症状——

feeling anxious when they don't have their e-cigarettes.

在不吸电子烟时会感到焦虑。

All these are hallmarks of a behavioral addiction.

这些都是他们上瘾的表现。

E-cigarettes are not only addictive

电子烟不仅会让人上瘾，

but they also affect many other organs in the body.

还会影响体内其他器官。

So nicotine, which is in e-cigarettes, for example,

在电子烟内的尼古丁

binds to a receptor called the nicotinic acetylcholine receptor,

会和一种叫烟碱型乙酰胆的 受体相结合，

which plays a key role in the functioning of almost all organ systems

这种受体对人体内大部分 器官系统的正常功能

in the human body.

有着重要作用。

And chronic exposure to nicotine changes the functioning of these systems.

而长期接触尼古丁 会改变这些系统的运作。

So as an example,

例如，

chronic exposure to nicotine decreases the flexibility of the blood vessels

长期接触尼古丁会降低血管的弹性，

and changes how the heart responds to acute challenges like stress.

还会改变心脏对压力等 急性应激的反应能力。

The teen brain is not only sensitive to the addictive effects of nicotine

青少年的大脑不仅对尼古丁 的成瘾作用很敏感，

but also to its toxic effects.

对它的毒性作用也很敏感。

In adolescent animals, nicotine is a very well-established neurotoxin,

在青春期，尼古丁是一种 广为流传的神经毒素。

and it decreases learning, memory and attention processes

这会降低他们的学习能力， 记忆力和注意力，

and increases hyperactivity symptoms.

还会增加患上多动症的几率。

Teens who use tobacco products are more likely to use

使用烟草产品的青少年更有可能

marijuana and alcohol

使用大麻和酒精，

and also develop depression and anxiety as a teen or as an adult.

在青少年或成人阶段 还会患上抑郁症和焦虑症。

So nicotine addiction through e-cigarettes could be leading them down the path

电子烟导致的尼古丁上瘾 可能会导致他们误入其他瘾途，

of other addictions and other mental health problems.

并引发其他精神和健康问题。

Now, in adolescent animals, nicotine also produces epigenetic changes,

在青春期，尼古丁还会导致基因表达

or heritable changes in gene expression,

发生表观变化或遗传变化，

for example, in the genes involved in asthma.

例如与哮喘有关的基因。

So teens who use nicotine may not only be harming themselves

因此青少年吸食尼古丁 不仅损害自身健康，

but they could be harming their future generations.

还可能影响下一代人。

You know, the very existence of e-cigarettes

电子烟的存在

could have led to an entire generation of nicotine-addicted youth.

可能会导致整整一代人 都对尼古丁上瘾。

Easy access to these devices could have led to more experimentation

轻易就能使用的电子烟 会使越来越多年轻人

with marijuana and many other vaporizable substances by youth.

去尝试吸食大麻和其他 可雾化有害物质。

While there is no doubt that providing smokers with a cleaner form of nicotine

毫无疑问，为吸烟者们提供 更干净的尼古丁这种方式

is and should continue to be a critical goal,

是且肯定是一个历史性目标，

we still do not know if these devices help smokers quit smoking,

我们仍然不清楚电子烟是否 真的帮助吸烟者戒烟，

and we know very little about the long-term effects of these devices.

我们也对长期使用电子烟 的影响知之甚少。

What we do know is that youth -- lots of youth -- are using these devices.

但我们知道的是，大部分 年轻人都正在使用电子烟。

In fact, the FDA commissioner recently used the term "epidemic"

实际上，最近药监局专员使用了“流行病”

to describe e-cigarette use in the US.

来描述美国境内的电子烟使用现象。

While trying to solve one huge public health problem, cigarette smoking,

当我们尝试去解决例如吸烟 这个巨大的公共健康问题时，

we may have created another colossal one.

可能引发出了另一个大问题。

Our lack of vigilance in the earlier years around cigarette smoking

近年来，由于缺乏对香烟危害的警惕

led to a cigarette epidemic and many, many cigarette-related diseases.

导致了吸烟行为的盛行， 和许多由吸烟引发的疾病。

We do not want to repeat the same mistakes with e-cigarettes.

我们不想再在电子烟上重复这些错误。

So now is the time for action,

所以，现在是时候做出行动，

for regulations that address the appeal and access of these devices to youth.

制定法规来解决电子烟对青少年 的吸引力和使用问题。

Do smokers really need 15,000 kid-friendly flavors to quit smoking?

吸烟者们是否真的需要 15,000种口味的烟油来戒烟？

Do they need so many different kinds of devices?

他们真的需要如此多种类的设备吗？

Is it a good idea to have devices which are so easy to hide

使用这种容易隐藏和使用的设备

and so easy to use?

真的是个好主意吗？

We recently heard that the FDA plans to introduce stricter regulations

我们最近听闻药监局计划出台

on sales of these devices that contain e-liquid flavors

针对电子烟和烟油在便利店和汽油站

in retail locations like convenience stores and gas stations,

这样的零售场所售卖的严格规章制度，

and also introduce stricter regulations

同时也会出台更加严格的规章制度，

on sales of devices to minors over the internet.

来约束电子烟对未成年人的网络销售。

Is this going to be sufficient to change this rapid increase in youth uptake?

这是否足以改变青少年 抽烟率快速增长的现状？

We need to ask and answer such critical questions.

我们需要询问和回答这些重要的问题。

Now is also the time for a serious public education campaign.

现在还应该开展严格的公共教育运动。

Teens and their parents need to know

青少年们和他们的父母都需要知道，

that while e-cigarettes may contain less toxins than cigarettes,

即便电子烟的毒性含量比香烟少时，

they're certainly not benign.

它们当然不是好东西。

Exposure of their bodies to the chemicals produced by these devices

身体长时间接触由电子烟 产生的化学物质

could be changing them in ways they may not like

可能会对身体产生负面影响，

and setting them up for future unknown toxicities and health problems.

并导致在未来产生未知 的毒性和健康问题。

You know, when I said earlier

我之前所说的

that e-cigarettes were a perfect fit for the smartphone generation,

电子烟完美地符合 智能手机一代的需求，

并不是在开玩笑。

I was not kidding.

We live in a technology-crazed world,

我们生活在高科技的世界，

where the latest device and technology gets a lot of attention

最新的设备和科技都被高度关注，

just because it is technology and because it is the latest thing.

仅仅因为它是高科技，它是最新的。

More and more over the next few years and for the rest of our lives,

在若干年后，在我们剩下的人生里，

我们将越来越多的看到 大量科技进入市场，

we are going to see technologies coming into the marketplace

这些科技一开始不会 引起任何健康问题，

that may not raise any health flags at first,

simply because they don't look unhealthy

只是因为它们看起来不那么不健康，

or they're not a medical device.

或者它们不是药用设备。

For example, we could see devices

举个例子，我们会看到有一些设备

that may make it easier to go longer without sleep

可以让人的睡眠时间变长，

or help us lose weight --

或帮助人们减肥——

a personal goal of mine --

这也是我的个人目标——

or achieve any number of other goals

或达成其他目标，

that we as consumers are very, very interested in.

作为消费者的我们对这些 肯定很感兴趣。

But many of these devices may come with unacceptable risks to our own health.

但是大部分的设备会对健康 造成不可承受的风险。

So if we want to protect our health and the health of our children,

所以如果我们想保护我们 和我们孩子的健康，

perhaps we should get out of the habit

或许我们应该远离那些

of automatically celebrating such new technology

不加思考地自动接纳新技术的坏习惯，

and get into the habit of looking at them with a critical eye,

而是养成用批判的目光 去判断新技术的习惯。

perhaps even through a medical lens.

甚至还可尝试用医学的角度。

Because, you know something?

因为你们都知道，

我们的健康，孩子的健康 还有子孙后代的健康都十分宝贵，

Our health, the health of our children and our future generations

is far too valuable to let it go up in smoke --

我们不能让它化为烟雾 ——

or even in aerosol.

甚至让它化为气溶胶。

Thank you.

谢谢。

(Applause)

（掌声）