Ruggedly handsome, covering billboards and advertisements, the Marlboro Man first rode onto the scene in 1954. For the next 45 years, he stayed there, propped atop his horse, with a cigarette stuck between his lips.
It’s no secret we live in an image-based society, with Hollywood showcasing many trends and behaviors that influence the young people in our own lives. Over the decades, certain behaviors, such as smoking, have become less socially acceptable, but one place that seems to be the exception is Hollywood.
In the 2014 movie the “Neighbors,” and again in 2016’s “Dirty Grandpa,” Zac Efron is seen using a vaping device. There’s also Dennis Quaid in “Beneath the Darkness,” and the list goes on.
The use of vaping devices are recent examples derived from an industry built on showing characters smoking cigarettes. Bette Davis in “Now, Voyager (1942), Olivia Newton-John in “Grease” (1978) and of course, Audrey Hepburn’s iconic role in “Breakfast at Tiffany’s” (1961), just to name a few.
“For today’s teenagers, the influence of what they see on screen can be harmful. It’s important that parents know how to combat what media their children taken in, and the best way we can do that is through education,” said Dr. Philip C. Corcoran, thoracic surgeon at Meritus Health, who specializes in treatment for patients with lung, chest and esophageal disease.
In fact, five of the original twelve Marlboro Men died of lung cancer and smoking related illnesses. One, who did survive, was operated on by Dr. Corcoran.
However, that cowboy character was often marketed to “post-adolescent kids who were just beginning to smoke as a way of declaring their independence from their parents,” according to the tobacco company Philip Morris International Inc.
Now, 23 years after the end of the Marlboro Man campaign, teenagers and young adults are still a target audience, but the product is changing. However, the constant remains the high risk for developing lung cancer.
While technically vaping devices and e-cigarettes are different, and come in many shapes and sizes, they work in a similar way: Puffing activates a battery-powered heating device, which heats liquid in a cartridge and turns it into vapors that are inhaled.
“Whatever is in that liquid is what the lungs are then exposed to, and this may include a variety of deadly chemicals. Many include nicotine, flavorants, propylene glycol and a host of other things that are not meant to be inhaled,” Dr. Corcoran said.
A recent report by the National Institutes of Health indicated that vaping is now more popular among teens than cigarette smoking, and one in four high school seniors say they have vaped nicotine in the last month.
According to the Office of the Surgeon General, it’s not only nicotine that’s extremely harmful, but the aerosol that users inhale and exhale from vape pens or e-cigarettes exposes them to heavy metals, volatile organic compounds and other ultrafine particles that are inhaled deeply in the lungs.
“Vaping can seriously diminish lung capacity. This puts the user at risk for lung diseases like emphysema, chronic bronchitis and lung cancer,” Dr. Corcoran said. “It’s not just harmless water vapor as many people believe,” he said.
Two disease conditions associated with vaping have been identified and are being investigated by the FDA: Popcorn Lung and EVALI (Electronic Cigarette and Vaping Acute Lung Injury). Both conditions have been associated with serious pulmonary illness and even death. The symptoms include shortness of breath, weight loss, night sweats, fever, fatigue, gastrointestinal symptoms of nausea, vomiting and diarrhea, low oxygen levels in the blood stream and even death in severe cases.
“Popcorn Lung presents with multiple lung lesions in both lungs seen on chest x-ray or CT Scan which are believed to be the response to inhaled oil droplets or microscopic metal fragments, which can cause serious lung injury, which may be irreversible,” Dr. Corcoran said.
He added that Vitamin E Acetate appears to be associated with EVALI. While Vitamin E Acetate is approved for use in foods (such as vegetable oils, cereals, meat, fruits and vegetables, or in vitamin supplements or skin care products), it is not safe for inhalation into the lungs, particularly in a superheated vaporized form.
“The federal government has recommended avoiding the use of any vaping products, especially those containing THC, the psychoactive ingredient of marijuana. Vaping cartridges which have been modified or obtained illegally appear to be frequently associated with the development of EVALI,” he said.
One of the most important things that parents can do is set a good example for their children by not using smoking devices of any kind.
“Prepare to talk to your children, and make sure you have your facts before doing so. Your goal is to talk, have a conversation and avoid criticism and encourage open dialogue,” said Dr. Corcoran.
While some things will always remain the same in the movies, heroes will still ride off into the sunset, what’s different now is that we know the influence those characters can have and the dangers of smoking are inescapable.
If you or your children have developed respiratory symptoms and suspect Popcorn Lung or EVALI, contract your physician or lung specialist immediately.
Philip Charles Corcoran, M.D., is a board-certified Thoracic Surgeon now seeing patients at Meritus Surgical Specialists in Hagerstown, MD. He has special training and skill in providing treatment for patients with lung, chest and esophageal diseases using minimally invasive surgery, including robotic and Video-Assisted Thaoracoscopic Surgery (VATS) approaches. Dr. Corcoran’s clinical interests include all chest surgery, pericardial, pleural cavity, benign and malignant pulmonary and esophageal disease, diaphragmatic procedures, thoracic trauma and chest wall reconstruction post trauma.
