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Dear Dr. Roach: My teens keep smoking all these flavored, ethereal wand vapors. They claim it tastes good and even try tricks with the vapor. I’m a concerned parent as I hear these are dangerous magic cigarettes. I would like to know more about them and get your advice on how to deal with these unruly teens.

H.R.

Dear H.R.: Vaping has become increasingly prevalent, with 1.7 million high school students (and almost 11 million overall adults in the U.S.) using these devices. One popular brand is called JUUL, but they also are called vape pens, e-cigarettes or e-hookahs. They are essentially drug-delivery devices for nicotine, an addictive and highly toxic substance. (Not all liquids used for vaping contain nicotine, although some labeled “nicotine free” were found to have nicotine. Cannabis also may be used in a vaping device.)

Although teens and young adults perceive them as being not at all dangerous or only minimally so, the extent of health dangers is not well known yet. While it’s clear that vaping is not as dangerous as smoking, that’s hardly a stellar recommendation.

In addition to nicotine, there are several other health risks in the aerosolized liquid that is inhaled into the lungs. Toxic chemicals, including lead and formaldehyde, are present in the vapor. The usual liquid used, propylene glycol, can cause asthma and allergic symptoms in some users. Similarly, the flavoring agents used can act as lung irritants, both to the user and to those who inhale the vapor secondhand.

It is concerning that the flavors and packaging used in vaping liquid may be appealing to young people. It is possible but unproven that people who vape are more likely to take up smoking. Thus, vaping has modest dangers in itself, but also might lead to tobacco smoking with its much greater risk of heart disease and cancer, neither of which is yet described with vaping.

I am not an expert on unruly teens. I can provide data and education, which may not be the most effective way of stopping underage use of e-cigarettes. However, as of this writing, the Food and Drug Administration is looking at a host of regulatory actions, which may be more effective in reducing vaping among young users.

Dear Dr. Roach: What are your thoughts on the effectiveness of oregano oil on the cold or flu?

D.L.G.

Dear D.L.G. There is almost no evidence on the effectiveness of oregano oil for any condition. However, there are substances found in oregano that are known to have beneficial biological effects. It’s not clear how well these beneficial substances are absorbed or whether they have helpful or harmful effects.

The known side effects of oregano oil seem to be mild; stomach upset and allergic reactions are reported.

The main concern I have about the use of alternative therapies is that it may prevent people from using traditional effective therapies. For colds, since there really aren’t any therapies that significantly speed healing, I have no objection with using oregano oil if it helps with symptoms. However, since there is moderately effective prevention for the flu (the vaccine) and modestly effective treatment (oseltamivir), I wouldn’t recommend that oregano oil be used instead of effective treatment for influenza. The flu was estimated to have killed 80,000 people in the U.S. last year.

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