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Best to quit vapor and smoke

DEAR DR. ROACH: I quit smoking about six months ago and was able to resist smoking again because I took up vaping immediately. Thanks to vaping, I think this time I will be able to stay off of cigarette smoking permanently after unsuccessfully quitting a half dozen times. I read some very alarming news reports about lung disease among vapers, which has me very worried. I do not want to stop vaping. Can you please advise on whether vaping is safe for me? — J.B.

ANSWER: Vaping uses a device with a battery and heating element to vaporize a liquid, usually containing nicotine, flavoring and chemicals to make the aerosol. Vaping is highly prevalent among younger adults, with more than 20 percent of high school students reporting use in the previous 30 days.

Some use vaping to quit smoking, and it is as effective or more so than nicotine replacement, such as patches or gum. However, 80 percent of people who quit smoking continued to vape at one year. Unfortunately, many of the young people who start vaping are doing so without ever having been a smoker.

Most data suggest that vaping is safer than smoking. However, there are no long-term data to support this. There are many chemicals produced in vaping, and their effect on the lung isn’t well-established, but the nicotine most e-cigarettes contain (even some labeled as containing no nicotine) is certainly dangerous to blood vessels. In August of this year, a death was reported in Illinois attributed to vaping, along with hundreds reporting a lung illness that one expert likened to a chemical inhalation injury. As of this writing, the underlying mechanism for this outbreak of lung disease associated with vaping is unclear.

I cannot tell you whether vaping is safe. I think it is very likely to be better than continuing to smoke cigarettes, but there is no doubt that stopping vaping would be best. Perhaps a traditional nicotine replacement regimen might be helpful to help you stop vaping with less risk of going back to smoking.

DEAR DR. ROACH: I am 75 and have Type 2 diabetes. I take metformin and glipizide. If my blood sugar is high, should I lie down and rest or get up and move around? What is the best way to prevent high blood sugar? — K.P.

ANSWER: Type 2 diabetes is mostly a result of insulin resistance, which has several treatments. One is giving more insulin; insulin shots do that, but the glipizide you are taking signals your pancreas to make more insulin. Another is making insulin work better, and many newer drugs do this. Metformin tells your liver not to make sugar, and another medicine — canagliflozin (Invokana) — causes your kidneys to lose sugar through the urine.

However, perhaps the two most important ways are to not take in so much sugar through sweets or starches through bread, rice and pasta. Your body turns these to sugar. The other is to exercise, which both uses sugar in the muscles but also acts against the insulin resistance.

If your sugars are consistently high, work with your diabetes specialist and a nutritionist dietician to come up with a plan.

At age 75, it’s also important to prevent blood sugars from getting too low, so your diet, exercise and medications need to be properly regulated together.

(Roach is a columnist for the North American Press Syndicate. Write to him at 628 Virginia Drive, Orlando, FL 32803.)

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