E-Cigarettes
'Teens
& Vaping: What You Need to Know JUULing: Get the Facts Public
health Q&A: Are e-cigarettes
safe? Is My Child Vaping? Heres 9 Signs to Watch For The
Pros and Cons of E-Cigarettes Dripping on the rise among teen e-cigarette users, study finds ResourcesHow to Get Teens to Stop Vaping
Teens &
Vaping: What You Need to Know What Are E-Cigarettes? Electronic cigarettes came on the market several years ago as an alternative to smoking traditional cigarettes made from tobacco. Also known a e-cigarettes, vapes, and vape pens, these battery-operated devices allow users to inhale an aerosol that typically (but not always) contains nicotine, flavorings, and chemicals like propylene glycol.[2] Some e-cigarette brands are designed to resemble real cigarettes while others may look more like a USB stick. As of 2014, there were nearly 500 brands of e-cigarettes on the market.[3] Brands like JUUL have exploded onto the market with a flashy, high-tech appearance and high nicotine delivery through their use of nicotine salt e-liquid formulations.[4] Teens and E-Cigarettes Many kids and adults perceive e-cigarettes as less harmful than tobacco. While they may be less damaging to teen bodies than inhaling tobacco smoke, e-cigarettes still deliver harmful chemicals in their so-called vapor.[5] Their use also can lead to a habit of smoking traditional cigarettes: 30.7% of e-cigarette users started smoking (tobacco products) within six months while only 8.1% of non-users began smoking in the same time frame.[6] And the use of these devices is more prevalent than cigarettes, perhaps due to a lack of understanding the dangers. According to research from the National Institute on Drug Abuse, 3.6% of 8th-graders used cigarettes in the past month versus 9.5% using e-cigarettes. For 10th-graders, 6.3% smoked while 14% used e-cigarettes. By 12th grade, the numbers climb to 11.4% of students who have smoked in the last 30 days and 16.2% who have vaped.[7] Our Pride Surveys Questionnaire for Grades 6-12 Standard Report from 2016-17 revealed that while more than 94% of students in 6th-12th grade had not smoked cigarettes in the last 30 days, 4% still used tobacco every week.[8] In this same report, 66% of students said their friends never use tobacco while 6% said they use tobacco a lot.[9] In another survey of children aged 12 to 17 years, the majority who reported ever experimenting with tobacco said they started with a flavored product, and 85% of current e-cigarette users aged 12-17 use some form of flavoring.[10],.[11] Minors are federally banned from purchasing (or being sold) vaporizers, e-juice, and other related products and states across the U.S. have raised the age to buy cigarettes or vaping products to 21. However, none of us would be surprised to find that teens are still getting their hands on these products and using them. In fact, flavored non-cigarette tobacco products like JUUL seem to be designed to appeal to youth with eye-catching packaging and popular flavors like mint, vanilla, cherry and piña colada. According to JUUL, a single pod contains as much nicotine as a pack of 20 regular cigarettes.[12] Research on Teens and Vaping Because e-cigarettes are still relatively new, there is little information on student perception, use, and prevalence in schools and communities. To begin to gather more data, the Pride Surveys Plus added two categories to the existing core measures including prescription opioids as well as e-cigarettes in 2018. Our Pride Surveys Questionnaire for grades 6-12 still contains the updated Core Measures required by the Substance Abuse and Mental Health Services Administration (SAMHSA) for their Drug-Free Communities Grant. Community coalitions and other grantees can use this survey to provide data for funding applications and evaluation. The survey is also compatible with many other grants including CARA, STOP ACT, Tobacco Cessation, and more. The benefit of choosing a survey company is that we take the guesswork out of the surveying process to ask the difficult questions. For more than thirty years, Pride Surveys has been helping schools collect data on teen substance abuse perceptions and drug use trends. We offer multiple drug-free community survey options as well as student risk perception surveys designed to help assess teen substance abuse and risk, including our student surveys for grades 6-12, and our supplemental surveys like the Drug-Free Community Survey Supplement. The Pride Survey Plus for Grades 6-12 will allow you to obtain a better understanding of your school climate and the safety of your students. Please contact us online or call (800) 279-6361 for more information. Setting a good example is also essential when it comes to preventing smoking. Quitting is one of the best things you can do for your health as it almost immediately improves your lung, heart, and brain function. If you need help quitting smoking, please call 1-800-QUIT-NOW. [1] Get the Facts: E-Cigarettes. Retrieved 30 December 2018 at e-cigarettes.surgeongeneral.gov/getthefacts.html [2] What Are Electronic Cigarettes? Retrieved 30 December 2018 at www.drugabuse.gov/publications/drugfacts/electronic-cigarettes-e-cigarettes [3] What Are Electronic Cigarettes? Retrieved 30 December 2018 at www.drugabuse.gov/publications/drugfacts/electronic-cigarettes-e-cigarettes [4] E-Cigarettes: Facts, Stats and Regulations. Retrieved 30 December 2018 at truthinitiative.org/news/e-cigarettes-facts-stats-and-regulations [5] E-Cigarettes: Facts, Stats and Regulations. Retrieved 30 December 2018 at truthinitiative.org/news/e-cigarettes-facts-stats-and-regulations [6] Teens & E-Cigarettes: National Institute on Drug Abuse; National Institutes of Health; U.S. Department of Health and Human Services. Retrieved 30 December 2018 at www.drugabuse.gov/related-topics/trends-statistics/infographics/teens-e-cigarettes [7] Teens & E-Cigarettes: National Institute on Drug Abuse; National Institutes of Health; U.S. Department of Health and Human Services. Retrieved 30 December 2018 at www.drugabuse.gov/related-topics/trends-statistics/infographics/teens-e-cigarettes [8] Pride Surveys Questionnaire for Grades 6-12 Standard Report 2016-17. [9] Pride Surveys Questionnaire for Grades 6-12 Standard Report 2016-17. [10] Flavored Tobacco Product Use Among Middle and high School Students United States 2014. Retrieved December 30 2018 at www.cdc.gov/mmwr/preview/mmwrhtml/mm6438a2.htm [11] Get the Facts. Retrieved 30 December 2018 at e-cigarettes.surgeongeneral.gov/getthefacts.html [12]
Recognition, Use, and Perceptions of JUUL Among Youth
and Young Adults. Retrieved 30 December 2018 at
tobaccocontrol.bmj.com/content/28/1/115 E-cigarettes,
Teenagers and Oral Health
When looking at e-cigarettes and oral health, especially in relation to teenagers, its important to remember that an e-cigarette is still primarily a nicotine delivery device and theres little debate as to the effects of nicotine on the body. The truth is, no one is completely
sure about the long-term health effects of e-cigarettes
which can make them a particular concern for adolescents.
Many teenagers are smoking e-cigarettes because they feel
they are safe or cool. Regardless of how its
delivered, however, nicotine is still a highly addictive
drug that should be avoided by everyone, especially growing
teens. With few laws banning their use among young people,
its important to educate your children about the
potential hazards of this growing trend. E-Cigarettes Also
Damage Lung Cells The researchers tested both mice and
human cells, exposing them to cigarette and e-cigarette
smoke with and without nicotine. They found that nicotine in
both types of cigarettes caused lung damage. Interestingly,
the nicotine-free e-cigarettes also contained a substance
that damaged lung cells. So, are e-cigarettes really a
better option than cigarettes? While it may not seem that
way right now, more research is needed to confirm. Signs Your Child
Might Be Vaping and What Steps to Take The article, Vaping Teens Exposed to as Much Nicotine as Tobacco Smokers But Dont Know It, brings to light results of an alarming new study that confirms our worst fear teens have no idea exactly what theyre vaping. In the study, researchers collected urine samples from more than 500 adolescents and found that 40 percent of teens who thought they were using nicotine-free products had positive urine sample tests. This is one of the first studies showing the amount of nicotine kids are getting from e-cigarettes, said the studys lead author Dr. Rachel Boykan, a clinical associate professor of pediatrics in the Renaissance School of Medicine at Stony Brook University. Theyre getting a lot as much or more than they would with traditional cigarettes. With the percentage of kids vaping hitting an all-time high according to the 2018 Monitoring the Future Survey and the U.S. Surgeon General declaring e-cig use as an epidemic among youth, more parents are feeling helpless in their attempt to prevent their kids from diving into the hottest teen trend thats sweeping the nation. According to one mother Raising Teens Today spoke with, I suspect my son is vaping, but I dont have proof. Hes at school most of the day, at his job, sports or hanging with friends the remainder of the day and he has plenty of free time to vape without me ever knowing. Im frustrated he wont listen to me and Im even more frustrated hes putting his health at risk. I feel helpless. Understanding and recognizing the signs that your child may be vaping is the first step in prevention. And, despite the sweet-smelling vapor that quickly dissipates, there are plenty of warning signs that parents can keep an eye out for. Approximately one year ago, Raising Teens Today published an article, Is My Child Vaping? Heres 9 Signs to Watch For, that identified several signs of vaping which included:
Since that article was published, more side effects have come to light that are often tell-tale signs of vaping. While most of the side effects listed in our previous article are specific to vaping in general, other more recent side effects that kids are experiencing are a direct result of the high nicotine content in vape products such as Juuls. To assist parents in identifying whether their child is vaping nicotine vape products such as the JUUL, Raising Teens Today dove into the facts, contacted the Centers for Disease Control for information and spoke with experts. 6 Signs Your Child May Be Vaping Nicotine Vape Products Moodiness According to SmokeFree.gov nicotine and mood are inextricably linked. Most people who smoke nicotine products think that smoking is a way to calm your nerves and deal with feelings of anxiety. However, the truth is, nicotine can cause anxiety symptoms or make them worse. Medical News Today also confirmed that nicotine withdrawal symptoms include moodiness, irritability, poor concentration and even a depressed mood. With one JUUL pod containing the equivalent amount of nicotine as 20 cigarettes, if youve noticed a marked change in your childs behavior including increased moodiness, irritability or signs of depression, it may be linked to nicotine vape products. Irregular Periods Although the Centers for Disease Control (CDC) confirmed with Raising Teens Today that vaping in and of itself may not be to blame for irregular periods or shifts in a womans menstrual cycle, smoking cigarettes (which has a high nicotine content similar to e-cig nicotine products such as Juuls) has been found to disrupt the normal menstrual cycle. According to the CDC, Some studies suggest that cigarette smoking may alter menstrual function by increasing the risks for dysmenorrhea (painful menstruation), secondary amenorrhea (lack of menses among women who ever had menstrual periods), and menstrual irregularity. WebMD also confirmed that statement, Women who smoke experience more severe premenstrual symptoms and have a 50 percent increase in cramps lasting two or more days. While there could be numerous reasons why your daughter is experiencing irregular, painful or missed periods, the high nicotine content contained in vape products such as Juuls could be an underlying factor. (According to the CDC, they have not conducted any specific studies to date that identify the connection between vaping and irregular periods or the impact of nicotine on teenage girls menstrual cycle.) Increased Heart Rate / Restlessness Although e-cigarettes have long been touted as the safer alternative for smokers and an effective way for people to quit smoking altogether, a new UCLA study shows that nicotine inhaled from e-cigs can greatly increase a persons heart and aggravate the sympathetic nerve system. A study conducted by the Karolinska Institute, a medical university in Stockholm, found that vape products with nicotine can result in stiffening of the arteries as well as increased heart rate and blood pressure. The study found that 30 minutes after vaping, study participants experienced a significant increase in blood pressure, heart rate and arterial stiffness. Stay tuned into your childs health. If he or she begins to notice or complain about an increase in their heart rate, it may be a side effect of smoking nicotine vape products. Shortness of Breath / Chest Pains Nicotine has its fair share of dangerous side effects, however, kids are especially at risk. According to the World Health Organization (WHO), Teenage smokers suffer from shortness of breath almost three times as often as teens who dont smoke. And, according to cardiologist, John D. Day, MD, director of heart rhythm specialists at Intermountain Heart Institute in Murray, Utah, E-cigarettes have nicotine and nicotine has dangerous cardiovascular effects. This is because nicotine narrows the arteries in the heart and throughout the body, he says. Over time, this can cause serious harm to the cardiovascular system and lead to heart attacks, strokes, and heart failure. Talk to your kids about the danger associated with nicotine vape products. According to the World Health Organization, teens who smoke are three times more likely than nonsmokers to use alcohol, eight times more likely to use marijuana, and 22 times more likely to use cocaine. Acne / Skin Changes While theres no clear connection between vaping, in general, and acne, experts have noted a connection between nicotine and changes in the skin including acne. And, since products such as JUUL contain high levels of nicotine, teens are at risk for changes in their skin. Nicotine ages the skin and slows wound healing. Increased facial blemishes such as acne or red spots that last longer than usual or have difficulty healing could be caused by vaping nicotine products. Pneumonia While most kids brush off the use of vape products claiming it isnt dangerous because its simply a vapor, emerging studies have confirmed that not only is vaping nicotine products particularly harmful for teens, the nicotine-free vape products are dangerous as well. In fact, unbeknownst to many teens and parents, vaping, whether its non-nicotine or nicotine vape products, can cause pneumonia. According to US News, there are nanoparticles present in e-cig vapor that can cause inflammation in the lungs. When lungs get inflamed, it can lead to pockets of bacterial infection and cause pneumonia. If you suspect your child has pneumonia, seek medical attention promptly. According to WebMD, symptoms of pneumonia include high fever (up to 105 F), chills that make you shake, low appetite, feeling tired or lethargic, coughing up mucus and feeling as though you cant catch your breath. Im Concerned My Child is Vaping Marijuana. How Can I Tell? According to a recent study published by the American Academy of Pediatrics, e-cigarettes use may also lead to smoking (or vaping) marijuana. If youre concerned your child may be vaping marijuana, read this article published by Partnership for Drug-Free Kids, How to Know if Your Kid is Vaping Marijuana, which outlines exactly how marijuana is vaped, how you can recognize the warning signs and what you can do if you suspect your child is vaping marijuana. How Do I Help My Teen Quit Vaping? You just found your childs empty vape pods. Now what? According to a recent article in the New York Times, How to Help Teenagers Quit Vaping, First of all, dont panic. Before you confront your child, educate yourself. Try to see the situation from your teens perspective. They know that on the scale of all things forbidden, lots of substances prescription and street drugs, alcohol and cigarettes, to name a few rank far higher than vaping. Remember too, a lot of teens are still under the impression that vaping isnt harmful. The trick is not to try to scare them, because scare tactics dont work at this point, said Dr. Suchitra Krishnan-Sarin, a Yale professor of psychiatry who focuses on adolescent behaviors and tobacco products. Explaining how these products are making them addicted is the way to go. Involve them in a conversation. Try to get them to recognize the compulsive quality of their behavior. Show them what researchers know about nicotine addiction and the questions they are raising about the possible long-term harms of vaping. The goal is to encourage them to want to quit for their own good, not just to give you lip service and continue behind your back. Additional Resources for Parents Ranked as one of the top highest
concerns of parents today, the infatuation with vaping among
teenagers shows no sign of slowing down. To better
understand what vaping is, how vape products work, more
information about how to recognize if your child is vaping
and what steps you can take to prevent your child from
vaping, Is My Child Vaping?
Heres 9 Signs to Watch For Originally designed to help people quit smoking cigarettes, e-cigs have turned into a national infatuation among teens and young adults. While vaporized liquid has been found by researchers to be less harmful to lungs than smoking traditional cigarettes, researchers have also found that vaping has a host of damaging side effects, especially for teenagers. Aside from the documented side effects associated with vaping, the vape devices are compatible with Marijuana, Cocaine, THC liquids, and other drugs, making substance abuse far easier and more discreet for teens and young adults. Plus, due to the discreetness of many vaping devices, teens are finding it exceptionally easy to hide their vaping habits. What is most concerning, however, is that information about vaping and its potential damage to the body is just now becoming more available which is leaving some parents and teenagers in the dark about its harmful side effects. Image: Juul, The Vape Device Teens are Getting Hooked On. Unexplained Sweet Scent Although the vapor produced by e-cigarettes can be either odorless or scented, given the choice, most teenagers will choose the scented (or flavored) vapor. The e-liquid, also known as e-juice, available on the market for e-cigarettes comes in a variety of enticing flavors such as Gummi Bear, Berry Lush, Frozen Lime Drop, and Watermelon Wave that all too many teens are eager to try. If you notice a sweet scent that is unexplainable, it might require further investigation on your part. Pens and USB Drives that Dont Look Normal E-cigs come in many forms. They can resemble traditional tobacco cigarettes, cigars, and pipes. However, the most common e-cigs among teens are vape pens which resemble a traditional pen, and Juuls, which are essentially sleek USB-shaped e-cigarettes that are being hailed as the iPhone of e-cigs. If you come across an unusual looking pen or USB drive, often with holes on each end, chances are its a vaping device and not a typical pen or USB drive. Skipping the Caffeine Some e-cig users suddenly find themselves developing sensitivity to caffeine. If your teen used to be hitting Starbucks regularly or chugging Red Bulls and is now suddenly passing on their favorite caffeinated drinks, this could be a red flag. Increased Thirst Dehydration, often described by vapers as dry or cotton mouth, is actually a fairly common side effect of vaping. Propylene Glycol, one of the ingredients in e-liquid, is the primary cause of the dehydration. The substance has been shown to absorb and hold in water molecules, preventing them from being absorbed into the body. Therefore, if you notice your teen drinking more than they typically do or you happen to notice other signs of dehydration such as dark circles under their eyes, you may want to dive a little deeper to determine the cause. Nosebleeds Typically, when a person vapes they exhale the vapor through their nose which can cause the inside of their nostrils to become dried triggering random nosebleeds. The chemical in the e-liquid, Propylene Glycol, is a dehydrating chemical that strips the moisture from the inside of the nose. Therefore, if your child is suddenly experiencing nosebleeds, it probably deserves more attention to determine the cause. Bloody Sores in the Mouth / Smokers Cough According to a 2017 article in Science News for Students, entitled Concerns Explode Over New Health Risks of Vaping, researchers are now linking e-cigs with mouth wounds that wont heel and smokers cough. The vapors disrupt the immune system which can have harsh effects on human cells. Keep your eye on your child if they complain of sores in their mouth or begin to show signs of an unexplained cough. It could be a sign that your child is vaping. Unfamiliar Batteries and Chargers While some vape pens can be charged with a simple USB cable, most require batteries. And, since an e-cig vape pen battery typically only last two hours with constant use, the battery needs to be charged regularly. If you find an unfamiliar battery or battery charging device, this could serve as another red flag that your child may be vaping. Finding Organic Cotton Balls and Metallic Wires If you stumble across any unbleached, organic cotton balls or thin metallic coils, which are components used when vaping, its typically a dead giveaway that your child is vaping. Discarded Juul Pods According to the Public Health Law Center, as of March 2018, Juuls represented nearly 55% of the e-cigarette retail market share and much of that growth is a result of teen use. While most teens consider Juuls cool, rising concern over their high nicotine content has many parents extremely concerned. To use a Juul, users purchase Juul pods. As the name suggests, the pod systems are e-cigs that make use of a pod as opposed to a traditional atomizer, although they pretty much serve the same function. If you happen to see discarded Juul pods in your childs backpack, bedroom, pockets or elsewhere, theres reason for concern. Discarded Atomizers The atomizer is an important part of
any e-cig. Its the component of the e-cig that turns
the e-liquid into vapor. The atomizers dont last
forever and eventually need to be discarded. Therefore, if
you happen to come across a discarded atomizer in your
childs room, it can be a good indication that your
child has been vaping. The Pros and Cons
of E-Cigarettes What made you decide to try the e-cigarette? After reading this article, share your comments and read what others have to say. You can smoke them virtually anywhere. Many say they will help you quit smoking, a plus for people with COPD who often struggle with smoking cessation. Others are skeptical and afraid to try them. The FDA would like to regulate them as medical products. The e-cigarette industry feels that the FDA has no substantiated reason to do so. There's a lot of talk going on about e-cigarettes, so before making a decision to use them, learn the facts about their pros and cons. What are E-Cigarettes? Electronic cigarettes, or e-cigarettes for short, are battery-powered devices filled with liquid nicotine (a highly addictive chemical) that is dissolved in a solution of water and propylene glycol. Many of them look like real cigarettes, with a white cylindrical tube, brown filter, and red-glowing tip. Others come in less conspicuous, darker colors. How Do They Work? Often termed "vaping," when you take a puff on the end of the e-cigarette tube, a battery heats up the nicotine, which creates a vapor that is then inhaled into the lungs. The end result is a sensation of smoke in the mouth and lungs without really smoking. The Upside to E-Cigarettes Unlike tobacco products, there are no current laws in effect prohibiting the use of e-cigarettes in public places. Case in point, I work in a hospital and a fellow nurse smokes them right there in the nursing station. Here's what current research says about the positive aspects of this product:
The Downside of E-Cigarettes If you are a savvy consumer, both positive and negative aspects of the the product you are considering should be scrutinized before you purchase it. The e-cigarette is no exception. Take a look at what some of the research says about the negative aspects of the e-cigarette:
The Best Way To Quit Smoking How you choose to quit smoking is a matter of personal choice. The best method is the one that works for you. With this in mind, doing whatever it takes to be successful -- and safe -- is how many people ultimately approach it. Consult your health care provider about different stop smoking aids, including nicotine replacement therapy, quit smoking medications such as Clonidine and Wellbutrin, quit smoking support groups, and educational materials. If you decide to try the e-cigarette, be sure to discuss this with your doctor and do your homework. Understand the pros, cons, and safety concerns, and then make an informed decision. The most important thing to remember is, no matter how you do it, you are making the best decision of your life when you finally decide to quit smoking, especially if you have COPD. If you're interested in purchasing an e-cigarette starter kit, compare prices here. Sources: Etter JF, Bullen C. Electronic cigarette: users profile, utilization, satisfaction and perceived efficacy. Addiction. 2011 Nov;106(11):2017-28. Epub 2011 Jul 27. Bullen C, McRobbie H, Thornley S, Glover M, Lin R, Laugesen M. Effect of an electronic nicotine delivery device (e cigarette) on desire to smoke and withdrawal, user preferences and nicotine delivery: randomised cross-over trial. Tob Control. 2010 Apr;19(2):98-103. Caponnetto P, Polosa R, Russo C, Leotta C, Campagna D. J. Successful smoking cessation with electronic cigarettes in smokers with a documented history of recurring relapses: a case series. Med Case Reports. 2011 Dec 20;5(1):585. Evangelopoulou, Gregory N. Connolly and Panagiotis K. Behrakis Constantine I. Vardavas, Nektarios Anagnostopoulos, Marios Kougias, Vassiliki. Acute pulmonary effects of using an e-cigarette: impact on respiratory flow resistance, impedance and exhaled nitric oxide. Chest; Prepublished online December 22, 2011. Fagerström KO, Hughes JR, Rasmussen T, Callas PW. Randomized trial investigating effect of a novel nicotine delivery device (Eclipse) and a nicotine oral inhaler on smoking behavior, nicotine and carbon monoxide exposure, and motivation to quit. Tob Control. 2000 Sep;9(3):327-33. Fagerström KO, Hughes JR, Callas PW. Long-term effects of the Eclipse cigarette substitute and the nicotine inhaler in smokers not interested in quitting. Nicotine Tob Res. 2002;4 Suppl 2:S141-5. Food and Drug Administration News and Events: Public Health Focus. http://www.fda.gov/newsevents/publichealthfocus/ucm172906.htm. Accessed 1/24/2011. Anna Trtchounian and Prue Talbot. Electronic nicotine delivery systems: is there a need for regulation? Tob Control published online December 7, 2010. Public health
Q&A: Are e-cigarettes safe? Answer: In 2010, Wisconsin implemented the Smoke-free Air law and almost five years later 86 percent of Wisconsinites enjoy and expect smoke-free air. E-cigarettes have recently exploded on the market and this new popular trend has created confusion regarding the statewide Smoke-free Air law. This new trend is invading the clean air we have come to expect. An electronic cigarette is an oral device that can be used to simulate smoking and that produces an aerosol of nicotine or other substances. The term e-cigarette is use to reference and array of products including, e-hookahs, hookah pens, vape pens, vaporizers, e-cigars, and e-pipes. You may be asking yourself, "But are they healthy?" As many as 10 different toxic or carcinogenic chemicals have been identified in e-cigarettes including, highly addictive nicotine. Studies have also found some e-cigarettes contain high levels of formaldehyde and diacetyl chemicals harmful to the human body. Currently, e-cigarettes aren't regulated and haven't been proven to be safe. E-cigarettes are being marketed as a healthy alternative to smoking, an effective cessation strategy and a way around existing smoke-free air laws. But smokers who use e-cigarettes for cessation often continue to smoke regular cigarettes. In addition, allowing e-cigarettes to be used indoors where cigarettes are not allowed undermines the smoke-free air law. The use of e-cigarettes indoors threatens Wisconsin's standard of clean air and makes enforcement confusing. Overall, more research is needed to show the long-term health consequences of e-cigarettes. Every month more information is coming out about what is actually in e-cigarettes and e-juice. It's more than just water vapor. The Central Wisconsin Tobacco Free Coalition strives to reduce tobacco/nicotine related death and disability through education and advocacy, creating a community environment that encourages tobacco free living. Destinee Coenen is a public health
educator with the Marathon County Health Department who is
part of the Central Wisconsin Tobacco Free Coalition. Have a
question about public health? Email it to
opinion@wdhmedia.com. Study: New
concerns raised over teen e-cigarette use The report, released Monday by the American Academy of Pediatrics, is based on a study that found overall smoking prevalence among youth in Southern California declined, but the combined e-cigarette or cigarette use was substantially greater than before e-cigarettes became available. The conclusion raises the question of whether e-cigarettes are merely substituting for cigarettes or being used by teens who wouldnt otherwise be smoking. In 2014, the Centers for Disease Control and Prevention reported e-cigarettes were the most commonly used tobacco product among middle and high school students, with an estimated 2 million users in that age group. Cigarette smoking declined among American teens in recent years, but the use of other tobacco products like e-cigarettes and hookahs increased, the report says. More teens now try vaping than smoking The potential safety of e-cigarettes, devices that heat a liquid consisting of nicotine, flavorings and other chemicals to create a vapor, is hotly debated. Unlike traditional cigarettes, e-cigarettes do not contain tar or other chemicals generated by the combustion of tobacco that are responsible for harmful tobacco-related diseases. They are, therefore, seen as a safer alternative to conventional tobacco use, the leading cause of preventable death in the U.S. Health care experts worry e-cigarettes could normalize cigarette use and create a new generation of smokers and nicotine addicts that will be likely to transition to more traditional tobacco products. But Brian Carter, the director of scientific communications at The Consumer Advocates for Smoke-free Alternatives Association, a group dedicated to ensuring the availability of smoking alternatives, asks why someone who prefers not to smoke but tries e-cigarettes would make the transition to a really nasty alternative. Aruni Bhatnagar, lead author of the American Heart Associations policy statement on e-cigarettes, said even if teens dont switch to other tobacco products, nicotine itself isnt benign. It increases heart rate and blood pressure and can, over time, contribute to cardiovascular and heart disease, he said. We are not entirely convinced that (e-cigarettes) are innocuous and contain minimal harm, said Bhatnagar, who also teaches medicine at the University of Louisville. We dont know what the harm is, its not clear cut yet. Tobacco use and addiction mostly begin during youth and young adulthood. Nicotine exposure during adolescent years, a critical time for brain development, can have lasting adverse consequences, according to the CDC report. Harold Farber, policy chair at the American Academy of Pediatrics Section on Tobacco Control and pediatric pulmonologist at Texas Childrens Hospital, said the adolescent brain is highly malleable, so addiction to nicotine is much more severe and difficult to kick in those who start using at a young age. E-cigarettes, which are sold in a variety of different flavors, are like a highly addictive candy directly marketed to youth, Farber said. Gregory Conley, president of the American Vaping Association, an advocacy group that champions vapor products for smokers looking to quit, argued most teens who do use e-cigarettes arent necessarily using vapes that contain nicotine. A 2015 National Institute on Drug Abuse report says over 60% of middle and high school students reported vaporizing just flavoring. However, some products labeled nicotine-free may actually contain nicotine, it added. The Food and Drug Administration issued new rules in May that for the first time extended federal regulation to e-cigarettes, with the intent to keep tobacco products out of the hands of minors. The new rules ban the sale of e-cigarettes to anyone under 18 and require manufacturers to register with the FDA, disclose detailed reports of their products ingredients and obtain permission to sell their products. FDA went way too far on e-cigarettes While these regulations are a move in the right direction, Bhatnagar says they could have gone even farther by increasing the age to 21, banning the different e-cigarette flavors and regulating advertisements on TV and in magazines. Bhatnagar says smoking was de-normalized when it was banned from public spaces and discouraged from display in TV and movies, which he credits for the major gains in decreased tobacco use and addiction. But vaping, which people do publicly in a variety of different environments, reverses these gains, he said. Carter, who has a background in clinical psychology, argues it is highly premature to conclude that something bad is going on with youth e-cigarette use. At best, this is a study that offers some small potential clue about what may be happening, he said. To suggest anything more concrete than this is to be very unscientific by touting speculation as fact. Farber says e-cigarettes are a huge experiment to be conducting on our future generations. With e-cigarettes were
seeing a step back in our battle, he said. But
Im hoping we realize the errors of our ways and decide
its worth protecting our children. 4 Facts You Need to
Know About E-Cigarettes We do know that traditional cigarette smoke contains upwards of 7000 toxins, including 250 poisonous and 70 cancer-causing chemical compounds. No level of secondhand cigarette smoke is considered safe to breathe. E-cigarette emissions on the other hand contain far fewer toxins, in part because the vapor is not a byproduct of burning organic matter, but of heating the nicotine-containing liquid, which causes it to vaporize. While e-cigarettes are less hazardous than traditional cigarettes, they're not harmless. Let's take a closer look at the issues you should be concerned with if you're thinking about using e-cigarettes as a smoking alternative or a quit aid. 1. Electronic Cigarettes are Not Regulated In the United States, tobacco products that are regulated must adhere to strict rules imposed by the U.S. Food and Drug Administration (FDA). These include:
Currently, regulated tobacco products include cigarettes, cigarette tobacco, smokeless tobacco, and roll-your-own tobacco. The FDA plans to extend their umbrella of control over more tobacco products soon. They are: e-cigarettes, cigars, pipe tobacco, nicotine gels, hookah tobacco and dissolvables. These products would be subject to the rules noted above and would also have to include health warnings, not be sold in vending machines at locations that are accessible to children, and adhere to minimum age and I.D. restrictions for sales. How Lack of Regulation Hurts Consumers The current lack of regulation on e-cigarettes means that you can't trust that the product you're buying contains the amount of nicotine it claims to, or that it is produced with any quality control. Pharmaceutical grade nicotine is used in all U.S. NRT products, but consumers can't count on that with unregulated tobacco products. Similarly, information on packaging regarding nicotine-free cartridges cannot be trusted. They may, and often do contain nicotine. This is especially bad if you're using e-cigarettes as a quit aid and trying to decrease nicotine gradually to zero. Finally, the quality of electronic cigarette devices themselves vary widely, which can affect vapor composition and toxicity. 2. E-Cigarettes Contain Some Surprising Toxins In a study reviewing available information about e-cigarette liquid, cartridges, vapor and exhaled emissions, authors noted the presence of a number of toxins in varying amounts, including formaldehyde, acetaldehyde, acrolein, o-Methyl benzaldehyde, acetone, volatile organic compounds, phenolic compounds, polycyclic aromatic hydrocarbons. While the amounts of these chemicals are much less in e-cigarettes than in traditional cigarettes, there is a risk of exposure to some of the same chemicals that are hazardous in cigarette smoke. TSNAs in e-Cigarettes E-Cigarette liquid and vapor has been shown to contain TSNAs, a group of four chemical compounds that are thought to be some of the most potent carcinogens in tobacco products and tobacco smoke. TSNAs are present in green tobacco and processed tobacco, including liquid nicotine. TSNAs are associated with lung cancer, oral and esophageal cancer, liver cancer and pancreatic cancer. There is growing evidence that TSNAs may contribute to cervical cancer. Heavy Metals in e-Cigarettes Researchers studying e-cigarette emissions have identified chromium, a metal not present in cigarette smoke, as well as a number of other heavy metals that are, including zinc and lead. The concentrations are much lower than in traditional cigarette smoke, but are not zero. Nickel is present in levels 4 times higher than in regular cigarette smoke. It appears that the metals probably come from the cartridges and that standardizing the quality of their construction may reduce these toxins. 3. E-Juice is Poisonous The "active" ingredient in e-cigarettes and the reason people use them is nicotine, and nicotine is a poison. It has been used in insecticides for years and is the addictive ingredient in both cigarettes and e-cigarettes. According to a CDC study that reviewed calls to poison centers across the United States involving e-cigarette liquid containing nicotine, the incidence of accidental poisoning has skyrocketed in the last few years as e-cigarettes have gained in popularity. There was just one call per month pertaining to liquid nicotine in September of 2010 and 215 calls per month by February of 2014. Approximately half of the calls involved children under the age of 5 being exposed to e-cigarette liquid, and 42 percent from people over the age of 20. E-liquid comes in several sweet, candy flavors, which is appealing to kids. Poisoning occurs when nicotine-laced e-liquid is inhaled, ingested or absorbed through the skin or eyes. In December, 2014, what may be the first death of a child due to liquid nicotine occurred in upstate New York state when a one year old who ingested liquid nicotine died soon after. Local police didn't confirm that the liquid nicotine was associated with e-cigarettes, however it is likely. And, earlier in 2014, a puppy in Britain got hold of an e-liquid cartridge and was dead within hours of chewing through it and ingesting a small amount of the liquid. 4. E-Cigarettes are a Smoking Alternative, Not a Quit Aid It's probable that e-cigarettes will be a regulated product in the future. When that occurs, it's also likely that a physician designed and endorsed regimen for smoking cessation using electronic cigarettes will eventually become available. When and if that happens, consumers will be able to count on a consistent level of manufacturing quality and nicotine quality and content. They will also have a program for stepping down and off of nicotine completely, which is the purpose of any quit aid. People are already using the e-cigarette as a means to quit nicotine altogether, and some are achieving success with it. On the flip side, many e-cigarette users either transfer their addiction from tobacco to the device, or eventually go back to smoking traditional cigarettes full-time because they're still actively addicted to nicotine. If you're thinking of using the
e-cigarette to quit smoking, do some research first on the
quit aids available on the market today, and have a
discussion about them with your doctor, who can offer advice
on the best choice for you. U.S. Food and Drug Administration. FDA proposes to extend its tobacco authority to additional tobacco products, including e-cigarettes. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm394667.htm . Accessed March 2015. British Medical Journal. Chemical Evaluation of Cigarettes. http://tobaccocontrol.bmj.com/content/23/suppl_2/ii11.full . Accessed March 2015. University of Southern
California. Secondhand E-Cigarette Smoke: Healthier Than
Regular Cigarette Smoke, But Still Contains Some Toxic
Elements.
http://pressroom.usc.edu/second-hand-e-cigarette-smoke-healthier-than-regular-cigarette-smoke-but-still-contains-some-toxic-elements/
. Accessed March 2015. 3 reasons to say no
to e-cigarettes - Kaiser Permanente 1. Safety concerns After analyzing e-cigarette samples, the U.S. Food and Drug Administration (FDA) found that some products contain cancer-causing agents and toxic chemicals such as diethylene glycol, an ingredient used in antifreeze. 2. No convincing evidence they will help you quit In fact, there is evidence suggesting the opposite: A 2014 study by researchers at the University of California, San Francisco, revealed that smokers who use e-cigarettes are a third less likely to quit than those who dont use them. 3. Whats proven to work still works Evidence shows the most effective way
to quit is to use a combination of FDA-approved medications
(like the nicotine patch, gum, lozenge, or bupropion) and
counseling support. Choose what works for you: Kaiser
Permanentes Wellness Coaching by Phone, tap into the
power of a group in a Health Education stop smoking class,
or try the online, self-paced program called
HealthMedia® Breathe.(TM) Learn more at kp.org/quitsmoking.
The Dangers of
Vaping: Understanding the Risks and How to Stop Throughout the United States, 805 cases of vaping-related respiratory illnesses have been reported in 46 states. These cases are linked to people who modified their vaping devices or use illegally modified e-liquid. Similarly, vaping products that contain THC, the component found in marijuana that produces mind-altering effects, is a common denominator as well. Due to these potential effects, vaping is a major health concern that may need intervention from a healthcare professional. Its of growing importance for family nurse practitioners to build more communicative relationships with youth patients as well as parents, in order to better identify and intervene where vaping is an issue. Early recognition and intervention by medical professionals are essential to slow the spread of chronic ailments, like respiratory illnesses that can be caused by vaping. Such nursing professionals also serve patients throughout their life cycle, which is beneficial to providing family-focused care and being able to communicate openly with both patients and parents to address these social determinants of health. For children younger than 18, pediatric nurses can help identify and prevent illnesses while providing routine care. Before seeking the help of a health professional, its important to understand problems associated with vaping, recognizing the signs of vaping, and taking action to address the issue. What Is Vaping? Vaping is the act of inhaling aerosol, which is often referred to as vapor, and is produced by e-cigarettes. Contrary to popular belief, e-cigarettes do not produce tobacco smoke or water vapor rather, the aerosol contains tiny, fine particles that consist of various toxic chemicals. Besides e-cigarettes, vaping devices include vape pens and advanced personal vapors, also known as MODS. E-cigarettes and vape pens are typically small in design and resemble regular cigarettes or fountain pens, respectively. Generally, a vaping device is made up of a mouthpiece, a battery, a cartridge, and a heating component. The cartridge, containing the e-liquid or e-juice, is heated up which turns the liquid contents into an aerosol. When someone inhales this aerosol, it makes its way into the lungs where it can cause severe damage, including irritation to both the upper and lower respiratory tract, as well as bronchospasms. Vaping can also cause more serious effects, including:
How Vaping Started Vaping originally hit the market as an alternative to smoking. Now it is a billion-dollar industry. 1930: This was the first reference to an e-cigarette in a patent. 1960s: Herbert A. Gilbert created the first vaping device that resembles modern e-cigarettes. 1979-80s: Phil Ray first commercialized the e-cigarette. However, the device was faulty and failed to sell. 1990s: Numerous patents were filed, however, the FDA denied requests to commercialize them due to the fact that they were considered an unapproved drug delivery device. 2003: The first successfully commercialized vaping device was created in Beijing, China. 2006: E-cigarettes were introduced to Europe. 2006-07: E-cigarettes are introduced to the United States. 2007: NJoy, one of the first major e-cigarette brands was founded. 2008: The World Health Organization (WHO) claims that e-cigarettes are not a legitimate smoking cessation. 2009: President Obama signs the Family Smoking Prevention and Tobacco Control Act, giving the FDA power to regulate the tobacco industry. 2010: The FDA can only regulate e-cigarettes as a tobacco product unless therapeutic claims are made. 2011: Studies are published stating that smokers are finding success in smoking cessation with e-cigarettes. 2012: The vaping industry starts holding conventions throughout the U.S. 2013: The Testimonials Project is born to collect stories from smokers who have found success in smoking cessation with e-cigarettes. 2015: JUUL starts advertising in Vice Magazine, the #1 youth media company. E-cigarettes are starting to sell online, making it convenient for people to obtain them. 2016: E-cigarette companies aggressively market to youth and young adults. Truth Initiative found that more than 20 million youth saw at least one e-cigarette advertisement. 2018: The number of vapers grows to 41 million. Users in the United States, the United Kingdom, and France spend $10 billion on vaping products. 2019: The vaping industry costs 12.4 billion and is expected to grow by 20.8% from 2020 to 2027. Vaping companies continually target young audiences in terms of marketing, including:
Although the Family Smoking Prevention and Tobacco Control Act banned cigarette flavors other than menthol, it does not regulate other tobacco products. E-cigarette companies capitalized on this regulation gap in order to market to a younger audience. Types of Vape Devices Vape devices come in all shapes and sizes, and its important to know how to spot them. Electronic Cigarettes:
Vape Pens:
Mechanical Modified Nicotine Delivery Systems (MODS):
Pod Systems:
Understanding the Dangers of Vaping Since the outbreak of cases related to e-cigarette or vaping product use-associated lung injury (EVALI), patients have experienced many symptoms, including:
More seriously, e-cigarettes are associated with respiratory disease among adults. Chronic bronchitis, emphysema, and asthma are among the most common. Since vaping devices can contain nicotine and other chemicals, vaping can also lead to changes in our appearances. These changes include:
Vaping can also be dangerous to nonusers, since vaping devices release high amounts of toxicants in addition to particulate matter. Is Vaping Addictive? Nicotine can be found in most vaping devices, which makes vaping a potentially addictive hobby. The more a body gets used to nicotine, the harder it becomes to go without it. As nicotine levels drop, the body feels withdrawal symptoms which makes a person want to ingest nicotine to curb those feelings. This is the definition of nicotine addiction. Other withdrawal symptoms include:
Nicotine withdrawal is different for everyone, which can make quitting hard or unreachable. Healthcare professionals from accredited nursing schools across the nation are trained to understand smoking cessation best practices, in large part due to the health risks associated with vaping. In fact, tobacco cessation training programs are fairly common for healthcare professionals. Many programs prepare healthcare professionals to talk to patients about quitting and to track their progress. Nurses and doctors are in key positions to influence and control tobacco cessation programs because of their roles as educators and researches. They can also help manage withdrawal symptoms in order to help their patients to quit smoking or vaping. Is Vaping Illegal for Minors? Federal regulations restrict the sale of vaping devices and products to people who are under the age of 21. However, many state laws regarding minors and vaping vary. For instance, some states do not define e-cigarettes as tobacco products, such as Florida, Ohio, and Washington. Additionally, Maryland allows 18-year old military members to purchase vaping devices and materials. If a minor is in possession of a vaping device, there are legal ramifications for both the user and the seller, although they do vary by state. Some examples include:
How to Address Vaping Vaping can cause lingering respiratory issues, which is why its important to recognize the signs of vaping and take the appropriate steps to address the situation. Signs of Vape Device Use It may be hard for parents to see signs of vaping in their children. With the epidemic of youth vaping, its more than likely that a child has been exposed. However, there are some common signs to watch for:
How to Stop Someone From Vaping Addressing a vaping situation requires a straightforward and open discussion. Its important to react in a calm manner and listen to what your child has to say. Other actions you can take include: Start talking to them about vaping at a young age. Prevention is one of the best ways to stop your children from vaping. By warning children about the dangers of vaping before they start, there is a better chance they wont start at all. Create an open environment. Your child could be more willing to talk with you if you create an honest relationship. Instead of catching them in the act of vaping, it is more productive to have an open dialogue about it. Stay calm. Children can easily shut down if they are met with opposition and anger. Though this might lead them to stop vaping, it can also lead to resentment. Instead, talk to your children about whether you can help them quit and the options they have. Get outside help. If your child has a nicotine addiction, it is best to get them the help they need from one of the resources in the last section of this guide. Learn Smoking Cessation Best Practices Healthcare professionals and guardians can help curb vape use by participating in smoking cessation training programs. These programs include counseling, behavior therapy, and smoking cessation tools like:
Additionally, nurses play a major role in helping their patients quit smoking. By obtaining their nursing certification, these healthcare professionals will be trained in the latest tobacco cessation methods. All of these tools, including nurses, can help an individual address their nicotine addiction. Online Resources to Stop Vaping In addition to seeking assistance from community-focused healthcare professionals, such as public health nurses, there are many resources and tools available online. Parent/Teen Resources CDC Youth Engagement User Guide: This guide employs strategies that appeal to youth and gives program managers information on how to engage young people as a part of a comprehensive tobacco control program. Consequences of Smoking Consumer Guide: This guide shows the effects of smoking and nicotine addiction, as well as the benefits of quitting and resources to help. The Ex Program: This is an online cessation program that is designed for employers and health plans. It provides an active social network with thousands of smokers and ex-smokers, and includes digital, personalized coaching. Ex Community: This site is made up of a community of people who want to quit smoking. People can post blogs about their journey, take a daily pledge, get support from an online community, and find motivation through others stories. Project Prevent: This is a statewide youth tobacco prevention coalition in Arkansas. They host monthly online meetings between different chapters and provide opportunities for youth participation, such as an annual conference. Quit Vaping: This site provides tools on how to quit vaping, including how to get through the first day without vaping, and strategies to combat vaping addiction and nicotine withdrawal. Youth Engagement Alliance: The Youth Engagement Alliance is a site that provides toolkits, resources, webinars, opportunities for engagement, and a list of national organizations. Resources for Healthcare Professionals QuitNowTXT Message Library: This text messaging service allows healthcare professionals to send text messages to serve as smoking cessation interventions for people ready to quit smoking. Treat Tobacco: this site is designed to provide support for the treatment of tobacco addiction. Cancer Control P.L.A.N.E.T: This portal provides web-based resources that can assist in assessing the cancer burden in a given state and identifying potential partner organizations. Quick Reference Guide: This Quick Reference Guide for Clinicians presents summary points from the Clinical Practice Guideline and provides appropriate treatments for every patient. Helping
Smokers Quit: A Guide for Clinicians:
This guide outlines a strategy to help patients quit
smoking. Tobacco (read e-cigarettes too) surely was designed to poison and destroy mankind - Philip Freneau |