Vaping and Substance Abuse

Electronic cigarettes are known as e-cigs, e-hookah, vapes, vape pens, Juules and mods.  They are battery powered electronic nicotine delivery systems.  The devices produce an aerosol which is created by contact of an e-juice or e-liquid mixture to a heating element called an atomizer.

• The e-juices contain varying amounts of nicotine ranging from 0 to 36 milligrams per millimeter.
• Many of the e-juices that can be purchased come in a variety of desirable flavors such as Watermelon, Berry Lush, and Frozen Lime Drop making vaping a pleasant experience for young kids and teens. 
• E-sigs come in many forms and can resemble traditional tobacco cigarettes, cigars, pipes or commonly seen USB memory sticks as seen with the brand of Juul.
• Health experts are extremely concerned about the Juul brand because each pod contains 5% nicotine, the equivalent of 1 pack of cigarettes (or 200 puffs).
• There are more than 450 brands of e-cigarettes on the market today and they all operate in a similar fashion. 

Research Studies

• There are many studies currently underway related to the health effects of e-cigarettes.  Several studies have already found that e-cigarettes and nicotine use in teens can cause severe health effects. 
• Recent studies have shown that some e-cig brands contain high levels of nickel, tin, lead, cadmium and chromium (in fine particulates), which most likely come from the metal heating coils of the atomizer (heating coil).
• Recent studies have found that e-liquids, flavorings and aerosols are simply unsafe.  According to the FDA, inhalation of diacetyl and acetyl propionyl (a flavoring found in some e-juices) is known to be associated with respiratory disease.

• According to the American Lung Association, inhaling diacetyl can cause bronchiolitis obliterans, also known as ‘popcorn lung’ which is the scarring of the tiny air sacs in the lungs which causes a narrowing of airways.  Symptoms of popcorn lung include wheezing, coughing and shortness of breath.

Nicotine

• Nicotine in a person’s bloodstream stimulates the release of epinephrine which increases blood pressure, breathing and heart rate.  More importantly, nicotine activates dopamine (a chemical messenger which reinforces rewarding behaviors).  Addiction to nicotine happens chemically when the body associates its use to a rewarding behavior through dopamine release. 
• Nicotine affects the development of the brain.  Teens are more vulnerable to addiction since their brains are still growing (until age 25) and rapidly making connections (synapses).
• Research has shown that nicotine addiction in teens can cause complications in brain development related to attention and learning, mood disorders and impulse control.  Source: Surgeon General Executive Summary 2016.
• Nicotine dependency can affect the brain’s reward system which increases addiction risk to additional drugs such as cocaine and methamphetamines.    

Paraphrased from the article "Is my child vaping? 9 signs to watch out for.
https://raisingteenstoday.com/is-my-child-vaping-heres-9-signs-to-watch-for/

1. Unexplained Sweet Scent: E-liquids come in a variety of fruity flavors and scents such as Gummi Bear, Berry Lush, and Watermelon Wave.
2. Pens and USB Drives that don’t look normal: many of the e-cigarette devices take the shape of USB drives and pens, but some may look like other inconspicuous electronics.
3. Suddenly Skipping the Caffeine:  Some people report a sensitivity to caffeine when vaping.
4. Increased Thirst: Cottonmouth is a common side effect of vaping.  Propylene Glycol (common ingredient in e-liquid) is the primary cause of the dehydration.
5. Nosebleeds:  Excessively exhaling vapor through the nose can trigger chronic and random nosebleeds.
6. Bloody sores and chronic cough: New research is linking vaping to mouth sores.  Chronic or unexplained coughing could be due to popcorn lung caused by inhaling diacetyl (additive in e-juices)
7. Unfamiliar batteries and chargers: E-cigs need batteries to function.  With constant use, the batteries need to be charged.  Some require unique charging devices.
8. Organic Cotton Balls and Metallic Wires: Some of the more expensive mods have replaceable coils.
9. Discarded Pods and Atomizers:  Juul pods and atomizers don’t last forever and need to be replaced.  They are small and easily concealable, but will need to be discarded when replaced.   

• Recent national studies show that nearly 1 out of 4 high school students are vaping with products such as e-cigarettes, e-cigars, vape pens, and Juuls. 
• 3 million U.S. adolescents currently use e-cigarettes
• On average, 1 out of 11 middle and high school students have smoked Marijuana using e-cigarettes according to a National Youth Tobacco survey which polled 20,000 students across the country.
• 1 out of 3 high school students who reported vaping also reported that they used cannabis in the device.
• Boys are twice as likely to vape as girls
• Teens who vape are 30.7% more likely to begin smoking within 6 months as opposed to the non-vaper at 8.1%
• 7 out of 10 teens (including middle and high schoolers) have been exposed to e-cigarette advertising including retail ads, television, movies, Internet, newspapers, and magazines
• Vape pens and other e-cigarette devices are incredibly easy to conceal.  Many devices look like USB drives, pens or other electronic equipment
• Most kids are not aware that ALL Juul pods contain nicotine

Articles and Links

National Institute on Drug Abuse
https://www.drugabuse.gov/publications/drugfacts/electronic-cigarettes-e-cigarettes

Vape 101: What parents need to know
https://raisingteenstoday.com/vape101-what-parents-need-to-know/

Is my child vaping? – 9 signs
https://raisingteenstoday.com/is-my-child-vaping-heres-9-signs-to-watch-for/

How much do you know about vaping?
http://newsroom.ocde.us/how-much-do-you-know-about-vaping/

Drug Facts
https://www.drugabuse.gov/publications/drugfacts/electronic-cigarettes-e-cigarettes

Teens hooked by vaping: FDA weighing a ban on flavored e-cigarette liquids
USA Today
https://www.usatoday.com/story/news/nation/2018/08/13/teen-vaping-fda-weighs-ban-flavored-e-cigarette-liquid/890218002/

More teenagers are vaping marijuana than previously thought, survey shows
Detroit Free Press – reproduced article from USA today
http://freep.mi.newsmemory.com/publink.php?shareid=08de45066

Parent Info.org
https://parentinfo.org/article/e-cigarettes-and-vaping-a-parent-s-guide

Surgeon General
https://e-cigarettes.surgeongeneral.gov/

Videos

Educators worry students don’t know vaping risks
PBS News Hour
https://www.pbs.org/newshour/show/educators-worry-students-dont-know-vaping-health-risks

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