What is an E-Cigarette or Vaping?
An e-cigarette is a battery-operated device that heats up a liquid chemical called e-juice into an aerosol that is then inhaled.
This is often called vaping. E-juice does not contain tobacco. However, most of these products contain substantial amounts of nicotine which is the addictive substance also found in cigarettes. Other chemicals and metals are found in e-juice. Some of these chemicals are the same ones found in tobacco cigarettes.
Vaping has not been proven to be a helpful quitting aid for the majority of people. Many become dual users (vaping and smoking) which may actually increase health risks.
Nicotine replacement therapy such as patches, inhalers and gum do not involve heating nicotine so using these “NRT” products does not expose the user to the types of chemicals that are found in tobacco and vaping products.
It’s just water vapour right? False! E-cigarettes may be less harmful than tobacco cigarettes, but that does not make them safe!
A Puff of Truth
A recent study found that the teens tested who had been vaping had toxic organic compounds in their bodies. The two major findings:
- Youth who were vaping had up to 3 times as many chemical organic compounds in their bodies as non-vaping youth.
- Those who smoked and vaped (dual user) had up to 3 times as many than those who were only vaping.1
If you don’t smoke, don’t vape.
Types of E-cigarettes
Common terms for e-cigarettes include:
- vape pen
One of the most common types used by youth include mods or tanks. These units can be refilled when empty. They may allow the user to turn the heat up or down. Turning the heat up creates larger vapour clouds, but is known to also increase the amount of nicotine and chemicals inhaled. There are also products specifically on the market to vape cannabis.
JUUL is a product which looks very similar to a USB stick and can be very small.
- Each pod contains as much nicotine as a pack of cigarettes.
- JUUL always contains Nicotine - high amounts using a liquid of Nicotine Salts.
- The less harsh nature of this product, high nicotine content and fruity flavours put youth at risk for quickly becoming addicted.
- They currently do not offer pods with lower amounts of Nicotine, making it a challenge for users to cut down their use.
- This product has captured half of the e-cigarette market in the U.S and the FDA has sounded the alarm about the numbers of youth and young adults using JUUL.
- JUUL’s websites lists the following ingredients in the pods: Glycerol, propylene glycol, natural oils, extracts and flavour, nicotine and benzoic acid.
What is in E-Juice?
Most e-juice includes a mixture of:
- propylene glycol
- vegetable glycerin
- flavor ingredients
It is not just harmless water vapour, but an aerosol. Many vaping websites state that propylene glycol, vegetable glycerin and flavourings have been considered safe food additives by the FDA. This is true, but there is no evidence to show that they are safe when heated and inhaled deeply into the lungs.
E-juice does not contain tobacco. However, most of these products contain nicotine which is the addictive substance also found in cigarettes.
Some products are labeled as having zero nicotine, but many are not correctly labelled and do in fact contain some nicotine. Even when labelled as containing nicotine, some e-juice has been found to have a greater amount of nicotine than what is listed on the label.
TOXIC STUFF: E-juice also contains chemicals and metals. Some of these chemicals and metals are the same ones found in tobacco cigarettes. When the ingredients in e-juice are heated, they break apart into toxic organic compounds such as:
- propylene oxide
Metals such as nickel, tin, and lead have also been found in e-juice. This is likely because the e-juice comes into contact with the metal coil used to heat the e-juice into an aerosol.
It is also possible to add other substances to e-juice such as cannabis oil or “rosin”.
Flavours in e-juice are one of the main reasons people are attracted to use vaping devices. Flavouring agents may carry their own health risks for the user. When some ingredients are heated they undergo chemical changes.
For example, saccharides are used to make e-liquid flavours that are sweet, but these e-liquid flavors can degrade and produce furans and aldehydes. Cinnamaldehyde is used to make cinnamon flavoured e-juice but has been shown to be toxic to living cells.
Health Concerns for Youth
Youth who do not use tobacco are beginning to experiment with vaping believing that it is safer. Nicotine is highly addictive, especially for the growing teen brain. It may lead to difficulty concentrating, problems with impulse control and there is evidence that nicotine addiction can lead to use of other drugs. For more about the health concerns for youth and Nicotine, visit https://e-cigarettes.surgeongeneral.gov/
Transition to Tobacco Cigarettes
The evidence is showing that vaping increases the risk of youth and young adults of ever using tobacco products. Also, there is moderate evidence showing that e-cigarette use increases the use and frequency of combustible tobacco products like cigarettes among youth and youth adults.
There is moderate evidence that vaping causes increased coughing and wheezing in youth. It also worsens asthma symptoms.
Dry Nose and Throat Irritation
One of the main ingredients in e-juice is called propylene glycol. It is a chemical that absorbs moisture. It can cause the sensitive lining of the nose to dry out. Bloody noses and throat irritation can also be a problem.
Studies of online posts by vapers show one of their top complaints is a dry mouth. Saliva helps wash away bacteria in the mouth. Over time, people who vape could be at increased risk for dental and oral problems. This includes periodontal disease or gum disease, which is an infection of the tissues that hold your teeth in place.
Germs and Infectious Diseases
Sharing a vape? Then you are likely swapping some spit and maybe other nasty stuff! Cold and flu viruses, mono and the bacterium that causes strep throat (group A streptococcus) are all passed through saliva.
Nicotine is a toxic substance and too much can lead to serious health issues and even death. Nicotine poisoning is a risk if the e-juice is ingested, touches skin or if too much is inhaled.
Small children are most at risk for nicotine poisoning. Just like other toxic substances, all e-juice and vaping products should be out of reach and locked up as the bright packaging and fruity flavours get the attention of small children. Know the signs of nicotine poisoning and get medical help right away if it is suspected.
Long-term Health Effects
Many of the toxic chemicals found in e-cigarettes have been linked to various types of cancer. The long-term health effects of vaping may not be known for many years. Those vaping may be putting the health of their heart, lungs and other organs at risk.
The ingredients in e-juice can cause allergic reactions for some people. Signs or symptoms could be similar to other allergic reactions such as difficulty breathing, hives, and feeling unwell.
Device Safety Concerns
There have been reports of explosions related to batteries in e-cigarettes and issues with charging cords. Caution should be used with batteries, altering of products and use of charging cords.
Promotion of Vaping
Vaping is now a multi-billion dollar industry and all major tobacco companies have vaping brands. JUUL alone is worth about $18 billion. Slick advertising, fruity flavours and messages that convey fun and safe are contributing to the growth of use among youth.
The advertising for e-cigarettes is very similar to the messages and themes used by the Tobacco Industry to make smoking seem normal or to make some products seem less harmful.
Youth are also allured into becoming reviewers of products in video reviews on platforms like youtube. These unofficial spokespeople do not always state that they have received money to review and even endorse a product. This increases the promotion of vaping among young people and it makes it appear more popular than it really is.
What is the situation in our region?
South Western Ontario
More young people are trying and using e-cigarettes compared to tobacco cigarettes.
In South Western Ontario in 2017, 16% of youth in grades 9-12 have used an e-cigarette in the past year compared to 14% for tobacco cigarettes.
Overall, vaping among students is also outpacing cigarette smoking (OSDUHS 2017). In Ontario in 2017, past year e-cigarette use among Grade 7 -12 students was 10.7% compared to 7% who smoked cigarettes. The use of e-cigs increases by grade with 9.2% of Grade 9 students and 18.9% of Grade 12 students reporting using e-cigarettes in the past year.
Forty percent of past-year e-cig users said they didn’t use nicotine, 28% did, 19% used both, 13% didn’t know. Many e-juices contain nicotine and students using them are at risk of becoming addicted.
For more information, visit the Ontario Student Drug Use and Health Survey online.
For more about the health risks of vaping, visit https://e-cigarettes.surgeongeneral.gov/default.htm
This tip sheet is a helpful resource to help talk about the issue of vaping with youth.