Vaping and E-Cigarettes Discussions to Have With Patients | September 2022 | Clinical Corner

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September 1, 2022

Vaping and E-Cigarettes

Discussions to Have With Patients

E-cigarettes are electronic devices that heat a liquid and produce an aerosol, or a mix of small particles into the air. They can be used to deliver nicotine, marijuana and other drugs. E-cigarettes are known by many different names. They are sometimes called “e-cigs,” “e-hookahs,” “mods,” “vape pens,” “vapes,” “tank systems,” and “electronic nicotine delivery systems (ENDS).”4

 

FACTS ABOUT VAPING:1

1: Vaping is less harmful than smoking due to exposure to less chemicals, but it's still not safe.

  • Nicotine is toxic and affects your health in a number of ways, like raising your blood pressure.
  • Nicotine also affects teens’ brain development, their learning, mood, and impulse control and increases the risk of developing depression and anxiety.
  • Since vaping nicotine is addictive, it rewires children’s brains and can possibly lead them to use other addictive drugs like alcohol or cocaine.

2: Research suggests vaping is bad for your heart and lungs.

  • E-cigarette liquids usually contain propylene glycol, which is known to release formaldehyde gas when heated. Diecetyl, a compound linked to “popcorn lung” disease, has been found in over 75 percent of flavored e-cigarettes.

3: Electronic cigarettes are just as addictive as traditional ones.

  • While not all vape products include nicotine which has been proven to be addictive, most do.

4: Electronic cigarettes aren't the best smoking cessation tool.

  • E-cigarettes have not received Food and Drug Administration approval as smoking cessation devices.
  • Most people who intended to use e-cigarettes to kick the nicotine habit ended up continuing to use traditional and e-cigarettes.

5: A new generation is getting hooked on nicotine.

  • According to the National Institute on Drug Abuse2, more than a third of 12th graders report having vaped in the last 12 months.

 

DISCUSSION POINTS:3

1: JUUL is one of a few e-cigarettes that use nicotine salts, which allow particularly high levels of nicotine to be inhaled more easily and with less irritation.

2: Using nicotine in adolescence can harm the parts of the brain that control attention, learning, mood, and impulse control.

3: What may start as social experimentation can become an addiction.

  • The most common reason U.S. middle and high school students give for trying an e-cigarette is “a friend used them.”
  • The most common reason youth give for continuing to use e-cigarettes is “I am feeling anxious, stressed, or depressed.”

4: Defective e-cigarette batteries have caused some fires and explosions, a few of which have resulted in serious injuries.

5: The e-cigarette aerosol that users breathe from the device and exhale can contain harmful and potentially harmful substances, including:

  • Nicotine
  • Ultrafine particles that can be inhaled deep into the lungs
  • Flavorings such as diacetyl, a chemical linked to a serious lung disease
  • Volatile organic compounds
  • Cancer-causing chemicals
  • Heavy metals such as nickel, tin, and lead

6: E-cigarettes also can be used to deliver other drugs, including marijuana.

7: Heated tobacco products (HTPs) like IQOS and Eclipse, sometimes marketed as “heat-not-burn” technology, represent a diverse class of products that heat the tobacco leaf to produce an inhaled aerosol. They are different from e-cigarettes, which heat a liquid that can contain nicotine derived from tobacco.

8: Even being near someone using an e-cigarette can expose you to the aerosol and chemicals in it. This is similar to secondhand smoke from regular cigarettes.

 

NOTE:

Vaping and E-Cigarette use is now a standard item in most EMR’s and can be documented in the “Social History” along with smoking history or tobacco use.

 

References:

  1. https://www.hopkinsmedicine.org/health/wellness-and-prevention/5-truths-you-need-to-know-about-vaping
  2. Teens using vaping devices in record numbers | National Institute on Drug Abuse (NIDA) (nih.gov)
  3. https://www.cdc.gov/tobacco/basic_information/e-cigarettes/Quick-Facts-on-the-Risks-of-E-cigarettes-for-Kids-Teens-and-Young-Adults.html
  4.  https://www.dartmouth-hitchcock.org/patients-visitors/vaping-facts

New South Wales (Australia) Fact Sheet