Description of vaping products and current health research to make informed decisions.
What are vaping products?
Vaping products, such as e-cigarettes, are small battery-powered devices that heat a liquid solution to create an aerosol (vapour or cloud). The liquid, typically referred to as e-juice, inside a chamber may contain a solution of propylene glycol and/or vegetable glycerin, flavourings, and varying amounts of nicotine. The act of inhaling and exhaling the aerosol produced is commonly referred to as “vaping”.
Vaping devices have attractive designs, some may look like traditional cigarettes, but recent designs resemble USB sticks, credit cards, and cell phones. The main components are consistent among all vaping devices, and include a:
• Chamber (cartridge or tank or reservoir) that holds the e-juice
• E-liquid (vaping liquid or “e-juice”) that usually contains nicotine and other chemicals
• Heating element (atomizer or cartomizer or clearomizer), which heats the e-juice to make vapour
• Battery of varying voltage that powers the atomizer.
What are the health and safety risks?
Of particular concern is the nicotine-content of vaping products. Nicotine is a chemical found naturally in tobacco leaves and is present in most e-liquids. Nicotine causes addiction and physical dependence. Upon inhalation of the aerosol, nicotine reaches the brain rapidly and binds to brain receptors that stimulate the release of a host of neurotransmitters. This activates the brain’s reward centre and triggers feelings of pleasure. Nicotine also causes increased heart rate, blood pressure, constriction of blood vessels, altered brain waves, and muscle relaxation.
The brain continues to develop until about the age of 25 years, thus nicotine’s effect on a developing brain is detrimental. Nicotine use during this period can impair the parts of the brain responsible for memory, mood, concentration and impulse control.
Nicotine-containing e-liquids can be poisonous if ingested in high volumes or by young children. The e-liquid can be toxic if spilled on the skin, leading to nausea or vomiting, difficulty breathing and even seizures.
The toxic chemicals present in the vaping aerosol, some of which are carcinogenic, can lead to short-term and long-term health effects.
In the short-term, vaping can lead to coughing and wheezing, inflammation of the lungs, and increased heart rate. The long-term health effects of vaping are currently unknown. Studies suggest that vaping could lead to similar diseases as smoking, though at a reduced rate.
Lithium-ion batteries that power vaping products can explode causing injury and fires. Proper use, storage, handling and charging of the batteries can reduce this risk.
What are the additional concerns with vaping products?
Vaping products may offer some potential for harm reduction, when used as a smoking cessation aid for people trying to quit using traditional cigarettes and tobacco. The vapour contains fewer toxic chemicals compared to smoking tobacco. Despite this, the inhaled vapour is not harmless.
To consider vaping as a less harmful alternative distracts from the issue of increased vaping by youth and its potential harm during this stage. Vaping is not a healthy choice for anyone who does not smoke. Vaping products model smoking behaviour to non-smoking youth and are easily accessible for use. They have the potential to renormalize smoking and may attract or hook non-smokers.
The research as to whether vaping may lead to cigarette smoking is emerging and indicates youth who vape may be at an increased risk or using tobacco, compared to those who do not vape. Further research is needed to identify whether youth tobacco use is a direct result of vaping, given other common factors that may account for initiation.
Some vaping devices are used for marijuana, hashish concentrates and oils, however, most devices are not compatible with various substances. Vape devices designed specifically for cannabis use are available on the market.
What are the youth vaping trends?
The Canadian Tobacco, Alcohol and Drugs Survey (CTADS), Canadian Student Tobacco, Alcohol and Drugs Survey (CSTADS), and BC Adolescent Health Survey (BC AHS) collect data on e-cigarette use among youth. CTADS and CSTADS capture both the percentage of youth who have ‘ever tried’ e-cigarettes and the percentage of youth who used e-cigarettes in the past 30 days. The 2018 BC AHS asked students about past 30 day use of e-cigarettes. Past 30 day use implies regular use as opposed to simply experimenting for the first time.
Data sets for both CTADS and CSTADS show an increasing trend of e-cigarette use among youth in Canada. Among people who have never smoked cigarettes, 41 percent of those who reported using an e-cigarette in the past 30 days were youth aged 15 to 19. The 2018 McCreary Centre Society BC AHS shows that 21% of BC students (grades 7-12) used a vaping product with nicotine, and 19% used a vaping product without nicotine.
In the United States from 2017 to 2018, e-cigarette use in the past 30 days has increased 78% among high school students, and 48% among middle school students. The Food and Drug Administration has declared an epidemic with regards to youth e-cigarette use.
What is the legislation to protect children and youth?
Canadian and international public health organizations recommend legislation to restrict marketing to youth as well as uphold or enhance existing smoking regulations.
Health Canada’s Tobacco and Vaping Products Act (TVPA) was enacted on May 2018 to regulate the manufacture, sale, labelling, and promotion of tobacco and vaping products. This federal act prohibits:
- The sale of vaping products to those under 18 years of age
- Promotion of vaping products that are appealing to youth, such as candy and dessert flavours
The B.C. Tobacco and Vapour Products Control Act and Tobacco Control Regulation was updated (2016) to include vaping products. This provincial act:
- Prohibits the sale of vaping products to those under 19 years of age
- Regulates products store displays to be the same as tobacco restriction
- Bans the use of vaping products in all public spaces where tobacco smoking is banned, including school property
- Health Canada – Talking with your teen about vaping: a tip sheet for parents
- BC Lung Association – Downloadable resources about vaping for youth, teachers, parents and health professionals