The Truth About Vaping

A recent article in the New Zealand Listener magazine concludes that “a product designed to counter the dangers of smoking was marketed at teens and ultimately taken over by Big Tobacco.” Based on the book The Devil’s Playbook, written by Lauren Etter, the article provides a continuation in the concerning information that has come to light about vaping.

It comes as a surprise to many parents to learn that most vape products contain nicotine, a stimulant drug that has been shown to affect the development of the adolescent brain. Nicotine is also highly addictive and while some vape juices contain lower levels of nicotine than traditional cigarettes, there is no proven ‘safe’ level of consumption for young people. While the US Food and Drug Administration (FDA) has vetoed some 950,000 e-cigarette products, many brands remain for sale both in the US and in New Zealand.

That vapes have attracted interest and investment from Big Tobacco – companies who literally made their profit by selling products that caused cancer and a range of other often fatal diseases – should in itself ring alarm bells. Altria, best known as the producer of Marlboro cigarettes, have invested NZ$18.2 billion in e-cigarette company Juul, seeing this as the future of nicotine delivery. This is a far cry from much of the early marketing of vapes in New Zealand, where they were pushed as a product to assist the cessation of smoking.

While there have been some belated recent moves in New Zealand to restrict vape sales, this is too little and too late. Much vape advertising is through social media and is often ‘indirect’, therefore not falling directly under our regulations. Etter, writing in The Devil’s Playbook, categorises vape marketing as “glamour, good times and cool young models”, far removed from the images we associate with cigarette smoking and tobacco consumption.

Etter notes that by the time the FDA regulated vape sales in 2016, banning sales to persons aged under 16, it was already too late – “Kids were becoming nicotine addicts.” While only anecdotal the number of young men who we are speaking to about vaping who indicate that they are having difficulty stopping would suggest that nicotine addiction is happening here too. There’s much more than just nicotine addiction to be concerned about:

· American hospitals have reported young people with damaged airways showing up in hospital emergency departments with a condition that was subsequently dubbed “Evali” – e-cigarettes or vaping use-associated lung injury.

· In another report, the FDA expressed concern that “nicotine can worsen symptoms of anxiety and depression in addition to the physical health risks associated with its use.”

· A Sydney teenager was recently admitted to ICU with vaping-related lung disease.

· More than 2,000 people in the United States have developed serious lung damage in a poisoning outbreak associated with the use of vaping devices this year. At least 39 people have died from the condition. Most of those affected are young men. Their symptoms, which developed over a few days to several weeks, included cough, shortness of breath, chest pain, nausea, vomiting, abdominal pain, diarrhoea, fever, chills, and weight loss.

One US study found that users of the common vape flavours menthol and mint are exposed to high levels of the carcinogen pulegone – synthetic pulegone is banned by the FDA as a food additive. In New Zealand, mint is one of three flavours still able to be sold in dairies under part of the new legislation that recently came into force.

Plus, vapes contain humectants, such as propylene glycol and vegetable glycerine, which heat up to make the vapour. As they break down, these generate other more harmful components, including highly toxic formaldehyde, creating inflammation in the lungs.

Last year, a study from Stanford University showed that young people who vape are five to seven times more likely to be infected with Covid-19 than those who don't. That study's senior author, Bonnie Halpern-Felsher, is a developmental psychologist and the founder of the Tobacco Prevention Toolkit. During her many years in tobacco research, Halpern-Felsher says she has never seen such a quick surge in uptake with any other product. Everything about Juul appealed to young people.

The lungs are an efficient route for a drug to reach the brain. Nicotine moves quickly from there to the bloodstream, then crosses the blood-brain barrier and binds to receptors in the brain that release neurotransmitters, including dopamine. We get a hit, then it wears off, so we crave another one.

Young people are particularly vulnerable to nicotine addiction. Almost 90 percent of daily smokers started smoking before the age of 18. But although cigarette use is more common among lower-income, lower-education groups, vaping has similar levels of popularity across all the demographics of wealth and gender.

"It's what I call an equal-opportunity bad thing," says Halpern-Felsher.

Vaping has been shown to be a healthier option than smoking as it contains fewer harmful substances than traditional cigarettes. However, that doesn’t make it safe and healthy. Vaping is a safer option for regular smokers, it is a potentially very harmful option for young people. It is this message that we need to ensure parents and young people understand.

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