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Stigs, Wax, and Diacetyl: What every youth advocate �needs to know about vaping

Abe Baker Butler, Students Against Nicotine

Created in collaboration with Judy Mezey, Student Assistance Services

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Three of these items are NOT vaping related. Can you spot them?

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What are Vape Devices?

Some names we hear are: Hookah Sticks, Cig-Alike, E-Cig, ENDS, Vape Pen, E-Hookah, Box Mod, Pen Mod, Juul….
Manufacturers use different designs and a range of ingredients.
Originally developed as a safer alternative to regular cigarettes and as a way to assist smokers in cutting down/quitting

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NY Times 9/6/19

Medical experts and federal health

officials warned the public about the

dangers of vaping and discouraged using

the devices as the number of people with

a severe lung illness linked to vaping

more than doubled to 450 possible cases

in 33 states and the number of deaths

rose to five.

NY Times 9/4/19

Another Patient Has Died From Lung Disease After Vaping

The investigator said that the person had apparently become sick after vaping T.H.C. from a product purchased at a recreational marijuana shop in the state.

NY Times 10/3/19

Lung Damage From Vaping Resembles Chemical Burns, Report Says

Doctors at the Mayo Clinic examined samples of lung tissue from 17 patients, all of which looked as if the people had been exposed to toxic chemicals, the researchers said.

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E-Juice�

E-juice without nicotine
E-juice with nicotine
Wax/hash oil/marijuana

Vegetable glycerin, propylene glycol (base chemical in anti-freeze), Flavoring

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Who is vaping what?

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Different Kinds of ENDS

Some come pre-filled with a liquid that may or may not contain nicotine (hookah sticks, Stigs)
Some come with “pods” or “cartridges” that are pre-filled with a liquid. (Juuls, Suorins)
Some have attachments where the user places their own liquid/leaf.

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More About the JUUL

ALL Juul products contain nicotine – many teens do not know this
The nicotine in Juuls is a form of nicotine that is especially easily absorbed (nicotine salt) making it even more potent than other vape devices.
Many teens do not consider Juuling vaping. They use the term Juuling as a verb.
Juuls are sold at many local gas stations and mini markets.
Juul pods can be hacked to add other liquids/drugs, and Juul compatible pods can be purchased pre-loaded with THC.

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Health Issues with Vape Pens – �Even without Nicotine

Lipid pneumonia is caused when lipids (which are, essentially, fatty acids) enter the lungs, causing the lungs to become inflamed. Some products in vapes (vegetable glycerine, Vitamin E acetate) are/contain fatty acids. (health.com)
Vaping (even second hand vape exposure) is associated with bronchitis and asthma (American Journal of Respiratory and Critical Care Medicine)
Youth who vape are 7X more likely to smoke cigarettes (JAMA Pediatrics)
The aerosol in the vape cloud contains cancer causing chemicals such as benzene and chromium. (New England Journal of Medicine)
Vaping is associated with gum disease, tooth loss, bad breath (Perio-implant Advisory)
Many vaping devices may be contaminated with harmful bacterial and fungal toxins (Harvard University)

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Case Study: Acetals and Chemical Byproducts

Chemical reactions in flavored e-liquids create unexpected chemicals, including acetals. These chemicals are know to irritate users’ airways, skin, eyes, nose, and throat and can cause headache, dizziness, and drowsiness. (Yale Tobacco Center of Regulatory Science)
“Any chemist could predict that these substances will react to form these possibly dangerous products, yet it is not labeled”

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More about flavorings

Many youth who start vaping, say that they started because of the flavorings.
Common vape juice flavorings (mint, vanilla, cinnamon, clove, butter (diacetyl), strawberry, banana, and eucalyptus) pose dangers to cells that line blood vessels and lymph vessels:
High concentrations of all the flavor chemicals caused cell death.
Low concentrations of menthol, clove, vanillin, cinnamon, and burnt flavors caused inflammation in the cells and reduced the production of nitric oxide (a molecule that helps blood vessels to function in a healthy way).
Flavoring compounds used in vaping products have adverse effects on cardiovascular health.

(The American Heart Association journal Arteriosclerosis, Thrombosis, and Vascular Biology, special thanks to Newport Academy for this summary)

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Vape Pens Exploding

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Buyer Beware

In 2015, of 18 vape products tested, “All but one of the cartridges labeled “no nicotine” did, in fact, contain nicotine” (FDA).
40% of teens who reported using products free of nicotine had levels of cotinine higher than the cut-off indicating nicotine use (Pediatrics)
Other drugs have also been found in vape devices:

Methamphetamine
Fentanyl
Synthetic marijuana
Morphine
MDMA (XTC/Molly)

(New Scientist)

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Health Issues – Vaping Nicotine

Nicotine is a powerful stimulant that is very highly addictive (US Surgeon General)
Nicotine use in teens disrupts executive functioning and can prime the brain for other addictions (National Institute on Drug Abuse)
The nicotine strengths in vape products can be so strong they can cause nicotine overdose – including seizures - in youth (US Dept of Health and Human Services)
Nicotine inflames lung tissue and reduces it’s ability to act as a barrier to foreign substances. (Irina Petrache, MD, lung specialist at Indiana University in Indianapolis)

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Marijuana related words

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THC in “Juul” Pods

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Weed Pens

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Vape pen

with replaceable cartridges

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The Vapen Clear looks exactly like your typical inhaler. It acts the same too, but without the albuterol. The Vapen Clear releases the good stuff, aka THC.

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American College of Pediatricians

“Marijuana is addicting, has adverse effects upon the adolescent brain, is a risk for both cardio-respiratory disease and testicular cancer, and is associated with both psychiatric illness and negative social outcomes.”

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August 29, 2019

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Marijuana

Cyclic vomiting, paranoia, psychosis

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Other drugs can also be vaped.

A teen might not even know what is in the vape device they are sharing.

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One of these products has flavorings (no nicotine).

One of these products has high potency THC extracts.

Which photo is of the high potency THC product?

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What about CBD?

CBD (Cannabidiol) derived from the hemp plant is legal in NY.

CBD should not have any psychoactive properties.

Pure CBD may have some therapeutic benefits.

BUT

Vaping CBD has all the same risks as vaping anything else

AND

There is little regulatory oversight and many CBD products contain dangerous chemicals or synthetic CBD oil.

For example, there were 52 cases of serious adverse effects including seizures, loss of consciousness, vomiting, nausea and altered mental status, in Utah from 2017 to 2018 after people ingested a CBD product. Surprisingly, no CBD was found in blood samples, only 4-cyano CUMYL-BUTINACA (4-CCB), or fake CBD oil. (Partnership for Drug Free America)
A forensic toxicologist at Virginia Commonwealth University tested CBD samples that were marketed on the company’s website as 100 percent natural. In four of nine samples, the lab discovered a synthetic compound, 5F-ADB. That ingredient has been linked by the Drug Enforcement Administration to anxiety, convulsions, psychosis, hospitalization and death. (NY Times, August 2019)

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Helping Youth Make Vape Free Decisions

Connect them with other vape free teens
Educate youth/parents about the risks
Recognize the devices and the clues of use
Listen to/watch/comment on the media they are immersed in
Emphasize health and safety
Get help when/if needed

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Reclaiming 420 with giant lungs and a focus on vaping

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April Fuul’s Day rally – vape flavors trap youth

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Youth Led Policy Change�Tobacco 21 and the Flavor Ban

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Recent Developments!

“Students Against Nicotine applauds the City of Yonkers for banning e-cigarette flavors. We have watched our friends become addicted to devices with unknown effects and a variety of dangerous chemical components, as e-cigarette companies appealing directly to our peers with whimsical flavors and other deceptive marketing methods. This legislation will go a long way towards ending the flavor trap and protecting the health of youth,” commented Abe Baker-Butler, Co-Founder, Students Against Nicotine.

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Interactive education

Hidden in Plain Sight and

DoIt4URLungs: A vape escape experience

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