Category Archives: Vaping

By Derek Yach

The Ecig Summit comes at a time of change in how tobacco harm reduction (THR) products are regarded by those who oppose or support their use as a means of ending smoking. In recent months new reports, editorials and comments in leading medical journals have highlighted the benefits of vapes for smoking cessation.1,2,3,4 Further, calls for medically licensed vapes have increased from academics who rarely agree on THR policies.5

Robin Mermelstein, director of the Institute for Health Research and Policy at the University of Illinois, opened the meeting by noting that diverse perspectives are needed for innovations required to end combustible use. With no scientists from the private sector allowed to present research (except for former Center for Tobacco Products (CTP) Director Mitch Zeller, who is currently an advisor to Qnovia), this goal was tough to achieve. And it comes shortly after an editorial in Nicotine and Tobacco Research, the lead journal of the Society For Research On Nicotine & Tobacco, calling for complete exclusion of industry scientists.6 One wonders how widely supported this view is.

I summarize key inputs from the Summit that address six questions:

Rafael Meza of the BC Cancer Research Institute showed that smoking and vaping prevalence in youth has declined. Frequent use (20 days of more over 30 days) is about 6 percent for smoking and vaping in both boys and girls. Among adults in middle age, cigarette consumption has declined in tandem with vaping increasing. Smoking rates, however, have not declined among people over 65 and remain highest among those with the lowest incomes and education. Mezas projections of future trends are flawed by excluding probable impacts of heated tobacco products and nicotine pounces joining vapes as providing alternatives to combustibles over the next few years.

Only 4 percent of all smokers live in the U.S. Resources and debate about global policies are shaped heavily by U.S. federal, academic, nonprofit, philanthropic and private sector perspectives. Global realities need to be brought into summits. To mention two. First, smoking rates exceed 40 percent in men across most Middle East and Eastern European countries, and in China and Indonesia. Smoking rates exceed 20 percent in women across eastern Europe and small island states. These were rates in the U.S. 40-50 years ago. THR provides a route to leapfrog over the road taken by the USA.

Second, toxic smokeless tobacco products are commonly used especially across South Asia and cause about 350 000 oral cancer deaths. Nicotine pouches could well be the route to eliminating this dreadful cancer. A global perspective would place this as an achievable goal.

CTP Director Brian King stressed that youth issues remain his priority. In response to Mermelstein, he could not explain why this remains a priority given extremely low vape use in youth and the absence of convincing evidence that vapes are a gateway to combustibles. In contrast, both the U.K. and New Zealand give priority to ending combustible use in adults.

King repeated his advice to adults who smoke: first use Food and Drug Administration-approved cessation medications and only then FDA authorized reduced risk products. Dual use is not supported. This advice is not in line with current evidence presented at the conference or multiple reports.1,2,3,4,5 Vapes are the most effective means to quit. Dual use lowers overall risks.

Scott Sherman of New York University stressed that the ultimate goals of tobacco control are to prevent the burden of tobacco related disease. About 70 percent of people smoke when diagnosed with chronic obstructive pulmonary disease, peripheral vascular disease, schizophrenia, alcohol use disorders, several cancers, to name some major outcomes. The majority are still smoking years after their diagnosis. Sherman believes such patients would benefit from trying vapes. There are few studies in this area. He outlined a small pilot study of patients with chronic diseases comparing vape to nicotine replacement therapy (NRT) use that motivates for larger studies. Patients with early stage chronic diseases who are between 40 and 55 years of age who quit are likely to yield major health benefits.

There are few such studies. Jamie Hartmann-Boyce, of the University of Massachusetts and the Cochrane Collaboration, presented a Cochrane review using indirect methods to compare a range of interventions. Vapes, NRTs and cytosine showed the strongest evidence of cessation effectiveness compared to other medications and interventions. She stressed the need for more high quality studies. Public, philanthropic and industry funders should invest in such research among populations and countries where smoking and toxic smokeless tobacco rates are extremely high.

Zeller mentioned new real world evidence using biomarkers that suggest benefits of dual use (of vapes and combustibles) in terms of proxy health outcomes. Mike Cummings briefly mentioned the need to use biomarkers of exposure and outcome to accelerate knowledge about THR impact on health outcomes. As an epidemiologist I have long felt that we need to complement self-reporting and mortality based studies with use of 21st century biomarkers that allow for more accurate assessment of exposure and earlier determination of outcomes. Tobacco industry scientists currently lead in developing and using biomarkers. Their extensive list of peer reviewed publications should be cited and used by academics.

Zeller believes improved medically approved tobacco harm reduction products are part of increasing access for adults to reduced risk products. Nancy Rigotti of Mass General Hospital stated that a medical pathway is needed, despite no medically approved products being available. Her views are based on knowledge that physician practices have widespread impact on their patients and on policies. She is concerned that the U.S. Preventive Services Task Force, the American Cancer Society, the Centers for Disease Control and Prevention, and the American Heart Association are still unclear about the benefits of vapes as being the most cost-effective means of achieving cessation. Their statements are either ambiguous or explicitly oppose vape use for cessation. She restated her NEJM call for clinicians to strongly advise patients who smoke to try vapes.2

King did not address this, and deflected issues related to cessation to FDAs Center for Drug Evaluation and Research (CDER). The lead FDA tobacco chief should have an integrated approach to ending smoking that involved CTP and CDER. That is the spirit of the messages in recent influential journals by leading academics and former FDA heads.3,5 Further, the FDA 2015 CDER guidance on alcohol shows how it accepts abstinence and harm reduction endpoints used for drug approvals. It seems time CTP and CDER could learn how well this is working to end the harm of tobacco use.7

Both Neal Benowitz and Clive Bates of Counterfactual Consulting said we need to address the benefits of nicotine as a range of new products become available. This has implications for future medical licensing and recreational use. We need innovative ways to tease nicotine effects from combustible smoke effects to make progress on the regulatory front and to inform messaging to health professionals and smokers. A recent paper by Jasmine Khouja and her colleagues that used biobank data and multivariable Mendelian Randomization elegantly showed that most harms of smoking are unrelated to nicotine.8 Hopefully work looking at the benefits of nicotine for Parkinsons Disease will follow. I recommend readers watch this space.

Like the U.S., adult smoking rates in the U.K. and New Zealand have declined as vaping has increased. Deborah Arnott of ASH UK indicated that dual use has followed the path seen years ago when NRTs were introduced and regarded this as a transitional route to eventual cessation. This is an important insight for U.S. policy makers to acknowledge.

The U.K. proposed legislation includes a ban on disposables, a new tax on e-liquid (which may reduce illicit trade from China and will maintain a differential tax relative to cigarettes), and measures to reduce the appeal of vaping to children in ways that allow adults to have continued access. Arnott supports vape promotion approaches that have more clinical, and fact based features and other policies that regulate proportionate to risk.

Ben Youdan of ASH New Zealand showed that for years New Zealand and Australia had similar rates of decline in adult smoking. Over five years, however, adult rates have diverged with New Zealand rates falling faster. He believes this is based on differences in vape policies and messaging. New Zealand media and policies support vaping to quit especially among the Indigenous population. Martin Dockrell of the U.K. Department of Health and Social Care, described U.K. government funded programs to provide vapes to homeless people, people with mental illness and other groups with high smoking rates. The hope is that these initiatives will lower social class inequalities in chronic diseases that are strongly driven by differences in smoking rates.

Ben Youdan stated that Australia treats people who vape as criminals or as sick people incapable of self-determination. The result of this is that 90 percent of vapes on the Australian market are illicit while cigarettes access is universal. The opposite is true in New Zealand.

King mentioned that the FDA is committed to health equity. The FDA should learn from the U.K. and New Zealands vape policies.

The extent of misinformation was a topic that pervaded sessions. Alex Clark of the Consumer Advocates for Smoke Free Alternatives Association, gave examples of how the FDAs youth education campaigns have contributed to negatives views about vapes and nicotine. This could accelerate with the deployment of Chatbots that are explicitly programmed to spread misinformation about vapes and nicotine. The latest WHO one being a notable worrying example.9 Researchers need to rapidly engage computer scientists in building AI driven ways to address misinformation continuously and at scale before the digital space is dominated by those who oppose harm reduction. This could draw upon the promising results of correcting misbeliefs about nicotine causing cancer and about vapes reported by Andrea Villanti of Rutgers.

For several years E-Cig Summits and related standalone vape meetings have led thought leadership about the value of tobacco harm reduction. With the growth of a spectrum of reduced risk products now available, is it time to consider transitioning such meetings into opportunities to address emerging ways to end smoking and the use of toxic smokeless tobacco products through a wider range of products? That would encourage comparative studies and for a deeper examination of how consumers use products throughout the day. It would also allow for policy discussions that focus more on harnessing a wider community of users and innovative companies to compete to accelerate an end to smoking.

David Levy of Georgetown University and Bates both made these point very strongly by placing the needs and interests of consumers first and seeing competition between companies and products as beneficial to meeting consumer needs to improve their health.

For that to succeed, future conferences will need to adopt Mermelsteins opening words in practice and end boycotts and bans of industry scientists so that all actively developing innovative ways to make progress can debate the best ways forward together.

Link:

The Takeaways Tobacco Reporter - Tobacco Reporter

Mixed evidence aside, vaping remains a popular tool for adults looking to quit smoking but usage patterns among youth tell a different story. Based on the most recent Canadian Tobacco and Nicotine Survey (CTNS), of Canadian teens who vaped in the last month, 69% have never smoked. In fact, several studies have found that young people who vape are much more likely to start smoking in the future, compared to youth who don't vape. As vaping continues to infiltrate the mainstream, Lung Health Foundation efforts underscore the urgent need for awareness and intervention to break the cycle, especially in the most dangerous developmental years of teens who vape.

Empowering Youth to Break Free from Nicotine Addiction with Quash

As World No Tobacco Day approaches on May 31, the Ministry of Education has provided $70,000 to the Lung Health Foundation to support an innovative school outreach initiative promoting the Foundation's multipronged youth cessation program, Quash. This positive initiative aims to be the real-world solution to smoking and vaping by offering judgement-free support to high school students looking to quit, as well as education sessions for educators and parents. It targets over 100 schools across Ontario before the summer break.

Six Ontario school boards representing thousands of students are participating in the Quash school outreach pilot program: Toronto Catholic District School Board, Near North District School Board, Simcoe County District School Board, Simcoe Muskoka Catholic District School Board, Renfrew County District School Board and St. Clair Catholic District School Board.

Developed with funding from Health Canada, Quash combines a cutting-edge mobile app with comprehensive adult facilitator training. TheQuash app, advanced with input from youth, draws on behavioural change theories like successful wellness apps Noom and Headspace. It empowers users to identify and overcome triggers, rewards progress towards quitting, and ultimately helps them regain control over addictive vaping habits, prioritizing their health and well-being.

A Holistic Approach to Nicotine Cessation

The Quash program takes a holistic approach to nicotine cessation, recognizing the complex factors that contribute to addiction. Through virtual adult facilitator training, school staff and parents can gain valuable insights and strategies to support students on their journey to a vape- and smoke-free life.

The program's website serves as a hub for information, resources and support, ensuring that students, educators and families have access to the tools they need to succeed.

By addressing the issue of youth smoking and vaping head-on, the Ministry of Education and the Lung Health Foundation are taking a proactive step towards empowering the next generation to make informed choices and lead healthier lives.

"Simply talking about the problem will not make it go away, and advocating for change is no longer enough to curtail the growing health crisis among young Canadians who vape," says Lung Health Foundation CEO Jessica Buckley. "The Lung Health Foundation, in conjunction with the Ministry of Education, recognizes there needs to be action that engages, educates and ultimately "quashes" the behavioural tendencies of teens who vape. We believe Quash accomplishes just that."

"Think Noom for people who vape," adds Buckley on the behavioural science behind Quashcontent. "It's an integrated youth-driven and youth-developed program with real-world impact, distinguishing itself within its category by prioritizing youth input and engagement. Quash emerges as the most ambitious digital intervention tool today to assist youth in quitting vaping."

The breathtaking truth about youth vaping:

Youth vaping is NOT harm reduction. Of youth 15-19 who have vaped in the previous 30 days, 69% have never smoked. In fact, young people who have used e-cigarettes are up to 3.6 times more likely to transition to smoking cigarettes compared to young people who have not.

Youth vaping is worsening health equity, especially among two notable demographics.LGBTQA+ youth are 1.5 times more likely to vape than heterosexual youth.Indigenous youth are 1.5 times more likely to vape than non-Indigenous youth.

Youth vaping is NOT a coping mechanism.31% of 15-19-year-olds who vape report that it's a form of stress reduction, making it the most common reason youth report vaping.Youth with poor mental health are almost two times more likely to vape.Some research has found that youth who vape are more likely to report anxiety symptoms, depressive symptoms and suicidal thoughts.

"Smash your goals (not your lungs)"

"We'll never stop highlighting the negative health effects of vaping, but this campaign takes the message even further by including facts that speak to youth values -- like the way that vaping can negatively affect appearance or athletic performance," explains Erin Dufour, Implementation Manager for Quash at LHF. "These messages sometimes resonate even better than talking about the very real danger."

With presence in hallways, bathrooms, gyms, cafeterias, locker rooms and other student gathering areas, there will be theme-specific graphic promotions and materials that students will immediately notice. "By fostering open dialogue and providing actionable resources, LHF is committed to creating a healthier, vape-free future for Ontario's youth," adds Dufour.

"We know that vaping is addictive and can cause serious, harmful health issues, both physical and mental. With high rates of vaping and cannabis amongst youth, it is clear we must take bold action to safeguard children from this risk," says Stephen Lecce, Minister of Education. "Ontario is introducing zero tolerance on vaping by expanding education and investing in new supports that help promote healthy decision-making and curbing this addictive behaviour. By partnering with Lung Health Foundation and other community organizations and public health agencies, our government is restoring focus, safety and personal responsibility back into Ontario schools."

The campaign is set to spark not just real conversation and debate on vaping triggers and habits in schools and at home, but to arm students, parents, guardians and educators with the ultimate tool to break free from the grip of vaping addiction, says Buckley. "This is especially important for high schoolers leading into exams and summer vacation when the opportunities and freedom to vape unnoticed are more frequent."

It Takes a Village to Stop Teen Vaping in Ontario High Schools

To organizations like the Lung Health Foundation, fresh initiatives that deter vaping are a welcome early step in tackling thispervasive issue on high school campuses across Ontario.

To move this work forward, the government is investing $17.5 million in new wrap-around supports for student mental health and parent engagement. This will include:

"Our job is to educate our students, but also to keep them safe," says Emily Samuel, Principal at Near North District School Board, one of the six school boards participating in the pilot program. "The Quash program gives us critical tools to work with students, parents and our teachers in a highly proactive and meaningful way. It is through a well-constructed educational initiative like this that we can help to curtail the teen vaping crisis."

"Every year we learn something new and scary about vaping," says Buckley, describing the breathtaking truth on the urgent need to address youth and vaping. "Vaping research is still in its infancy. We're one of the few North American lung health charities allocating funds to devoted vaping research over the next five years."

About Lung Health Foundation

The Lung Health Foundation is dedicated to improving lung health for all Canadians. Through a range of community initiatives, grass-roots educational programs, research, and advocacy, the organization elevates awareness and fosters a compassionate environment for those affected by lung conditions, including their caregivers. Building on the legacy of the Ontario Lung Association (OLA), which for over a century served as the recognized leader, voice, and primary resource in lung health, LHF has expanded its efforts nationally. To learn more visit lunghealth.ca or for further assistanceemail [emailprotected].Visit us on Instagram @lunghealthfoundation, Facebook at lunghealthfoundation/, and on X at @LungHealthFdn.

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SOURCE Lung Health Foundation

For further information: FOR MEDIA INTERVIEWS AND BROADCAST SEGMENTS: Contact Rob Bailey, Email: [emailprotected], Phone: 201-819-1134; Margo Rapport, Email: [emailprotected], Phone: 416-895-5672

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Lung Health Foundation and Ontario Ministry of Education Partner to Launch First Judgement-Free Initiative to "Quash ... - Canada NewsWire

This week, the Government is expected to agree on a new plan to raise the legal age for the sale of cigarettes from 18 to 21 years.

After falling for years, the number of people who smoke in Ireland has plateaued. Just under one-in-five Irish adults are still smoking.

On todays podcast, In the News producer Aideen Finnegan explains what we know about the proposal.

Then we hear from Averil Power of the Irish Cancer Society, who welcomes the move. But she says the Government must urgently tackle the growing use of vapes among young people. Her warning comes as Irish researchers have found the acutely toxic chemicals in flavoured vapes could lead to a whole new wave of chronic diseases among users.

Presented by Sorcha Pollak.

Produced by Aideen Finnegan and Declan Conlon.

More here:

Ireland is getting stricter on cigarettes. But is vaping a more urgent problem? - The Irish Times

Opinion: A recent study published in Natures Scientific Reports recently presented a novel approach to predicting which chemicals might be emitted from a vape.

During heating, chemicals can break down into smaller molecules. A process known as pyrolysis. This study combined deep learning computational methods with chemical structure information from experimental databases.

They looked at 180 flavouring chemicals and predicted which breakdown molecules could be created, finding six or seven chemicals emerging from each single flavouring chemical.

By matching these predicted chemicals with a large chemistry database containing information on potential harms of different chemicals, they found that 127 of the chemicals predicted were classed as acutely toxic, 153 as health hazards and 225 as irritants. This is a useful study, as it is challenging to capture and measure all the chemicals being emitted from an e-cigarette.

Vaping was not so long ago heralded as a revolutionary invention to curb smoking rates among diehard smokers, before it was repurposed to appeal to young people, consequently creating a new generation of nicotine dependants. Last year the e-cigarette manufacturer Juul Labs Inc in the US agreed to pay US$462 million to six states and the District of Columbia to resolve investigations into its marketing of addictive vaping products to children, with bright attractive ads, giveaways, easily concealed products and flavours aimed at the palates of young people.

Vaping works by using a heating coil to heat up an e-liquid to transform it into an aerosol to be inhaled.

The key ingredients are propylene glycol and vegetable glycerol, which act as a carrier for nicotine and flavourings and produce a nice cloud of vapour reminiscent of smoking. Flavourings and nicotine are added in smaller amounts but at variable concentrations.

More than 400 brands and 8000 flavours of vaping products were reported in 2016/17. Flavours can be roughly divided into tobacco, menthol, alcohol/drink, fruit and candy flavours, but with myriad flavours within each category: cinnamon, red hot cinnamon, blueberry, raspberry, watermelon, banana, kiwifruit, passionfruit Some vaping websites invite consumers to come up with flavour requests. As e-cigarette producers know (as do chip, ice cream, wine, and craft beer makers etc) our craving for novel taste is insatiable.

There is a large range of complex chemical profiles used within different e-liquids.

Many manufacturers specify that their ingredients are recognised as safe for oral consumption, but little is known about their health effects when inhaled. Vape aerosols have been found to contain known toxicants, including carcinogens and heavy metals, and a recent study found cadmium, lead, and uranium in urine samples from regular vapers. Our own research at the Auckland Bioengineering Institute has found silicon, iron, zinc, and chromium in vaping products.

Potentially toxic compounds include volatile organic compounds such as benzene, degradation products such as carbonyl compounds (for example formaldehyde), and heavy metal particles. The levels of toxic substances found in e-cigarette vapour are far lower than those found in cigarette smoke, with one study showing levels of toxicants were 9-450 times lower in vapour than cigarette smoke.

However, though thought to be safer than conventional cigarettes, they still expose users to potentially harmful chemicals.

New Zealand has one of the highest youth vaping rates in the world with 18 percent of 14-15-year-olds reported to be regular vapers, compared with, for example, the 7.6 percent of UK 11-17-year-olds who vape, and the 5 percent of New South Wales 14-17-year-olds who reported vapingbetween 10 and 30 days in the previous month in a 2021 survey.

Though e-cigarettes have been welcomed into New Zealand as a smoking cessation aid, there has been an unexpected uptake of vaping by never-smokers. Among daily vapers aged 18-24, 37 percent are never-smokers and in those aged 15-17, the proportion of never-smokers is even higher at 76 percent. Mori are also over-represented in vaping prevalence rates, with one survey showing that a quarter of 14-15-year-old Mori females are vaping daily.

What can we do about this? Obviously, regulation of the products would help, but so far this has proven to be fraught and complicated, and those with financial interests at stake tend to find ways to get around the rules. But a study in the US examined how the appeal of e-cigarettes among adolescents and young people would be affected by the flavours available, if theyd be likely to stop vaping if they couldnt buy so many flavours.

The national survey of 1400 adolescents and young adults found that 38.8 percent of those surveyed said theyd likely stop using their e-cigarette if tobacco and menthol-flavoured e-liquids were the only options, whereas 70.8 percent would stop vaping under a tobacco-only product standard.

Though we know vaping carries fewer chemicals and less harmful ones than smoking, we dont yet know how this translates to health impacts.

Our research is testing several hypotheses to determine whether vaping leads to the same/similar health impacts of smoking, including studying inflammation (the bodys normal defence mechanism), lung lymphatics (which coordinates the immune system response of the lungs) and cardiovascular impacts. This new study published in Nature and our current research is aiming to predict the long-term health effects of vaping before they become widespread in the rapidly growing vaping population.

There is a well-documented latency period for tobacco-related disease that spans a minimum of 25 years, and by then smoking created one of the greatest public health crises of the 20th century. It will be at least two decades until definitive findings from long-term studies on e-cigarette use are available, but such research is urgent to ensure we prevent an epidemic of vaping-related disease in our future generations.

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Vaping and how to stop another chemical generation - Newsroom

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Vaping Rates Fall Among Teens, But Still Too High - Shelbynews

However, rates of vaping among 1117-year-olds have not increased, with 7.6% of young people vaping occasionally or regularly, and 17% of young people having ever vaped, similar to the levels reported in 2023.

The most recent wave of ASHs surveys were conducted by YouGov in Feb/March 2024:

The proportion of current vaping among 11-17-year-olds is still significantly up from pre-pandemic levels (7.6% in 2024 compared to 4.4% in 2019).

Exposure to vape marketing remains high among young people; only 19% say they dont see vapes being promoted.

Young people are most likely to see vapes promoted in shops (55%) followed by online (29%). TikTok is where 11-17-year-olds most frequently report seeing online promotion. In addition to charting the current levels of vaping among adults and youth, ASH also assesses the level of public understanding about the relative safety of vaping compared to smoking.

This year has seen public understanding plunge to an all-time low, with half of all adults (50%) and more than half (58%) of 11-17-year-olds believing vaping is as bad for health, or worse than, smoking. Hazel Cheeseman, deputy chief executive of Action on Smoking and Health, said: The Tobacco and Vapes Bill includes the powers needed to bring youth vaping down and must be enacted swiftly.

However, getting adults to quit smoking is important for childrens health too. The evidence has grown that vaping is less harmful than smoking, but public understanding has gone in the other direction.

It is to be hoped that 2024 can be a turning point and youth vaping will fall, alongside an improvement in public understanding about the role vaping can play in helping the UKs 6 million smokers stop.

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Youth vaping plateaus while adult vaping hits all-time high, survey shows - Talking Retail

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Vaping Rates Fall Among Teens, But Still Too High - Rockdale Newton Citizen

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Vaping Rates Fall Among Teens, But Still Too High - The Caledonian-Record

PARENTS have been urged to talk to their children about the potentially lethal effects of vaping unknown substances such as spice.

The Public Health Agency issued the warning for the synthetic drug, which mimics the effects of cannabis.

Kevin Bailey, Regional Lead for Drugs and Alcohol at the PHA, said: Synthetic cannabinoids are relatively new drugs and evidence is still coming out about harms associated with their use. However, we do know that people can have severe reactions after using them, and using with vapes could make them even more unsafe.

He said the contents or strengths of products within vapes could not be fully verified, meaning the effects and duration of the effects could be unpredictable and change depending on the product and type of synthetic cannabinoid.

With hundreds of different combinations, he said some were stronger and more toxic than others, meaning there was no way of knowing what you were taking.

The dangers of taking these substances also increase if you add other drugs to the mix including alcohol, prescription medication and other illicit substances, he said.

You can become dependent on synthetic cannabinoids with regular use. For some people who use them frequently, dependence can develop quickly.

Inhaling synthetic cannabinoids, including spice, through a vape is extremely dangerous for young people.

The PHA is working to raise awareness of the issue with community and voluntary organisations, local councils, the PSNI, education sector as well as health and social care partners.

For young people, using substances is particularly dangerous during a time when they are still developing physically and mentally, with drugs having the potential to damage their cognitive and emotional development, Mr Bailey said.

Parents and guardians can play an important role in helping young people understand the risks, so they dont choose to take drugs without realising the harm they could be exposing themselves to. Dont wait until theres a problem before you decide to talk.

It is important to advise young people that regardless of what they have been told, even by a close friend, that it is impossible to know what is contained in these substances. All drugs, whether alcohol, illegal drugs or prescription medication, carry risks.

For young people with someone who has taken drugs and become unwell, the PHA urged them to seek medical help immediately.

It might be frightening and they will be scared of getting into trouble, but they need to look out for their friends, stay with them and get them help it could save their lives, a spokesperson said.

Further information on how to help someone who may have a problem with alcohol and/or drugs is available at http://www.DrugsAndAlcoholNI.info.

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Parents warned over potentially fatal effects of spice vaping - The Irish News

Many young people who started vaping nicotine as teens several years ago haven't quit the habit, data show. Daisy-Daisy/Getty Images hide caption

Many young people who started vaping nicotine as teens several years ago haven't quit the habit, data show.

G Kumar's vaping addiction peaked in college at the University of Colorado, when flavored, disposable vapes were taking off.

The disposables would have more than a thousand puffs in them. "I'd go through, let's say, 1,200 puffs in a week," said Kumar, who uses they/them pronouns.

Vaping became a crutch. Like losing a cell phone, losing a vape pen would set off a mad scramble. "It needs to be right next to my head when I fall asleep at night and then in the morning I have to thrash through the sheets and pick it up and find it," Kumar recalled.

They got sick often, including catching COVID and vaping through all of it.

Kumar, now 24, did end up quitting. But many of their generation can't shake the habit.

"Everyone knows it's not good for you and everyone wants to stop," said CU senior Jacob Garza who works to raise awareness about substance use as part of the school's Health Promotion program.

"But at this point, doing it all these years ... it's just second nature now," he said. "They're hooked on it."

For years, slick marketing by e-cigarette companies, and the allure of sweet, fruity or even candy-like flavors and names, led teens to try vaping. As more high schoolers and even younger kids picked up the behavior, doctors and researchers warned it could lead to widespread addiction, creating a 'Generation Vape.'

Now, new data about substance use among young adults suggests that many of those former teen vapers haven't quit.

In Colorado, the share of those aged 18 to 24 who regularly vaped rose by about 61% from 2020 to 2022 to nearly a quarter of that age group.

"That's an astounding increase in just two years," says Dr. Delaney Ruston, a primary care physician and documentary filmmaker.

Nationally, vaping rates for young adults increased from 7.6% in 2018 to 11% in 2021.

Disposable electronic cigarette devices displayed for sale on June 26, 2023. While most flavored disposables are officially banned in the U.S., they continue to be sold. Rebecca Blackwell/AP hide caption

Disposable electronic cigarette devices displayed for sale on June 26, 2023. While most flavored disposables are officially banned in the U.S., they continue to be sold.

Research has shown nicotine is highly rewarding to the brains of young people.

"It's not surprising that many of them start in high school for social reasons, for all sorts of reasons," says Ruston, whose latest film is Screenagers Under the Influence: Addressing Vaping, Drugs, and Alcohol in the Digital Age. "And many of them now we're seeing this have continued to college and beyond."

Meanwhile, vape rates have actually dropped among Colorado high schoolers, said Tiffany Schommer, the tobacco cessation supervisor with Colorado's state health department.

At one point, before the pandemic, Colorado led the nation in youth vaping, topping 37 states surveyed for use of electronic cigarettes among high school students.

Vaping peaked among minors in Colorado in 2017 with 27% of Colorado youth reporting they had vaped in the past month, according to the Healthy Kids Colorado Survey. But by 2021, the most recent year for which there's data, that dropped to 16%.

Nationally vaping rates among high schoolers dropped from 28% in 2019 to 12.6% in 2023, according to the Annual National Youth Tobacco Survey.

But for many young people who started vaping at the height of the trend, a habit was set.

"E-cigarette use has increased, particularly among people who have never smoked [traditional cigarettes,]" said Schommer. "So these are folks who started with vapes, continue with vapes."

Preliminary data indicates that almost half of those vaping 18- to 24-year-olds started vaping before they turned 18, according to the Colorado 2022 Tobacco Attitudes and Behaviors Survey.

At Children's Hospital Colorado, pediatric pulmonologist Dr. Heather De Keyser pulls up on her screen a clouded X-ray of the lung of a young adult damaged by vaping.

"This is a patient with vaping-related lung injury," she says.

For years, doctors like her and public health experts wondered about the potential harmful impact of vaping on pre-adult bodies and brains especially the big risk of addiction

Dr. Heather De Keyser, pediatric pulmonologist at Children's Hospital Colorado, points to the X-ray of a lung of a young adult damaged by vaping. John Daley/CPR News hide caption

Dr. Heather De Keyser, pediatric pulmonologist at Children's Hospital Colorado, points to the X-ray of a lung of a young adult damaged by vaping.

"I think, unfortunately those lessons that we were worried we were going to be learning, we're learning. The data is bearing out in that," said De Keyser, an associate professor of pediatrics in the Breathing Institute at Children's Hospital Colorado. "We're seeing increases in those young adults. They weren't able to stop."

It's no coincidence the vaping rates soared during the pandemic, according to several public health experts.

For the past couple of years, undergraduates have talked about the challenges of isolation and using more substances, said Alyssa Wright, Early Intervention program manager at Health Promotion at CU Boulder.

"Just being home, being bored, being a little bit anxious, not knowing what's happening in the world," Wright said. "We don't have that social connection, and it feels like people are still even trying to catch up from that experience."

Other factors driving addiction are the high nicotine levels in vaping devices, and "stealth culture," says Chris Lord, CU Boulder's associate director of the Collegiate Recovery Center.

"The products they were using had five times more nicotine than previous vapes had," he says. "So getting hooked on that was ... almost impossible to avoid."

As far as "stealth culture," Lord means that vaping is exciting, something forbidden and secret. "I think as an adolescent, our brains are kind of wired that way, a lot of us," Lord said.

Wind the clock back half a decade and one could see the seeds of these current vaping rates.

In 2019, if you typed the word "Juul" into the search bar on YouTube, you could find an endless stream of videos of young people showing off how cool it was to use the company's sleek, high-tech-looking vaping device.

Juul packages are seen on a shop shelf on December 07, 2022. Michael M. Santiago/Getty Images hide caption

Juul packages are seen on a shop shelf on December 07, 2022.

In one video Colorado Public Radio found in 2019, two young women show how they "make parties more fun."

"We just chillin',' one says, laughing. "We vapin' and we Juul-in'."

Many of those videos are no longer available, pulled off the platform once the trend took off. Searching for Juul now brings up many videos warning of the dangers and how to talk to kids.

All over the U.S., state and local governments, including Colorado, filed suit, alleging Juul Labs misrepresented the health risks of its products.

Juul agreed to pay hundreds of millions in settlements, including a nearly $32 million settlement last year with Colorado.

Juul had become No. 1, the top e-cigarette company, the lawsuits argued, by first aggressively marketing directly to kids, who then spread the word themselves by posting to social media sites like YouTube, Instagram and TikTok.

"What vaping has done, getting high schoolers, in some cases even middle schoolers, hooked on vaping, is now playing out," says Colorado attorney general Phil Weiser, a parent of two teens himself. He said vape companies followed the tobacco industry playbook with a similar impact on young consumers. "They're still hooked. This is a very addictive product."

Juul did not respond to requests for comment.

R.J. Reynolds, which makes another popular brand, Vuse, sent NPR this statement: "We steer clear of youth enticing flavors, such as bubble gum and cotton candy, providing a stark juxtaposition to illicit disposable vapor products."

Other big vape companies, like Esco Bar, Elf Bar, Breeze Smoke and Puff Bar didn't respond to requests for comment.

"If we lived in an ideal world, adults would reach the age of 24 without ever having experimented with adult substances. In reality, young adults experiment," said Greg Conley, director of legislative & external affairs with American Vapor Manufacturers. "This predates the advent of nicotine vaping."

The FDA banned flavored vape cartridges in 2020 in an effort to crack down on marketing to minors, but the products are still easy to find.

One claim often made in defense of vaping is that it can help users quit cigarette smoking.

Joe Miklosi, a consultant to the Rocky Mountain Smoke-Free Alliance, a trade group for vape shops contends the shops are not driving vaping rates among young adults in Colorado.

"We keep demographic data in our 125 stores. Our average age (of customers) is 42," he says.

Vape shops sell products to help adult smokers quit, Miklosi says, with lower levels of nicotine than big companies like Juul. Miklosi claims he's talked to thousands of consumers who claimed vaping helped them quit smoking cigarettes.

But the Colorado data belies that, according to longtime tobacco researcher Stanton Glantz.

The 18-24 age group leads all age groups in regular use, and use gradually dropped with each age cohort, up to the 65+ demographic, of which just 1% use e-cigarettes.

The data are "completely inconsistent with the argument that most e-cigarette use is adult smokers trying to use them to quit," said Glantz, the now-retired director of the Center for Tobacco Control Research and Education at the University of California San Francisco.

Glantz says because of the onslaught of sleek technology, flavors, and marketing used by Juul and other companies "the kids are getting addicted younger and faster," compared to earlier decades when traditional cigarettes dominated the tobacco market.

For recent college graduate G Kumar, now a rock climber, the impetus to quit vaping was more ecological than health-related. It was "knowing the amount of trash [from used up vape devices] that I was accumulating and the amount of money I was spending," they said.

Kumar got some help from a package of cessation literature and quitting aids from CU's Health Promotion program. It included two boxes of eucalyptus-flavored toothpicks, which tasted awful to Kumar, but provided a distraction and helped with oral cravings.

"The fact that I could just gnaw on toothpicks for weeks on end was, I think, what kept me sane," Kumar said.

It took a while and a lot of willpower to overcome the intense psychological craving, something many others in that generation know all too well.

This story was produced in partnership with CPR News and KFF Health News.

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Vaping is still cool in college and beyond for young adults : Shots - Health News - NPR