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Friday, 13 April 2018

'Vaping': What is it and is it 'safer' than smoking for our teens?

Recently I have received a number of messages from parents wanting to know more about 'vaping'. Each of them had recently found a device in their child's room and had little, or no idea, what it actually was, how it was used and whether it was harmful or not. Here is an edited version of one of the requests for information:

"Last weekend I found a strange-looking device in our son's room. When I asked him what it was he said it was a 'vape'. It looked like a long cigarette and when we asked him why he had it he told us that it was a 'bit of fun' and he and his mates occasionally used it when they got together. He insisted he only used it to do tricks and that these vapes were harmless. We confiscated it anyway and told him we wouldn't allow it in the house. Since then we found out that one of his friends is smoking cigarettes. Our son played it down and said his mate is actually using the device to try to give up smoking. Just last night I found another vape in my son's desk drawer as I was looking for something. I wasn't spying on him - he was in the room at the time. I confiscated it and again I got the same arguments - "Don't be ridiculous mum, these things are harmless" and "I only do tricks on them like blowing round circles!" So now I have two vapes confiscated. What should I do? Are they really harmless? I have got no clue what substance he has inside the vape."

So, what is a 'vape'? Essentially it's a street term for devices usually referred to as 'e-cigarettes'. So what exactly are these and how are they different from traditional cigarettes? More importantly, what are the harms associated with their use, particularly when it comes to young people?

Firstly, let me make it clear that I do not want to try to get into the middle of the debate that has been raging in the smoking cessation area for the past few years. There are some in the tobacco prevention area who believe that e-cigarettes could (and should) play a major role in assisting smokers quit in this country, while there are others who are staunchly opposed to their use and have campaigned (and for the most part been successful) to ensure there is a blanket ban of these devices. My only concern here is for young people and their parents and trying to sort out 'fact from fiction'.

An e-cigarette is a nicotine delivery device that simulates tobacco smoking by producing a vapour. Operated by a battery, it vaporizes a liquid solution (called 'e-liquid' or 'e-juice') which may contain nicotine (amongst other things, including a range of flavours from fruit through to chocolate and bubble-gum) and is promoted by manufacturers as being 'safer' than traditional smoking because it is a tobacco-free product that eliminates the burning process. When the liquid is turned into a vapour, this is inhaled or 'vaped'. Confusing the issue is that many of these e-liquids are nicotine free, with these devices simply releasing a flavoured vapour!

We have little up-to-date data on how many Australian teens are vaping. What we do have suggests that this is an issue that we need to monitor carefully. According to the latest Australian Secondary School Students Alcohol and Other Drugs (ASSAD) study conducted in 2014, 13% of 12-17-year-old students reported that they had ever used an e-cigarette. Use increased with age, from 5% of 12-year-olds to 22% of 17-year-olds, with young men being more likely to say that they had ever tried (one quarter (25.8%) of 17-year-old males), with 7.7% reporting use in the previous four weeks. It is unclear as to whether use has increased since that data was collected but from the anecdotal reports I am getting from schools and parents, it certainly seems as though this issue has not gone away ...

So are these devices legal? It is currently illegal in Australia for commercial retail outlets to sell nicotine e-cigarettes. Regulation of the sale of non-nicotine e-cigarettes continues to vary across Australian state and territory jurisdictions. While nicotine e-cigarettes or the nicotine vial refills may be purchased online for personal use, throughout Australia it is illegal to do this without a medical prescription for nicotine. As far as schools are concerned, most of those I have spoken to about this issue have elected to view these devices as tobacco products, whether or not they contain nicotine, and deal with them accordingly.

I have one major concern about these devices, regardless of whether they contain nicotine or not. We continue to have some of the lowest smoking rates in the world, particularly amongst school-based young people, due in no small part to making smoking be seen as anti-social. Even though e-cigarettes don't involve 'smoking' per se, they still simulate the practice and there is a very real danger that the 'anti-social' message could be eroded over time. This issue is compounded by the number of times you see these devices now being used on American TV programs, particularly comedy shows, where they are usually (but not always) using them to smoke cannabis. Now that cannabis has been legalised for recreational use in California, we are seeing more and more US comedy shows using the vaping (and smoking) of cannabis to get a laugh.

In the mother's message above she talks about her son telling her that he "only used it to do tricks". Type in 'vaping tricks' into YouTube and you will literally see hundreds of videos that have been uploaded by people from around the world. Some of you may remember some of the party tricks that smokers would do back in the days when smoking a cigarette was pretty cool - these vaping videos put all of those to shame! This compilation video of vaping tricks clearly shows why some young people are attracted to these devices. Ok, it's not smoking, but vaping's increased presence on TV shows and in other media certainly increase the visibility (and possibly perceived acceptability) of a behaviour that for a long time was seen in a very negative light, particularly by young people. Most worryingly, smoking (or something that looks a lot like smoking) becomes 'cool' again.

So does the evidence suggest that vaping by teens is a 'gateway' to smoking? As the mother discusses in her message, it would certainly appear that there are some young people who could be vaping in an attempt to quit smoking. The research evidence in this area is mixed and both sides of the e-cigarette debate often throw the same data around to support their particular stand, which makes it even more difficult to sort through! There have been studies that suggests vaping is actually 'replacing' rather than 'encouraging' tobacco smoking amongst young people, while others have found that those who do experiment with vaping are, in fact, actually more likely to become smokers. This is usually explained by the fact that teens who experiment with vaping are more likely to be sensation-seekers, who would be more inclined to try smoking later anyway. Regardless, adolescent vaping cannot be ignored and some parents are going to find themselves faced with having to deal with finding out their teen is using one of these devices.

The one thing that all those in tobacco prevention field agree on is that whatever policy is adopted in the e-cigarette area, it should include some kind of restrictions around vaping by young people. As an excellent article written for the New York Times by Lisa Damour titled 'How to Talk With Teenagers About Vaping' states - "Vaping is generally understood to be less risky than smoking. But not vaping is healthier than vaping". She then goes onto talk through some simple strategies that parents can use in this area. Even though most use by teens appears to be experimental and regular use is rare, what is abundantly clear is that trying to prevent young people vaping is a good idea!

What's my advice for parents in this area and what did I say to the mother who sent me through the message? Firstly, I recommend parents follow how most schools are dealing with these devices - treat them just like you would any tobacco product, regardless of whether they contain nicotine or not. In most cases, parents would have outlined their expectations and values around tobacco smoking and if they then subsequently found their child with a pack of cigarettes, most would confiscate the product and roll out a consequence. You have to make the decision for yourself but as far as young people are concerned, it is most probably best to regard experimenting with smoking or vaping in the same light.

What happened in this mother's case is that she found the product, confiscated it and then made it clear to her son that such a device was not allowed in the house and then he openly defied her. Strike one! He also successfully bamboozled her with information about a product she knew nothing about and left her floundering. She was completely left on the back foot! Strike two! As I always say to parents who contact me when they have found some strange product, device or substance in their child's room, don't react before trying to find out exactly what you're dealing with! By all means remove it if you feel you need to but then do your best to try to find out all you can about what it is as quickly as possible (and don't just rely on what your teen tells you!). The best place to go in the first place is the Alcohol and Drug Information Service in your state and territory (you can find the number for where you live on the DARTA website). This is an anonymous and confidential telephone helpline manned by trained counsellors who should be able to provide you with some advice and information on whatever you may have found.

Vaping is not going to go away anytime soon and parents need to be prepared. Although smoking rates amongst young people are still at an all time low, parents continue to have discussions with their children about this issue. A friend of mine recently told me about a conversation she had with her 5-year-old daughter after she saw a 'no-smoking' sign and wanted to know what it was. When she told her, her child responded with "What's smoking?" It's a wonderful story and shows exactly how far we've come in this area. My advice is to add e-cigarettes to any discussion you may have around smoking - don't force the issue, let it come naturally - but raise it and let your child know exactly where you stand on young people and vaping.
References:
Damour, L. (2018). How to talk with teenagers about vaping. New York Times, February 14. https://www.nytimes.com/2018/02/14/well/family/how-to-talk-with-teenagers-about-vaping.html
accessed 13 April, 2018.

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About Me

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Paul Dillon has been working in the area of drug education for the past 25 years. Through his own business, Drug and Alcohol Research and Training Australia (DARTA) he has been contracted by many organisations to give regular updates on current drug trends. He has also worked with many school communities to ensure that they have access to good quality information and best practice drug education. His book 'Teenagers, Alcohol and Drugs' was released nationally in February 2009. With a broad knowledge of a range of content areas, Paul regularly appears in the media and is regarded as a key social commentator, with interviews on television programs such as Sunrise, TODAY and The Project.