Vaping 101

1. Vaping 101

2. Discussion: What do you know about e-cigarettes/vaping?

3. What is an E-Cigarette? A battery-operated device that changes a liquid chemical (e-juice) into a vapour that can be inhaled. E-cigarettes are also known as e-cigs, e-hookahs, vapes, vape pens, mods and tank systems. 4 main components: • Battery • Cartridge or tank • Liquid chemical (e-juice) • Atomizer with a heating element E-juice = propylene glycol and/or glycerin, flavouring and often nicotine. 1000s of flavours like fruit, candy, mint, coffee, belgian waffle, strawberry daiquiri...

4. Types of E-cigarettes Cigalike Disposables: one-time use, look like cigarettes Cigalikes: look like cigarettes, use replaceable, pre-filled cartridges for e-juice Vape Pens: pen-style devices, can be refilled with e-juice Advanced Tank Systems: Box-like or tubular, can be refilled with e-juice, modifiable settings Cigalike Tank Systems Vape Pens

5. JUUL • A brand of e-cigarettes popular in the U.S. that are now sold in Canada • Look similar to a USB flash drive • 1 JUUL “pod” (e-juice cartridge) has as much nicotine as 1 pack of cigarettes

6. Other Electronic Devices E-Hookahs: essentially the same as e-cigarettes, marketed with designs that reflect hookah culture. Heated Tobacco Products (“heat-not-burn”): heat tobacco to high temperatures using battery-powered heating systems that create aerosols (e.g., IQOS, Glo, Ploom, Pax). Cannabis Vaporizers: heat either leaf cannabis or cannabis oil to a temperature that creates aerosol. Not usually interchangeable with e-cigarettes, but some e-cigarettes can be modified to vape cannabis.

7. Discussion: Why do youth vape?

8. Why Do Youth Try E-cigarettes?

9. In WDG: • 80% of grade 7 and 10 students reported not using an e-cigarette in the past 12 months. • Grade 10 students were more likely to report use than grade 7 students. WDG Youth Survey, 2017-18 In Ontario: • 89% of students in grades 7-12 reported not using an e-cigarette in the past year. • Use was higher among males and students in grades 11-12. Ontario Student Drug Use and Health Survey (OSDUHS), 2017 In Canada: • 77% of youth in grades 7-12 had never tried an e-cigarette. • Use was higher among males and students in grades 10-12. Canadian Student Tobacco, Alcohol and Drugs Survey (CSTADS), 2016-17 Use of E-cigarettes By Youth

10. Sharing E-cigarettes & Spreading Illnesses • Even if people are not sick, they can still spread microorganisms (germs). • If sharing e-cigarettes, keep in mind that many germs exist in saliva, and illnesses can be spread through direct exposure to saliva. • It is recommended that e-cigarettes be cleaned with soap and water and sanitized with a bleach and water solution (½ teaspoon of bleach for every litre of water) for 45 seconds.

11. Discussion: What are the negative health effects of vaping?

12. What’s in E-Cigarette Vapour? • Flavouring: chemicals like diacetyl which can damage the lungs when inhaled have been found in many sweet e-juice flavours (e.g., vanilla). • Particles: sometimes at levels comparable to cigarette smoke. Can increase the risk of heart disease, lung cancer and asthma attacks and interfere with lung function. • Metals: like lead, chromium, nickel, copper, aluminum and mercury. Exposure can have a variety of negative health effects including brain damage and cancer. • Tobacco-specific nitrosamines: compounds found in cigarettes that cause cancer. • Carbonyls: like formaldehyde which potentially cause cancer.

13. Health Effects of E-Cigarettes • E-cigarette vapour can cause light-headedness, eye and throat irritation, headaches, dizziness and coughing. • E-cigarettes can cause injuries. Defective batteries have caused fires and explosions. • Poisonings have been documented, with mostly minor toxic effects like vomiting and nausea. • The effects of long-term, frequent exposure to e-cigarette vapour are not yet known.

14. What About E-Juice with Nicotine? Nicotine... • Affects the developing adolescent brain • is addictive • is a poison • affects immune function • has risks for pregnant women and newborn babies

15. What About Second-Hand Exposure to Vapour? • Second-hand vapour is less toxic than cigarette smoke, but more testing is needed to determine levels of exposure that may be dangerous for some people (e.g., children, people with asthma). • Some ingredients in second-hand vapour can cause eye and throat irritation. • Flavouring chemicals can create odours that irritate people who are sensitive to smells.

16. Take Home Message If You Don’t Smoke, Don’t Vape. There is enough evidence to suggest that anybody who does not smoke cigarettes should not vape e-cigarettes.

17. What About Smokers? • Most smokers who try e-cigarettes don’t quit smoking. They are more likely to co-use or to switch for a short time and then go back to smoking cigarettes. • E-cigarettes are not proven to help people quit smoking.

18. Vaping as a Gateway to Smoking • Current research shows that youth who vape are more likely to start smoking cigarettes.

19. Discussion: • Is e-juice with nicotine legal in Canada? • Is it legal to use e-cigarettes on school property? • Is it legal to buy an e-cigarette if you are 18?

20. In Canada: On May 23, 2018, the Tobacco and Vaping Products Act (TVPA) took effect to regulate the manufacture, sale, labelling and promotion of tobacco and vaping products sold in Canada. Under the TVPA, the sale of e-juice containing nicotine is legal in Canada. In Ontario: On October 17, 2018, the Smoke-Free Ontario Act, 2017 (SFOA, 2017) took effect. Under the SFOA, 2017, the smoking of tobacco, use of an e-cigarette and the smoking/vaping of cannabis is prohibited in many areas, such as: • Enclosed public places; • Enclosed workplaces; • Primary and secondary schools and their grounds; and • Public areas within 20m from the perimeter of the grounds of primary and secondary schools. Under the SFOA, 2017, the sale and supply of e-cigarettes to anyone under 19 is prohibited. E-Cigarettes & the Law

21. Discussion: No way! I didn’t know that…

22. Testing Your Knowledge • E-juice contains... • Propylene glycol + flavouring + water • Tobacco + flavouring + nicotine • Propylene glycol + flavouring + nicotine • Corn syrup + flavouring + water

23. Testing Your Knowledge 2. Why do youth try e-cigarettes? • Flavours taste good • To quit smoking • Friends are doing it • All of the above

24. Testing Your Knowledge 3. What’s in e-cigarette vapour? • Flavouring chemicals + water + metals • Flavouring chemicals + metals + chemicals that cause cancer • Flavouring chemicals + water • Just water

25. Testing Your Knowledge 4. What are the negative health effects of e-cigarettes? • The long-term health effects of e-cigarettes are not yet known. • Tooth decay • Eye and throat irritation • Answers a & c

26. Testing Your Knowledge 5. E-juice often contains nicotine. Nicotine... • Is addictive • Affects the developing adolescent brain • Has risks for pregnant women • All of the above

27. Testing Your Knowledge 6. When people try e-cigarettes to quit smoking, they often: • Quit smoking • Switch completely from cigarettes to e-cigarettes • Use both e-cigarettes and cigarettes • Switch to nicotine replacement therapy

28. Testing Your Knowledge 7. On October 17, 2018, the Smoke-Free Ontario Act, 2017 took effect. Under the SFOA, 2017... • The sale of e-juice with nicotine is now legal in Canada. • The sale of e-cigarettes to anyone under 19 is prohibited. • The use of an e-cigarette on school property is prohibited. • Answers b &c