FROM THE NATIONAL COUNCIL ON SUBSTANCE ABUSE
by
Lindsay Bynoe
Vaping is a growing habit throughout the world, and gained popularity in Barbados so in this article we take a close look at this phenomenon. It is sometimes referred to as juuling, but this is so because Juul is a popular E-cigarette brand among teenagers.
What is Vaping?
Vaping is the act of inhaling and exhaling the aerosol, often referred to as vapour, which is produced by an e-cigarette.
What is an Electronic or E-Cigarette?
An electronic cigarette is a hand-held electronic device that simulates the experience of smoking a cigarette. It works by heating a liquid which generates an aerosol or vapour that is inhaled by the user. Using e-cigarettes is commonly referred to as vaping.
What Types of Vaping Devices are There?
Vaping devices include not just e-cigarettes, but also Advanced Personal Vaporisers (APVs) or vape pens and vape Mods. E-cigarettes look like regular (‘analog’) cigarettes. The cartridges in these come pre-filled and must be replaced with new cartridges. The e-liquid also known as e-juice, is a waterbased liquid infused with nicotine. The e-liquid comes packed in different nicotine strengths categorised in milligrams: ultralight (6 mg), medium (12 mg), regular (18 mg), and strong (24 mg). There is even 0 milligrams which contains no nicotine for those who just want to vape minus the nicotine hit.
In vape shops, you will also find Advanced Personal Vaporisers (APVs), also known as vape pens, and vape Mods. APVs contain electronics allowing the user to regulate the power level and produce a moderate amount of vapour.
What are E-Liquids or E-Juices?
These consist of generally four ingredients: The main base is vegetable glycerine (VG). The glycerine does not carry flavour well but does produce a lot of vapour.
Propylene glycol (PG) is a main ingredient in asthma inhalers and is considered safe to inhale when vaporised. It is thinner than VG and carries flavour very well.
Flavourings – these are food-grade, can be natural or artificial and are limited only by the imagination of the juice maker. Some flavours on the market are cinnamon, cotton candy, vanilla, caramel cheesecake, buttered popcorn, raspberry, watermelon and blueberry.
The final ingredient is pharmaceuticalgrade nicotine, and most juice manufacturers make their product available in various nicotine strengths or zero nicotine.
It must be mentioned that vaping cannabis is also growing in popularity. To create this vapour, the active compounds in cannabis are heated at low temperatures. Unlike with smoking cannabis, no combustion or burning takes place at these low temperatures, so there is no smoke. Cannabis flowers and plant material or concentrates are packed into the chamber of the device and the vapour is inhaled.
What are the Dangers Associated With Vaping?
In a recent incident in November 2019, eight Wisconsin teenagers were hospitalised and doctors found that they had seriously damaged lungs connected to their use of vape pens. Michael Gutzeit, M.D. Chief Medical Officer of Children’s Hospital Wisconsin, held a press conference about the eight patients his faculty treated. He said that the teens came in with a “variety of illnesses”- some of which required “significant therapy” in order for them to breath. “We don’t understand all the implications of that right now,” Gutzeit said, “but they all had fairly severe lung damage.” According to Fox 6 News, the teenagers complained of symptoms such as shortness of breath, fatigue, chest pains, cough, weight loss, vomiting and diarrhoea. While Gutzeit said it’s too soon to know whether the cases are linked to the same type of vape pen, he suggested there is something bigger to be gleaned from the cluster of cases. “Vaping in teenagers is causing significant damage; we want the message to be loud and clear.”
In Barbados, there are no present statistics on the level of e-cigarette use among the youth, but some high school children have admitted to vaping in some form or the other.
Llona Jaspers, Ph.D., Deputy Director of the Centre for Environmental Medicine, Asthma and Lung Biology at the University of North Carolina at Chapel Hill, has seen, in her studies on vaping, a particularly troubling number of complications in the lungs, including acute lung (or respiratory) distress, pneumonia, acute lung injury, and a series of symptoms in which patients describe the feeling of fluid in their lungs, which is newly being called “wet lung.”
In an article written by Hannah Knowles and Lena H. Sun, entitled “What we Know about the Mysterious Vaping – Linked Illness and Deaths”, the first death from a vaping-related illness was reported on 23 August 2019 in Illinois, USA. At that time, federal and state officials were investigating almost 200 cases of the baffling sickness in 22 states, according to the Centres for Disease Control and Prevention (CDC). Oregon officials announced a second death, saying a middle-aged adult fell seriously ill after vaping with marijuana oil. The list of states with deaths has grown quickly since.
Officials are still trying to figure out exactly what is causing people to fall ill. The latest national and state findings in the USA suggest that products containing THC, particularly those obtained off the street or from other informal sources (e.g. friends, family members, illicit dealers) are linked to most of the cases and play a major role in the outbreak, the CDC has said.
Other possible sources of vaping dangers are being investigated and indicates the importance of allowing more time for longitudinal studies to be done.
How Popular is Vaping?
According to the latest statistics from the World Health Organisation (WHO), the number of vapers has been increasing rapidly – from about seven million in 2011 to 35 million in 2016. Market research group, Euromonitor, estimates that the number of adults who vape would reach almost 55 million by 2021.
The United States, Japan and the UK are the biggest markets. Vapers in the three countries spent a combined $16.3 billion on smokeless tobacco and vaping products in 2016.
Is Vaping Legal in Barbados?
Vaping is not illegal in Barbados for adults. It is illegal for minors (those below 18) to use and sell tobacco products. According to a 2017 amendment to the Health Services Act of Barbados (Cap. 44), tobacco products include electronic smoking devices.
The Prohibition of Tobacco Smoking in Public Places, Regulation 2010, also covers emissions from electronic smoking devices.
CONCLUSION
In the area of Secondary Drug Prevention, vaping is being seen by many as a safer alternative to smoking tobacco since there is evidence that electronic cigarettes can encourage tobacco consumption reduction even among those not intending to quit. In the area of Tertiary Prevention or Treatment/ Rehabilitation, vaping is also being seen and used as a harm-reduction method and a pathway to quitting smoking by those who are addicted to tobacco.
Should this situation lead us to conclude that vaping is safe and should be encouraged? Not at all. There is enough evidence that vaping is potentially dangerous, and all should be encouraged, including those trying to quit smoking, to seek safer alternatives and more wholesome activities or practices.
