E-Cigarettes 101:Understanding the Vaping CrazePlacer County Tobacco Control ProgramAmie McGrath & Alexandra Wride

What is an E-Cigarette?• An e-cigarette is a battery powered

device that heats up a liquid—that usually contains nicotine—and allows the user to breathe in the vapor liquid

An E-cigarette by Any Other Name…

• Breeze• JUUL• Novo• Mod• Tank• Vape• E-Hookah• Vape Pen• E-Cig• Hookah Pen

• Vape Pipe• Rig• Electronic

Smoking Device (ESD)

• Electronic Nicotine Delivery System (ENDS)

Is still an E-Cigarette.

E-Cigarette Generations

E-Juice, Vape Juice, E-Liquid, Pods…

• E-juice is the liquid that is put into an e-cigarette to produce a smoke-like vapor.

What is in E-Juice?• Propylene glycol and/or

• Vegetable glycerin

• Flavoring

• Diacetyl (creamy and some fruit flavors)

• Nicotine (still found in bottles that say 0mg on them)

• ???????

What’s in JUULPods?• Nicotine (Nicotine Salts)

• Benzoic Acid

• Glycerol

• Propylene Glycol

• Natural Oils

• Extracts and Flavor

E-Cigarette Vapor Aerosol

Lithium Silver Copper Rubidium

Cadmium

Aluminum

N-Nitro-Sonor-Nicotine

Ethylbenzene

Acetic acid

Benzaldehyde

Nickel

Fluorine

Lead Formaldehyde

Benzo(ghi)perylene

AcetaldehydeArsenic

While these chemicals may vary, studies have identified at least 10 known carcinogens found in all e-cigarette vapor.

Vaping on Social Media

Vaping at School• Easy to hide

• Low vapor

• Smells Fruity

Hidden Vapes

Youth Use Rates

Ever smoked a whole cigarette 1% 4% 8% 52%

Current cigaretteuse 1% 2% 3% 28%

Ever used an e-cigarette 6% 15% 24% 60%

Current use of an e-cigarette 3% 7% 12% 30%

Used an e-cigarette 4 or more times 2% 7% 14% 45%

7th

Grade9th

Grade11th

Grade NT*

*NT=Continuation, Community Day, and other Alternative school types

Nicotine and the Brain

• Nicotine is derived from tobacco and has psychoactive and physiological effects

• Nicotine is known to cause birth defects during pregnancy and affects the developing brain

• Nicotine is as addictive as heroin, cocaine, and alcohol

Nicotine and the Brain

• Vaping results in the rapid distribution of nicotine to the brain, with drug levels peaking within 10 seconds

• Nicotine inhaled reaches the brain two times faster than heroin

• Most nicotine users need to use every 30 to 50 minutes to feel “normal”

• Through inhaling smoke, the average smoker takes in 1 or 2 mg of nicotine per cigarette

• Prefrontal Cortex (PFC)

• Adolescent smokers show reduced PFC Activity (Memory and Attention)

• Youth smoking/vaping associated with substance abuse and mental health problems later in life

• Addiction

Nicotine and theTeenage Brain

Nicotine and the Body

Popcorn Lung(Bronchiolitis Obliterans)

E-Cigarette Effects (reported by Actual users)

• RESPIRATORY Shortness of breath, wheezing, nosebleeds,

coughing, asthma, discolored mucus, sinus infections

• MOUTH/THROAT Dry tongue, numbness, sore throat, lip sores,

receding gum line, tonsil stones, thrush, laryngitis

• CIRCULATORY Irregular heartbeat, increased blood pressure,

bruising easily, heart palpitations

• NEUROLOGICAL panic attacks, depression, hot flashes, fainting,

insomnia, slurred speech, fatigue

• UROGENITAL Blood and “foam” in urine, painful menstrual

cycle, kidney pain

• SENSORY Metallic taste, lost taste, swollen eyes, distorted

vision, ringing ears, plugged ears

• DIGESTIVE heartburn, vomiting, flatulence, constipation,

indigestion, bloating

• IMMUNE Cold/flu symptoms, increase in cold/flu sensitivity

E-Cigarette Effects (reported by Actual users)

• MUSCULAR/SKELETAL Cold/flu symptoms, increase in cold/flu sensitivity

• SKIN Acne, rashes, stains from e-juice, burning skin,

itches

E-Cigarette Effects (reported by Actual users)

Exploding E-Cigarettes

From 2015-2017 estimated 2035 e-cig explosion and burn injuries presenting to US hospital emergency departments

Calls to Poison Control

2,836Number of calls in 2018

Poison Control Calls

0

500

1000

1500

2000

2500

3000

3500

4000

4500

2012 2013 2014 2015 2016 2017 2018

460

1,543

4,024 3,744

2,9072,478

2,836

NIC SICK aka NICOTINE POISONING

EARLY SYPTOMS: Feeling queasy or throwing up StomachacheMouth wateringQuick, heavy breathing Faster heartbeat Higher blood pressure Pale skin Headache Dizzy, off-balance, or confused

NIC SICK aka NICOTINE POISONING

LATE-PHASE SYMPTOMS:Diarrhea Shallow breathing Slower heartbeat Lower blood pressure Lethargy Feeling weak, slow reflexes, or

unable to control muscles Seizures

Nicotine Poisoning

• As little as 1 teaspoon of liquid nicotine can be fatalfor the average 26-pound toddler

Vaping Other Products

• Marijuana• Supplements

• Cocaine

• Plus More

E-Cigarette Laws

• 21 and older

• Illegal to provide or purchase any tobacco product to anyone under 21

• No vaping where smoking is not allowed

What is Being Done?• FDA

– restrict the sale of flavored e-cigarettes to age-restricted/adult-only, in-person stores (e.g., tobacco only stores, vape shops)

– ban flavored cigars

– ban menthol-flavored cigarettes.

What is Being Done?• California

– SB 424: Single-use tobacco products

– SB 39: Packages of online tobacco sales

– SB 538: E-cigarette manufacturer requirements

What is Being Done?• Placer County

– Tobacco Retailer Density & Zoning• Auburn

– Smoke-Free Parks

– Youth Engagement

What is Being Done?• DOJ Grant Funding

– Placer County Division of Public Health

– Reduce prevalence amongst youth throughout Placer County

– Provide education for school administrators, teachers, students, and tobacco retailers

What can you do?• Educate yourself about e-cigarettes

• Follow our Facebook page; Placer County Tobacco Prevention Program

• Join the Placer County Tobacco Prevention Coalition

Helpful Websites• stillblowingsmoke.org

• e-cigarettes.surgeongeneral.gov

• flavorshookkids.org

• tobaccofreeca.com

• truthinitiative.org

• teen.smokefree.gov

• nobutts.org

Questions?

Contact UsAmie McGrath

Placer County Tobacco Control Program11484 B Ave, Auburn, CA 95603

(530) 889-3629amcgrath@placer.ca.gov

ReferencesCalifornia Healthy Kids Survey, Placer County, 2018

Chen, A. (2017, December 04). Teenagers Embrace JUUL, Saying It's Discreet Enough To Vape In Class. Retrieved February 09, 2018, from https://www.npr.org/sections/health-shots/2017/12/04/568273801/teenagers-embrace-juul-saying-its-discreet-enough-to-vape-in-class

Hua, My, Mina Alfi, and Prue Talbot. “Health-Related Effects Reported by Electronic Cigarette Users in Online Forums.” J Med Internet Res Journal of Medical Internet Research 15.4 (2013): n. pag. Web

Kenne, D. R., Fischbein, R. L., Tan, A. S., & Banks, M. (2017). The Use of Substances Other Than Nicotine in Electronic Cigarettes Among College Students. Substance Abuse: Research and Treatment, 11, 117822181773373. doi:10.1177/1178221817733736

Resources to learn more about e-cigarette use among youth and young adults | Know the Risks: E-cigarettes & Young People | U.S. Surgeon General's Report. (n.d.). Retrieved February 09, 2018, from https://e-cigarettes.surgeongeneral.gov/resources.html

Schools seeing increase in JUUL use among middle, high students. (2018, February 05). Retrieved from http://wreg.com/2018/02/05/schools-seeing-increase-in-juul-use-among-middle-high-students/

Staff, K. (2018, January 10). Rocklin police: Battery likely sparked fire at Studio Movie Grill. Retrieved February 09, 2018, from http://www.kcra.com/article/rocklin-police-battery-likely-sparked-fire-at-studio-movie-grill-theater/14952625

Unit 6 - Why Should I Be Worried About JUULs? (n.d.). Retrieved February 09, 2018, from http://med.stanford.edu/tobaccopreventiontoolkit/E-Cigs/ECigUnit6.html

https://support.juulvapor.com/home/learn/faqs

https://e-cigarettes.surgeoneneral.gov/resource.html