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Prevention-Education & SAP Services
Addiction Medicine Services of Western Psychiatric Institute & Clinic
University of Pittsburgh Medical Center
Franklin Building, Floor 4
1011 Bingham Street
Pittsburgh, PA 15203
Susan L. Tarasevich, Ed.D.
David Suda, M.Ed.
Pat S. Woodke
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Trending – E-Cigarettes, Vaping & Hookah Pens: Not Just Nicotine Anymore
The word “vape” was recognized as the word of the year by the Oxford dictionary, and defined as the act of inhaling or exhaling vapor from an electronic cigarette, vape, or Hookah pen.
Though originally developed in the 1960’s, tobacco marketers are inaccurately promoting the electronic cigarette as a nicotine delivery system without the pulmonary risks and dangers of cigarettes. While the risk of addiction and other issues for adolescents is real, the increasing popularity of these devices has created a fad with youth.
In its basic form, the e-cigarette consists of a battery, a heating element, and a simple switch. Some offer a puff- activated switch with a small light that closely mimics the look and feel of a traditional cigarette (Figure 1).
SAP TRAINING DATES
Pittsburgh 3190 William Pitt Highway Pittsburgh, PA 15238
Time: 8:15 am - 3:30 pm
*code required for admittance
$350* per participant
(This is a Three Day Training)
Act 48 Credits
Specialty credits available at a nominal fee
How it Works
The e-cigarette uses a cartridge containing nicotine mixed with glycerin that when heated makes a vapor. As all things evolve, the newest generation of “E-Cigarettes” is electronically the same, but all the components are now larger. Most importantly, the name of the device has changed. Today, the term “Vape Pen” replaces the term “e-cigarette”. The first generation (far left), originally designed to resemble a traditional tobacco cigarette, is marketed as a safe alternative to smoking.
The Next Generation
The second generation (Figure 2) is electronically similar, but physically larger. This second generation Vape Pen no longer physically resembles the first, and most importantly, tobacco companies stress that the user is no longer “smoking” but “vaping” since they were now using a Vape pen. The term “vaping” describes the vaporization of nicotine mixed with glycerin (vegetable oil) that is often flavored with fruity compounds. “Hookah” Pen refers to a Middle Eastern type of “Vape” Pen. The Vape Pen and Hookah Pen refer to the same device.
There is a “new” world of users that personalize their Vape Pens, and the changes are not just cosmetic as reported by police and in online “vape forums”. Manufacturers have responded (most pens are made in China) by offering a variety of sizes, reservoirs to accept liquids, varying wicks, and longer-life batteries. The real problem with Vape Pens is that the concentration of nicotine varies from pen to pen. Users have no indication of the amount of nicotine that they are inhaling.
Marijuana, Crack & Meth Delivery
Users are able to modify the Vape pens to deliver drugs. THC the psychoactive chemical in marijuana has been reformulated and distilled for the Vape Pen, and is called “Dab” (Figure 3).
The waxy substance contains butane hash oil. Butane, gas, an explosive is used to extract THC, pot's active ingredient, during the process. A hit the size of a head of a pin is equal to one to two full cannabis joints.
Street-grade cannabis has about a 5-to 17% concentration of THC. When distilled using butane, the THC concentration of the “DAB” is around 30%. Originating from the slogan, “just a Dab will do ya”, the “Dab” is reported to create a much more intense high than that achieved from traditionally smoked marijuana. Some sites estimate that a “Dab” may contain 70%-90% THC. As the Vape Pen becomes more popular and widely accepted, proponents of marijuana legalization see “Dabbing with a Vape Pen” as being the accepted way to enjoy marijuana, similar to how vaping itself replaced smoking. Other traditionally abused drugs such as methamphetamine, cocaine and crack can be used in the Vape Pen.
Vape Pens are multi-colored and come in wide variety of sizes, and capacities. Most have rechargeable batteries, with more powerful heating elements, and user accessible reservoirs. The vape pen allows the user to experiment with specialty flavored glycerin liquids sometimes called “E-Juices”. E-Juices have become the focus and popularity of the Vape pen, coming in a wide variety of flavors and tastes. These included the most basic flavors, cherry, grape, blueberry, orange, strawberry, and lemon, clearly targeted to children. Some flavors resemble common foods or breakfast cereals like Captain Crunch or Fruity Pebbles.
Figure 3. Courtesy of www.drugpossessionlaws.com,2014
Top Three Prevention TIPS for SAP’s
1. Educate Teens about Health Effects
First, the dose of nicotine delivered with each puff may fluctuate widely between manufacturers. The FDA found nicotine in products labeled as nicotine free. Multiple studies indicate that nicotine is known to be addictive, toxic to fetuses and harmful to adolescent brain development. Nicotine addiction is powerful and happens quickly.
Second, electronic cigarettes deliver an array of toxic chemicals, including diethylene glycol (a highly toxic substance found in antifreeze), various nitrosamines (powerful carcinogens found in tobacco), and at least four other chemicals suspected of being harmful to humans. While the amount of these substances is smaller than found in “real” cigarette smoke, it is not zero. For this reason, the U.S. Food and Drug Administration issued a warning about their use.
Third, there are no scientific studies of e-cigarettes. There is no evidence that they are a safe way to quit smoking. There are better and safer ways to quit. The most effective strategy involves using an FDA approved nicotine replacement or a medication along with some sort of counseling or support, in person, either by telephone, or even by text message. Teens and adults can receive counseling and support from the free PA Quitline 1.800. QUIT NOW.
Call 1-800-QUIT-NOW (784-8669)
2. Update School Tobacco Policies to Include e-cigarettes including current and future tobacco products
Provide a definition of tobacco products to include current and future tobacco products.
Prohibit the following items on campus (inside or outside) and at off-campus, school-sponsored events by anyone
- tobacco products and tobacco-related devices,
- imitation tobacco products,
- lighters, and
- electronic cigarettes.
Prohibit accepting any donations or curriculum from any tobacco-related industry.
Prohibit any promotion of tobacco products.
3. Refer ALL Tobacco Policy Violators to SAP
There is a strong relationship between youth smoking and negative affect, such as depression, anxiety, and stress, and lower rates of academic achievement among smokers. The relationship between depression and smoking among adolescents is bidirectional. Depressed teens are more likely to smoke, and those who smoke are more likely to become depressed (Brown, 1996). Smokers have lower grade point averages (GPA) than nonsmokers do. The Harvard College Alcohol Study found that smokers are 27.0% less likely than nonsmokers to have an above B grade average (Rigotti, 2000). Daily smokers were found to have even lower GPAs than high-risk drinkers did. This sounds like a powerful opportunity for SAP to intervene.
Your 30-Second Sound Byte on E-Cigarettes
1. E-cigarettes are tobacco products.
2. No one knows what is in e-cigarettes or what the health impacts may be.
3. According to CDC, youth use of e- cigarettes has doubled in 1 year.
4. FDA has not found any e-cig to be safe & effective in helping smokers quit.
5. Initial studies have shown formaldehyde, benzene & other items in secondhand e-cigarette emissions
6. That is why it is so important for FDA to begin its oversight.