E-Cigarettes Defined

Current Trends & Data

Approaches to Youth Prevention

Officer Joe Delgehausen -Edina High School Resource Officer

Christopher Lawler - Licensed Alcohol and Drug Counselor at Edina High School

PTO

NIDA’s Positive Parenting Guide: https://www.drugabuse.gov/family-checkup

NIDA Site for Parents: https://teens.drugabuse.gov/parents/helpful-links

CDC Guide for Parents (Handout):

https://e-cigarettes.surgeongeneral.gov/documents/SGR_ECig_ParentTipSheet_508.pdf

FREE Curriculum on E-Cigarettes through Stanford Medicine:

http://med.stanford.edu/tobaccopreventiontoolkit/E-Cigs.html

FDA Summary on E-Cigarettes. GREAT for e-distribution:

http://www.scholastic.com/youthvapingrisks/pdfs/YoutheCigarettePreventionInfographicFINAL.PDF

Drug use on social media links:

https://americanaddictioncenters.org/drugs-on-social-media

https://drugabuse.com/featured/instagram-drug-dealers/

https://www.thetreatmentcenter.com/resources/wiki/social-media-drug-use/

https://www.theedgerehab.com/blog/drug-dealers-targeting-teens-on-social-media/

Drug Slang Dictionary: https://www.noslang.com/drugs/dictionary.php

DEA Drug Slang Report: https://ndews.umd.edu/sites/ndews.umd.edu/files/dea-drug-slang-terms-and-code-words-july2018.pdf

Teen Slang Dictionary for parents:

https://www.verywellfamily.com/a-teen-slang-dictionary-2610994

The Guardian article on drug purchases on social media:

https://www.theguardian.com/society/2017/dec/31/youth-workers-warn-of-rise-in-drugs-purchases-through-social-media

The Sun article on emojis and drug sales:

https://www.thesun.co.uk/uncategorized/4016726/teenagers-drugs-emojis-stacey-dooley-bbc-three/

CDC: E-Cigarette “Know the Risks” Site specific to youth:

https://e-cigarettes.surgeongeneral.gov/knowtherisks.html#risks

In response Codiene (“Lean”) Withdrawal:

https://www.healthline.com/health/codeine-withdrawal#causes

Talking to Teens about E-Cigarettes (A Parent’s Guide): https://e-cigarettes.surgeongeneral.gov/documents/SGR_ECig_ParentTipsheet_508.pdf

NY Times Article on Talking to Youth about E-Cigarettes: https://www.nytimes.com/2018/02/14/well/family/how-to-talk-with-teenagers-about-vaping.html

Washington Times Article on the link between sex trafficking and drug addiction:

https://www.washingtontimes.com/news/2016/nov/28/addiction-crisis-fuels-human-trafficking/

Mayo Clinic: The Dangers of E-Cigarettes

https://www.youtube.com/watch?v=59gCYDMf_uQ

How to Talk to Kids About E-Cigarettes

https://www.youtube.com/watch?v=6JCAyb3lDTo

E-Cigarettes: Risk of Infections

https://www.youtube.com/watch?v=QgXbS4B3VwE

Nicotine and Vaping: What Parents Need to Know

https://www.youtube.com/watch?v=Fn1-qiTWPWk

There are many different kinds of Vapes and E-Cigs

They all use heat to vaporize a liquid as an alternative to smoking cigarettes

They are marketed as an alternative/healthier way to consume nicotine

Below are common types of Vaping devices

JD

FIRST GENERATION DEVICES Devices designed to look like traditional cigarettes

“cigalikes”

Battery-operated, originally composed of 3 pieces:

A Battery to provide power

Atomizer, providing heat

A Cartridge that holds liquid and flavoring

SECOND GENERATION DEVICES

Devices are larger and typically do not resemble a cigarette

-Different sizes, shapes, and colors.

Large, separate cartridges or “tanks” for liquids and flavorings.

THIRD GENERATION DEVICES Like second generation devices, but are typically larger.

Contain different cartridge, atomizer, and battery options

Produce higher heating element temperatures and produces more heat and impacts the amount of the aerosol.

-Overheating has been a problem.

E-CIGARETTES – JUUL DEVICE

Popular e-cigarettes like JUUL have developed new technologies utilizing nicotine salts that are absorbed into the body more effectively and come in record-high levels of nicotine.

JUUL pod can contain much more nicotine than regular cigarettes.

Come in a wide variety of fruit and other flavors that appeal to youth.

Easily hidden, have limited odor

Aerosol that disappears quickly enabling youth to use them in public places.

JUUL controls over 50 percent of the E-Cig market

E-CIGARETTES – JUUL DEVICE

E-CIGARETTES: RATES OF USE

The 2017 Minnesota Youth Tobacco Survey (MYTS) revealed that one in four middle school and high school students (25.9 percent) reported having tried an e-cigarette at least once.

The portion of students that had tried e-cigarettes increased with each grade in school.

In 2017, about one in two high school seniors had tried e-cigarettes. A larger portion of students had tried e-cigarettes than conventional cigarettes (25.9 percent vs. 20.2 percent).

Source: MN Department of Health

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JD

E-CIGARETTES

Larger disparities exist among racial and ethnic groups. A larger share of students that identified as American Indian, Hispanic, or multiple races (non-Hispanic) reported having ever used e-cigarettes.

These patterns among subgroups are consistent with the 2016 Minnesota Student Survey data on past 30-day use of e-cigarettes.

Source: MN Department of Health

E-CIGARETTES: SLANG

e-cigs

e-hookahs

hookah pens

vapes

vape pens

mods (customizable, more powerful vaporizers)

Whether done on purpose or not

the different types of

vapes/tobacco products look a lot

like items your kids would

normally have in a back pack.

JD

The JUUL is a small device that is easily concealed

There is little smell from the smoke making it easier to conceal

It looks like a USB Drive – it is charged by plugging it into a USB Port

Less irritation to the lungs when smoking the vape making it easier to start

The flavors are teen friendly with many fruity flavors

There is a much higher nicotine level in JUUL products versus other E-Cigs

- 1 JUUL Pod is equal in nicotine to 1 pack of cigarettes

- JUUL has 59 milligrams per milliliter of oil versus only 6-30 milligrams in most other E-Cigs

JD

The vape oil is often flavored

The flavors vary but are often fruit flavored

There is no cigarette smoke smell

The vaporized liquid is not as irritating to the respiratory system

Vaping can be done much more covertly than traditional cigarettes

Vaping is seen as more socially acceptable

Vaping is a trendy form of smoking that is often seen as cool by teens

JD

JD

With the growth in using Vapes to consume nicotine the use of the same devices to smoke THC wax/oils has grown (Dabbing)

Benefits of Vaping the wax/oils include:

- Less smell in consuming it when using the Vapes

- Easier to conceal

- Can easily add the wax/oil to the normal nicotine vaping liquid

- Not as recognizable as marijuana/THC as traditional blunts or dugouts

CANNABIS : CONCENTRATES

One comparison can be an espresso machine: as the water passes through the ground coffee beans it strips them of their oils (which contain the caffeine, flavor, and aroma) into a filtered, highly concentrated solution.

One popular extraction method uses butane, a highly flammable solvent, which is put through an extraction tube filed with marijuana.

This method is dangerous because butane is a very explosive substance, has resulted in many explosions and accidents in houses, apartments, etc.

MANY videos on YouTube on how to manufacture.

CANNABIS : CONCENTRATES

There is a current trend towards consuming marijuana wax or oils instead of traditional marijuana

Waxes/Oils can have up to 8 times higher THC levels than natural marijuana leading to a much stronger and longer lasting high

The wax/oils do not have the typical strong smell of marijuana and therefore are easier to store and consume

The wax is usually a yellow/honey like color and is often the consistency of butter, honey, or can be hard

CANNABIS : CONCENTRATES -SLANG

“Dabbing”: Using an e-

cigarette/vaporizer to ingest marijuana

concentrates is commonly referred to

as “dabbing” or “vaping”.

CANNABIS : CONCENTRATES -SLANG

Also known as: 710 (the word “OIL”

flipped and spelled backwards), wax, ear

wax, honey oil, budder, butane is hash oil,

butane honey oil (BHO), shatter, dabs,

black glass, and errl.

E-Cigarette use/possession falls under the tobacco statutes

Monetary Fine

Possible Educational Class

THC use/possession falls under controlled substance statutes

Regular (plant form) marijuana is a petty misdemeanor

Monetary Fine

Possible Educational Class

THC oil used to smoke marijuana using vaping devices is a felony

Will have a court date with the juvenile court

Depending on priors consequences can vary widely

Community Service, Probation, Education Classes, Court Ordered Counseling. Fine, Etc.

JD

Online Sales

Buying through an 18 year old

History repeats itself; Gas station attendees, other business staff who may not be properly carding minors.

Illicit sales, drug dealers who sell pre-packaged THC concentrate e-cigarettes.

“Facebook sucks!” – A young person, 2018

Growing numbers of teenagers are buying illegal drugs on social media sites such as Instagram and Snapchat.

Social media sellers use hashtags and emojis to communicate what they stock, and also share images of the substances.

Alternative contact details are provided, and most transactions take place on other platforms such as the encrypted messenger application Wickr.

Social media drug dealers work not to be noticed. Instead, they choose apps like Instagram, Tinder, Grindr, Kik, Whisper, or Yik Yak, which allow users to create pseudonyms or remain anonymous with accounts.

Some precautions social media drug dealers make: doing sales transactions in person rather than online, or accepting payment via Amazon gift cards as opposed to traceable accounts.

Anyone looking for marijuana can simply look up #weed4sale or #kush4sale, and if they’re looking for specific “recreational drugs,” then they can easily find them under their specific names, like #mdma or #oxycontin.

On Instagram, users might look for photos that display piles of opioid pills or powder behind a Crema filter to bring out their whiteness, or an some nugs (A nug is the slang term for a chunk of the bud material of high-quality cannabis. It’s a shortened form of “nuggets, ”and refers to the way pieces of bud look once they have been removed from the plant, dried and cured) and acid paper accentuated by trippy Perpetua to get users in the mood.

Deals on Tinder are just a matter of swiping right until you find a local match.

And then once they’ve found their next hit, it could be taken to another app like Kik or Whisper, where anonymous direct messaging apps where social media drug dealers can be places to detail plans for payment and delivery.

MARKETING

Juul employees get a special $2 billion bonus from tobacco giant Altria — to be split among its 1,500 employees

Do electronic cigarettes help people stop using “traditional” tobacco products?

Do electronic cigarettes help people stop using “traditional” tobacco products?

SMOKING CESSATION:

Lack of evidence on dual use concerns.

Gateway of e-cigarettes to traditional tobacco use.

GATEWAY TO TRADITIONAL TOBACCO USE:

A study of more than 44,000 school children in Canada found "strong evidence" that e-cigarettes are associated using tobacco cigarettes, contrary to recent studies that have suggested vaping helps people quit tobacco.

Researchers from the University of Waterloo in Canada followed 44,163 high school students for one year.

They put them into six groups: current daily smokers, occasional smokers, former smokers, experimental smokers, puffers and those who have never tried smoking.

E-cigarette users were found to have higher prevalence of tobacco use in the last 30 days.

E-CIGARETTES: HARM REDUCTION? Current controversy: Perceived as less harmful

Harms are largely untested with controlled studies.

Multiple studies are ongoing and needed.

Many devices developed and marketed by the tobacco industry.

Future impact on tobacco prevalence and cessation rates is a debated topic and largely unknown.

Acrolein: Lung and eye irritant

Formaldehyde: Lung and eye irritant and known carcinogen

Acetaldehyde: Eye, nose and throat irritant. Has caused nasal cancer in animal testing.

Nicotyrine: Inconclusive risks, however could increase risks of liver injury following various liver diseases.

Glycidol: Skin, eye, mucous membrane, and upper respiratory tract irritant and may also cause central nervous system depression followed by stimulation.

Diacetyl: Industrial exposure has resulted in rare and serious lung diseases; “popcorn lung”

Acetone: Nose, throat, lung, and eye irritant. Can cause intoxication, headache, fatigue, increase pulse, mental confusion and changes to menstrual cycles in women.

Glycerine: Respiratory tract and skin irritant. Has been proven to cause kidney damage.

Propylene Glycol: Upper respiratory tract and eye irritant. Can case allergic reaction leading to skin inflammation. Principal ingredient in vapor

Benzaldehyde: Used in perfumes to provide scent.

E-CIGARETTES: HEALTH RISKS

Overall, significantly fewer chemicals than in combustible cigarettes (40-60 versus 7000)

Some flavorings associated with known health risks; 31

Tin, silver, iron, lead, copper, nickel, and aluminum.

Concentrations of nickel are higher than conventional cigarettes

E-CIGARETTES: HEALTH RISKS

Immediate effects on lung function and nitric oxide levels can vary but still consistent with conventional cigarettes.

Lipoid pneumonia attributed to e-cig use in a young woman

Cardiovascular Concerns: Arrhythmias and hypertension with e-cigarette use have been reported

Besides highly addictive nicotine, e-cigarettes can contain harmful and potentially harmful ingredients, including:

Ultrafine particles that can be inhaled deep into the lungs

Flavorants such as diacetyl, a chemical linked to serious lung disease; “popcorn lung”

Volatile organic compounds such as benzene, which is found in car exhaust.

Heavy metals, such as nickel, tin, and lead

$$$$$$$$

“We don’t know what a e-cigarette user will look like in 30 years”

Legal consequences with THC concentrates/edibles.

NICOTINE FACTS

Highly addictive

Can cause cognitive impairments in a developing brain

Can cause behavioral impairments in a developing brain

Can lead to dependence and the later use of other forms of tobacco

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NICOTINE FACTS: Nicotine which is known as a stimulant and impacts the same part of the

brain as amphetamine and cocaine.

Nicotine acts directly on the heart changing a persons heart rate and blood pressure

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NICOTINE FACTS: It acts on the nerves that control respiration to change breathing patterns

Nicotine stimulates the brain, creating the feeling of pleasure;

Dopamine and Acetylcholine.

Nicotine is as addictive as heroin or cocaine.

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NICOTINE RISK FOR TEENS: TRADITIONAL TOBACCO People who start smoking before the age of 21 have the hardest time quitting,

and fewer than 1 in 10 people are successful in quitting when they try.

Tobacco use is the leading preventable cause of disease, disability and death in the United States.

For every 1 person that dies, 33 more suffer from 1 serious illness that is tobacco related

Smoking accounts for one-third of all cancers, including 90% of lung cancer cases

Total population of Minneapolis: 413,651

More than 480,000 premature deaths happen in the United States each year from smoking and exposure to second hand smoke.

Tobacco kills more Minnesotans than alcohol, homicides, car accidents, AIDS, illegal drugs, and suicide combined.

NICOTINE FACTS: ADDICTION AND WITHDRAWAL

Most common symptoms of nicotine withdrawal:

Irritability

Problems with thinking and paying attention

Sleep problems

Increased appetite

Craving which can last 6 months or longer

Depression

Headaches

NICOTINE AND THE DEVELOPING BRAIN:

NICOTINE AND THE DEVELOPING BRAIN:

Until about age 25, the brain is still growing.

Young people's brains build synapses faster than adult brains.

Because addiction is a form of learning, adolescents can get addicted more easily than adults.

The nicotine in e-cigarettes and other tobacco products can also prime the adolescent brain for addiction to other drugs; stimulants.

Review credible information. Arm up on facts.

Avoid criticism and encourage an open dialogue; roll with resistance.

Encouraging a conversation, not a lecture.

Conversation can take place over time in increments. Often more effective.

For parents: providing resources or referrals to assist them in establishing expectations in the home if needed.

Clear, concise expectations and follow through on consequences.

It takes a village. Encouraging parents to involve trusted adults in the conversation about concerns. Coaches, counselors, relatives, health care professionals. Referring parents to professionals in the school and community.

NIDA’s Positive Parenting Guide: https://www.drugabuse.gov/family-checkup

NIDA Site for Parents: https://teens.drugabuse.gov/parents/helpful-links

Address with medical doctor

Quit Plan

Know your reasons. Ask your teen to think about why they want to quit. Make a list of these reasons. This can assist in reinforcing motivation.

Set a quit date. Help your teen set a quit date.

Avoid temptation. Avoid people, places and activities that your teen links with smoking.

Be prepared for cravings. Remind teens that if they can hold out long enough, usually just a few minutes, the craving will pass. Offering up sugarless gum, hard candy, celery or carrot sticks. Going for walks, deep breathing, physical activities.

Consider stop-smoking products. Nicotine replacement products like nicotine gum, patches, inhalers or nasal sprays weren’t meant for teens, but they can might helpful in some cases. Ask your teen's doctor about the options.

Seek support. A tobacco cessation specialist can give your teen the tools and support he or she needs to stop smoking. Local organizations might offer stop-smoking groups for teens. Web base support.

Smokefree.gov

Quitplan.com

Freedomfromsmoking.org

Center for Disease Control: https://www.cdc.gov/tobacco/campaign/tips/quit-smoking/guide/quit-plan.html

Questions?Officer Joe Delgehausen

Edina High School Resource Officer

Joe.Delgehausen@edinaschools.org

(952) 848-3809

Christopher Lawler

Licensed Alcohol and Drug Counselor at Edina High School

Chris.Lawler@edinaschools.org