Vaping

Cate Booth

The e-cig industry...- In 2016 the FDA deemed e-cigarettes to be regulated

“tobacco products” under the Tobacco Act of 2009- Full FDA oversight will not be in place until 2022- FDA reviewed 18 different cartridges and found toxic

ingredients in some, but not all- All were labeled “no nicotine,” all but one included

nicotine- Quality control processes are inconsistent or

non-existent

What are vape pens?- A delivery system for nicotine and THC- Vape pens vaporize the drugs from a liquid form as

opposed to the combustible leaf form- Vape pens heat materials instead of burning them- Although research is limited, there appears to be a

legitimate claim to the idea that e-cigarettes are somewhat safer than common cigarettes due to the decrease of carcinogens

- Due to absorption rates, most e-cig users inhale three times the amount of nicotine opposed to traditional cigarettes

Parts of the e-cig/mod●

● Disposable e-cig: Cheaper than entry level models and meant to be used to introduce the new e-cig user to the product. They usually come in different flavors such as fruit juice and bubble gum.

● Pen vaporizers: aka vape pens, these are the most popular vaporizers today. They come in all shapes, sizes and colors. Different models are designed to vaporize liquid nicotine, flavored “vape juice,” liquid marijuana, marijuana concentrates (dab), and dry leaf marijuana.

Inhaler Vaporizer

E-pipe Palm Vaporizer

Concealed vape pens

What’s in that vape juice???- Nicotine: juices are available with or without nicotine

- Flavoring:

- Diacetyl- buttery flavor, leads to “popcorn lung”- Unicorn Milk, Krispy Krack Donut, Pony on Acid! are “trade

secrets”

- Propylene glycol (PG)- used in food, drugs, cosmetics, artificial smoke or fog machines, can irritate the lungs and eyes

- Vegetable glycerin- sugar alcohol used as a sweetener, preservative or texture enhancer in food; while consumption is safe, inhalation risks are unknown

It’s just water vapor….- Vapes do not create water vapor, they create aerosol that

users inhale- A vape “cloud” is a mixture of many different chemicals

that were either present in the vape juice before or produced during the heating process

- A vapor is a chemical that has evaporated- An aerosol is a mixture of liquid particles suspended in

a gas - Instead of just mixing with the air like a pure gas,

aerosols can leave drops behind

Heating up...Toxic chemicals are created when the vape juices are heated. The higher the temperature, the more chemicals are produced, in higher amounts:

•Propylene glycol •Glycerin •Nicotine •NNN •NNK •NAB •NAT •Ethylbenzene •Benzene •Xylene •Toluene •Acetaldehyde •Formaldehyde •Naphthalene •Styrene •Benzo(b)fluoranthene •Chlorobenzene •Crotonaldehyde •Propionaldehyde •Benzaldehyde •Valeric acid •Hexanal •Fluorine •Anthracene •Pyrene •Acenaphthylene •Acenapthene •Fluoranthene •Benz(a)anthracene •Chrysene •Retene •Benzo(a)pyrene •Indeno(1,2,3-cd)pyrene •Benzo(ghi)perylene •Acetone •Acrolein •Silver •Nickel •Tin •Sodium •Strontium •Barium •Aluminum •Chromium •Boron •Copper •Selenium •Arsenic •Nitrosamines •Polycyclic aromatic hydrocarbons •Cadmium •Silicon •Lithium •Lead •Magnesium •Manganese •Potassium •Titanium •Zinc •Zirconium •Calcium •Iron •Sulfur •Vanadium •Cobalt •Rubidium

**Compounds in red are from FDA 2012, Harmful and Potentially Harmful Substances-Established List

Marijuana and vapes● Using vapes to smoke marijuana leaves very little odor

and no smoke. ● It is very difficult to tell the difference between

nicotine and marijuana cartridges.

Types of marijuana vapes● Dry Herb Vaporizer: this pen is designed to vape dry

marijuana and concentrates. ○ There is no cartridge for use with liquids○ Dry marijuana is placed in the ceramic heating chamber and vaporized

● Replaceable Cartridge Vaporizers: more closely related to e-cigs. Users can purchase a multitude of cartridges that contain THC concentrates of specific strains, such as Sativas, Indicas, and hybrids (strains are color coded).

● Globe attachments: creates a miniature nail and dome bong used to smoke dabs. This is a single purpose attachment used strictly to smoke marijuana concentrates.

Dripping● Users manually applies a few drops of liquid directly to

the exposed heating coil of the e-cig● 26% of those who have tried vaping also report dripping● Dripping produces thicker clouds of vapor, gives a

stronger sensation in the throat and makes flavors taste better

● Dripping generates higher heating coil temperatures than conventional e-cigs, these higher temps lead to greater emissions of harmful chemicals. These chemicals are associated with cancer and COPD.

Signs of vape use1- The scent: although e-cig vapor can have no odor at all, most users choose to flavor with fruity scents or mint.

2- “Pens” that aren’t pens: take a closer look at your teen’s thumb drives, pens and stylus. Often vape pens are disguised as other objects.

3- Thirst: one major ingredient in vaporized liquid can lead e-cig users to have a constant state of dry mouth. Dry skin is another common side effect.

4- Nosebleeds: the water-holding effect of e-cig vapor can also dry out the nasal passages, leading to bloody noses.

5- Passing on caffeine: some e-cig users develop a sensitivity to caffeine and begin to curb their caffeine intake.

6- Unfamiliar chargers or batteries: while most vape pens use USB chargers, some MODs use 18650 batteries.

7- Metal wires, cotton wicks, pods or atomizers: many vape parts are replaceable

ADOLESCENT MARIJUANA USE

Jennifer H. Chuang, MD, MS

Assistant Professor of Clinical Pediatrics

Craig-Dalsimer Division of Adolescent Medicine

Children’s Hospital of Philadelphia

Perelman School of Medicine of the University of Pennsylvania

WHAT DOES MARIJUANA DO TO THE TEEN BRAIN?

Understanding the brain

Giedd JN. PBS--Frontline: Inside the Teenage Brain

Frontal Cortex—”CEO” *Planning, Strategizing, Logic, Judgment

Amygdala*Emotional and gut responses; fear and anger*Used more in Adolescents

Cerebelleum*Coordinates muscles/ movement*Coordinates thinking processes

Corpus Callosum*Connects Hemispheres*Creativity & Problem Solving

Hippocampus*Forms Memories*Coordinates thinking processes

THE ADOLESCENT BRAIN

HOW DOES MJ AFFECT ADOLESCENTS DIFFERENTLY THAN ADULTS?

• Brain maturation, particularly prefrontal cortex, proceeds into the mid-20’s

• Developing brain may be at particular risk for development of substance use disorders

• The earlier the initiation, the more likely a substance use dependency or addiction

HOW DOES MJ AFFECT ADOLESCENTS DIFFERENTLY THAN ADULTS?

• MJ may alter the developing brain• Perform more poorly on tests of working memory, visual scanning, cognitive

flexibility, and learning

• Heavy use found to have greater gray matter volume, suggesting an interference with synaptic pruning

• Heavy MJ use correlated with poorer verbal and attention performance

• fMRI shows abnormalities in activation during cognitive tasks

Effect of smoking a cannabis cigarette containing 20 mg tetrahydrocannabinol (THC) on pilot performance in a flight simulator landing task (Leirer et al, 1991).

C. HEATHER ASHTON BJP 2001;178:101-106

©2001 by The Royal College of Psychiatrists

- - ▪ - -, 20 mg THC

- ——, placebo

Effect of smoking a cannabis cigarette containing 20 mg tetrahydrocannabinol (THC) on pilot performance in a flight simulator landing task (Leirer et al, 1991).

C. HEATHER ASHTON BJP 2001;178:101-106

©2001 by The Royal College of Psychiatrists

- - ▪ - -, 20 mg THC

- ——, placebo