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Matt Cassity
Project Coordinator
Community Alliance for Prevention
360 Youth Services
What You Need to Know
About Vaping
0
5
10
15
20
25
30
35
40
1997 1999 2001 2003 2005 2007 2009 2011 2013 2015
High School Students
24
.7
23
.5
22
.7
21
.6
20
.9
19
.7 20
.6
18
.9
17
.8
14
.9
Adults 18+
Cigarette Smoking Is Down
Source: Adult cigarette smoking prevalence data are from the National Health Interview Survey (NHIS); 2015 data based on NHIS Early Release data for January - June. High school cigarette smoking prevalence
data are from the National Youth Risk Behavior Survey.
The Evolving Tobacco Product Landscape
• Text
Current Tobacco Product Use Among U.S. High School Students: NYTS 2011-2018
Source: Gentzke AS, Creamer M, Cullen KA, Ambrose BK, Willis G, Jamal A, King BA, Vital Signs: Tobacco Product Use Among Middle and High School Students – United States, 2011-2018. MMWR Morb
Mortal Wkly Rep 2019; 68(6):1-8.
Facing New Challenges
• 30 day cigarette-free 96% (2016 high school)
• 30 day cigarette-free 99% (2016 8th grade)
• 30 day e-cigarette-free 90% (2016 high school)
• 30 day e-cigarette-free 98% (2016 8th grade)
• 30 day e-cigarette-free 82% (2018 high school)
• 30 day e-cigarette-free 96% (2018 8th grade)
Source: Illinois Youth Survey 2016 and 2018 DuPage County Data
E-cigarettes
Anatomy of an E-cigarette
39
31.6
31
17.1
7.8
7
4.8
3.2
1.5
FRIEND OR FAMILY MEMBER USED THEM
SOME OTHER REASON
THEY ARE AVAILABLE IN FLAVORS, SUCH AS MINT, CANDY, FRUIT, OR CHOCOLATE
THEY ARE LESS HARMFUL THAN OTHER FORMS OF TOBACCO, SUCH AS CIGARETTES
TO TRY TO QUIT USING TOBACCO PRODUCTS SUCH AS CIGARETTES
THEY CAN BE USED IN AREAS WHERE OTHER TOBACCO PRODUCTS, SUCH AS CIGARETTES ARE NOT ALLOWED
THEY ARE EASIER TO GET THAN OTHER TOBACCO PRODUCTS SUCH AS CIGARETTES
THEY COST LESS THAN OTHER TOBACCO PRODUCTS SUCH AS CIGARETTES
FAMOUS PEOPLE ON TV OR IN MOVIES USE THEM
Reasons for Youth E-cigarette Use
Source: Tsai J, Walton K, Coleman BN, Sharapova SR, Johnson SE, Kennedy SM, Caraballo RS. MMWR Morb Mortal Wkly Rep. 2018 Feb 16;67(6):196-200. Reasons for Electronic Cigarette Use
Among Middle and High School Students, NYTS, U.S. 2016.doi: 10.15585/mmwr.mm6706a5
Major Conclusion: “E-cigarettes are marketed by promoting flavors and using a
wide variety of media channels and approaches that have been used in the past for marketing conventional tobacco products
to youth and young adults.”
Source: E-cigarette Use Among Youth and Young Adults: A report of the Surgeon General: https://e-cigarettes.surgeongeneral.gov/documents/2016_SGR_Exec_Summ_508.pdf
Marketing and Ads
Where do you think teens are seeing vaping ads?
Social Media
Are E-cigarettes a Pathway to Smoking
Conclusion 16-2. Among youth and young adult e-cigarette users who ever use combustible tobacco cigarettes, there is moderate evidence that e-cigarette use increases the frequency and intensity of subsequent combustible tobacco cigarette smoking.
Source: The National Academies of Science, Engineering, and Medicine. Public Health Consequences of E-cigarettes. 2018. Leventhal, Adam, Strong, David, et al,
Association of Electronic Cigarette Use with Initiation of Combustible Tobacco Product Smoking in Early Adolescence, JAMA, 2015. Primack, Brian, Soneji, Samir, et al, Progression to Traditional Cigarette Smoking After
Electronic Cigarette Use Among US Adolescents and Young Adults, JAMA, 2015
JAMA
JAMAPediatrics
Never smoking high school students who reported ever using e-cigarettes at baseline:• Were 2.7 times more likely to report initiation of combustible tobacco use after 1 year compared with never users of e-cigarettes.
Never smoking U.S adolescent and young adult e-cigarette users at baseline:• Were 8.3 times more likely to progress to cigarette smoking after 1 year than non-users of e-cigarettes.
The Rise of JUUL
Source: Nielsen Total US xAOC/Convenience Database and Wells Fargo Securities, LLC
Nicotine Salts vs. Free Base Nicotine
Source: Center for Disease Control and Prevention - Brian A. King PhD, MPH.
Nicotine Affects the Brain
Source: The health consequences of smoking – 50 years of progress: a report of the Surgeon General. – Atlanta, GA. : U.S. Department of Health and Human Services. Centers for Disease Control and Prevention,
National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014.
Most e-cigarettes contain nicotine, which is highly addictive
and can harm brain development, which continues until about
age 25.
• Each time a new memory is created or a new
skill is learned, stronger connections are built
between brain cells.
• Young people's brains build these connections
faster than adults.
• Because addiction is a form of learning,
adolescents can get addicted more easily than
adults.
Nicotine Use Can Lead to Addiction
The nicotine in e-cigarettes and other tobacco products can also prime the adolescent brain for addiction to other drugs such as
cocaine, opioid painkillers and marijuana.
Source: The health consequences of smoking – 50 years of progress: a report of the Surgeon General. – Atlanta, GA. : U.S. Department of Health and Human Services. Centers for Disease Control and Prevention, National
Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014.
Behavior Risks
Nicotine can also lead to mood disorders and permanent lowering of impulse control.
Source: The health consequences of smoking – 50 years of progress: a report of the Surgeon General. – Atlanta, GA. : U.S. Department of Health and Human Services. Centers for Disease Control and Prevention, National
Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014.
Forty-Two Chemicals Identified in Electronic Cigarettes
Source: GASP of Colorado (Group to Alleviate Smoking Pollution) www.gaspforair.org,
Centers for Disease Control and Prevention https://www.cdc.gov/tobacco/basic_information/e-cigarettes/index.htm
a= exposure can be especially harmful to the health. Chemicals in red are emitted in secondhand smoke.
2-butanone (MEK)2-furaldehydeAcetaldehyde aAcetic AcidAcetone aAcrolein aAluminumBariumBenzene aBoronButanal
Butyl hydroxyl tolueneCadmium aChromium aCopperCrotonaldehydeDiethylene Glycol aFormaldehyde aGlyoxalIronIsoprene aLead a
Limonenem,p-XyelenMagnesiumManganeseNickel aNicotine aN-Nitrosonornicotine ao-Methylbenzaldehyde ap,m-XylenePhenol aPolycyclic Aromatic Hydrocarbons a
PotassiumPropanal aPropylene GlycolSulfur aTin aToluene aValeraldehydeZincZirconium
E-cigarette Secondhand Aerosol Exposure
Source: E-cigarette Use Among Youth and Young Adults: A report of the Surgeon General: https://e-cigarettes.surgeongeneral.gov/documents/2016_SGR_Exec_Summ_508.pdf
Beyond Nicotine: Vaping Marijuana
• Source: JAMA Pediatrics: https://jamanetwork.com/journals/jamapediatrics/article-abstract/2702200• US National Library of Medicine National Institutes of Health: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5326604/
JAMA9% of students reported using e-cigarettes
with marijuana.
JAMA
Pediatrics
Students who use e-cigarettes are 3.5 times more
likely to use marijuana than those who do not.
Beyond Nicotine: Vaping Marijuana
• Marijuana contains THC, which impacts the brain.
• Use can lead to impaired learning, cognitive and physical performance.
• Marijuana is linked to lower grades, school failure and poorer quality of life.
• Younger age of first use leads to increased risk of substance use disorder.
• THC content can be much stronger in vaping products than traditional marijuana.
• Source: JAMA Pediatrics: https://jamanetwork.com/journals/jamapediatrics/article-abstract/2702200
• US National Library of Medicine National Institutes of Health: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5326604/
Tobacco Twenty-One
Source: Preventing Tobacco Addiction Foundation. http://tobacco21.org.
Conversation
How many of you have talked with your child about vaping?
How to Have the Conversation
• Be a good listener.
• Keep an open dialogue.
• Have short, calm, frequent conversations to touch base about important topics.
• Use non-judgmental verbal and non-verbal language.
• Establish clear expectations.
Youth who have conversations with their parents about substance use are less likely to use.
CommunityAllianceforPrevention.org
Matt Cassity
Project Coordinator, Community Alliance for Prevention
