'Vaping' or 'juuling': When a 15-year-old birthday invitation includes the words 'No vaping' you know something is happening!

I last wrote about 'vaping' after receiving a number of messages from parents wanting to know more about the topic. They had all found a strange-looking device in their child's room and had little, or no idea, what it actually was, how it was used and whether it was harmful or not. Since that time I have been contacted by more and more schools who are looking for advice on how to deal with students who are caught vaping (sometimes as young as Year 8 or 9), as well as an increasing number of parents who have discovered their teen is vaping or 'juuling' (I will explain that term in a moment) and are struggling with how to handle the situation.

But it was a phone call I had recently from a mother regarding an invitation her son had received to a 15th birthday party that made me think I should take another look at this issue. Basically, this is what she told me:

"Yesterday, my Year 10 son came home with an invitation to one of his classmate's birthday party. He is fairly social but we are fairly careful with where he can and can't go on a Saturday night. Sadly, we have got used to seeing the sentence "Strictly no alcohol allowed" on the invitations he receives. Don't get me wrong, I'm happy that parents have made a strong stand around alcohol but both my husband and I find it sad that you even have to think about it when they are 14 or 15. This invitation covered the alcohol issue but also had another sentence listed below - 'No vaping'. When we asked our son what that was about he was fairly open with us and said that some of his friends were now 'vaping' at parties he was going to - something we were completely unaware of. The host mother  (who we later spoke to) had seen some teens vaping when she picked her son up from another party a few weeks before. She then made it clear to him that she would not allow this at her house. We just want to know is vaping becoming that big that we are likely to see more of this?"

To be perfectly honest, this was the first time I had ever heard of any reference being made to vaping on a birthday invitation. Interestingly, however, I have talked about this mother's story at a number of recent parent nights and it does not appear to be an isolated incident, with a couple of Mums and Dads telling me that they have also seen similar messages on invitations their teens have brought home.

A 'vape' is a street term for devices usually referred to as 'e-cigarettes'. An e-cigarette is a nicotine delivery device that simulates tobacco smoking by producing a vapour. Operated by a battery, it vaporizes a liquid solution (called 'e-liquid' or 'e-juice') which may or may not contain nicotine, as well as flavourings ranging from fruit through to chocolate and bubble-gum. They are promoted by manufacturers as being 'safer' than traditional smoking because it is a tobacco-free product that eliminates the burning process. When the liquid is turned into a vapour, this is inhaled or 'vaped'.

'Juuling' is a fairly new term that refers to a particular brand of device. The JUUL was introduced to the US market in 2015 and is now the most popular e-cigarette in that country, often referred to as the 'Apple of vaping'. It looks very much like a long USB and is non-refillable, using disposable pods containing nicotine e-liquid in a range of flavours including Virginia tobacco, classic tobacco, crème, fruit, mint, mango, menthol or cucumber flavours. One pod is the equivalent of around 200 puffs or 20 traditional cigarettes. These nicotine pods are not available for sale in this country but can be purchased online. A four-pack from the US can cost as little as $28, plus shipping, but more likely to be around $35-45. They're certainly not cheap ...

So are these devices legal? Australia permits the usage of e-cigarettes but it's important to note that the legal age to vape in this country is 18. Every jurisdiction has slightly different laws in this area but it is illegal for commercial retail outlets to sell nicotine e-cigarettes across the country. Regulation of the sale of non-nicotine e-cigarettes continues to vary. While nicotine e-cigarettes or the nicotine vial refills may be purchased online for personal use, throughout Australia it is illegal to do this without a medical prescription for nicotine.

What is worrying is that I have been to a number of schools recently where students have approached me quite concerned about friends who were vaping, or in many cases 'juuling'. In one case, a group of Year 11 girls were telling me about their friend who was going through a couple of pods a day (that's the equivalent of around 40 cigarettes). According to the girls, she was buying them online or through older guys who were importing large numbers and on-selling them to students. She was also bringing the juul device to school and was vaping in the toilets because she claimed she couldn't get through the school day without doing so - she was now obviously nicotine-dependent.

According to the 2017 Australian Secondary School Students Alcohol and Other Drugs (ASSAD) study, the use of e-cigarettes is fairly stable, with similar rates to those reported in 2014. Thirteen per cent of 12 to 17-year-old students reported that they had ever used an e-cigarette. Of those, it was younger students who were more likely to have used them recently. Around one third (34%) of 12 to 15-year-old and just over one quarter (27%) of 16 and 17-year-old e-cigarette users reported vaping at least once during the past month. Males were far more likely to vape than their female peers across all ages. More than half (57%) of the users reported getting their last vaping device from friends, with 8% accessing it from siblings and, most surprisingly 7% stated they had got it from their parents. Even though it is illegal for a minor to purchase an e-cigarette in this country, just over one in ten (12%) reported buying one themselves, with older students being more likely to access a device in this way.

As I wrote in my last piece on this topic, I have a number of concerns about vaping. Firstly, even though e-cigarettes don't involve 'smoking' per se, they still simulate the practice and there is a very real danger that the 'anti-social' message we have developed around smoking could be eroded over time. In fact, there's no getting away from it - vaping is really 'cool'. Type in 'vaping tricks' into YouTube and you will literally see hundreds of videos that have been uploaded by people from around the world. Some of them are truly amazing and even I find it difficult not to be impressed by what they're doing - is it any surprise teens want to try it?

The research evidence on whether vaping is a 'gateway' to smoking is mixed. The one thing that all those in tobacco prevention field agree on, however, is that whatever policy is adopted in the e-cigarette area, it should include some kind of restrictions around vaping by young people. Last time I quoted an excellent article written for the New York Times by Lisa Damour titled 'How to Talk With Teenagers About Vaping' where she provided a great summary statement about what we know about this topic  - "Vaping is generally understood to be less risky than smoking. But not vaping is healthier than vaping". Unfortunately, the article is no longer freely available but there is a great little fact sheet developed by the Government of Canada that provides parents some really useful tips on how to talk with their teens about this complex topic.

Even though most Australian teens' use of e-cigarettes appears to be experimental and few regularly use, what is abundantly clear is that trying to prevent young people vaping is a good idea. If the birthday invitation discussed above is a sign of things to come, parents need to be prepared.

Although smoking rates amongst young people are still at an all time low, parents continue to have discussions with their children about this issue. My advice is to add e-cigarettes to any discussion you may have around smoking - don't force the issue, let it come naturally (we are seeing increasing numbers of Australians vaping in public places - your children are bound to ask you what they are doing at some point). Most importantly, once you have worked out your view on the issue, let your child know exactly where you stand, always remembering that you will always have an influence on your child's choices both now and in the future. That influence may change over time but it is always there ...

References:
Damour, L. (2018). How to talk with teenagers about vaping. New York Times, February 14. https://www.nytimes.com/2018/02/14/well/family/how-to-talk-with-teenagers-about-vaping.html
accessed 13 April, 2018.
Government of Canada (2019). Talking with your teen about vaping: a tip sheet for parents. https://www.canada.ca/en/services/health/publications/healthy-living/talking-teen-vaping-tip-sheet-parents.html accessed 31 August, 2019.