5 issues for teens to consider when it comes to vaping

Earlier this year I wrote a blog providing some advice for parents who were struggling with the vaping issue. I had been contacted by an increasing number of parents who had discovered their child was using e-cigarettes and when they tried to challenge them about their use they were met with responses that they feel ill-equipped to deal with appropriately. The purpose of the piece was to assist parents, who knew little about the new phenomenon, when responding to some of the statements that their child was likely to throw at them in any discussion around the vaping issue, e.g., "But it's not smoking". 

The article I wrote was not an attack on 'vaping' or those smokers who are looking for an alternate nicotine delivery system. I have made it clear time and time again that I'm not interested in being involved in the current debate about vaping and its role in smoking cessation - my only concern here is for young people, their parents and teachers. I was not prepared for the quite horrific response I received from the pro-vaping lobby from across the world. This appears to be an extremely well-organised group that attacks in a coordinated way, with some of the things they write not only personal and offensive but also quite disturbing. Some of the messages accused me of being a "Nazi", with one claiming that I was "responsible for more deaths than the Holocaust".  

Adults vaping to assist them with their nicotine dependence is of no concern to me – if that's what you want to do, go for it! But the insistence by some that regular vaping amongst our teens is simply not happening and that there are no possible harms linked to the use of e-cigarettes is ridiculous. I would agree with the pro-vaping lobby that for many young people they simply try it a couple of times and then move on but I am meeting growing numbers of teens who have now been vaping for a couple of years and are well and truly nicotine-dependent. 

This week alone I have had three emails from parents looking for help and support with their teens who have all been vaping for a year or more and are struggling with school due to their nicotine dependence. Here is a quote from each of them:

• "He's been caught selling them at school and told us that's the only way he can pay for as many as he's using a day"
• "He somehow gets through his day on nicotine patches and gum"
• "The school's been wonderful and trying to keep her but she can't make it through a lesson without her nicotine hit and ends up with an 'in-school suspension' at the very least"

The pro-vaping lobby keep insisting that vapers were likely to have been smokers first, something that research from the UK and the US supports. In each of the cases above, however, none of the teens had ever smoked and that's certainly what I have heard from students that I meet across the country. We have limited data about the Australian experience but the most recent ASSAD survey of secondary school students found that of those who reported vaping, 48% had never smoked a cigarette before their first vape. It's always a problem comparing data from different countries but what we need to remember is that a packet of cigarettes in the US costs $8, $14 in the UK and they're $25 here. Research has found that cost plays a key role in teen experimentation – it's not surprising that vaping is their first port of call in this country, with some teens reporting paying as little as $7 for a disposable vape. 

What amazes me is that the pro-vaping lobby keeps saying that teens should not be vaping. If that is the case then we should be allowed to develop evidence-based prevention messages for that target group without fear of being trolled and accused of mass-murder. Insisting that vaping is 'risk-free' and that if you don't support that message you are supposedly being funded by Big Tobacco (which I was also accused of) is insulting.

It was made clear in my previous blog that parents need to be honest in their discussions with their child when it comes to any alcohol and other drug issue. They should try to have the most accurate and up-to-date information on hand and not try to use 'scare tactics' to frighten them off from experimenting with whatever ... With that in mind I have come up with five simple things for school-based young people to consider around vaping that appear to be having some impact with the students I have been working with:

• why were vapes originally invented and who were the target group? They were developed as an alternate nicotine delivery system for those who wanted to quit or cut-down their smoking - they even started out looking like a cigarette. Why don't they look like that now?
• have you ever thought about how a vape actually works? These are devices that have to heat a liquid and turn it into a vapour. Most of them, particularly the disposable ones that are popular with teens, are made in China and there is little quality control. Showing them what is actually inside one of these devices is very powerful - the photos above let them see that the different components are held together by sticky tape! 
• can you ever really know what is in the e-liquid? How do you feel about vaping nicotine? There is no way that you can actually know what is in the e-liquid you are vaping without expensive testing. Some teens are even surprised that there is a liquid inside a disposable vape at all. Australian research has shown that many of the disposable vapes that claim to be 'nicotine-free' do actually contain the drug, often in very high doses 
• why are the flavours added and why those particular flavours? We know that one of the most effective smoking prevention messages for teens is a greater awareness of manipulation by tobacco companies. Getting young people to think about not only why flavours are added, but why particular ones are chosen (e.g., do bubble gum or cotton candy really sound like flavours that are being used to appeal to long-term smokers in their 30s and 40s?) is important
• what about the environmental impact of vaping? When disposed of inappropriately, e-cigarettes introduce plastic, nicotine salts, heavy metals, lead, mercury, and flammable lithium-ion batteries into waterways, soil, and to wildlife. Disposable vapes, most likely to be used by Australian teens won't biodegrade even under severe conditions. Our young people are far more environmentally conscious than we were, perhaps this is a useful prevention message 

So, to the pro-vaping lobby who really do not want teens to use e-cigarettes, support these messages. None of them are challenging your decision to vape and none are making wild claims about potential harms. They're simply asking young people to consider some issues before they make a decision to start vaping. Most importantly, please stop negating many parents' real-life experiences when it comes to teen vaping. To be constantly being told that there isn't a problem and that Australian young people aren't vaping is unfair and only makes the problem that some of them are facing so much more difficult to deal with.