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Do you Smoke?

Do you smoke?  If so, then replacing cigarette smoking with vaping may reduce your exposure to harmful chemicals. But vaping is not without risks.

Are You a Youth?

Are you a youth? Unfortunately, vaping is not as safe as the marketing would have you believe. Don’t let yourself be manipulated into spending your money that simply ends up profiting big industry.

What is Vaping?

Vaping (also known as e-Cigarettes) is when you puff (breath in and out) a “vapour” (an aerosol). This vapour is produced by a battery-operated e-cigarette device,such as mods, vapes, vape pens, e-hookahs, or tank systems. Vaping devices have been available since 2004.

A typical vape device has these parts:

• A mouthpiece
• A battery-powered heating element
• Tank, cartridge or pod for the vaping liquid (aka e-juice, or e-liquid).
• Vaping liquid comes in either a bottle with a dropper to fill the e-cigarette tank or pods that are inserted into the device.
• Most liquids have nicotine -- this is what makes tobacco so addictive, and makes people buy cigarettes and other nicotine products that profit the tobacco industry.

Cannabis can also be vaped.

Vape devices come in several shapes and sizes. Smaller ones can look like a pen or USB drive.

In addition to nicotine, e-juice contains, flavouring, chemicals and metals mixed with propylene glycol, which is used to make artificial fog, and glycerin.

It does not contain tobacco, hence no smoke -- which is why it was originally marketed as being safer than smoking. Unfortunately, the reality is that some people are vulnerable, and have had permanent lung injuries from vaping.

Red Flags for Parents

Do you notice any of the following?

• Change in your child’s mood, e.g. more irritable.
• Changes in your child’s behaviour, e.g. acting more secretive.
• Breathing symptoms, such as more cough, wheezing, worsened asthma.
• Changes in friends, e.g. spending time with new friends who vape.

Note that it can be tricky to spot vaping because:

• Unlike smoking cigarettes which can leave smells such as smoke, vaping may not leave a lingering identifiable smell.
• Vaping products themselves are often disguised, with add-ons such as vinyl “skins” or wraps”.

Vaping and the Law

In Canada:

• Under the Tobacco and Vaping Products Act (TVPA), enacted federally on May 23, 2018, vaping products are prohibited from being sold or given to anyone under the age of 18. Purchasers must be aged 18-19, depending on the specific province.
• Despite this, vaping products are marketed in a way that they end up attracting young people. A study by Dr. David Hammond, professor at the University of Waterloo, showed that those as young as 12 are starting to experiment. Reasons include cool packaging, cool flavours (like mint, fruit, chocolate), doing “tricks” with the vapour and slick marketing that reaches youth, e.g. using social media influencers.

In Ontario, under Ontario’s Smoke-Free Ontario Act, 2017, it is against the law to:

• Sell or supply tobacco and vaping products to anyone under the age of 19
• Use a fake ID to purchase tobacco or vapour products
• Vape or hold an activated e-cigarette in certain places, including public areas within 20 meters of school grounds, playgrounds or the grounds of community recreational facilities
• Vape in cars or other motor vehicles with anyone younger than 16 present.7 Learn more https://www.ontario.ca/page/where-you-cant-smoke-or-vape-ontario

Nova Scotia

• Vaping is permitted, however sales of any kind of flavoured e-cigarettes and juices are banned (effective Apr 1, 2020), as the flavour contributes to making them addictive.

Myths and Facts about Vaping

MYTH: It helps you quit smoking.

FACT: Vaping has NOT been proven to help you quit smoking, and research actually shows you have a greater chance of starting to smoke tobacco cigarettes if you vape (Soneji, 2017).

MYTH: Everyone is vaping.

FACT: Most people are not vaping -- the majority of Ontario students (over 75%) have NOT tried an e-cigarette in the past year (Boak, 2020).

MYTH: It’s safe, you’re just breathing “water vapour”.

FACT: It's not water vapour -- it’s a combination of various substances and chemicals that can be harmful.

MYTH: Vaping is harmless.

FACT: Vaping is not harmless.

It carries many risks:

• Mild risks
  • Sore mouth or throat, coughing, shortness of breath and nausea.
    
• Severe risks
  • Lung damage. As of Feb 2020, thousands of cases of lung damage have been reported in the USA and Canada.The highest risk appears to be from products that contain vitamin E acetate).
  • Weakening your lungs, which makes you more vulnerable to COVID-19.
  • Spreading illnesses when you share e-Cigarettes with others.
  • Eye injuries and burns when defective batteries catch fire or explode.
  • Vaping liquid contains high levels of nicotine and thus it can be dangerous if e-juice is swallowed or spilled on your skin or eyes. Definitely keep e-juice away from younger children and pets.
• Long-term risks
  • Increasing your exposure to inhaling chemicals such as glycerol; flavours; propylene glycol; nicotine, which is what makes vaping addictive so that you buy more.
  • Increasing your exposure to harmful chemicals such as contaminants (e.g. metals) that get into the vaping products, and new chemicals (e.g. formaldehyde) created from the heating process.
  • You may not notice issues in the short run, but in the long run, you may notice it’s harder to learn, harder to pay attention, have troubles getting stressed easily, and have mood problems.
  • Addiction to nicotine and cannabis. Vape manufacturers are counting on you to get addicted because that is what keeps you coming back to buy their product.
  • Negative effects on brain development. Because your brain is still developing until age 25 or so, the concern is that vaping will prevent your brain from developing properly.

• Withdrawal symptoms
  • Do you vape in the morning, then at lunch, and then after school?
  • If so, you may notice that you have uncomfortable symptoms of withdrawal during the in-between class times, such as strong cravings, irritability, anxiety, difficulty concentrating, headaches, and trouble sleeping.
  • These symptoms can start after only a few weeks of regular vaping.

• Risks from trying to obtain vapes.
  • It is illegal for youth to obtain vapes (e.g. in Ontario, Canada, it is illegal for anyone under 19. As a result, youth may try obtaining vape devices and e-liquids in unsafe ways. This can include meeting up with strange adults that you don’t know in order to buy the vape illegally or exchanging items (like stolen items) or services (e.g. nude photos or worse) for vapes.

Vape manufacturers profit from selling an addictive product and market it as being enjoyable. But there is nothing enjoyable about messing up your brain, getting lung injury or having to do illegal things to get your vape.

Advice for Parents: Build a Positive Connection Before They Start Vaping

Want your child to disconnect from less healthy people and behaviours (such as drugs, alcohol and vaping) and reconnect to healthier people and behaviours?

The best way to protect your child is to have a good relationship, in which you keep open lines of communication with them about vaping as well as other drugs. Drugs can’t simply be kept out of the home by relying on supervision and parental controls; it ultimately requires a close emotional connection with your child.

Do’s

• Do keep a healthy connection with your child through:
  • Listening when your child is talking or expressing their feelings;
  • Validate and accept how they might be feeling upset, sad, etc.
  • Spending time together, including
    • Day-to-day activities (including doing household chores and responsibilities together),
    • Fun and recreational activities, and
    • Serious times, when you are 1:1 and listening to your kids about their concerns.
• Do talk about vaping before they get older and you have concerns about vaping, for example:
  • Are you passing by a store with vape products? Are you seeing other people vaping?
  • Ask:
    • What have you heard about vaping?
    • What are positives or reasons that people vape?
    • What are the negatives such as
      • Health problems from vaping
      • Financial costs of vaping
• Keep the conversation curious and open. Do help your child feel open to talk by not jumping to lecturing or criticism. Use “connection” before “correction”.
• Do gently find a way to tell them how smoking / vaping affects youth more than adults because youth brains are still developing (up to age 25 on average). Validate that this is unfair that they may see adults smoking / vaping, and it feels unfair that they can’t.
• Do set parental boundaries and limits around vaping, such as:
  • No vaping at home.
• Do be a good role model yourself by not using nicotine or vaping yourself.
• If you do vape or smoke yourself, then use the power of stories. Tell your teen about the reasons why you (or other family or friends) started to smoke/vape, and what you had originally hoped vaping would do to help. Tell your teen about the problems that vaping has caused, e.g. effects on physical, mental health, relationships, finances, etc.)
• Consider quitting vaping or smoking in order to set a good role model for your child. It is never too late to quit!

Advice for Parents: Your Child is Vaping

Do’s

• Do you suspect your child is vaping but your child is denying it?
  • Do validate that you are worried, and you care about them, and whenever they want to talk about it, you will be there for them.
    

• Do thank them for being open with you if they have told you voluntarily that they vape.
  

• Do express your concerns about their physical safety, and ask about how they are obtaining vapes, e.g. from strangers, from people they know, etc.

• Do try to understand any reasons for vaping.
  • “Is it hard to say no to peer pressure? Are you wanting to fit in with others?” If so, then you can help your child by practicing how to say no, helping them have healthier friends, etc.
  • Is it about being bored? If so, you can work with them to find other ways to deal with boredom. They may need more activities, chores and responsibilities. But don’t simply send them a way to do more activities, but instead, keep them close with caring adults, at least in the beginning.
  • Coping with stress? If so, you can ask your child about stresses with school, friends, family and try to find other ways to deal with the stresses.

• Do get support from other adults. Are there other adults that your child will trust or listen to, like a relative, friend of the family, a teacher, coach, relative, faith leader? Ask them if they can spend time with your child. Having helpful adult influences can help pull your child away from less healthy influences.

Don’ts

• Don’t get into a battle or power struggle.

• Don’t get angry upset at them. Are you angry or upset at them? If so, realize that anger is unlikely to help your child feel closer to you. Instead, express what is underneath any anger, e.g. that you are worried and sad about the situation.

• Don’t jump in with criticism or lecture them about vaping, because then you may discourage them from communicating with you. Start with “connection” first, with validating and understanding their perspective before you introduce your perspective.

Advice for Youth: How to Say No to Vaping

What do I do if someone is offering me a vape?

• If so, you can say things like the following
  • “Thanks a lot and…
  • “ I don’t want to get sick. I’d rather not share an e-cigarette.”
  • “I saw in the news that you can end up in the hospital for lung injuries after vaping. I’d rather not take that risk.”
  • “Thanks but I gotta go…”
  • “I’m an athlete / I play sports / I need my lungs to be 100%.”

Making Vaping Less Bad: Harm Reduction Strategies

Are you going to be vaping anyways?

Do the following strategies to make it less bad:

• Vape less often.

• Vape with lower concentration nicotine.

• Vape nicotine, rather than vaping cannabis. Studies suggest that vaping cannabis causes more lung damage. 

• Do you really want to vape cannabis? Wait until age 25 before vaping cannabis. Using cannabis before age 25, while your brain is still developing, increases the risk of permanently disrupting normal brain development.

• Don’t share your vape with others. Sharing your vape increases your risk of catching and spreading diseases such as COVID. With vaping, sharing is NOT caring!

Warning Signs

Are you or a friend really sick after vaping?

• You might need immediate medical attention. Call a Poison Centre.

In Ontario

• Ontario Poison Centre at 1-800-268-9017

Do you smoke or vape? Are you having symptoms that don’t go away, like chest, lung pain, shortness of breath or cough?

• All of these could be signs of serious lung disease. See your family doctor.

Where to Get Help to Quit Vaping or Smoking

Do you or a loved one need professional help to quit vaping or smoking?

• Connect to Kids Help Phone
  • Talk to a counsellor (1-800-668-6868);
  • Text CONNECT to 686868
  • Visit www.kidshelpphone.ca
    
• Connect to a free Quit Coach by calling Telehealth Ontario
  • 1-866-797-0000, or toll-free 1-866-797-0007
  • Canadian Cancer Society Smokers’ Helpline
    • www.smokershelpline.ca or texting iQuit to 123456
      
• For free help, visit http://gosmokefree.gc.ca/quit or call 1-866-366-3667.

For More Information

"Talking with your teen about vaping", Government of Canada

https://www.canada.ca/en/services/health/publications/healthy-living/talking-teen-vaping-tip-sheet-parents.html

"About Vaping", Government of Canada 

https://www.canada.ca/en/health-canada/services/smoking-tobacco/vaping.html

References

Centre for Disease Control. Outbreak of Lung Injury Associated with the Use of E-Cigarette, or Vaping, Products.

Updated Feb 25, 2020. https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html. Accessed May 11, 2021.

US Department of Health and Human Services. E-cigarette Use Among Youth and Young Adults: A Report of the Surgeon General, 2016.

URL: https://www.cdc.gov/tobacco/data_statistics/sgr/e-cigarettes/pdfs/2016_sgr_entire_report_508.pdf. Accessed April 24, 2020.

Soneji S et al.: Association between initial use of e-cigarettes and subsequent cigarette smoking among adolescents and young adults: A systematic review and meta-analysis. JAMA Pediatrics, 171 (8), 788–797, 2017.

URL: https://www.ncbi.nlm.nih.gov/pubmed/28654986. Accessed May 13, 2020.

Boak, A., Elton-Marshall, T., Mann, R.E. & Hamilton, H.A. (2020). Drug Use Among Ontario Students, 1977–2019: Detailed Findings From the Ontario Student Drug Use and Health Survey (OSDUHS). Toronto, ON: Centre for Addiction and Mental Health.

Authors

Written by Victoria Hatfield, Addictions Counselor, Rideauwood; Tea Rosic, Child Psychiatrist, CHEO; Michael Cheng, Child Psychiatrist, CHEO. Reviewed by members of the eMentalHealth.ca Team and the professionals at the Children’s Hospital of Eastern Ontario (CHEO) in Ontario, Canada.

French translation by Mary Velez (uOttawa RN candidate, class of 2024).

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Disclaimer

Information in this fact sheet may or may not apply to your situation. Your health care provider is the best source of information about your situation.