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Clearing The Air Vaping , Nicotine and Cannabis Presented by: David Fialko, BS, NCTTS, ICPS 2 (C) 2020 THE COUNCIL OF SOUTHEAST PENNSYLVANIA, INC. 3 (C) 2020 THE COUNCIL OF SOUTHEAST PENNSYLVANIA, INC. Risk Factors Associated With ATOD Use


  1. Clearing The Air Vaping , Nicotine and Cannabis Presented by: David Fialko, BS, NCTTS, ICPS

  2. 2 (C) 2020 THE COUNCIL OF SOUTHEAST PENNSYLVANIA, INC.

  3. 3 (C) 2020 THE COUNCIL OF SOUTHEAST PENNSYLVANIA, INC.

  4. Risk Factors Associated With ATOD Use Access: ▪ Illicit Drugs are easier to obtain then ever before ▪ Zip Code does not matter! Purity: ▪ Drugs today are more potent than prior generations ▪ Can be either very pure or something even more dangerous Perceived Level of Harm ▪ Social norms and media have influenced an all time acceptance of drug use by the US population. 4 (C) 2020 THE COUNCIL OF SOUTHEAST PENNSYLVANIA, INC.

  5. Reoccurring themes that promote ATOD use amongst adolescents • Lack of family support & ineffective communication • Not feeling safe in home setting and/or school setting • Unclear or complete lack of boundaries & expectations • Antisocial / unhealthy adult, peer and parent role models 5 (C) 2020 THE COUNCIL OF SOUTHEAST PENNSYLVANIA, INC.

  6. Nicotine ▪ 80 percent of smokers do it primarily to self-medicate emotional problems. ▪ They are using cigarettes as a form of antidepressant or tranquillizer, a drug of solace for negative emotions. ▪ Three-quarters of people with a history of depression become depressed after quitting, compared with 30 per cent of people with no such history. ▪ Months or years after giving up, we still crave nicotine because, as with Prozac or Valium, it improves our mood. ▪ Nicotine has a profound beneficial effect on the emotional state of people who could benefit from psychotropic medication. ▪ Nicotine also improves concentration and performance on tasks that demand these. (C) 2020 THE COUNCIL OF SOUTHEAST PENNSYLVANIA, INC.

  7. Nicotine ▪ Nicotine is a highly addictive substance, distributed quickly through the blood stream ▪ Provides an increase in dopamine (Bodies “natural happy drug”) also acts as a stimulant (C) 2020 THE COUNCIL OF SOUTHEAST PENNSYLVANIA, INC.

  8. Motivational Salience The Limbic System aka Emotional Brain Prefrontal cortex helps us select the right behavior Hippocampus moves short term memories to long in a given situation term storage Site of Dopamine Target of Dopamine Motivates us Excitatory Amygdala ads relevance to memories and perceived Brakes rewards / consequences (C) 2020 THE COUNCIL OF SOUTHEAST PENNSYLVANIA, INC.

  9. Nicotine & Cannabis (C) 2020 THE COUNCIL OF SOUTHEAST PENNSYLVANIA, INC.

  10. PA Medical Cannabis (Marijuana) Under Act 16 of 2016 (the Pennsylvania Medical Marijuana Act or the Act), the term “medical marijuana” refers to marijuana obtained for a certified medical use by a Pennsylvania resident with a serious medical condition and is limited by statute in Pennsylvania to the following forms: ◦ Pill ◦ Oil ◦ Topical forms, including gel, creams, or ointments ◦ A form medically appropriate for administration by vaporization or nebulization, excluding dry leaf or plant form ◦ Tincture ◦ Liquid ◦ Plant material (for vaporization only) ◦ Entourage effect (Terpenes, CBD’s and THC’s) ◦ Carbonization destroys many of the terpenes, just like it destroys many of the cannabinoids. (above 365 degrees f)

  11. Effects of Cannabis on Body Endocannabinoid System (ECS) Previously known as the Anandamide System “Endocannabinoids” are endogenous neurotransmitters that are produced by our bodies. They regulate neurotransmission and allow for feedback loops. ▪ Anandamide ▪ Mood enhancer ▪ Modulates and regulates Dopamine transmission

  12. Effects of Cannabis on Body 12 (C) 2020 THE COUNCIL OF SOUTHEAST PENNSYLVANIA, INC.

  13. Effects of Cannabis on Body Down Regulation & Up Regualtion 13 (C) 2020 THE COUNCIL OF SOUTHEAST PENNSYLVANIA, INC.

  14. Effect of Nicotine on Body ▪ Increased risk of cardiovascular, respiratory, gastrointestinal disorders. ▪ Decreased immune response and it also poses ill impacts on the reproductive health. ▪ Epigenetics! ▪ Nicotine affects the cell proliferation, oxidative stress, apoptosis , DNA mutation by various mechanisms which leads to cancer. ▪ Affects the tumor proliferation and metastasis and causes resistance to chemo and radio therapeutic agents. Indian J Med Paediatr Oncol. 2015 Jan-Mar; 36(1): 24 – 31. doi: 10.4103/0971-5851.151771 (C) 2020 THE COUNCIL OF SOUTHEAST PENNSYLVANIA, INC.

  15. Effects of Nicotine on Body Up Regulation & Down Regulation 15 (C) 2020 THE COUNCIL OF SOUTHEAST PENNSYLVANIA, INC.

  16. Nicotine Vs. Exercise? What's the difference? ◦ The healthy heart only has to work under pressure for brief intervals, several hours of strength / cardio training per week. ◦ Heart becomes stronger with a lower resting heart rate ◦ Nicotine results in high blood pressure for extended periods throughout the day, seven days a week. ◦ Dependency increases frequency ◦ Heart becomes weaker with a higher resting heart rate ◦ Exercise stimulates the production of new blood vessels! ◦ Improving blood delivery ◦ Nicotine also promotes the growth of new blood vessels BUT also stimulates tumor growth and the build up of plaque inside arteries. ◦ Tumor enhancer qualities of Nicotine allowing tumors to grow much more quickly which are more densely packed with blood vessels feeding the tumor. Nicotine Stimulates New Blood Vessel Formation; Also Promotes Tumor Growth And Atherosclerosis July 31, 2001 Source: Stanford University School of Medicine (C) 2020 THE COUNCIL OF SOUTHEAST PENNSYLVANIA, INC.

  17. Nicotine Vrs Caffeine Juul co-founder James Monsees stated in 2018: “Chemically, nicotine is very similar to caffeine, and coffee is one of the most widely traded products in the world. While people of all ages around the world enjoy coffee, nicotine has been heavily stigmatized.” (C) 2020 THE COUNCIL OF SOUTHEAST PENNSYLVANIA, INC.

  18. Effect of Nicotine on Learning ▪ Nicotine raises pulse & heart rate. Brain EEG becomes same as when people are agitated. ▪ Nicotine has a half life of 2 hours. Students who smoke may have more challenges learning and trouble concentrating due to withdrawal symptoms. ▪ Youth report withdrawal symptoms with lower amount of consumption than adults, even as low as 5 cigarettes per week. ▪ Smoking actually contributes to problems; withdrawal causes stress, anxiety. 18 (C) 2020 THE COUNCIL OF SOUTHEAST PENNSYLVANIA, INC.

  19. Nicotine Vrs Caffeine Caffeine: A stimulant that works by blocking the receptor for adenosine, a neurotransmitter that causes relaxation! ◦ Does Not increase dopamine, does not increase risks of heart disease or cancer, does not effect epigenetics ◦ Is Not : A tumor enhancer a cardio-toxic chemical, Nicotine: A stimulant which increases the release of multiple different neurotransmitters. ◦ Increases the release of Dopamine, Norepinephrine, Acetylcholine ◦ Nicotine (Acetylcholine) receptors change into a state that is more easily activated, thereby providing a memory for nicotine exposure. J Neurosci. 2005 Jun 8; 25(23): 5563 – 5572. Caffeine increases striatal dopamine D2/D3 receptor availability in the human brainN D Volkow,1,* G-J Wang,1 J Logan,2 D Alexoff,2 J S Fowler,2 P K Thanos,2 C Wong,1 V Casado,3 S Ferre,4 and D Tomasi1 doi: 10.1523/JNEUROSCI.5240-04.2005 (C) 2020 THE COUNCIL OF SOUTHEAST PENNSYLVANIA, INC.

  20. (C) 2020 THE COUNCIL OF SOUTHEAST PENNSYLVANIA, INC.

  21. Transition From E-cigs (ENDS) to Tobacco Products A study by the University of Pittsburgh Schools of the Health Sciences found that young adults who use e-cigarettes are more than four times as likely to begin smoking tobacco cigarettes within 18 months as their peers who do not vape. (C) 2020 THE COUNCIL OF SOUTHEAST PENNSYLVANIA, INC.

  22. “ENDS” Electronic Nicotine Delivery Systems ▪ According to the FDA, ENDS are devices that allow users to inhale an aerosol (vapor) containing nicotine or other substances. ( E lectronic N icotine D elivery S ystem) ▪ The main component of ENDS is the e-liquid contained in cartridges combined with nicotine. ▪ Juul: contains nicotine salts & benzoic acid ▪ Benzoic acid: Is an irritant to the nose, throat and lungs if inhaled, which may cause coughing, wheezing and/or shortness of breath. (C) 2020 THE COUNCIL OF SOUTHEAST PENNSYLVANIA, INC.

  23. 5 Ideas about ENDS 1. ENDS are “less harmful” than traditional smoking 2. ENDS are harmful 3. ENDS are equally addictive to cigarettes 4. ENDS are NOT the best smoking cessation aid 5. ENDS are getting a new generation hooked on nicotine!! How…….? (C) 2020 THE COUNCIL OF SOUTHEAST PENNSYLVANIA, INC.

  24. Vaping is not in fact “vapor” It is aerosol: ◦ In physics, a vapor is a substance in the gas phase whereas an aerosol is a suspension of tiny particles of liquid, solid or both within a gas. ◦ Vapor from an electronic cigarette simulates tobacco smoke, but the process of burning tobacco does not occur. ◦ The aerosol of electronic cigarettes is generated when the e-liquid reaches a temperature of roughly 200 – 500 °F within the coil chamber. ◦ The aerosol is made-up of liquid sub-micron particles of condensed vapor, which mostly consist of propylene glycol, glycerol, water, flavorings, nicotine, and other chemicals. THE COUNCIL OF SOUTHEAST PENNSYLVANIA, INC. (C)

  25. VG vrs PG ? 25 (C) 2020 THE COUNCIL OF SOUTHEAST PENNSYLVANIA, INC.

  26. Anatomy of an E-Cigerette 26 (C) 2020 THE COUNCIL OF SOUTHEAST PENNSYLVANIA, INC.

  27. Anatomy of an E- Hookah 27 (C) 2020 THE COUNCIL OF SOUTHEAST PENNSYLVANIA, INC.

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