[PDF] - Lobby Poll: How much do you know about e-cigarettes and vaping? PDF Document

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Lobby

Poll: How much do you know about e-cigarettes and vaping? Beginner Intermediate Advanced

E-cigarettes and Vaping:

The Mechanics of Use, Risks to Youth, and Prevention Efforts

Liz Wilhelm & Marina Epstein June 12, 2019

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Disclaimer

This webinar is being recorded and archived, and will be available for viewing after the webinar. Please contact the webinar facilitator if you have any concerns or questions. Please note, the views expressed in this webinar do not necessarily represent the views, policies, and positions of the Substance Abuse and Mental Health Services Administration or the U.S. Department of Health and Human Services.

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Upcoming Events
Systems Change and Strategic Financing – July 31st
Sustaining Substance Misuse Prevention Efforts – September 6th

Marina Epstein is a Research Scientist at the Social Development Research Group. Her research on e- cigarettes focuses on the interplay between e-cigarette and combustible cigarette use among youth and adults and on identifying targets for prevention. Liz Wilhelm is the Prevention Works in Seattle (WINS) Coalition Coordinator and co-designer and trainer of the Washington State E-Cigs: Finding the Truth Among the Vapors Training of Trainers.

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Overview

Introduction to e-cigarettes/vapes
E-cigarette/vape and youth
Risks of e-cigarette/vape use
Adult e-cigarette use
What is happening in Washington State
Prevention intervention points and resources

What are e-cigarettes?

Battery operated device that vaporizes a liquid

nicotine for inhalation

Known by several names: e-cig, vape, Juul

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COMBUSTIBLE CIGARETTES VS. E-CIGARETTES

Contain tobacco leaves, a natural source
f nicotine
Smoke from burning the contents is

inhaled

A significant amount of nicotine is

exhaled with the smoke (secondhand smoke)

Contains some 7,000 chemicals added

by the tobacco companies

Cost: $8.05/20 cigarettes
Contains nicotine synthesized in the

lab, no tobacco

Nicotine is inhaled along with water

vapor, not smoke

Little nicotine is exhaled
Contains up to 200 chemicals added

by the e-cigarette companies

Cost: $20 for device + $30/4 refills

(~80 cigarettes)

Battery Atomizer/coil Absorbent material:

Nicotine Propylene glycol Vegetable glycerin Flavorants

What are e-cigarettes?

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3 basic types of e-cigarettes

Mods or Tanks Minis or Ciglikes Mid-size re-chargable, pen

E-cigarettes and youth

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JUUL

Electronic cigarettes: heterogeneity in flavors.

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Why are e-cigarettes so popular? Money spent on advertising Marketing to youth

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Rise in E-cigarette use among youth

Poll question:

Why do young people try e-cigarettes?

Good Flavors
Friends Use
Curiosity
Smells better than combustible cigarettes
Easy to use anywhere/easy to hide
Healthier/safer than combustible cigarettes

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Why young people try e-cigarettes Cigarette and e-cigarette use among high school youth

5 10 15 20 25 30 2011 2012 2013 2014 2015 2016 2017 2018

Percent Year

Trends in Cigarette Use for High School Students

E-Cigarettes C-Cigarettes

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Problem with e-cigarettes?

1.Nicotine use had negative health effects for youth

a. Attention and learning problems
b. Nicotine is addictive

2.Nicotine use puts youth in the path of cigarettes

a. Once addicted, they may be more inclined to use another

nicotine product

b. Using one nicotine product may “renormalize” tobacco

products

E-cigarettes are cool, taste good, less harmful than cigarettes. What’s the problem?

Problem with e-cigarettes?

3. Youth use e-cigarette

cartridges to vape marijuana

In late 2018, JAMA study published that 1 in 11 teenage students used marijuana vapor product.

E-cigarettes are cool, taste good, less harmful than cigarettes. What’s the problem?

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Poll question: Why vape marijuana?

Get higher, faster
Limited odor
More discrete
Ease of any time use
Healthier than smoking
Socially “cool”

King County Youth Marijuana and Education Program Regional Network

Listening Sessions with Youth:
Average Age: 15.4 years
“They do it cause their friends are

using it. I’ve heard of a lot of people getting “sucked into it” because they’re at a gathering and all their friends are doing it, so they think “Oh, it must be pretty harmless. It must be really fun, I wanna try it too. That looks really cool.”

68 72 112 189 327

Get High Curiosity Access Self-medicating Social norms

50 100 150 200 250 300 350

2018 Youth Listening Session

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Problem with e-cigarettes?

4. E-cigarettes as a

pathway to combustible cigarette use

E-cigarettes are cool, taste good, less harmful than cigarettes. What’s the problem?

11 40 8 31

7 31 10 38

10 20 30 40 50 60 70 80 90 100

Did not use e-cigarettes Used e-cigarettes % used cigarettes

Barrington-Trimis (2016) Leventhal (2015) Miech (2017) Primack (2015)

Implications for prevention

Preventing combustible cigarette use remains an important

public health issue

Preventing e-cigarette use must be a part of that prevention effort
Educating youth is one aspect of prevention:
Manipulative advertising by e-cigarette companies
Juul and other companies merging with “Big Tobacco”
Dangers of nicotine
FDA regulation of distribution, flavor, and availability of e-

cigarettes must be a priority

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E-cigarettes and adults

Poll question:

What do adults say about their use of e-cigarettes?

E-cigs may help in giving up smoking
E-cigs might taste good
E-cigs may be good for my health
E-cigs may satisfy my desire to smoke
E-cigs may be healthier for people in my life

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Why adults use e-cigarettes

Youth and adult patterns of e-cigarette use

67% 13% 33% 64% 20% 0% 20% 40% 60% 80%

Youth Adults E-cigarette users

Never smoker Current smoker Former smoker

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E-cigarette use among adults and youth: two different public health problems

Youth

Youth e-cigarette/vapes users are

usually non-smokers

There is a danger that using e-

cigarettes/vapes can lead to an uptake in tobacco use

Goal is to prevent e-cigarette use

Adults

Adult e-cigarette use are usually

current or former smokers

There is hope that e-cigarette use

can help smokers cut down or quit cigarettes

Goal is to switch users entirely

away from combustible cigarettes

What is happening in Washington State?

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WA Healthy Youth Survey 2018: Vapor Products

Perceived Risk of E-Cigarette Use or Vaping

students who report "great risk" of harm from using e-cigarette or vape pen regularly (almost daily)

SOURCE: 2018 Healthy Youth Survey

Seattle

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Are current Washington State 18-20 year olds “grandfathered” in? Can they continue purchasing tobacco products even though they are not 21 years old?

No. Starting January 1, 2020, retailers are

prohibited from selling tobacco and vapor products to individuals who are under 21 years of age as of January 1, 2020.

Washington State Tobacco 21 begins January 1, 2020

This includes e-cigarettes.

Prevention of e-cigarette/vape use among youth

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Tools of information and discussion to prevent youth use

Understand the laws in your

state (e.g. Tobacco 21)

Recognize the power of norms

and perceptions

Identify family risk factors such

as family history

Discuss mental health and

behavioral health issues

Acknowledge the role of

impulse control

Appreciate the power of role modeling
Discuss the influence of other adults,

peers, pop culture, boredom, lack of confidence, instant gratification, self medication, and escape

Correct misinformation

Youth in King County, WA reported about marijuana during listening sessions

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What can parents do to prevent youth use?

Express a no use attitude
Continue conversations with your

teen at every opportunity

Don’t make substances available

to your teens or their friends

Practice skills with your teen to

refuse nicotine and other drugs

Have big shoulders to be the “bad

guy” for your teen

Set clear guidelines and grow

them with your teen’s maturity

Keep track of your teen
Keep lines of communication open
Encourage teens and yourself to

practice mindfulness

Monitor your own behavior
U.S. Surgeon General’s Report on E-Cigarette Use Among Youth and Young Adults
teen.smokefree.gov
quitSTART app and text messaging program (Text “Quit” to 47848)
Adolescent medicine pediatricians
Truth Initiative – What is Juul?
CDC – E-cigarettes and youth people
Partnership for Drug Free Kids
National Institute on Drug Abuse

Our favorite e-cigs/vapes prevention and cessation resources

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Stanford Tobacco Prevention Toolkit

https://med.stanford.edu/tobaccopreventiontoolkit.html Liz Wilhelm, M.S., CPP, ICPS Drug Free Communities Coordinator Prevention WINS Coalition Division of Adolescent Medicine | Seattle Children’s Liz.wilhelm@seattlechildrens.org Marina Epstein Research Scientist Social Development Research Group School of Social Work | University of Washington marinaep@uw.edu