VAPING AND THE CRISIS WITHIN OUR SCHOOLS Ranayda Drayton, CHES, - - PowerPoint PPT Presentation

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VAPING AND THE CRISIS WITHIN OUR SCHOOLS Ranayda Drayton, CHES, - - PowerPoint PPT Presentation

Sep 10, 2022 31 likes •756 views

VAPING AND THE CRISIS WITHIN OUR SCHOOLS Ranayda Drayton, CHES, CSAPC, LCSW-A Youth Tobacco Prevention Coordinator Pine Lake Prep January 16, 2019 FAQ By Parents What exactly is vaping? What might explain the dramatic rise in teenage

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VAPING AND THE CRISIS WITHIN OUR SCHOOLS

Ranayda Drayton, CHES, CSAPC, LCSW-A Youth Tobacco Prevention Coordinator Pine Lake Prep January 16, 2019

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FAQ By Parents

  • What exactly is vaping?
  • What might explain the dramatic rise in teenage vaping?
  • Some products do not contain nicotine. How are such products

dangerous?

  • How can vaping impact the teenage brain?
  • What is Juul? What does Juul’s look like? Smell like? Why are they

so popular?

  • How can vaping products be disguised?
  • What are the signs that your child is vaping?
  • Is vaping addictive?
  • Is vaping a gateway drug to other types of drug use?
  • How are institutions such as the FDA and law enforcement agencies

addressing the teenage vaping issue?

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1945 2016

We’ve made a lot of progress on Smoking Rates In NC

~50% ~17.9%

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90%

  • f

tobacco users start before the age

  • f 18

95% before 21

Should We Be Worried? YES!

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15.0 11.3 9.3 5.8 4.5 4.3 4.2 2.5 2.3 2.5 31.6 27.8 27.3 20.3 19.0 16.7 15.5 13.5 9.3 8.9

5 10 15 20 25 30 35 1999 2001 2003 2005 2007 2009 2011 2013 2015 2017 PERCENTAGE OF STUDENTS

Cigarette Use in Past 30 Days, NC YTS, 2017

Cigarette e smokin ing h has d decr creased ed a amon

  • ng y

youth th

2017 North Carolina Youth Tobacco Survey Results

High School Middle School

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18.4 17.4 14.3 10.5 9.1 10.5 9.9 8.6 11.6 10.7 38.3 35.8 33.7 28.5 26.6 25.8 25.8 29.7 27.6 28.8

5 10 15 20 25 30 35 40 45 1999 2001 2003 2005 2007 2009 2011 2013 2015 2017 PERCENTAGE OF STUDENTS

Use of Any Tobacco Product in Past 30 Days, NC YTS

Overall N NC youth tobacco u use continues t to trend h high

2017 North Carolina Youth Tobacco Survey Results

Middle School High School

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E-cigarettes are still the #1 product used by youth

2017 North Carolina Youth Tobacco Survey Results 3.7 3.4 4.5 6.3 8.9 12.7 16.9 0.8 2.0 2.5 2.3 2.5 3.8 5.3 5 10 15 20 25 Snus Roll-your-own cigarettes Hookah Chewing tobacco/snuff/dip Cigarettes Cigars/cigarillos/little cigars E-cigarettes PERCENTAGE OF STUDENTS

Use of Tobacco Products in Past 30 Days, NC YTS 2017

Middle School High School
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SLIDE 13 2017 North Carolina Youth Tobacco Survey Results

Between 2011-2017 Current Use of E-Cigarettes Increased:

430% Middle School 894% High School

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Risk and protective factors for e-cigarette use

YDS, 2018

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What are E-cigarettes?

Temp Control Box Mod (4th Generation)

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Electronic Nicotine Devices (ENDS)

Electronic cigarettes & Juul considered

“tobacco products”

“The nicotine is derived from tobacco”

  • Hookah Pens
  • Personal Vaporizers
  • Mods
  • JUUL
  • Sourin Drop / Air
  • E-cigarettes
  • Cigalike
  • E-cigars
  • E-pipes
  • E-Hookah
  • Vape Pens
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It’s an Aerosol, Not a Vapor

Image Credit: via thenounproject.com
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  • Over 460 brands (Zhu et al., 2014)
  • 7,764 unique flavors 15,500
  • Not approved for inhalation
  • Contain Nicotine
  • Are poisonous
  • Pose safety concerns

Currently

UNREGULATED

E-Liquid or E-Juice

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What are E-liquids?

Hadwiger, Michael E., et al. "Identification of amino-tadalafil and rimonabant in electronic cigarette products using high pressure liquid chromatography with diode array and tandem mass spectrometric detection." Journal of chromatography A1217.48 (2010): 7547-7555.

% Propylene Glycol (PG) % Vegetable Glycerin (VG) Flavorings Nicotine (0, 6, 12, 18, 24, 36 mg/ml)

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99% of e-cigarettes sold in US

convenience stores, supermarkets and similar outlets in 2015 contained nicotine.

US Centers for Disease Control and Prevention, 2015

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How Addictive is Nicotine?

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Some e-cigarette manufacturers claim flavorings are safe because they meet the FDA definition of “Generally Recognized as Safe” (“GRAS”) Your Gut Can Handle More Than Your Lungs

GRAS does not apply to products that are not food

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Flavors

Flavors, including many with diacetyl, are associated with respiratory irritation and disease.

MMWR, 2007 Apr 27;56(16); Farsalinos, K.E., et al (2015). Nicotine & Tobacco Research; Tierney, P. A., et al (2015). Tobacco Control

Employee wearing protective gear

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Common E-cig Flavors

Benz nzyl a l acetate Cinna nnamaldehyde de Benz nzalde dehyde de Vanil nilli lin Isoamyl acetate

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Res esea earch a at UNC-CH H School o

  • f Me

Medicine (TCORS RS)

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What are the Long-Term Effects?

When Inhaled:

  • Irritation to the lungs, nose, and throat
  • Coughing, shortness of breath and even wheezing

When Exposed to Skin:

  • Cracking and drying
  • Little research; what are the long term effects?

Addiction

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2015 FDA Deeming of Tobacco Products Became Effective August 2016

Electronic cigarettes, all ENDS products, including all the parts/components, but not accessories

Liquids/e-liquids

Hookah tobacco, water pipes

Cigars

Pipe tobacco

Certain dissolvable tobacco products (i.e., dissolvable products)

The rule includes currently marketed products:

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WHY DO TEENS USE E-CIGARETTES?

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1 in 3

Middle School students say they use e-cigarettes because of FRIENDS

1 in 4

High School students say they use e-cigarettes because of FLAVORS About 40% of middle and high school students report getting e-cigarettes from their friends

2017 North Carolina Youth Tobacco Survey Results
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Safety Concerns Explosions and Fires

Kristie Wolff –Manager Tobacco Prevention and Advocacy American Lung Association in ND
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From: Electronic Cigarette Fires and Explosions in the US 2009-2016, FEMA, July 2017 195 incidents

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https://www.youtube.com/watch?v=AFOpoKBUyok

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JUUL

Now at

76.1%

market share

As of 4 week period ending November. 8, Wells Fargo Securities analyst Bonnie Herzog: https://www.journalnow.com/business/juul-s-leading-e-cig-market-share-may-be-leveling/article_375135d7- e5bf-57ab-a8b6-0463e6b6a04b.html

$15 Billion Company

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JUUL’s Sleek Design

The JUUL device, with its sleek design that resembles a flash drive, is a special hit with teens. Teens say:

  • "It's definitely more discreet"
  • "JUULs are so simple and easy

to use"

  • “JUUL has multiple flavors”

A starter kit sales for $49.99

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Stronger E-Cigarette/Vape

salt-based nicotine freebase nicotine

59 mg of nicotine per ml anywhere from 0 to 36 mg of nicotine per ml

refillable tank pods not refillable

Image Credit: https://vaping.com/blog/wp-content/uploads/2017/06/ING_18993_01762.jpg

tobaccopreventiontoolkit.stanford.edu

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Just How Much Nicotine?

5% on box is misleading The JUUL pods contain 0.7 ml

  • f e-liquid with a big kick of 5%

nicotine by weight. 59mg/ml = pack of cigarettes

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What’s in that JUUL pod?

  • Nicotine
  • Benzoic Acid
  • Glycerol
  • Propylene Glycol
  • Natural Oils
  • Extracts and Flavors
  • ???

devices and pods produced

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JUUL pods and Flavors

Fruit Medley Virginia Tobacco

$15.99 per 4-pack of JUULpods

  • 5 flavors in so-called “pods”
  • Pre-filled JUULpods sold in

flavors

Mango Crème Brulee Cool Mint

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JUUL pods and Flavors

3 additional flavor “pods” added:

  • Classic Menthol
  • Classic Tobacco
  • Cool Cucumber

New pods with lower nicotine levels of 3ml. being introduced to market in August 2018 (limited) with October full implementation

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JUUL Capturing Mainstream Youth Audience

Source:

https://www.npr.org/sections/health-shots/2017/12/04/568273801/teenagers-embrace-juul-saying-its-discreet- enough-to-vape-in-class

Teen Quote: "People who JUUL can be normal people, but people who vape are like a certain crowd." "I know it's an e-cigarette, but I don't like to call it that because you can JUUL and not be addicted to nicotine. I don't smoke cigarettes, and I don't think I ever will.”

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JUUL look-a-likes

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blu Launches New Design

Source: Convenience Store Decisions, Feb. 2018

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Suorin drop

Suorin drop $27.99

Suorin air

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Notice the pattern?

The tobacco industry is making tobacco products that are easily disguised as

  • ther things…
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About half of students who use tobacco, use more than one product

2017 North Carolina Youth Tobacco Survey Results
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Dual Use

  • 11.6% of all

high school students used more than one tobacco product in the past 30 days.

  • 3.5% of all middle

school students used more than one tobacco product in the past 30 days.

2017 North Carolina Youth Tobacco Survey Results
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E-cigarettes and Marijuana

“E-cigarette products can be used as a delivery system for cannabinoids and potentially for other illicit drugs.”

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FDA Actively Moving to Address Youth E-Cigarette Epidemic

NORTH CAROLINA

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2018 F 2018 FDA Youth To Tobacco Preven ention

  • n P

Plan

ACCESS – MARKETING –EDUCATION

Warning Retailers for selling JUUL to minors Protecting Children from E-liquid Dangers Requiring Manufacturers to provide critical information Ensuring Teens Understand the Harmful Effects

  • f Tobacco

Helping Retailers Comply with Age Restrictions

Halting Ilegal Sales No More Misleading Labels Review Marketing Tactics (Youth) Real Cost Education Campaign on E-Cigarettes Retailer Education Campaign – This is Our Watch

  • ACCESS
  • MARKETING
  • EDUCATION
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Juul Suspends Selling Most E-Cigarette Flavors in Stores

Credit Joshua Bright for The New York Times—image (11-14-18)

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FDA and Juul-alikes

Blu and Altria are pulling their Juul-like products off the market.

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North Carolina Law Regarding E-cigarettes

  • Youth Access: NC law prohibits e-cigarette sales to minors.
  • Public Schools: NC law prohibits the use of all e-cigarettes on

school campuses as part of a 100% tobacco-free school policy

  • Child Resistant Packaging: NC law requires child resistant

packaging for e-liquid containers

  • Excise Tax: NC law places an excise tax on e-cigarettes at 5 cents

per milliliter of nicotine solution

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Public Health Concerns

  • Appeal to youth
  • Potential for graduation to cigarettes
  • Potential gateway drug to substance use
  • Harms to adolescent brain development
  • Toxic exposure to users and nonusers
  • Renormalization of smoking
  • Delay quitting among smokers
  • Child poisoning from nicotine e-liquid
  • Harm from explosions and fires
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WHAT CAN PARENTS DO?

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Parents Can…

  • Be equipped with the facts
  • Have conversations
  • Try to understand why
  • Convey your expectations
  • Role play refusal skills
  • Be a good role model
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Questions

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Resources

  • National Academy Of Sciences: Public Health Consequences of E-Cigarettes, Jan. 2018
  • FDA Center for Tobacco Products
  • Campaign for Tobacco Free Kids – website
  • Centers for Disease Control: E-Cigs Ads and Youth, Vital Signs
  • TRUTH Initiative – website
  • Public Health Law Center – website
  • ANRF (American Nonsmokers’ Rights Foundation)

– Electronic Cigarettes Bibliography, 2018

  • NC Tobacco Prevention & Control Branch, NCHHS – website; E-cigarette materials
  • American Academy of Pediatrics – Electronic Nicotine Delivery Devices
  • California Department of Public Health Campaign – Flavors Hook Kids
  • FEMA Report on Electronic-Cigarette Fires and Explosions, 2018
  • SAMHSA (Substance Abuse and Mental Health Services Administration) News – E-Cigarette
  • Partnership for Drug Free Kids: Latest Drug & Alcohol News – E-Cigarettes and Vaping
  • Cleveland County, NC - Escape the Vapes Campaign