“In the case of cigarettes and e-cigarettes, history will judge us harshly as to how we answer this billion-person question. It may also look back in anger at policymaking amounting to institutionalised manslaughter.” — Professor Julian Kinderlerer, president of the European Group on Ethics in Science and New Technologies (EGE).

Vaping is a relatively new phenomenon. However, this practice has caught on like wild fire in many parts of the world. Vaping devices are popular among pre-teens and teenagers. According to the National Institute on Drug Abuse (NIDA) vaping devices are the most commonly used form of nicotine among youth in the US. Some research shows that many teens do not even realise that vaping cartridges contain nicotine and assume the pods contain only flavouring. The attractiveness of vaping is rooted in the easy availability of these devices, appealing advertisements, various e-liquid flavours, and the belief that vaping devices are safer than cigarettes. Additionally, vaping devices are easy to hide from teachers and parents because they do not leave behind the stench of tobacco cigarettes, and are often disguised as flash drives.

NIDA states that a study of high school students found that one in four teens reported using e-cigarettes for dripping, a practice in which people produce and inhale vapours by placing e-liquid drops directly onto heated atomiser coils. Teenagers reported the following reasons for dripping:

* to create thicker vapour (63.5 per cent);

* to improve flavours (38.7 per cent); and

* to produce a stronger throat hit a pleasurable feeling that the vapour creates when it causes the throat to contract (27.7 per cent).

According to National Council on Drug Abuse (NCDA) Research Analyst Uki Atkinson, vaping is almost like a trend among primary and high school students. The NCDA study found that the risk perception of vaping is very low among students as they fall prey to the marketing of these products that come in a range of flavours and which the tobacco industry claims can help reduce the harm of smoking tobacco products.

Vaping in the Caribbean

Currently, 11.3 per cent of adolescents between 13 and 15 years of age in the region use tobacco, compared to the world average of 10.3 per cent. The Healthy Caribbean Coalition (HCC) and the Pan American Health Organization (PAHO) delivered a webinar in June 2023 on ‘Clearing the Air – Vaping and Youth in The Caribbean’ to launch HCC’s new report, ‘Vaping among Adolescents and Youth in the Caribbean: Situation, Policy Responses, and Recommended Actions’, in which the panellists emphasised the urgency of taking action to combat youth vaping given its high prevalence use among adolescents in the Caribbean.

Smoking prevalence in the region has been reduced in the last few decades as a result of the regional tobacco control efforts. PAHO, which is the Americas regional office of the World Health Organization (WHO), estimates that “between 2007 and 2015, the prevalence of tobacco smoking dropped from 22.1 per cent to 17.4 per cent, a greater drop than that recorded globally”. This trend is expected to continue, with the region being the “only WHO region expected to achieve a 30 per cent relative reduction in the prevalence of current tobacco use by 2025”.

Jamaica has the highest rate in youth consumption in the region, with 28.7 per cent, followed by Colombia with 22 per cent and Chile with 19.7 per cent. Brazil has the lowest rate of tobacco consumption amongst the youth, as a result of the efforts of the country to introduce tobacco control measures as advertising ban, health warnings, and flavouring ban.

What Are vaping devices?

A typical vaping device costs between US$10 – US$50. Vapes also have recurring costs such as e-liquid and replacement pods or coils. Vaping devices are battery-operated devices that people use to inhale an aerosol, which typically contains nicotine (though not always), flavourings, and other chemicals. They can resemble traditional tobacco cigarettes (cig-a-likes), cigars, or pipes, or even everyday items like pens or USB memory sticks. Other devices, such as those with fillable tanks, may look different. Regardless of their design and appearance, these devices generally operate in a similar manner and are made of similar components.

Alarmingly, more than 460 different e-cigarette brands are currently on the market. In addition to the unknown health effects, early evidence suggests that vaping might serve as an introductory product for preteens and teens who then go on to use other nicotine products, including cigarettes, which are known to cause disease and premature death. A study showed that students who had used e-cigarettes by the time they started 9th grade were more likely than others to start smoking cigarettes and other smokable tobacco products within the next year. Another study supports these findings, showing that high school students who used e-cigarettes in the last month were about seven times more likely to report that they smoked cigarettes when asked approximately six months later, as compared to students who said they didn’t use e-cigarettes. It is clear that the tobacco industry has done their work in creating and marketing vaping devices. Given how impressionable teenagers are there is no doubt that the marketing strategies of the tobacco industry has worked.

Physiological impact

The nicotine in e-liquids is readily absorbed from the lungs into the bloodstream when a person vapes an e-cigarette. Upon entering the blood, nicotine stimulates the adrenal glands to release the hormone epinephrine (adrenaline). Epinephrine stimulates the central nervous system and increases blood pressure, breathing, and heart rate. As with most addictive substances, nicotine activates the brain’s reward circuits and also increases levels of a chemical messenger in the brain called dopamine, which reinforces rewarding behaviours.

Pleasure caused by nicotine’s interaction with the reward circuit motivates some people to use nicotine again and again, despite risks to their health and well-being. The National Institute on Drug Abuse adds, e-cigarette use exposes the lungs to a variety of chemicals, including those added to e-liquids, and other chemicals produced during the heating/vaporising process. A study of some e-cigarette products found the vapour contains known carcinogens and toxic chemicals, as well as potentially toxic metal nanoparticles from the device itself. The study showed that the e-liquids of certain cig-a-like brands contain high levels of nickel and chromium, which may come from the nichrome heating coils of the vaporising device. Cig-a-likes may also contain low levels of cadmium, a toxic metal also found in cigarette smoke that can cause breathing problems and disease. More research is needed on the health consequences of repeated exposure to these chemicals. There are also reports of lung illnesses and deaths related to inhalation of certain vaping oils into the lungs, which have no way to filter out toxic ingredients.

In Part 2, the discussion moves to required action and workable solutions.

Wayne Campbell is an educator and social commentator with an interest in development policies as they affect culture and or gender issues. Send comments to the Jamaica Observer or waykam@yahoo.com, @WayneCamo