Submitted by Laura Tangelder, SRT BHSc, Fanshawe College

A relatively new device has increased in popularity in Canada over the last decade and has become the nicotine delivery method of choice for many, particularly for youth. This potentially addictive hobby, known as vaping, has the highest prevalence in youth and young adults aged 15-24, according to Health Canada (2018). Vaping is defined by the Government of Canada (2019) as the “act of inhaling and exhaling an aerosol produced by a vaping product, such as an electronic cigarette”. These products create a vapor that can come in an assortment of flavours and can also include various amounts of nicotine.

A 2017 study of Canadian youth aged 15-19 reported that 16.4% have tried a traditional cigarette at least once, while 22.8% have used an e-cigarette at least once. This same study reported that 12.6% of children in grades 7-9 have tried an e-cigarette, while 8.6% have tried a cigarette (Reid at al., 2019). This quantifies the increasing popularity of vaping products compared to cigarette smoking in Canadian youth, and the importance of understanding the different respiratory health implications in this population.

While vaping produces less carcinogens and contaminants than cigarette smoking, there are still negative health effects that can be associated with the inhalation of vaporized substances. Consistent e-cigarette use has been shown to constrict peripheral airways, potentially as a result of the chemical propylene glycol that is produced while the vape device is in use (Vardavas et al., 2012). This irritation is a particular concern to populations who already have or are at risk for respiratory pathologies such as asthma, emphysema, or chronic bronchitis. Additionally, substances such as formaldehyde, acetaldehyde, and acetone can be produced in e-cigarettes and other vaping products, which are carcinogenic and can have lasting impacts on respiratory functioning (Arnold, 2014). A condition referred to as “popcorn lung”, medically known as bronchiolitis obliterans, can result from exposure to diacetyl, a chemical used to flavour vape aerosols. This substance causes airway epithelial necrosis and inflammation in the nose, larynx, trachea, and bronchi (Hubbs et al., 2008), and can be fatal after long-term exposure. Diacetyl is a respiratory hazard, and its effects on youth exposed to it through inhalation are still being researched.

The issue of second-hand vapour exposure, effects of new vaporizing devices, and the combination of chemicals inhaled while vaping are all topics that need continual research. If vaping continues to increase in prevalence and accessibility, particularly in younger Canadians, more information is needed on the long-term effects of vaping and respiratory health. The validity of e-cigarettes and other vaporizing products as a cigarette smoking cessation plan also requires more research, to prove if this is a sustainable treatment option. It is essential for all health care providers, respiratory therapists especially, to keep up to date with new literature and information regarding this current health matter.

References

Arnold, Carrie. (2014, September 1). Vaping and health: What do we know about e-cigarettes? Environmental Health Perspectives, vol. 122 (9).
Retrieved from https://doi.org/10.1289/ehp.122-A244

Government of Canada (2019, August 6). About vaping.
Retrieved from https://www.canada.ca/en/health-canada/services/smoking-tobacco/vaping.html.

Health Canada (2018, November 15). Health Canada Statement on Use of Vaping Products on Youth.
Retrieved from https://www.canada.ca/en/health-canada/news/2018/11/health-canada-statement-on-use-of-vaping-products-by-youth.html.

Hubbs, A., Goldsmith, W., Kashon, M. (2008, February). Respiratory toxicologic pathology of inhaled diacetyl in sprague-dawley rats.
Toxicologic Pathology, vol. 36. Retrieved from https://doi.org/10.1177%2F0192623307312694

Reid, J.L., Hammond, D., Tariq, U., Burkhalter, R., Rynard, V.L. & Douglas, O. (2019).
Tobacco use in Canada: Patterns and trends (2019 edition). Waterloo, ON: Propel Centre for Population Health Impact, University of Waterloo.
Retrieved from https://uwaterloo.ca/tobacco-use-canada/sites/ca.tobacco-use-canada/files/uploads/files/tobacco_use_in_canada_2019.pdf

Vardavas, C.I., Anagnostopulos, N., Kougias, M., Evangelopoulou, V., Connolly, G.N. & Behrakis, P.K. (2012). Short-term pulmonary effects of using an electronic cigarette: impact on respiratory flow resistance, impedance, and exhaled nitric oxide. Chest, 141(6): 1400-1406.  doi:10.1378/chest.11-2443.
Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/22194587

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