Stigs, Wax, and Diacetyl:

What every youth advocate

needs to know about vaping

Abe Baker Butler, Co-Founder, Students Against

Nicotine (YOUth Decide)
With Judy Mezey, Director of Community Based
Programs, Student Assistance Service
Three of these items are NOT vaping related. Can
you spot them?
What are Vape Devices?
• Some names we hear are: Hookah Sticks, Cig-Alike, E-Cig, ENDS, Vape Pen, E-Hookah, Box Mod, Pen Mod,
Juul….
• Manufacturers use different designs and a range of ingredients.
• Originally developed as a safer alternative to regular cigarettes and as a way to assist smokers in cutting
down/quitting
 NY Times 9/4/19
NY Times 9/6/19 Another Patient Has Died From Lung Disease After
Medical experts and federal health Vaping
officials warned the public about the
dangers of vaping and discouraged using
the devices as the number of people with
a severe lung illness linked to vaping
more than doubled to 450 possible cases
in 33 states and the number of deaths
rose to five.
The investigator said that the person had apparently become
sick after vaping T.H.C. from a product purchased at a
recreational marijuana shop in the state.

NY Times 10/3/19
Lung Damage From Vaping Resembles Chemical Burns, Report Says
Doctors at the Mayo Clinic examined samples of lung tissue from 17
patients, all of which looked as if the people had been exposed to toxic
chemicals, the researchers said.
E-Juice
* Vegetable glycerin, propylene glycol (base
chemical in anti-freeze), Flavoring
• E-juice without nicotine
• E-juice with nicotine
• Wax/hash oil/marijuana
Who is vaping what?
 More About the JUUL
• ALL Juul products contain nicotine – many teens do not know this
• The nicotine in Juuls is a form of nicotine that is especially easily
absorbed (nicotine salt) making it even more potent than other vape
devices.
• Many teens do not consider Juuling vaping. They use the term Juuling as
a verb.
• Juuls are sold at many local gas stations and mini markets.
• Juul pods can be hacked to add other liquids/drugs, and Juul compatible
pods can be purchased pre-loaded with THC.
Health Issues with Vape Pens –
Even without Nicotine
• Lipid pneumonia is caused when lipids (which are, essentially, fatty acids)
enter the lungs, causing the lungs to become inflamed. Some products in
vapes (vegetable glycerine, Vitamin E acetate) are/contain fatty acids. (health.com)
• Vaping (even second hand vape exposure) is associated with bronchitis and
asthma (American Journal of Respiratory and Critical Care Medicine)
• Youth who vape are 7X more likely to smoke cigarettes (JAMA Pediatrics)
• The aerosol in the vape cloud contains cancer causing chemicals such as
benzene and chromium. (New England Journal of Medicine)
• Vaping is associated with gum disease, tooth loss, bad breath (Perio-implant Advisory)
• Many vaping devices may be contaminated with harmful bacterial and fungal
toxins (Harvard University)
Case Study: Acetals and Chemical Byproducts
• Chemical reactions in flavored e-liquids create unexpected
chemicals, including acetals. These chemicals are know to
irritate users’ airways, skin, eyes, nose, and throat and can
cause headache, dizziness, and drowsiness. (Yale Tobacco Center of Regulatory
Science)

• “Any chemist could predict that these substances will react

to form these possibly dangerous products, yet it is not
labeled”
 More about flavorings
• Many youth who start vaping, say that they started because of the
flavorings.
• Common vape juice flavorings (mint, vanilla, cinnamon, clove, butter
(diacetyl), strawberry, banana, and eucalyptus) pose dangers to cells that
line blood vessels and lymph vessels:
• High concentrations of all the flavor chemicals caused cell death.
• Low concentrations of menthol, clove, vanillin, cinnamon, and burnt
flavors caused inflammation in the cells and reduced the production
of nitric oxide (a molecule that helps blood vessels to function in a healthy
way).
• Flavoring compounds used in vaping products have adverse effects on
cardiovascular health.
(The American Heart Association journal Arteriosclerosis, Thrombosis, and Vascular Biology, special thanks to
Newport Academy for this summary)
Vape Pens Exploding
 Interactive education
Hidden in Plain Sight and
DoIt4URLungs: A vape escape experience
Resources:
• Thisisquitting.com
• The Truth Initiative https://truthinitiative.org/news/what-is-juul
• Youth Decide (Students Against Nicotine) studentsagainstnicotine.org
• The Stanford Curriculum
https://med.stanford.edu/tobaccopreventiontoolkit/E-Cigs.html
• Catch My Breath (CVS)
https://catch.org/units/catch-my-breath-middle-school
• Partnership for Drug Free Kids
https://drugfree.org/parent-blog/how-to-talk-with-your-kids-about-vaping-
guide/