Coach on Call. Thank you for your interest in E-Cigarettes: Your Questions Answered. I hope you find this tip sheet helpful.

Transcription

1 Coach on Call It was great to talk with you. Thank you for your interest in. I hope you find this tip sheet helpful. Please call me if you have more questions about this or other topics. As your health coach, I m ready to help in any way I can. Electronic cigarettes (e-cigarettes) are becoming more popular every year. Between 2015 and 2023, U.S. sales are expected to soar from $1 billion to $15 billion. Vaping is a popular term many people use to refer to using e-cigarettes (e-cigs). The companies that make e-cigs claim that vaping is safer than smoking. They also claim it can help wean smokers off tobacco. Are these claims true? Keep reading for answers to some common questions about e-cigs. How do e-cigs work? E-cigs are designed to deliver nicotine to the body with the same sensations as smoking cigarettes but without burning tobacco. E-cigs include a cartridge that contains liquid nicotine, flavorings, and other chemicals. E-cigs also have a battery and a heater. When the user inhales on an e-cig, the cartridge contents are heated. They become a vapor, which is absorbed through the lining of the mouth and airways. Is the amount of nicotine in e-cigs regulated? Not at this time. In the spring of 2016, the U.S. Food and Drug Administration (FDA) required companies that make e-cigs to disclose their ingredients and submit them to the FDA for approval. The companies were told they could keep selling their products for two years while they submit their applications, and then for one more year while the FDA reviews the submissions. By 2018, all e-cigs must be sold with the warning: WARNING: This product contains nicotine. Nicotine is an additive chemical. A healthier life is life on is the on line the for you! line for you! CMN (s) UPMC_18_1567 Copyright 2018 UPMC Health Plan Inc. All rights reserved C ON C ECIG QSTNS 17CA0925 (MCG) 2/12/18 PDF

2 Page 2 of 6 Studies have shown that the dose of nicotine from an e-cig puff can vary greatly from what is stated on the label. Also, nicotine has been found in e-cigs labeled as nicotine-free. Many leading public health groups and the FDA itself have called for further federal regulation of e-cigs. Is the vapor from e-cigs safer than tobacco smoke? Tobacco smoke contains more than 7,000 chemical compounds. More than 70 of them cause cancer. Some cause heart and lung diseases. The vapor from e-cigs also contains many chemicals. Among them are diethylene glycol, which is toxic, and nitrosamines, which cause cancer. In general, the total amount of toxins is less than in cigarette smoke. But one study showed 15 times more cancer-causing formaldehyde in e-cig vapor than in tobacco smoke. The long-term health effects of breathing e-cig vapor are unknown. The American Lung Association states that e-cig vapor can be potentially harmful, and many local and state governments, including Pennsylvania, have banned the use of e-cigs everywhere that smoking is banned. Do e-cigs help people stop smoking? Some studies say yes, but most say no. Health experts call for more research. A serious concern is that e-cigs mimic the experience of smoking. This may lead ex-smokers to return to real cigarettes. It may also encourage never-smokers who try e-cigs to turn to regular cigarettes. By contrast, FDA-approved medications have been proven to double or triple the chances that a smoker will quit. Examples are nicotine replacement gums, lozenges, and patches. Also included are two non-nicotine pills.

3 Page 3 of 6 How might e-cigs harm kids? In the spring of 2016, the federal government banned the sale of e-cigs to anyone under the age of 18. The reasons for the ban include: Some e-cigs are made to appeal to kids. They come in different colors and flavors. Examples are bubble gum and cotton candy. Before the ban, they could be easily bought by kids online or in mall kiosks in many states. The use of e-cigs among preteens and teens has been climbing sharply. It doubled from 2011 to 2012 and tripled from 2013 to In a 2014 survey, 450,000 middle school students and 2 million high school students reported using e-cigs. Nicotine is highly addictive. E-cigs may lead kids to try tobacco products. This is highly likely to lead them to use tobacco as adults. A recent survey was done of sixth- through 12th-graders. More than 4 out of 10 who had used e-cigs said they intended to smoke real cigarettes over the next year. This was twice as many as those who had never used e-cigs. About 90 percent of all adult smokers first tried smoking as teens. Three out of four teenage smokers keep smoking into adulthood. Preteens and teens are less likely than adults to keep e-cigs out of the reach of younger children. Poison centers are reporting more calls about swallowing, inhaling, or exposing the skin to the liquid nicotine in e-cigs. More than half the calls are for children under 6 years old. Some children and toddlers have become very ill, even needing emergency care. Many health experts have called for further federal regulation of e-cigs, for example by banning the use of e-cig flavors and placing curbs on advertising. Kids who see ads for e-cigs may view smoking tobacco as normal or glamorous. Many ads feature celebrities who appeal to kids. Are e-cigs safer than smoking during pregnancy? Most pregnant women know that smoking during pregnancy is dangerous. It is linked to stillbirth, premature birth, and low birth weight babies. It increases the risk of birth defects, serious lifelong health problems for the baby, and infant death. Many pregnant women think vaping is safer and will also help them quit smoking. But research does not support this.

4 Page 4 of 6 The U.S. Preventive Services Task Force (USPSTF) recommends that pregnant women avoid e-cigs. The dangers include: E-cigs contain nicotine. The amount is not regulated. Nicotine has been found even in e-cigs labeled as nicotine-free. Nicotine passes to the unborn child through the placenta. It is highly toxic. It can cause premature birth and low birth weight. It damages lung development and may alter brain development. More research is needed about the effect of other chemicals in e-cigs. For example, some contain heavy metals that might harm a fetus. Nicotine from any source is addictive. Also, e-cigs mimic the experience of smoking. These factors may lead pregnant women to return to real cigarettes after their baby is born. This will expose the baby to secondhand tobacco smoke. The bottom line Follow these tips: FF If you do not smoke, do not start vaping. FF If you smoke or use e-cigarettes, do everything you can to quit. Talk with your health coach and doctor about behavioral programs and FDA-approved medications. There is clear evidence that they help! FF If you have children, do everything you can to discourage them from using e-cigs or tobacco products.

5 Page 5 of 6 Take Action My SMART Goal for This Week Check when completed Do your best to reach the SMART* goal you set with your health coach. Write it here. Check the box when you have completed it. Staying on the Path to Wellness When you are ready, choose one or two tips above that you would like to put into action. Set a weekly SMART goal for each one. Write your goals here. Check the boxes when you have completed them. SMART Goal 1: SMART Goal 2: *SMART goals are specific, measurable, appropriate, realistic, and timely. For example, On Saturday I will take a walk with my 12-year-old son and talk with him about the risks of using e-cigarettes and tobacco. SMART goals help you succeed! If you have any trouble setting your weekly SMART goals, ask your health coach for help. The information in this tip sheet is for educational purposes only. It is not intended or implied to be a substitute for professional medical advice. Before making changes, always talk to your doctor about what is right for you.

6 Page 6 of 6 Sources: Chemicals in Tobacco Smoke. Centers for Disease Control and Prevention, U.S. Department of Health and Human Services. Available at consumer_booklet/chemicals_smoke/. Accessed July 23, E-Cigarette Use Triples Among U.S. Teens in 1 Year. WebMD.com. Available at teen use: Accessed July 23, E-cigarette vapor filled with cancer-causing chemicals, researchers say. CBSnews.com. Available at Accessed July 23, (Primary source: Jensen RP, Luo W, Pankow JF, Strongin RM, Peyton DH. Hidden formaldehyde in e-cigarette aerosols. N Engl J Med. 2015;372(4):392-4.) State Laws Prohibiting Sales to Minors and Indoor Use of Electronic Nicotine Delivery Systems United States, November Centers for Disease Control and Prevention, U.S. Department of Health and Human Services. Available at mmwrhtml/mm6349a1.htm. Accessed July 23, Nicotine-Free E-Cigs Still Deliver the Juice. Medpagetoday.com. Available at Accessed July 23, Can E-Cigarettes Help Smokers Quit? Experts Unsure. WebMD.com. Available at e-cigarettes-help-smokers-quit?ecd=wnl_nal_050615_evening&ctr=wnl-nal evening_nsl-hdln_5&mb=1tirxrvqndxgdcve%40o1x9ohnvev1imbcpxqzb4fmf6g%3d. Accessed July 23, Bhatnagar A, Whitsel LP, Ribisl KM, Bullen C, Chaloupka F, Piano MR, et al. Electronic cigarettes: a policy statement from the American Heart Association. Circulation. 2014;130: Available at documents/downloadable/ucm_ pdf. Accessed July 23, E-cigarette devices and liquid nicotine. American Association of Poison Control Centers. Available at Accessed July 23, Tobacco Smoking Cessation in Adults and Pregnant Women: Behavioral and Pharmacotherapy Interventions. Draft recommendation statement from the U.S. Prevention Services Task Force. Available at draft-recommendation-statement147/tobacco-use-in-adults-and-pregnant-womencounseling-and-interventions1. Accessed July 23, 2015.