Breathe in. Breathe out.
A sweet-tasting and sweet-smelling cloud billows into the air, and a rush of nicotine enters the system.
Vaping has become a common activity among college students, and vaping shops are dotted all over Stillwater to keep up with the demand from the students. It’s advertised as a safer alternative to traditional cigarettes, but recent research from Oklahoma State University’s Behavior Change Lab is finding evidence against that claim.
Thad Leffingwell, the lab director, has authored studies looking into several aspects of vaping such as sleep patterns in college student users and characterizations of patterns of use.
“We know vaping as a whole has been on (a) rapid rise across the country, and we weren’t quite sure about college students and how they were using and perceiving,” Leffingwell said. “Sure enough, they fit into that widespread use (pattern), and information about how they found it to be normatively acceptable was new information.”
Because vaping is relatively new, not much research has been conducted on the possible effects. Eleanor Leavens, a tobacco regulatory scientist at the University of Kansas Medical Center in the Department of Population Health, talked about possible concerns from the vapor going into the lungs.
“If we are talking about users who have never used a combustible product, who have never used a product that involves inhalation of smoke,” Leavens said, “then we would see e-cigarettes' use as more harmful. Any time you are taking anything into your lungs other than air, we see that as a potential harm to health. With e-cigarettes, really in the short term, they are much less harmful than cigarettes, but we don’t know the long-term health consequences of them because they have not been around for very long.”
The primary concern in the vaping research is not the nicotine itself but is instead the delivery system.
Regular e-liquid contains vegetable glycerin, propylene glycol, nicotine, flavoring and long chains of ringed carbon called polycyclic hydrocarbons, associated with the development of cancer. Because of the heating of the liquid to produce the vapor, those compounds could change due to the decomposition of the chemicals, making it hard to characterize what exactly is in the vapor people inhale.
“Interesting thing about that is nicotine is not the dangerous part," Leffingwell said. "Nicotine, while it does create dependence for the use, is not known to have any detrimental health effects itself. The dangerous part of nicotine use is the delivery system. In cigarettes, it’s the smoke, the smoke itself is the deadly part. The nicotine is the part that gets people hooked, but the part that kills them is the delivery system. That’s the part we’re not sure about with vaping.”
People are aware of the addictive properties of nicotine, but in the early days, some people were unaware of the nicotine in vaping devices. Now, devices such as JUULpods allow users to choose the amount of nicotine used in the e-liquid. Susanna Lopez, a doctoral student in OSU's Tobacco, Health and Drinking lab, reported on what new research is showing.
“I think being able to control that, the nicotine concentration, it is palatable for students, but what we’re seeing in the literature is that non-nicotine e-cigarettes are actually decreasing,” Lopez said. “People are choosing higher concentrations of nicotine.”
The higher concentration of nicotine means faster and stronger dependence on the nicotine. Although safer nicotine options are available, much of the addiction comes from how the nicotine is delivered.
“If you were to take a drug in through your stomach, that is a very slow way to deliver a drug, and so it has long for you to feel the effects," Leavens said. "And it just isn’t as reinforcing. The faster the drug is delivered, the more reinforcing it becomes, the more you are going to want it again in the future.”
Kara Niccum, a substance abuse counselor, works with students at University Counseling Services and explains how addiction to any substance works.
“It’s that idea that once you introduce a substance into your body, your body identifies that it gives it a rush, that it feels good, and then it wants you to repeat,” Niccum said. “The more you use, the more your body says use more. That is how people become addicted. If you think about addiction, it’s repeated use despite sometimes catastrophic consequences. Now, with nicotine, you don’t have the same kind of catastrophic consequences, but there are some nonetheless.”
The nicotine makes people addicted, but many people get started vaping through social interaction. Lopez’s research focus is on social normative alcohol use, which can be expanded to vaping use.
“It’s very social," Lopez said. "If you are around friends who vape all the time, smoke all the time, it might bias you partially with how prevalent it is on campus. If you’re around it all the time, you might think that everyone is smoking e-cigarettes and everyone is doing it, same with alcohol use. When in reality, it isn’t all that prevalent. People might choose to vape because their friends are doing it to fit in. It's easy to connect with people if you have something like that in common.”
Cigarette smoke has had a similar social role, but unlike smoking, vaping is being seen as safer and less of a bother to the people around it. In the counseling center, Niccum treats people who vape, but that is not the reason they walk into the door.
“They aren’t identifying it as the problem generally because vaping isn’t quite the nuisance that smoking or alcohol or other drugs possess,” Niccum said. “It’s rather inconspicuous, there’s not the smell, there’s not the yellow stained teeth, people just don’t seem to see it quite as the problem, which might be the reason it is very rampant. It doesn’t have a lot of the traditional negative aspects to it that smoking cigarettes has.”
The overall consensus from the researchers at OSU is that more research into the short and long-term effects is needed to determine the safety of vape products.
“For me, it's really important to make sure any products that are available to the public are regulated in a way to limit their harm to the public while also having the greatest health benefit possible," Leavens said. "To me, it's really important for us to have a good understanding of who these products are helpful to and who these products pose the most risk to."