Adolescents and Adult Activities
The making of smokers
Over 90% of smokers start before they are 20 years old. 1
Considering that every year, only 2.5% of smokers quit long term 2, smokers are very profitable for those corporations that make tobacco cigarettes and treat smoking related diseases.
Making a smoker
Chemicals are added to tobacco cigarettes to make them more addictive. 3, 4
Scientists employed by tobacco companies created the modern cigarette. When a tobacco cigarette is burned, the smoke contains over 7,000 chemicals; at least 250 of which cause harm and 69 cause cancer. 5
examples of chemicals and what they do
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Some strange ingredients can be added to cigarette tobacco such as smoke flavour, furfuryl mercaptan, snakeroot oil and 6-Acetoxydihydrotheaspirane.
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Ammonia salts lower the pH of the smoke which increases the amount of nicotine absorbed into the bloodstream (increased bioavailibility).
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Menthol numbs the lungs to suppress coughing (local anesthetic).
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Eucalyptol and theobromine chemically stretch the lungs (bronchial dilators) to help deliver more smoke into the lungs.
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Lactones reduce the body’s ability to get rid of nicotine.
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Acetaldehyde acts as an antidepressant in the brain (MOA inhibitor). 3
Nicotine is up to 3x less addictive than tobacco smoke Shareable.
The bar graph (on the Shareable) shows the percentage of people that were able to stop using different sources of nicotine: cigarettes, smokeless tobacco and nicotine gum. Each volunteer was given placebo medications and after 6 months reported whether they quit using the nicotine source.
The graph shows that the people that were on nicotine gum (which is just nicotine) had the easiest time quitting because 36% were able to quit. The people that were smoking had the hardest time quitting because only 10% quit. This indicates that cigarette smoke is up to three times more addictive than just nicotine on its own. 6
Experimenting with adult activities is a normal part of adolescent development.7
“Adolescence is defined by characteristic behaviors that include high levels of risk taking, exploration, novelty and sensation seeking, social interaction and play behaviors.” 8
It is not uncommon for teenagers to experiment with adult taboos such as sex, alcohol and smoking (9).
During adolescents, the brain starts to build adult connections that make different parts of the brain work together more efficiently. The last part to develop is the frontal lobe that controls judgment and insight and this is why teens take more risks than adults and why addiction often starts in youth. 7
Teens are different than adults in that they are more susceptible to peer pressure and they are “sensation-seeking”; they do things that give a rush such as driving a car fast or eating Tide Pods. 10 Therefore, teenagers are the age group that typically tries smoking 7 and why “virtually all cigarette smoking begins before 18 years of age…” 11
The more cigarettes a person smokes, the more likely they are to become a smoker. 6
The key factor to creating a smoker is to get the tobacco smoke into the person. 6 Addiction is a loss of ‘autonomy’; autonomy means to act independently of something. So, someone who is addicted to tobacco smoke has difficulty functioning without cigarettes. 12
The Hooked On Nicotine Checklist (HONC) Scale is an assessment tool used to determine if someone is addicted to smoking.
The more ‘yes’ answers to these questions, the more a person is addicted to tobacco smoke:
1. Have you ever tried to quit, but couldn’t?
2. Do you smoke now because it is really hard to quit?
3. Have you ever felt like you were addicted to tobacco?
4. Do you ever have strong cravings to smoke?
5. Have you ever felt like you really needed a cigarette?
6. Is it hard to keep from smoking in places where you are not supposed to?
When you haven’t used tobacco for a while … OR When you tried to stop smoking …
7. did you find it hard to concentrate because you couldn’t smoke?
8. did you feel more irritable because you couldn’t smoke?
9. did you feel a strong need or urge to smoke?
10. did you feel nervous, restless or anxious because you couldn’t smoke? 13
Loss of Autonomy Shareable
This graph shows at least one answer of ‘yes’ on the HONC scale by the number of cigarettes smoked.
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After only one to two cigarettes, 25% have lost some autonomy!
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At 20 cigarettes (a pack of cigarettes), half are reporting signs of addiction.
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At 100 cigarettes (4-5 packs) 94% are becoming life-long smokers. 6
What about vaping?
On this website, we reference nicotine vaping products purchased in specialty vape shops when used as intended.
Vaping nicotine based eliquids is 95% reduction in harm compared to smoking. 20 Vaping is less addictive than smoking because it has a fraction of the ingredients found in tobacco cigarettes. 3
Learn how vaping compares to smoking in this two minute video.
This 30 second video explains the epidemic that is related to vaping.
We don't know the long-term effects of vaping but we do know the long-term effects of smoking. (14)
The electronic cigarette was patented in 2004 15 and has been mainstream for about 5-10 years, depending on the country. To date, millions of smokers have switched to vaping. 16 There has never been a case of serious adverse effects from vaping nicotine based products from a specialty vape shop when used as intended.
Unlike with cigarettes, vaping has been developed in an age when science has studied and catalogued thousands of substances and how they effect human health. Eliquid and vapour have been thoroughly analyzed and the results consistently indicate that vaping is a very small fraction of the harm compared to smoking. 17
Over 9000 observations on the constituents of vapor were compared to universally recognized workplace exposure standards; and all (except 2 were less than <5%) were less than 1% of Threshold Limit Values. 18
Smoking is the most common addiction in North America. (19) (20)
Half of smokers try to quit every year; yet only 5% quit of those quit attempts achieve long term success. 21, 9 Vaping may be a better solution for smokers because it is inhaled like smoke is and replaces the ritualistic component of smoking addiction.
The Royal College of Physicians reviewed the science on vaping & wrote an 111 page report. (17)
In April 2016, they released the report, Nicotine without Smoke: “…the likely harm to health and society of e-cigarettes at about 5% of the burden caused by tobacco smoking.” 17
"People smoke for nicotine but they die from tar." -M. Russell
WHO prioritized the nine most toxic chemicals found in tobacco smoke for reduction. Vaping significantly reduces or eliminates these toxic chemicals! 6
We have more info on vaping as a harm reduction strategy for current smokers.
Visit our Shareables and our Downloads pages.
Youth and vaping
“Every 10 minutes, two Canadian teenagers start smoking cigarettes; one of them will lose her life because of it.” -Health Canada (22)
View the full infographic and other free printable materials on our Downloads page!
VAEP does not condone youth using any product intended for adults.
“…nurses have a responsibility to provide non-judgmental care to individuals and families affected by substance use, regardless of setting, income, age, gender identity, ethnicity or other socio-demographic characteristics.” 23
Vaping exists today because of the demand from smokers who want a harm reduction option. However, the evidence suggests that vaping seems to be having an unintended consequence which is that vaping may be interrupting the uptake of youth smoking. Vaping may be preventing the next generation of smokers.
The adolescent brain is more susceptible to addiction than the adult brain.
Studies have shown that because of the development in the brain during adolescent years, teens are more susceptible to continue impulsive behaviours and develop dependence than adults. 24, 12, 25
Research has also shown that teens are less receptive the the abstinence-only approach and find a harm reduction approach more helpful. 26
We have made some suggestions for an approach that may be more beneficial to this age group than the current fear-provoking narrative in our Harm Reduction section at the end of this page.
Grade twelve smokers are the next adult smokers.
A 35% drop in grade 12 smoking rates is very significant!
If vaping was a gateway to smoking, we would see an increase in the smoking rates. Instead the youth smoking rates are dropping. This suggests that vaping may be reducing the uptake of smoking in youth.
In 2017, 11% of grade 7-12 students had one puff or more 30 days and 1.2% vaped daily.
In 2015, 17.7% grades 6-12 students had at least one puff from a vape. In 2017, 22.8% grade 7-12 students had at least one puff from a vape; an increase of 28.8% in two years. 9, 27
35% of grade 10-12 students have ever smoked and 33% have ever vaped. (27)
Is there a smoking epidemic?
This graph shows a 16 year history of current smoking rates of 15-19 year olds over a 16 year period.
Within 3 years of vaping being introduced, the smoking rate decreased at a level not seen in 14 years! 9, 27, 28, 29
More info on vaping and youth.
Visit our Shareables page for more information.
In Great Britain, vaping is recognized as a significant harm reduction strategy and is promoted by Public Health England. (30)
Yet, less than 2% of 11-18 year olds vape more than once a week. 31
This indicates that promoting harm reduction and allowing it to be attractive to smokers such as allowing all sorts of flavours (adults like flavours) does not create increased usage among youth.
'Public Health Consequences of E-Cigarettes' from the national Academies of Sciences, Engineering and Medicine (32)
This quote illustrates the potential not only for current smokers but to prevent the next generation of smokers. 32
The graph illustrates the significant drop in American youth smoking rates since vaping has been introduced in the USA. 33
A small percentage of never smokers are abusing nicotine salts eliquids, mainly with pod devices such as JUUL. (34)
‘Nicotine salts’ are nicotine with additives that lower the pH level to crate a faster absorption rate than just pure nicotine. 35 This process is part of tobacco cigarette production and the rapid absorption of nicotine into the blood is what the smoker is accustomed to. 8
Nicotine salts eliquids are an alternative for the current smoker, usually a heavy smoker, when pure nicotine is not enough to transition off of tobacco smoke.
A very small percentage of youth that have never smoked are abusing nicotine salts to achieve a ‘heady’. A heady is the physiological experience of too much nicotine such as a head rush, nausea or racing heart rate.
When youth have difficulty coping with their stressors, some will seek to escape reality with drug use as evidence by 40% or grade 10-12 students have participated in high risk alcohol consumption in the last year. 9 This type of behaviour indicates the youth may benefit from resources that can help them cope such as support groups or anger management courses.
When it comes to substance use, teens find the abstinence only approach to be unhelpful, yet they find a harm reduction approach to be supportive. 26 Instead of the fear-based abstinence-only narrative, perhaps a more beneficial strategy would be a program that provides these youth with resources to cope with their stressors and prevent addiction.
The current narrative
Well intentioned warnings from trusted health authorities may be giving the wrong message to age groups with full cognitive reasoning.
How many smokers have walked through these doors and have been dissuaded from considering harm reduction?
“Vaping nicotine can alter teen brain development.”
– Health Canada
This study was done on rats.
It would be unethical to give nicotine to teens and then test their brains.
Considering the difference in brain structure, a more accurate message would be to specify ‘rat’ brain. 11
The dose was 2mg/kg/d of nicotine.
serious adverse effects from nicotine present at 1mg/kg depending on tolerance. (2)
These rats were given the equivalent of 136 mg of nicotine per day through a 24 hour IV to a 150 pound person. 11
There are over 7000 chemicals in smoke. (5)
Most of the harmful chemicals found in tobacco smoke are eliminated with vaping. (2)
Nicotine is a mild stimulant much like caffeine and does not cause disease. 6
To quote the study:
"Although the precise fraction of those [effects] attributable specifically to nicotine has not been precisely quantified." (25)
On one occasion in this study, smokeless tobacco was used as a data source, the rest were all about tobacco smoke. It is literally impossible to determine if any of the health effects on the developing fetus or adolescents who smoke are caused from nicotine.
“Vaping can cause lung damage.”
– Health Canada
Is this the right message for smokers?
The 5.3 million smokers in Canada have a right to know that vaping is a 95% safer alternative. (9) (36)
Yet, these alarming messages hardly illustrate the significant harm reduction strategy!
Where is the evidence?
Health Canada provides no references for this public announcment on their website or literature.
To quote the only statement associated with this public announcement: “Vaping can expose you to harmful chemicals like formaldehyde and acrolein, and metals and contaminants like nickel, tin and aluminum. You don’t want any of these in your lungs!” 37
Health Canada has some positive messages for smokers.
Find more quotes from Health Canada on our Shareables page.
Harm reduction
VAEP is run by registered nurses.
We are required to promote harm reduction that is based on credible evidence instead of ideology, personal beliefs, or misconceptions. 23
we would like to suggest a compassionate strategy to address the youth vaping issue.
When youth have difficulty coping with their stressors, some will seek to escape reality with drug use as evidence by 40% or grade 10-12 students have participated in high risk alcohol consumption in the last year.9 This type of behaviour indicates the youth may benefit from resources that can help them cope such as support groups or anger management courses.
When it comes to substance use, teens find the abstinence only approach to be unhelpful, yet they find a harm reduction approach to be supportive.26 Instead of the fear-based abstinence-only narrative, perhaps a more beneficial strategy would be a program that provides these youth with resources to cope with their stressors and prevent addiction.
A description of an online youth resource centre targeting youth that are 'JUULING'.
A small percent of youth are ‘ JUULing” to achieve a ‘heady’. A heady is the adverse effects of too much nicotine such as a head rush, nausea and rapid heart rate. Not all youth are pushing through these unpleasant effects to achieve the head rush and that is what separates those that are at risk of addiction and those that aren’t. In nursing, we would call this a ‘teachable moment’: an opportunity to identify a problem and offer solutions.
Instead of spending millions of tax dollars on fear-provoking advertising that scares smokers away from vaping, perhaps a better investment would be an online interactive program that connects the troubled teen with resources to over come their stressors by building new skills or accessing support.
For example: Suzy is a 14 year old female who loves to socialize. Her parents are going through a divorce and she is having difficulty coping with it. Suzy has tried JUULing and liked the heady sensation. She wants to try it again because it took her out of her emotional pain for a while.
A website could be built that targets these youth with a lead in relating to JUULing. It would take the youth through a series of qualifying questions to match them with the right resources. So, with Suzy, this program could connect her to resources such as an online video conferencing support group for teens whose families are going through a divorce.
A proactive approach could interrupt the use of drugs to cope with life; it could prevent future addicts.
A proactive approach could help the 5.3 million Canadian smokers instead of deterring them from harm reduction with fear-provoking advertising.
How many smokers have been diagnosed with irreversible diseases as a result of continuing to smoke because they did not know they had an alternative?
Our Founding member accessed a medical data base in 2014 and read hundreds of published articles on vaping. This paper was the result of that research and was copyrighted in 2015.
In a 15 minutes, the reader will gain a comprehensive understanding of vaping as a harm reduction strategy for current smokers. This paper is written in conversational English and cites 52 references. It comes in American, Canadian French and English and versions.
What this illustrates is that the evidence has been available for at least 5 years.
If someone you care about smokes, please send them to our website.
Updated 31AUG2019