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THE USE AND EFFECT OF VAPES & E-CIGARETTES AMONG COLLEGE STUDENTS

PEER EDUCATION & OUTREACH:

FINAL RESEARCH PAPER

CHRISTINA ANDERSON

Abstract

Vaping and the use of electronic cigarettes or e-cigarettes is a fairly new trend and on the rise among college students today. Vaping/ smoking e-cigarettes is the smoking industry’s “healthier and safer” alternative to conventional smoking, but research was found that the industry’s claim is not entirely true. Potential negative health effects of vaping are examined as well as the reasons college students choose to vape. Additionally, this paper details ways to prevent college students from vaping and potential treatments to nicotine addiction, which is a harmful chemical found in conventional and e-cigarettes. Increased use of vaping and or smoking e-cigarettes was also found to lead to increased conventional cigarette usage among college students. However, there is a significant amount of limitations in the vape and e-cigarette industry while this paper outlines those limitations in the existing scientific literature on vaping.  

The Problem with E-Cigarettes

Vapes and e-cigarettes are fairly new tools in the smoking cessation world, that bring along endless debates on the positives and negatives regarding the usage of these devices, in order to determine how dangerous these devices are on the aspects of human health. According to the CDC.gov (2021), vapes and or electronic cigarettes (E-cigarettes) are electronic devices that simulate tobacco smoking in conventional use cigarettes, and can be used to deliver nicotine, cannabis (THC, CBD), flavorings, chemicals, and other substances into the body. There are four generations of e-cigarettes, which are in order disposable e-cigarettes that resemble the typical conventional cigarette, e-cigarettes with a prefilled or refillable cartridge, Tanks or MODS, and finally POD MODS which are refillable or prefilled devices. An example of a POD MOD is a JUUL pen which is a brand of e-cigarette that resembles a small sleek shape like a flash drive which is rechargeable with a USB port and uses POD’s which are small cartridges containing nicotine and flavor. These devices are primarily used by young individuals who can smoke the device surreptitiously like in school and can disrupt classroom instruction. (Walley et al. 2019). The most common type of vape/ e-cigarette used by young people/ college students today is a JUUL pen over any other type of vaping device and will be compared to at length. Other types of fourth generation vapes/ e-cigarettes are sold under the name of Suorin and SMPO. (Walley et al. 2019). According to Barrington-Trimis et al. (2016), vaping and the use of e-cigarettes are new tools in the smoking world that are currently on the rise of discovery of the long-term effects these devices have on the human body, however these researchers concluded that American youth who were frequent (daily or couple times a week) e-cigarette/vape users were more likely to initiate use of any combustible product- with a 95% confidence interval and odds ratio of 4.98. Barrington-Trimis et al. (2016) therefore mean that these youth were more likely to utilize conventional cigarettes because the same addictive properties in conventional cigarettes were also found to be in e-cigarettes which is the primary chemical nicotine. Nicotine has an effect on the physiological aspects of the human body affecting how our bodies naturally produce the neurotransmitter dopamine and tricking the brain into becoming dependent on the drug- and allowing for it to feel like the new “normal” state in our body and that we need it to function throughout the day. This desire to keep smoking that the chemical nicotine gives users is an increasing problem especially prevalent in young adults or college students. Dinakar and O’Connor (2016) state that nicotine is found to be a highly addictive chemical, and that the use of e-cigarettes by persons who do not use tobacco clearly has an adverse effect on promoting nicotine addiction. Since vapes and e-cigarettes use the same chemical that is used in regular conventional cigarettes this explains why so many users are influenced to try conventional cigarettes. Barrington-Trimis et al. (2016) state from their results of their experiment that adolescents who were classified as susceptible to cigarette use were more likely to report e-cigarette usage as well, with an odds ratio of 2.48 and a confidence interval of 95%. Also, it is important to note that from prior knowledge we know that the use of those cigarettes causes risks like lung cancer, financial blunders, problems with relationships etc- which is why this problem of the rising use of vapes and e-cigarettes should be addressed so these negative consequences don’t affect the newest generations of individuals.  

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Another primary problem that will be further discussed in the trends section, with the increased usage of vapes and e-cigarettes among college students is the amount of flavors of vapes and e-cigarettes that are out there, because also according to Dinakar and O’Connor (2016), a particular challenge with this topic of flavoring is that the chemicals in the e-cigarette liquids are widely unknown and there are over 8000 types of flavorings that are produced in many different ways, allowing difficulty for researchers of these smoking devices to come to conclusions on what else is actually in these devices causing addictiveness. According to an article by Harrell et al. (2017) flavorings is one of the primary reasons why college students and young people are drawn to using e-cigarettes and vapes, with their study concluding that 83% of Texas college students and 74% of young adults nationwide were found to smoke vapes and e-cigarettes with a fruity flavor and to prefer the fruity flavor over a plain tobacco flavor like older adult users. Since many vapes “taste good” this is one characteristic that makes them appealing toward this demographic, yet it is an important characteristic to become aware of since researchers have very little information on what is actually included in these flavorings.  

 

Also, another problem on the rise with the increased use of vapes and e-cigarettes among college students and young people is that students with certain diagnosed mental health disorders such as anxiety, major depression, bipolar disorder, personality disorders, drug use disorders etc, were found to be more likely to purchase and use vapes and e-cigarettes more than other members of their age group without a mental disorder diagnosis. Hefner et al. (2019) state that there is a 33.6% increase that students diagnosed with mental health disorders are more likely to try vaping and e-cigarettes then those without a mental health diagnosis and on top of their regular medication they may take for their mental disorder, which is a problem because smoking and ingesting nicotine when on other drugs is extremely risky and dangerous for human health.

Causes of Vape and E-Cigarette Use

It is important to address one of the primary causes of increased vape and e-cigarette use among college students and young adults which is that it is peer related. An article by Noland et al. (2015) concludes that undergraduate students in a study were found to have given greater acceptance to utilizing emerging tobacco products than for cigarettes and consistently overestimated the percent of their peers who use various tobacco products. The students who were reported to have used or use emerging tobacco products such as e-cigarettes and vapes were asked in the study how many of their peers they thought utilized these products, and over half of the participants stated that their peers did utilize the products. This explains that young people and especially college students heavily rely on trying new things/ products simply because of their friends or because they believe “everyone else does so.” Another article by Dobbs et al. (2018) concludes that friends of college students who vape and utilize e-cigarettes are the most credible source of receiving information about these emerging cigarette products from college students, meaning that most college students studied on in this study were found to receive most of their information regarding these smoking devices from their friends and peers. The authors stated that a confirmation bias and scientific importance bias characterized the assessment of e-cigarette information in these students. The experiment conducted by Barrington-Trimis et al. (2016) also had conclusions that stated that the young adolescent individuals who had one or more friends who smoked combustible tobacco products and these individuals never had really smoked a smoking device in their life before, also had an increase in the likelihood of e-cigarette use at the initial evaluation of their experiment simply based on peer influence, with an odds ratio of 2.61 and a confidence interval at 95%. 

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Toumbis (2016) also has statistical conclusions that peer influence is one of the primary causes of increased vape use and e-cigarette smoking amongst the target demographic of college students. Toumbis (2016) reported that a nationally ranked study of young people found that 31.6% of users used smoking products out of peer influence. Toumbis (2016) also mentioned that certain advertising of e-cigarette related products through online advertising, social networking, celebrity endorsements, and television commercials were the most popular sources of advertising and is a potential cause of increasing curiosity and peer influence use of young people with vape and e-cigarette usage. Toumbis (2016) noted that many of these advertisements indicate that the use of these new smoking cessation products was a lifestyle choice and used celebrity endorsers that young people told were known to admire, and once someone sees someone they admire use a certain product chances are they will want to use and continue to use it and tell their friends about the product, therefore Toumbis (2016) was reporting increased usage of vapes and e-cigarettes in this target group in the next five years, since these advertisements were promoting the “pros” of e-cigarettes. Seeing an endorser or someone that one admires trying something new is incredibly prevalent in this demographic of young people like college students and adolescents, since this age group greatly values fitting in with their peers and society, and because this is such a common value among young individuals, there will be an increased use of these products if positive messages continue to arise in the user’s world.        

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Friends and peers among most individuals but especially prevalent in young people are the primary cause of trying anything new and continued use. It is important to recognize that in most college students, peer influence was the primary reason for trying vapes and e-cigarettes and continued use of such products, and the usage will continue to rise among young individuals until more trending data about the negative effects these smoking devices have on the body become more prevalent in today’s society.            

Prevalence

According to many different sources, the overall issue that vapes lead to conventional cigarette use is a problem that can affect anyone who chooses to vape, but it was mainly found that younger adults and teenagers were the primary age demographic to use such substances. According to ACHA (2020) it was found from asking college students (both males and females) in the past three months how often they used or use tobacco/nicotine delivery products. Out of the small sample, it was found that 27% of male college students smoke vapes and e-cigarettes on the daily and 20% of female college students smoke vapes and e-cigarettes daily. The next highest category for both male and female college students was students that have smoked vapes and e-cigarettes only once or twice in the span of the past three months from the day they were asked the questions, and that was 22% for male students and 24% for female students. The fact that smoking vapes and e-cigarettes on the daily is one of the highest categories for college students that were asked these questions for this data, is an interesting find to see that vapes and e-cigarettes have become much more prevalent among this age demographic like no other. Another article by Michael Toumbis states that the highest number of usage of vapes and e-cigarettes is most prevalent among college students/young adults. Specifically, Toumbis (2016) states that in 2013 it was reported that usage of vapes and e-cigarette smoking devices were highest in groups of people aged 18-24 years (14.2%) and that the number declined with age, or people switched to conventional cigarette use with time. Toumbis (2016) also states that in the following year- 2014, the numbers increased of e-cigarette usage among this target demographic and that young people of even less than 18 years of age were found to have increased usage of smoking cessation products. Toumbis (2016) also noted that daily smokers of this age demographic were reported having the most usage, compared with former smokers.

Trends

Among college students, the use of e cigarettes and vapes have been increasing in the past five years. According to the article by Toumbis (2016), this author identified two main factors that influence this particular group of college students/young adults to increased vape and e-cigarette usage, which are sheer enjoyment of the product and the flavors.  

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Toumbis (2016) mentioned a report that four colleges in New York State discussed the primary reason for vape and e-cigarette use among undergraduate users was out of enjoyment. Enjoyment of vape and e-cigarette products in the undergraduate years stem from a curiosity of wanting to try such products in high school, Toumbis reported because according to a national representative sample of middle and high school students, “high curiosity” of trying these products was reported at 13.4% and “some curiosity” was reported at 12.4%. The majority of this target demographic (74.1%) reported no curiosity about such products, but primarily because this was a younger age demographic then college students, and certain middle and high school individuals, were reported in a later study to develop such curiosity about these smoking related products with age- at 54.4% of students smoking these products out of enjoyment that came with their age.  

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Flavor is the second most reason for increasing vape and e-cigarette usage in college students and adolescents at 43.8% of young adults reported this being the reason for usage in a national representative sample in the U.S. of students. Toumbis (2016) mentioned that there are over 8,000 flavors of vapes and e-cigarettes for users to try and they are often fruit, confectionery, or candy like aromas that would appeal to a younger demographic like young college students and teenagers. The various flavors of vapes combined with the mentality that many young people were found to have a desire to try and experiment with vapes and e-cigarettes, will lead to an increased usage of vapes and cigarettes among this demographic for a while, Toumbis (2016) reports. 

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Health related concerns were also found to be the one of the least likely reasons for quitting e-cigarettes, according to Toumbis (2016) at only 12.1% of young adult users in a nationally ranked study. The most primary reasons for quitting were related to loss of interest by the target demographics peers (23.6%). Still these numbers are very low, therefore there is predicted to be an increase in vape and e-cigarette usage in this target group since users were only found to quit out of peer influence and not as much from scientific evidence that these smoking cessation products lead to poor health conditions.           

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Boredom was also another factor reported by Toumbis (2016) in a nationally representative sample of high school and college students for wanting to try vapes and e-cigarettes at 23.5%. This is an important statistic to take into consideration for future purposes in the coming years after Toumbis discovered his findings, because in the coming years after this study as we know now due to the COVID-19 pandemic many institutions have closed and students have been given more time at home away from their friends and are more likely to develop a sense of boredom from being away from their friends and peers at university for such a long period of time. Thus as a result of this it can be predicted that there will be increased usage of smoking cessation products such as vapes and e-cigarettes among young people and college students out of something to do and for enjoyment during the time of isolation.

Negative/Positive Effects of Problem

Mental Health

As briefly mentioned in the initial problem with vapes and e-cigarettes, there has been an increase in usage of these e-smoking devices by college students and young people with mental disorder diagnoses, and these users were found to be smoking these devices while on their prescribed medications for their mental disorders. As a result of this, these users have an increased risk of premature death due to that fact that they are smoking nicotine on top of their regularly prescribed drugs according to Hefner et al. (2019). To further explain this, an article by Prochaska et al. (2016) states that this issue regarding premature death of mental health patients is so important because it can cause an individual who smokes vapes and or e-cigarettes to die almost 25 years premature. Prochaska et al. (2016) concluded that there is not a whole lot of specific evidence on what is exactly inside each chemical in the vapes and e-cigarettes that negatively affects mental health patients’ medications and causes the premature death, because as previously mentioned there are so many different chemicals in each flavor of vape and it has been difficult to identify a true main cause from the vapes and how it affects every type of drug for many mental health patients. However, researchers are certain that smoking vapes and e-cigarettes on mental health medication causes premature death in the users because the study that Prochaska et al. (2016) conducted also concluded that after testing patients in mental health hospitals who smoked regularly during their stay, lead to a totally of 40,000 deaths among these individuals per year nationally. Prochaska et al. (2016) stated that a probable cause for this large amount of deaths among these users was from cravings and a tobacco and nicotine relapse and that the medications the patients were on heightened the cravings each patient had for the tobacco and or nicotine. Knowing this, Prochaska et al. (2016) concluded that vaping and smoking e-cigarettes on mental health medications does make one’s mental health condition progressively worse since the increased cravings can lead to premature death. Young individuals with mental health disorders such as anxiety, major depression, bipolar disorder, personality disorders, and drug use disorders were also found by Hefner et al. (2019) to try and continue to use vapes and e-cigarettes more than any other individual in their age group and were more likely to try vapes and e-cigarettes compared to those with alcoholic disorders or binge drinkers. 

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With this in mind, young individuals diagnosed with mental health disorders are more likely to purchase and try vapes and e-cigarettes. A study conducted by Zvolensky et al. (2019) found positive expectancies between young adults diagnosed with anxiety and vapes and e-cigarettes and that smoking these vapes help reduce their anxiety sensitivities and was related to greater perceived benefits by smoking these vapes like relieving stress in these individuals diagnosed with an anxiety disorder. However, the authors do mention that despite this small significant interaction being present in individuals with anxiety, there is very little research on what effects the chemicals in the vapes and e-cigarettes can have on the body, (other than just relieving some stress and anxious feelings in individuals for a short period of time)- the long-term effects are widely unknown. All that was reported was that young individuals with pre-existing mental health disorders, tend to try and like using vapes and e-cigarettes more than any other young person, and that individuals with anxiety were found to enjoy using vapes and e-cigarettes as a way to relieve their stress as a result of their condition.     

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Zvolensky et al. (2019) conclude that future clinical research would benefit from researching and understanding the potential therapeutic role of vapes and e-cigarettes on anxieties sensitivity and expectancies for e-cigarette use behavior.         

Physical Health 

There are a few physiological effects that vapes and e-cigarettes have on the body from the chemical nicotine inside in the vapes/e-cigarettes, which is the same chemical in conventional cigarettes. According to Dinakar and O’Connor (2016), these effects include an increase in heart rate and blood pressure and effects on the human brain such as the ability to produce the neurotransmitter dopamine. Vapes and e-cigarettes were found to affect how the body naturally produces dopamine, and that the devices are stimulants which in other words means that when one stops smoking the devices, they begin to crave the device and the nicotine in the device even more because users will soon need nicotine to feel “normal.” An article by Walley et al. (2019) mentions that since these devices have some of the same properties as conventional cigarettes, evidence has been found that these devices will lead to an increase in conventional cigarette use, which is a huge problem as we know the damages that those cigarettes can have on the human body. Specifically, a quote from Walley et al. (2019) text Pediatrics: Official Journal of the American Academy of Pediatrics, helps to explain that smoking vapes and e-cigarettes leads to increased use of potentially smoking conventional cigarettes in the near future because vapes and e-cigarettes were found to include some of the same chemicals that conventional cigarettes contain.    

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“There is substantial evidence that adolescent e-cigarette use leads to use of combustible tobacco products. E-cigarette companies commonly advertise that e-cigarettes contain nicotine, flavoring chemicals, and humectants (propylene glycol and/or vegetable glycerin), but toxicants, ultrafine particles, and carcinogens have also been found in e-cigarette solutions and emissions, many of which are known to cause adverse health effects” (Walley et al., 2019, p. 1).  

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To get a better understanding on how these chemicals work in both conventional and e-cigarettes included is a comparative chart with information from Walley et al. (2019) and Heck et al. (2002) (information on conventional cigarette chemicals) between the two types of smoking and the three main chemicals/ components that were found to be included in both devices.  

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From these findings, Walley et al. (2019) concluded that JUUL’s were found to carry more nicotine then other typical vapes and e-cigarettes with almost twice the amount of nicotine then in regular vapes and e-cigarettes, therefore stating that JUUL’s are the more dangerous vapes compared to other types of vapes and e-cigarettes since they contain more nicotine than an average vape/ e-cigarette, and from knowledge of conventional cigarettes, nicotine is a highly addictive and toxic chemical containing carcinogens that can cause cancer and other illnesses. Regarding the issue with JUUL’s, Walley et al. (2019) also found that only one pod of nicotine in a JUUL is equivalent to exactly one pack of conventional cigarettes or 200 puffs, and these devices are marketed as “safe smoking alternatives” and come in a variety of flavors that appeal to younger users and teens yet are in reality the more dangerous substance over conventional cigarettes. Therefore Walley et al. (2019) predicts an increased use of conventional cigarettes among this target demographic since this is an age group with the most reported sales for these highly addictive nicotine devices and may lead to conventional cigarette use since young individuals were found to develop a nature of always wanting to try new things. Despite these conclusions, Walley et al. (2019), state very little research found on the humectants in vapes and e-cigarettes and very little information regarding benzoic acid which is a chemical found in JUUL’s. Walley et al. (2019) report that the humectants in vapes and e-cigarettes are supposedly safe for indigestion, but there is little evidence of long-term effects, and hardly any research reported on the effects of benzoic acid. 

 

There is also reported information found about potential harmful carcinogens in vapes and e-cigarettes, which are two chemicals called formaldehyde and acetaldehyde that are also found in the chemical nicotine. Supposedly these carcinogens were found in lower concentrations in e-cigarettes then in conventional cigarettes according to Dinakar and O’Connor (2016). Despite these chemicals being found at lower doses than in conventional cigarettes this still means that there is concern about the chemicals that are in vapes and e-cigarettes since both formaldehyde and acetaldehyde are carcinogens that can lead to illnesses like lung cancer if constantly ingested through increase consumption of this harmful chemical nicotine.    

Prevention/Treatments

A possible prevention that was found toward the issue regarding the vastness of the various flavorings of vapes and e-cigarettes and increased nicotine consumption was discussed by Harrell et al. (2017), that certain cities like Chicago and New York City are beginning to restrict sales of flavored tobacco products and e-cigarettes that are so appealing toward young people, to better help them avoid temptations of purchasing. Harrell et al. (2017) also mention that the U.S. Department of Health Human Services, 2012 characterize that these flavors are very enticing toward young adult users at onset and with continued use. The department states that using the process of elimination and restriction of these flavored tobacco products in the future, could be an essential element of comprehensive tobacco control in these users to reduce the appeal of these tobacco products in young people. If more states and cities participate in the ban of flavored e-cigarette devices then this could very well become a start to an effective method of prevention, since young adult users will become less gravitated to using vape and e-cigarette products that don’t “taste as good.” Harrell et al. (2017) also state that in their study conducted with Texas college students and young adults nationwide, 72.9% of Texas college students and 64.8% of young adults nationwide reported to choose vaping flavored products because they come in flavors, they “like.” Eliminating popular fruity and candied flavors can help to fix this issue among young users. 

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Another possible prevention option that was discussed in articles by Noland et al. (2015) and Dobbs et al. (2018) to help raise awareness of these negative effects and factors of utilizing vapes and e-cigarettes in college students is to provide proper education from health education specialists and required classes through communication channels about the dangers on the use of these products so students will acquire proper accurate information about vapes and e-cigarettes rather than hearing information from their peers about them (which is the primary way these young adults and students were gathering information and utilizing these devices), and therefore will be less persuaded to try vaping and utilizing e-cigarettes since they will be made aware of the known effects of these devices and what chemicals are included in them. Such classes were found from the research in each two articles to be deemed effective since they provided accurate awareness of the products and the little-known research inside them. 

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Some possible treatments toward nicotine addiction among vape and e-cigarette users according to researchers George and O’Malley (2004) are to utilize NRT’s (Nicotine Replacement Therapies). There are two types of NRT treatments which are slow acting NRTs and fast acting NRTs. These therapies are tools such as the nicotine patch-(TNP) formulation which is a slower acting treatment to treating nicotine addiction. George and O’Malley (2004) state that in order for one to reduce the amount of nicotine they crave daily, the recommended administration and dose range of the nicotine patch should be between 7-22 mg. George and O’Malley (2004) also mention that they are faster acting NRT formulations one who is addicted to the chemical nicotine can take which are nicotine gum, nasal spray, nicotine vapor inhaler, and the most recent fast acting nicotine treatment- the nicotine lozenge. George and O’Malley (2004) mention however if one were to start treatment for nicotine addiction and use one of these fast-acting products they would have to completely cut off their nicotine use immediately and withdraw because of concerns about nicotine toxicity with concurrent NRT and tobacco use, and mixing nicotine with these fast acting treatment chemicals can have the opposite effect on the person who is trying to get treatment for nicotine addiction. George and O’Malley (2004) concluded that the faster acting nicotine treatments were found to be helpful in controlling for the positive effects of nicotine administration through smoking, (like for example one’s desire to smoke and smoking satisfaction one gets from the nicotine). George and O’Malley (2004) also concluded that the slower acting nicotine treatment constant supply of low levels of nicotine through the patch when adequately dosed, can relieve nicotine withdrawal symptoms effectively. Both types of NRT treatment were found to be effective measures by George and O’Malley (2004) for nicotine addiction. These treatment options were found to treat conventional cigarette users with an addiction to nicotine and demonstrated superior efficacy in placebo-controlled clinical trials with odds ratios of 1.5-2.5, 23, and 26 at both the end of trial and long-term treatment (6 month and 12-month assessments). Since vapes and e-cigarettes were found to have the same chemical of nicotine in the devices, the same nicotine treatments for conventional cigarettes may apply to vape and e-cigarette users.   

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Another possible treatment for nicotine addiction found by researchers George and O’Malley (2004) is the use of the phenylaminoketone atypical antidepressant agent bupropion in the sustained-release formulation (Zyban) and is the first non-nicotine pharmacotherapy for smoking cessation or sustained-release bupropion. According to George and O’Malley (2004), this non nicotine drug is essentially DA and NA reuptake blockers, that block the human body's desire to crave nicotine. George and O’Malley (2004) state that this is now considered a first-line treatment for nicotine dependent smokers, however the actual mechanics of the drug are not entirely proven. George and O’Malley (2004) state that there are numerous side effects to taking sustained-release bupropion which are headaches, jitteriness, dry mouth, initial insomnia, and gastrointestinal symptoms which do go away in a matter of a few weeks of prescription. However, the biggest contradiction toward the use of this treatment of bupropion is that there is a past history of seizures of any etiology and can occur when the dosage exceeds 450mg per day, according to (George & O’Malley, 2004). With the knowledge that there is controversy with this form of nicotine treatment, it is evident that NRT’s may be one of the better forms of treating nicotine addiction for all users of either conventional cigarettes and vapes and e-cigarettes.                      

Limitations of Current Research/ Further Directions

As previously mentioned, there is very little research about the effects of vapes and e-cigarette devices and what these new smoking devices can do on the human body since these smoking devices are so new- especially in fourth generation vapes and e-cigarettes like the JUUL. Therefore, there are many limitations of current research about the effects of vapes and e-cigarettes and what effects they can have on the human body, both physically and mentally/emotionally. Here are just a few examples that researchers have given where and what future researchers of this topic should study next in order to come to more conclusions about the effects of vapes and e-cigarettes on humans and college students in particular since they were found to use e-cigarette devices the most out of any age group.   

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One aspect where further research is suggested in order to gain knowledge of the full effects of vapes and e-cigarettes is to research further about any of the positive expectancies that come with vape and e-cigarette use as discussed by Zvolensky et al. (2019), that young individuals with anxiety were found to utilize the vapes and e-cigarettes to relieve stress. Despite this finding in their study, Zvolensky et al. (2019) concluded that future clinical research would be best when  researching and understanding the potential therapeutic role of vapes and e-cigarettes on anxieties sensitivity and expectancies for e-cigarette use behavior. There is little evidence on the positive expectancies of e-cigarettes and if this one positive outweighs the bad about vapes and e-cigarettes, mainly because there are so many different flavors and types of vapes all containing different chemicals that have different functions and it will take a while to examine each flavor that one can possibly vape to determine if there are any additional positive benefits. 

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Another aspect where further research is suggested into understanding the full effect these smoking devices can have in a person’s life but specifically among college students is if the nicotine in these devices does negatively affect a student’s grades in school/ their academic performance overall. The article by Walley et al. (2019) briefly brings up that the use of the JUUL/ vape pens are reported by educators of increased usage in the classroom because of their small sleek size and since these devices are so small and look like a regular looking object (flash drive), they can be hidden while smoking, which implies that there could be a potential correlation that the distraction from these devices could affect how a student performs in their classes, and if there even is a decrease in brain and neural activity connections from the increased use of these vape pens.  Walley et al. (2019) stated that the market for these fourth- generation smoking devices was increasing greatly starting in August 2018 at 72.1% of the market share in the U.S. of the U.S. cigarette market compared with 13.6% of the market in the first quarter of 2017, and most of the users purchasing were teens/ young adults, who most likely attend high school or university. Walley et al. (2019) addresses that knowing that the primary market for fourth generation vapes and e-cigarettes (these vapes are the ones produced in today’s times), there is a desire for conducting more research on the lifestyles of young people who vape and how it affects their work life or in this case or school and their academic performance. In order to research further into this probable correlation a study could compare students' grades who currently vape, with their past grades before they started vaping and compare their performance with students who do not vape. 

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It would also be interesting to gather further research to determine if purchasing vapes and e-cigarettes can cause financial problems for individuals and particular college students. According to Walley et al. (2019), vapes and e-cigarettes are a lot more costly than conventional cigarettes with a JUUL starter kit for example that comes with the JUUL, charger, and pods starts at $49.99! To smoke vapes and e-cigarettes all these items are essential for use since they run on a power charge and the pods or vape juice for the Suorin and SMPO vapes. There are also packs of four JUUL pods that can be purchased typically on average for $15.99 and the average cost of a conventional cigarette pack is $10-12. This is an expensive difference! Walley et al. (2019) also reported from certain findings that young people who smoke vapes and e-cigarettes, typically range from buying packs of pods or vape juice every few days to every week. Knowing this, researchers could benefit from researching more into these users spending patterns and their economic state, and the advertisements from the vape and e-cigarettes industries and see if there is another cause why the number of young people vaping has increased- to see if the marketing of their products also allows for young individuals to be persuaded into trying and buying these products more, aside from being persuaded to buy out of peer influence.     

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Further research about what is actually in the chemicals of many vape pens, e-cigarettes and JUUL’s would also be beneficial when coming to conclusion about the long-term effects these new e-cigarette devices have on the human body physically. Specifically, Walley et al. (2019) mention that there is little research about benzoic acid which is a humectant in JUUL pens. There are hardly any conclusions whether this chemical is bad or good for human health which should be developed further in the future to answer this question. Also previously stated by Walley et al. (2019), there is little known evidence about the effects of vape and e-cigarettes humectants- Propylene Glycol (PG) and Vegetable Glycerin, which are claimed to be safe chemicals, but researchers are still unsure of the long-term effects on the human body when these are consumed. There also is little research on the potential carcinogens in vapes and e-cigarettes as expressed by Dinakar and O’Connor (2016), and what is actually in the two chemicals- formaldehyde and acetaldehyde that causes lung cancer. It would be imperative for teachers to test this question regarding these carcinogens in order to save human lives, from these dangerous and potentially deadly chemicals, which is why research in this topic of physical effects should be developed. Sadly, it seems that individuals may have to pass away in order to get some of these answers about these harmful chemicals and to examine a person's lungs, since this is how researchers gathered evidence and conclusions about conventional cigarettes. 

References

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headshot_Christina Anderson.png

Christina Anderson '21

My name is Christina Anderson and I'm a senior Psychology major with a Marketing minor! I also am a dual sport athlete for the College in Cross Country and Track and Field, while also am working at the Center for Career Development as an Office Assistant this semester. My plans for post-graduation are to work a full-time job in Manhattan as a social media marketer!

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