To vape or not to…

By Lara Pickford-Gordon

snrwriter.camsel@catholictt.org

The Trinidad and Tobago Cancer Society (TTCS) and the Vape Association of Trinidad and Tobago (VAPETT) agree that misinformation surrounds vaping, but they differ sharply on the nature of that misinformation, particularly as concern rises about youth use.

The Catholic News spoke with Dr Vasant Basdeo, a director of the TTCS and member of its health promotion and education committee, and Richard Hill, President of the VAPETT, about health risks, youth access and the need for regulation.

Dr Basdeo said one major misconception is that vaping is harmless. While tobacco smoke is already recognised as a Class 1 carcinogen, he said vaping also carries serious health risks, pointing to E-cigarette or Vaping product-use Associated Lung Injury (EVALI), identified by the US Centers for Disease Control and Prevention after a spike in emergency room cases in 2019.

“These young persons were showing up in the emergency rooms with these lung injuries and when they did the investigation they were associated with these vaping devices,” he said, adding that vaping can damage the lining “from the mouth all the way down to the lungs.”

The dangers of vaping

Dr Basdeo linked the presence of harmful chemicals in vapes to the industry being unregulated. “We have found in laboratories across the world things like formaldehyde, what we use to preserve the bodies in Mt Hope [hospital], nickel, lead and of course high unregulated concentrations of nicotine,” he said. He also challenged the belief that second-hand vapour is harmless: “You are inhaling second-hand nicotine, second-hand carcinogens.”

Because the brain continues developing until about age 25, Dr Basdeo warned that nicotine addiction in youth can have lasting consequences. “If you use these devices and you become addicted to nicotine before the age of 25, the evidence is that you are four times more likely to become an actual cigarette user after,” he said, adding that such users are also at greater risk for other substance dependence.

Drawing on his involvement when the World Health Organization (WHO) developed tobacco-cessation guidelines, Dr Basdeo said recommended nicotine replacement therapies such as gum, lozenges and patches are used.

“In our treatment plans that would last for maybe 6 weeks to 12 weeks after which you are cigarette free and nicotine-free.” With vapes being promoted to help persons stop smoking, he asked: “Why replace one addiction with another addiction?”

He also questioned the use of fruity flavours which appear tailored to attract young users. Parents, he added, often assume vaping is “just water vapour,” but research indicates otherwise.

Dr Basdeo cautioned about the signs of nicotine withdrawal in young people after the nicotine receptors in their brain are heightened from vaping. “They are very agitated, restless, impulsive, they can’t concentrate, emotional control isn’t there”. They may seek other forms of immediate gratification or act out, “because they’re feeling shaky, tremulous, heart is racing, shortness of breath, anger, and we see it in our schools and our young population,” Dr Basdeo said. He mentioned a school visit where more than 20 students had been suspended for using vaping devices. Through an anti-tobacco and anti-vaping campaign with the Scotia Foundation, the TTCS has been visiting secondary schools to provide evidence-based information to students, teachers and parents.

Hill, however, said vaping has always been presented as a reduced-harm product for smokers and is not intended for non-smokers or people without nicotine dependence.

What is VAPETT

He disputed some of the claims often made against vaping, including those involving diacetyl and formaldehyde. Hill said diacetyl, associated with “popcorn lung” in US factory workers, is no longer used by the vape industry, while findings on formaldehyde came from a study in which devices were heated beyond normal operating levels.

He acknowledged parental concern over youth nicotine use and said families must play a central role. “A big role we always advocate is parents’ role in guiding their kids…and always have an open-door policy to discuss with their kids things like vaping,” he said.

Because children may not volunteer such information, he urged parents to be observant and ask questions, and to “guide and shape the direction based on your family values.”

VAPETT, formed in 2022, has eight registered members and says it follows US and UK guidance on branding and advertising restrictions. Hill said the association discourages mainstream advertising and has a Code of Responsible Conduct that bans sales to people under 18 or adults buying on their behalf.

“We have an 18-plus policy … and we have a no-school uniform policy,” he said, though he surmised that youth access is more likely through groceries, minimarts and other outlets that may not properly check age.

Hill said VAPETT has met with the Health Ministry’s Tobacco Control Unit on customs and other issues and has submitted recommendations for local rules. He argued that a move to ban vapes would be misguided, pointing instead to the UK model.

“They have adopted a healthy, progressive stance on the whole vaping thing,” he said, with limits on device sizes, nicotine levels, age restrictions, and advertising.

Vaping has come under scrutiny from the WHO. For World No Tobacco Day on May 31, it estimated that 40 million children aged 13 to 15 use tobacco products and 15 million use e-cigarettes.

The WHO called on governments to act decisively by banning flavours, restricting advertising and promotion, and regulating product design and packaging.