Electronic Cigarettes – What nurses need to know Vanessa M. Antolin, MSN, AGACNP-BC Thomas W. Barkley, JR., PhD, ACNP-BC, FAANP

Introduction Electronic cigarettes are becoming more popular worldwide, especially among young adults. The battery-powered devices deliver smoke-free nicotine to users without using combustion. Sales of e-cigs are booming even though little is known about the risks and benefits. E-cigs do not provide warning labels, ingredient lists, and are not regulated by the U.S. government.

Design & Operation The user activates the device by pressing a button that heats and aerosolizes the liquid (or “e- juice), creating a vapor. The vapor is then dispersed into the lungs and exhaled as a fine mist. E-cigs have 3 main components: Battery Atomizer Cartridge

Design & Operation There are many manufactures and types of e-cigs. They have many different street names as well, such as: Hookah pens E-hookah Vape pipes Mod PV (personal vapor) They come in many different sizes, flavors, and nicotine levels.

Regulations In 2008, the World Health Organization banned ads suggesting that e-cigs are a safe and effective smoking cessation aid. E-cigs are currently banned in the following countries: Australia Canada Panama Israel Brazil Singapore Uruguay

Popularity Interest in e-cigs continues to rise. As of January 2014, there are over 460 brands and models and more than 7,700 flavors. The National Youth Tobacco Survey found that you people’s useage of e-cigs between 2011 and 2013 had increased from 79,000 to over 263,000.

Studies and Surveys The evaluation of 2 brands of e-cigs to tobacco cigarettes showed that there were lower levels of nicotine, diethylene glycol, ethylene glycol, and nitrosamines in e-cigs than in tobacco cigarettes. Survey showed 43% of youths who’d used e-cigs intended to smoke traditional cigarettes vs. 21% who’d never smoked e-cigs intended to smoke traditional cigarettes.

Health Risks Addiction to nicotine Progression to smoking traditional cigarettes Lung damage Unsafe handling of the components Appeal to youth Potentially changing social norms making tobacco smoking more acceptable Second hand exposure to vapor Different flavors of liquids (or juice) may increase attractiveness to youths, especially those who are not smokers.

Benefits Reduction in the desire to smoke traditional cigarettes E-cigs contain less toxins then traditional cigarettes Much more research will need to be performed to learn the long term risks and benefits of chronic exposure to e-cigs.

Nursing Considerations According to the CDC, tobacco use is the most preventable cause of disease, disability, and death in the United States. Nursing tobacco screening and brief intervention can have significant impact on patients’ smoking cessation success. The hospital setting imposes a period of abstinence on patients – nurses can provide support and encouragement during this time.

Nursing Considerations As always, nurses must address patients with respect and provide nonjudgmental care. They need to be knowledgeable about the vaping culture and ready to promote the development and maintenance of healthy habits. Nurses can offer advice about the health risks of both e-cigs and traditional smoking.

Conclusion Nurses are challenged to provide current, evidence-based information about e-cigs. As more research findings are made available, nurses need to educate patients about the potential impact of e-cigs on public health. PASSWORD IS “Liquid Smoke”

References Antolin, V., Barkley, T., (2015). Electronic cigarettes: What nurses need to know. Nursing 2015, 45, 60-64.