1. Caroline O. Cobb, Ph.D. VCU Psychology Department & Center for the Study of Tobacco Products Vaping & Students: Who’s Puffing What?

2. Goals for this session Describe e-cigarette technology and constituents. Review current prevalence trends and implications of e-cigarette use.

3. First things first…What are e-cigs? 1.Has a battery or power source 2.Uses an electrical heater with a heating element or atomizer 3.Contains liquid that is aerosolized (i.e., vaped) LOTs of variation in these three components.

4. Several generations or “types” of e-cigs 3 Tank Cartomizer OPEN SYSTEMS (2 nd /3 rd gen, mods) CLOSED SYSTEMS (1 st gen, “cig-a-likes”) Cigarette

5. How much nicotine can they deliver? Same e-cig liquid used 18 mg/ml Farsalinos et al., 2014

6. Plasma nicotine ng/ml How much nicotine can they deliver? 0 0 5 10 15 20 25 5 20 35 50 65 6.6 4.9 23.5 15.8 18.8 TIME (min) Farsalinos et al., 2014; Vansickel et al., 2010 10 Ad lib e-cigarette use

7. Plasma nicotine ng/ml How much nicotine can they deliver? TIME (min) 0 0 5 10 15 20 25 5 20 35 50 65 6.6 4.9 23.5 15.8 18.8 Farsalinos et al., 2014; Vansickel et al., 2010 Cig-a-like Mod Cigarette

8. 1. Nicotine (but some are labeled 0% nicotine) 2. PG/VG- responsible for the aerosol, a humectant & solvent needed for colors and flavors: PG – propylene glycol, VG – vegetable glycerine 3. Flavorings: Tobacco, Menthol, Fruit, Coffee, Cinnamon, Vanilla But wait there’s more!...THC, alcohol, vitamins What else is in e-cigarette liquid?

9. Tobacco-specific nitrosamines Volatile aldehydes (Formaldehyde) Metals VOCs Polycyclic aromatic hydrocarbons Contents VARY significantly within and between brands and products. HINT: It is NOT just water vapor! What about other chemicals? Cheng, 2014

10. Who is using e-cigarettes? Past 30-day use in US high school students 13.4% 9.4% Source: National Youth Tobacco Survey, 2011 - 2014.

11. In 2014 among 18-24 year olds nationally: - 5.1% currently used e-cigs - 16.7% currently smoked cigarettes In 2013 across four colleges/universities in NY: - 29.9% were ever users - 14.9% were current users: males, current/former smokers, other tobacco users, binge drinkers more likely to use e-cigs What about among college-aged students? National Health Interview Survey; Saddleson et al., 2015

12. Do e-cigs help cigarette smokers quit? Few randomized controlled trials. Observational reports vary (+ and – findings). Many methodological/methods differences as well as problems. Factors potentially related to e-cig cessation success: – Nicotine delivery ability (e.g., device type) – Intensity of e-cig use (daily/intensive use). MORE HIGH QUALITY RESEARCH NEEDED!!

13. Goals for this session Lots of products, lots of variability in levels of nicotine or other toxicants they deliver. E-cigarette use surpassing conventional smoking in some populations. Role as smoking cessation aid not conclusive, but early evidence appears promising.

14. Thanks for listening! Questions?