Harm reduction for current smokers: Perspectives on vapes as potential nicotine replacement therapy system

Despite health benefits for cigarette smokers, public health officials recognize that a greater prevalence of vapes allows them to be more easily accessed by youth (Chapman et al., 2018). Studies have noted that the initiation of vape use is largely influenced by the friend and family circle a teenager has (Pentz et al., 2015). Therefore, the more people around a teenager who are using vapes, the more at risk the youth is.

Youngsters are more susceptible to subtle peer influence, such as having a group of friends who smoke. In order to feel included, adolescents feel pressured to conform to group standards, which can lead to them picking up the habit (Harakeh et al., 2011). This effect has been most strikingly noted in school settings, where middle and high schooler vapers increased twofold in 2011 (Nitzkin, 2014). Since then, the rate at which high schoolers utilized vapes went up 9 times, and 6 times in middle school in three years since 2011 (Patrick et al., 2016).

Public health officials are concerned that the same reasons why vapes appeal to adults apply to adolescents (Tierney et a., 2015). These include tasty flavors, apparent lack of risk, and cheapness, when all augment the appeal to young people (Patrick et al., 2016). Even though teens think vapes are safe, scientific evidence indicates they are not. 

For individuals who have never smoked, the quantities of carcinogenic chemicals present in vape flavors are cause for toxicological concern. Flavorings that appeal to adolescents, such as “butter crumble” and “cotton candy” are synthesized with highly toxic aldehydes and benzenes (Tierney et al., 2015).

Other compounds, like diacetyl, which adds a rich, butter-like flavor, can lead to Bronchitis obliterans, or “popcorn lung” (Barrington-Trimis et al., 2014). This irreversible condition causes abnormal collagen growth along the skin close to the alveoli and thickening of the small muscles around the bronchioles of the lung. In later cases, lung transplants, inhalers, or oxygen machines may be needed (Krishna, 2017). 


(a mostly random selection of Marlboro microdestinations)