E-cigarettes heat a liquid into an aerosol or vapour cloud that is inhaled by the user, typically delivering doses of nicotine to the lungs. Photo / Getty Images
Vaping is becoming more and more popular, and with it comes a new battle for schools. In the second of a four-part series, Jodi Bryant finds out what is in the 'e-liquids' in vapes.
Hospitals are now recording specific health effects from vaping amid questions over the unknown chemical compounds used to flavour the devices.
The Centre for Adverse Reaction Monitoring records adverse effects and has been monitoring vaping since November 2020.
Where a condition or symptom appeared to be vaping related, district health boards' coding departments assign a code for the condition.
This information was obtained from the Northland DHB after the Northern Advocate inquired as part of a vaping series running this week.
The information is then collated by the Ministry of Health, which had recorded 13 reports of adverse effects from vaping nationwide since reporting began.
The data showed six men and seven women aged 21 to 47 had suffered adverse effects relating to vaping. The most commonly reported adverse reactions recorded were either cough related, or affiliated with the tongue, lips and throat. Others were nausea, vomiting, toothache and skin issues.
Studies towards understanding what goes into "e-liquids" - the additive used with vapes and e-cigarettes - were commencing, with scientists saying it was necessary to know what was being inhaled and the potential damage it caused.
University of Otago food scientists - through an Explorer Grant from the Health Research Council - would be investigating the flavours in e-liquids and the compounds generated, to find unknown safety and long-term health effects.
Lead researcher Dr Graham Eyres, who had experience in food industry flavours, said those added to liquids used with e-cigarettes or vaping devices were regulated under the Food Standards Code.
He said the code covered the safety of ingesting the flavourings in food, but not when inhaled.
"E-cigarettes heat a liquid into an aerosol or vapour cloud that is inhaled by the user, typically delivering doses of nicotine to the lungs," said Dr Eyres.
"In New Zealand, the range of flavourings added to the liquids in e-cigarettes have not been characterised or quantified.
"This is concerning because some of the volatile organic compounds generated during vaporisation may be directly harmful if inhaled at high concentrations, or may degrade to form harmful compounds."
Eyres said there would be "hundreds of chemical compounds" across an array of flavourings, and not enough was known to make a "robust safety assessment for vaping".
"Our goal is to determine what is the composition of e-liquids in New Zealand and then to analyse the composition and concentration in the aerosol droplets inhaled during vaping."
As an example, Eyres cited the use of diacetyl – a flavouring responsible for the buttery characteristic of chardonnay. He said it had been linked 20 years ago to an incurable lung disease in a popcorn factory where workers breathed in large amounts of the compound over hot vats of oil.
Recent international research has shown that 74 per cent of commercial liquids in e-cigarettes contained diacetyl, with more than 40 per cent at concentrations higher than the recommended safety limits.
While diacetyl had been banned from e-liquids in the United Kingdom, the proportion of New Zealand e-cigarettes that contained diacetyl was unknown and represented a potential health risk to New Zealanders.
"Diacetyl also serves as an example of how a flavour compound can be generally regarded as safe when consumed; but has a different impact on safety when inhaled into the lungs."
Eyres said the research would allow toxicologists and health professionals to work out the level of risk posed by the compounds, allowing regulators evidence to put in place guidelines for e-cigarettes.
E-cigarettes were generally considered to be less harmful than smoking traditional cigarettes because they operated at a lower temperature and were likely to generate lower levels of carcinogenic compounds.
For this reason, they were often recommended as an effective tool in helping people stop smoking, including by the Ministry of Health.
A study conducted in 2019 shows more than a third of school students reported having tried an e-cigarette, and 12 per cent reporting to be regular users of e-cigarettes.
Vaper speaks:
"I work for a Māori health organisation and I know what you're thinking. .. 'Why did you take up vaping?!' You're a healthcare worker! You should know better at 25! And the truth is, I did know better. But I chose to vape anyways, in the hope that it would make me feel better.
"My reasons all came down to stress and anxiety. I didn't know how to manage it, so I took the easy way out and used a tool; a vape pen. I knew that the nicotine in the e-liquid would release dopamine, making me happy for the time being, so I took the risk. I started vaping in October 2020 and would use it on the way to work, anytime I felt stressed at work, on my drive home from work, and when I had been drinking and around others who would vape. Although my e-liquid only had 5mg of nicotine in it, I could feel the rush of dopamine within 10 minutes of using my vape pen, which I think was because I had never been a tobacco smoker before. So, for me, at that time, this method felt like it was working; it was helping me feel less anxious.
"In March of this year, I decided I needed to seek help that would actually address my stress and anxiety. But that's not entirely the reason why I decided to give up vaping. I began to notice over time that my vocal abilities had begun to diminish. I wasn't able to hold notes for as long, nor hit notes as high as I could in the previous year. Singing has always been a passion of mine. I pursued music for two years after leaving high school. The thought of losing something I had worked so hard for and loved, made me feel miserable about myself. So I threw my vape pen in the bin and haven't touched one since.
"I'll be honest with you, my stress and anxiety has gotten worse. My doctor has actually made a referral for EAP counselling and I've been waiting for over a month to be able to access these services (I can't yet as my organisation isn't registered - they're trying to sort it asap, though). So, in the meantime, I've been using the 1737 number to help me cope with the stress and anxiety. Although my mental health isn't the best, I can now hit those high notes and hold them for longer. I feel good that I haven't turned back to the vape."