A thick cloud of smoke streaming out of lungs that haven't fully developed yet – to take off the edge, to fit in with peers. Whatever the reason teens take up vaping, researchers agree it isn't as harmless as it's often hailed to be.
Even though research shows smoking cigarettes is declining in popularity, more youth are trying vapes. A recent survey found 9.6 per cent of Year 10 students say they have tried vaping, up from 3.1 per cent pre-pandemic in 2019.
Similar to young people, the number of Māori taking to vaping devices has risen since the pandemic. One in five Māori who vape today first tried it during the August 2021 lockdown.
Thirty-seven per cent of Māori who vape began as a way to quit smoking – a widely accepted method recommended by health authorities.
While the Government has tightened rules around vaping since 2020 and has started to monitor more closely where products are sold and the chemicals in e-liquids, vapes remain readily available around Northland.
There are 19 specialists vape retailers in Tai Tokerau - two in Dargaville, one each in Kerikeri, Mangawhai and Kawakawa, and seven each in Kaitāia and Whangārei.
Additionally, there are 200-plus general retailers that sell tobacco and often vape products.
Bridget Rowse, smokefree adviser for the Northland District Health Board, criticised how freely available vapes were over the counter given they are meant to be a tool to help people quit smoking.
She said they should be in the hands of health professionals who provide support and advice to those who want to quit smoking.
As health advocates and the Government try to find the balance between promoting vapes as a substitute for cigarettes and discouraging youth from starting to vape, researchers explore what the little device actually does to the lungs.
Last year Associate Professor Dr Kelly Burrowes of the bioengineering institute at the University of Auckland launched three years of research to help understand the potential dangers of vaping.
Together with her team, Burrowes is creating computer models to simulate and measure the health impacts of vapour in the lungs.
"We can simulate how air and blood flows through the lungs," Burrowes explained.
"By doing that we can look at different diseases and change our computer models to look at how lungs are working."
As part of her study, Burrowes is currently looking at different chemicals in both the e-liquids and aerosols.
In the next step, Burrowes and her team will be growing lung cells in the lab to expose them to vapour and measure any changes that happen to the cells.
Finally, she will get young people who vape to participate in the study. The researchers will examine the participants' lungs with magnetic resonance imaging (MRI). Burrowes is still looking for participants.
"We can use the MRI to measure how the air and blood are flowing in the lungs. We're going to take pictures before and right after someone uses their vape so we can look at what changes happen in their lungs."
Burrowes said there are people around the world who have been and still are looking at all these different aspects of research.
What makes Burrowes' study unique is that her computer models unite the different data to create a more comprehensive understanding of the impacts of vapes.
Her team are focused on New Zealand e-liquids and tested 20 different ones, finding that there are 140 different chemicals added to the products, including aldehyde as well as heavy metals in the vapour which is dispersed from the coil that heats the liquid.
"The flavours are thought to be safe to eat but no one has tested if they are safe to breathe in."
Burrowes stressed that current research doesn't reveal enough about the long-term effects of vaping.
One of the international studies on animals and lab-grown cells showed a link to cancer. A couple of studies indicated links to emphysema – a lung condition that causes shortness of breath – similar to smoking.
In 2019-2020, the United States saw a surge of the novel e-cigarette or vaping use-associated lung injury (EVALI) with over 1000 cases and more than 20 deaths. Around 80 per cent of the people affected reported using products containing tetrahydrocannabinol (THC).
An Australian man in his early 70s died in October last year with the autopsy determining EVALI as the cause of death.
"At the moment people think it's safer than smoking because vapes have less of those harmful chemicals but there are some different chemicals and they could actually create a different disease," Burrowes said.
While at this stage of the study, Burrowes presumes that vaping is indeed safer than smoking, she hypothesises that vaping can cause inflammation in the lungs.
"There is a fine line between putting smokers off and having young people start vaping.
"Everyone who smokes should switch to vaping but there is going to be some harm associated with vaping.
"We just don't know exactly what it is yet. My advice would be, anyone who doesn't smoke should not start vaping."
Burrows believes it could be another 10 years before the general public becomes and accepts any dangers associated with vaping.