Written by Aimee Oliveri (Clinical Psychologist & Mental Health Content Creator) in Collaboration with Clarity Health Care

Understanding Nicotine Vaping

Nicotine, a highly addictive substance, is a stimulant drug that speeds up the messages travelling between the brain and body. Nicotine vaping involves the inhalation of aerosolised nicotine through electronic devices such as vape pens, e-cigarettes, or mods. These devices heat a liquid solution containing nicotine, propylene glycol, vegetable glycerin, and flavourings, creating a vapour that is then inhaled.

Vapes, or e-cigarettes, are sometimes promoted as a tool to help you quit smoking and are often marketed as a safer alternative to traditional smoking. However, there is little evidence to suggest they help with quitting, and nicotine vaping still carries significant health risks and addictive properties.

Effects of Nicotine Vaping

Nicotine affects everyone differently, based on:

-          Size, weight and health

-          Whether the person is used to taking it

-          Whether other drugs are taken around the same time

-          The amount taken

-          The strength of the tobacco and how much is contained in the product

Additionally, all e-liquid solutions used in vaping contain a mixture of unregulated chemicals and additives. For instance, the two main ingredients used in all e-liquids are propylene glycol and vegetable glycerin, which are considered safe in certain food products. However, the health consequences of repeatedly heating and inhaling these chemicals into the lungs is relatively unknown.

Vapes may also contain harmful chemicals and toxins, including heavy metals and carcinogens, which pose health risks when inhaled. What’s more, nicotine labelling on vapes can be inconsistent, with many not disclosing the presence of nicotine and other potentially toxic chemicals.

Short-Term Effects

Although largely dependent on the aforementioned factors, the immediate short-term effects of nicotine vaping are:

-          Nicotine Addiction: Inhalation of nicotine can lead to rapid addiction and dependence, similar to traditional smoking.

-          Respiratory Irritation: Vaping can cause throat and mouth irritation, persistent coughing and shortness of breath.

-          Elevated Heart Rate: Nicotine consumption can lead to increased heart rate and blood pressure, potentially exacerbating cardiovascular issues.

-          Acute Nicotine Toxicity: Ingestion of high concentrations of nicotine liquids can result in nausea, vomiting, dizziness, and even seizures.

-          Certain ingredients in vapes have been linked to lung injuries.

Long-term Effects

The long-term effects of nicotine have been well documented, and are a major preventable cause of premature death and disability around the world, including:

-          Respiratory Issues: Chronic vaping has been associated with lung inflammation, respiratory infections, and potentially irreversible lung damage.

-          Cardiovascular Risks: Prolonged nicotine exposure can increase the risk of cardiovascular diseases, including hypertension and atherosclerosis.

-          Potential Gateway to Smoking: Research suggests that nicotine vaping among youth may serve as a gateway to traditional cigarette smoking, perpetuating nicotine addiction and associated health risks.

-          Development of various cancers, including lung, throat, and mouth cancer.

-          Compromised immune system functioning.

-          Regular vaping can reinforce nicotine dependence, making it challenging to quit and leading to withdrawal symptoms upon cessation.

Vaping And Psychiatric Medications

The effects of using nicotine while taking over-the-counter or prescribed medications can be unpredictable. Nicotine vaping has the potential to influence the body's metabolism of certain medications. For instance, nicotine interacts with medications such as clozapine, olanzapine, or haloperidol, altering their effectiveness. Additionally, combining nicotine vaping with contraceptive pills may heighten the risk of blood clot formation.

It's essential to consult with a medical professional to assess how nicotine vaping might affect any medications you are currently taking. This is true both when you are smoking and when you are considering quitting.

Harm Minimisation Strategies

While quitting vaping is the ultimate goal for many individuals, harm minimisation strategies can help mitigate risks associated with nicotine vaping:

-          Choose Lower Nicotine Strengths: Opt for e-liquids with lower nicotine concentrations to reduce overall nicotine intake.

-          Monitor Usage: Track vaping habits and set limits to prevent excessive nicotine consumption.

-          Stay Informed: Educate yourself about the ingredients in vaping liquids and potential health risks associated with long-term vaping.

-          Practice Responsible Vaping: Avoid modifying devices and using counterfeit products.

-          Become aware of the habits that tempt you to vape.

-          Use the 4D’s:

o   Deep breath

o   Drink fluids (avoid coffee and alcohol)

o   Do something else

o   Delay when you feel like a smoke

-          Establish designated vaping areas and avoid vaping indoors.

-          Engage in activities that distract from cravings, such as exercise, hobbies, or relaxation techniques.

Quitting Nicotine Vaping

Nicotine is highly addictive. Repeated use causes changes in our brain’s reward pathways and alters parts of the brain involved in learning, stress and self-control. This can make it very difficult to stop using nicotine. Moreover, withdrawal symptoms can be intense, can last days or weeks, and people can be susceptible to feelings of loss, sadness, and anxiety.

If you’re aiming to reduce or quit nicotine vaping, consider the following:

-          Nicotine Replacement Therapy (NRT): Nicotine is the addictive ingredient in tobacco and can be replaced via patches, lozenges, inhalers, gum or sprays to decrease the desire to vape and gradually reduce nicotine dependence. Doses are initially tailored to the amount you usually vape and then gradually reduced to a dose that stops you craving.

-          Medical professionals can prescribe medications such as varenicline or bupropion, which can aid in reducing cravings and withdrawal symptoms. However, these medications require caution and careful consideration, as they carry side effects, especially for people with mental illness.

-          If you have a mental illness and you want to stop vaping or change your vaping habits, it is very important that you contact your doctor or a member of your healthcare team to discuss this, especially if you are on clozapine, olanzapine, or haloperidol, as your dose may need to be adjusted, even if you are planning to use Nicotine Replacement Therapy.

Thus, taking steps to reduce or quit nicotine is best done under the guidance of qualified professionals to ensure safety and increase chances of success.

 Getting Help

 If you're struggling with nicotine vaping, reach out for support and assistance:

 -         See your Doctor for information and referral.

-          Contact Quitline Australia on 13 78 48 for free and confidential advice and support tailored to quitting vaping.

-          Path2Help: The Alcohol and Drug Foundation’s free, online platform that helps you find alcohol or other drug services near you.

-          Explore online resources such as QuitNow and My QuitBuddy for additional information, tools, and community support.