Vaping and your health

Did you know…?

• Vaping should only be used as a tool to quit smoking. If you don’t smoke, the safest option is not to vape. 
• Possession of vapes is illegal in some countries, including Singapore and Thailand. If you are preparing to deploy or travel always check the destination country’s government travel advice. 
• The visible vapour cloud is a mix of gases and tiny chemical droplets. These fine particles can travel deep into the lungs, where they may lodge and irritate the airways. Over time, this may raise the risk of long term lung disease and cancer.
• Vape flavourings may taste appealing, but most were designed to be eaten, not inhaled. Research into the long term effects of inhaling these chemicals is still developing. Heating vape liquids can cause some ingredients to break down into harmful compounds, including substances known to cause cancer.
• Some pod-style vapes contain very high levels of nicotine. For example, a pod with 20 mg of nicotine (nicotine salts) can deliver a similar amount as around 10 cigarettes, depending on how often and how deeply you vape. Flavours such as fruit or menthol can also mask the harshness of high nicotine levels, making it easier to consume.
• A mouth-to-lung vape is easier on the lungs and can assist with reducing nicotine consumption. Sub-ohm vapes are direct-to-lung, and provide a higher concentration of nicotine per inhalation.
• Even vapes that don't contain nicotine can expose users to harmful substances. These can include known cancer-causing agents, such as:
  Formaldehyde – used in industrial glues and preservation
  Acetone – found in nail polish remover
  Acetaldehyde – used in plastics and chemicals
  Acrolein – found in some weedkillers
  Heavy metals such as nickel, tin, lead, and cadmium
  Propylene glycol – used in fog and smoke machines
  Antifreeze-related compounds
  Arsenic – found in rat poison

Health impacts of vaping

Physical health

Both short and long-term vaping can result in:

• lung inflammation and throat irritation
• persistent coughing
• breathing problems such as shortness of breath and wheezing, which can also decrease physical performance
• temporary loss or change in taste
• nausea
• nicotine dependence.

Vaping also increases the risk of periodontal disease and oral infections impacts oral health, and can contribute to:

• swelling, bleeding and redness of the gums
• dry mouth
• enamel erosion.

In a military environment where dental fitness directly affects deployability, vaping can contribute to avoidable dental issues, emergency presentations, and preventable non battle injury.

Wellbeing and mental health

Vaping and nicotine can also affect:

• your mood, particularly when nicotine levels in your body drop, and may make mental health issues like anxiety and depression worse.
• your brain, which is still developing until your mid to late 20s. It can harm parts of the brain that control attention, learning and memory. 

Vaping and nicotine dependence

Most vapes contain nicotine, which is highly addictive. Nicotine activates receptors in the brain releasing dopamine, which makes you feel good.

As the nicotine levels in the body fade, the brain craves more dopamine. 

Once you are dependent on nicotine, you’ll experience withdrawal symptoms without it, which can make quitting hard. Check out the Setting yourself up for success section below for strategies to reduce your nicotine use.

Common symptoms of nicotine withdrawal include:

• intense cravings for a vape
• feeling irritable or grumpy
• finding it hard to concentrate
• feeling jittery, nervous or restless
• changes in appetite
• feeling like the flu
• feeling dizzy or having head spins
• feeling sad or down
• finding it hard to sleep (insomnia).

Other nicotine products

Other nicotine products, such as nicotine pouches, often contain high levels of nicotine – sometimes more than is stated on the packaging. These products may also contain other unknown or harmful ingredients that can negatively affect health. Potential side-effects just on the mouth include dryness, oral keratosis, and gingival inflammation and recession.

Switching from vaping to other nicotine products, including smoking, is not risk‑free and does not remove the health risks associated with nicotine use.

What are your reasons to quit?

Quitting vaping is a key step for better health. List your reasons for quitting and review them often to stay motivated.

They may include:

• Improving your health – the evidence of health risks related to vaping is growing. Stopping vaping reduces further exposure and gives your body a chance to repair. It can also boost mental health by reducing anxiety and depression.
• Having more money – quitting vaping can save you hundreds of dollars each year...consider how else you could use that money.
• Being free from addiction – ending nicotine dependence allows you to make choices without being controlled by cravings.
• You’re going on deployment or overseas holiday to a country with vape restrictions – possession of vapes is illegal in some countries, and restricted in many. There may also be variation in quality.
• You're planning a family – vaping may make it harder to fall pregnant as it can affect fertility in both wāhine and tāne. If you're already pregnant, vaping may increase the risk of health issues for both you and your baby.
• Helping your friends, family and the environment – quitting reduces passive exposure to toxins for those around you and prevents environmental pollution from vape waste.

Setting yourself up for success

It’s normal to find it difficult to give up vapes. Because nicotine is so addictive, it's really helpful to have the support of health professionals, friends and whānau when you make the decision to quit.

Knowing who's on your team, what to expect and making a plan for how to deal with cravings and mood swings are great ways to set yourself up for success.

Get professional advice and support

• Your Defence Health Centre has staff trained to support those wanting to stop vaping. They can help you work out a plan and support you on your journey.
• Quitline | Me Mutu is a 24/7 confidential nationwide service of Quit Advisors. Phone 0800 778 778, text 4006 or register here for help working out a quit smoking plan and supportive phone calls and/or regular text messages with tips to keep on track. You can also join their online community for support from others going through the same thing.
  
• Sign up for a free Quit Coach. A Quit Coach gives you a much better chance of quitting for good. They can help you make a plan to get everything in place so you can just get on with quitting.

Download a Quit vaping app - your free, pocket-sized support crew

• My QuitBuddy
• Pave
• Quash
• Puff count

Reduce your nicotine consumption 

Gradually reducing nicotine consumption may help to minimise nicotine withdrawal symptoms. Monitor your refills and keep a record of when you make changes to the nicotine dose. 

Here are some strategies you might like to try: 

1. Slowly decreasing the nicotine content of your vape/e-liquid. This could look like reducing the nicotine strength in the vape/e-liquid from 20mg/mL to 10mg/mL to 5mg/mL to 0mg/mL in two-weekly intervals.
2. If you are using DIY e-liquids, you can gradually reduce nicotine strength. Commercial nicotine-containing e-liquid can be combined with zero-nicotine liquid of the same flavour. More zero-nicotine flavour can be added each time until eventually you can switch to zero altogether. 
3. Use two vapes – one for your existing strength and another at a lower strength. Use the lower strength as much as possible.
4. Increase intervals between vapes – challenge yourself to increase the time between vapes more each day.
5. Change to a flavour you like less.
6. Monitor your refills or pods and keep a record of when you make changes to the nicotine dose. 

Know your triggers and be prepared for cravings

• Be aware that withdrawal symptoms are strongest in the first week, and most symptoms will disappear within four weeks of stopping smoking.
• Cravings may feel intense, but they generally only last a few minutes and will become less frequent over time.
• Cravings can occur without warning – the trigger may be seeing someone else vaping, smelling smoke or vapour, or simply feeling bored. A handy technique to use is the 4 Ds: Delay, Deep breath, Drink water, Do something else. Remember that every craving will pass if you give it time.
• Cravings can seem worse when blood sugar levels drop, so keep a healthy snack handy.
• It may not be possible to avoid triggers, so think creatively about what coping mechanisms you can use – check out some ideas here.
• Physical activity is a reliable way to crush cravings, by both offering a distraction and boosting endorphins and dopamine. Your Physical Training Instructor (PTI) can work with you to design an individualised training programme.
• Connect to Hā (your breath) podcast helps the listener understand how their breath is a fundamental part of who they are and how it connects them to te taiao and all the way back to the atua. 
• The NZDF ResCo app has a guided tactical breathing feature.
• Find and practise healthy ways to manage your mood or stress levels. Check out Small steps and Just a thought.

Celebrate your progress

• Keeping a diary can help track your progress.
• Set goals and plan rewards for reaching them.
• Remind yourself how far you’ve come and the benefits of being vape-free. Every day without vaping is a win!