Dr Liz Gordon: Vaping, Addiction and Innovation

I am not opposed to vaping.  Someone very close to me had much difficulty in giving up smoking, and a move to vaping has made a big difference to her.  She vapes on small devices, easily concealed within the hand, and with very little steam emerging. There is no smell. She purchases her vape stuff (the liquid, does it have a name?) from reputable dealers.  She is the quiet and unobtrusive side of vaping if you like.

The other side is the macho side, with large, usually black, implements that puff out huge amounts of steam to make their presence known.   They remind me of the pipes that my parents’ generation used to smoke. In addition to these two extremes, there is a large range of vapers (is that their name?) ranging from pretty silvery, pinky things designed to attract young girls to a range of gorgeous, smart things that look like expensive fountain pens.

Vaping

This wide range and the shops that sell them are intended to sell the message that vaping is acceptable and glamorous for all. While the glamour of smoking has long gone, with cigarette packets now covered in garish pictures of rotten teeth and clogged arteries, there are no such restrictions on vaping.  The equivalent would be everyone having to buy a bog standard machine in yellowish beige, perhaps with a health warning up the side.

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We are far from such restrictions.  The free market has got its blooded claws very much into vaping, in order to provide a new mechanism to assuage the human affinity for addictive substances that make one feel good.  At the moment, the focus is on vaping as a delivery mechanism for nicotine. This is of concern in itself. Unlike cigarettes, whose nicotine content is standardized simply by the nature of the tobacco, the vaping liquid can deliver nicotine at almost any strength, and this area is totally unregulated.  There is the possibility that a new generation of super-addicts can be bred.

That is not the only concern about the liquids.  We know about the flavored ones aimed at children and young people, and I can see that we are heading for a law change for those.  But what about the propensity of vapers to deliver heroin, ecstasy, MDMA, P, even cannabinoids straight into the pockets of users, then into the lungs, with huge difficulties for authorities in tracing, tracking and stamping out such practices.

Vaping is a potential delivery mechanism for a wide range of things, and while the worry is about the proliferation of addictive substances, it is also being used for good.  In particular, in some areas of medicine vaping is beginning to supersede tablets or injections. Because the vapor bypasses the digestive system, it absorbs quickly into the bloodstream. For all those diabetics out there who currently inject themselves daily, the vaper is a more precise and simple tool (there is already inhalable insulin). Not available in New Zealand, though.

The future might see even the most complex medical cases treated with a precisely targeted cocktail of drugs self-delivered by a daily vape.  It might also include vitamins and minerals and a little dash of something to make one feel good (I mean caffeine, of course), relieve pain or enhance our brainpower!

However, every expansion of vaping will bring enormous profits to the drug companies, significant costs to the system or user and enormous risks as legitimate expansion is mirrored by illegal drugs produced in vaping form.  It is a really dangerous territory, which the government’s planned law changes barely addresses.

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In short, there is a need to address vaping as a smoking alternative (which the bill largely does), as a potential mechanism for delivery of addictive substances (which is partially covered in a product recall section) and as a potential future for health management for the whole population (which is not addressed at all).

While a start, the bill introduced today is about risks around smoking.  In the future, there will need to be legislation around the risks and possibilities around vaping.