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Nicotine and cannabis are substances with significant potential for abuse. Nicotine is a notoriously addictive stimulant found in tobacco. This compound affects the central nervous system, producing tachycardia, hypertension, and dependence. Cannabis, sourced from the Cannabis sativa plant, contains psychoactive compounds such as tetrahydrocannabinol and cannabidiol. Cannabis has recognized medicinal properties for conditions such as chronic pain, epilepsy, and multiple sclerosis. However, chronic use is also linked to impaired cognitive function, mental health disorders, and respiratory issues. Vaping involves inhaling aerosolized liquid from an electronic cigarette, which is heated to produce a vapor containing substances such as nicotine and cannabis. This method avoids combustion, which is the primary source of harmful byproducts in traditional smoking. However, vaping presents its own set of hazards. Nicotine users mistakenly consider vaping a harm-reduction strategy if they cannot quit smoking through other means. Similarly, cannabis users think of vaping as a method of administration that reduces respiratory irritation compared to smoking, with little reliable evidence. Clinicians should remain vigilant about the potential for dependence on these substances and their psychological and physical tolls. This activity for healthcare professionals is designed to enhance learners' proficiency in evaluating and managing the health risks of vaping. Participants gain a deeper understanding of how vaping devices work, the appeal of these devices to young individuals, the short- and long-term health effects of vaping, and best treatment practices. The interprofessional team's role in educating patients about these devices is also emphasized. Greater competence enables learners to collaborate effectively within an interprofessional team caring for individuals who use vaping devices and face associated risks. Objectives: Screen patients for vaping use, including frequency, duration, and type of substances used. Assess the short- and long-term health impacts of vaping on patients, focusing on respiratory, cardiovascular, and mental health. Apply appropriate clinical guidelines for managing vaping-related health issues, including respiratory and psychological interventions.

Screen patients for vaping use, including frequency, duration, and type of substances used. Assess the short- and long-term health impacts of vaping on patients, focusing on respiratory, cardiovascular, and mental health. Apply appropriate clinical guidelines for managing vaping-related health issues, including respiratory and psychological interventions. Collaborate with the interprofessional team to educate, treat, and monitor patients who use electronic vaping delivery of cannabis and nicotine to improve patient outcomes. Access free multiple choice questions on this topic.

One of the latest public health controversies centers around the rising popularity of electronic nicotine delivery systems.[1] These devices, most commonly called "e-cigarettes" or "vaporizers," aerosolize various combinations of glycerol, propylene glycol, flavorings, nicotine, or cannabis to be inhaled by consumers. The marketing strategy for e-cigarettes is a “healthier” alternative to traditional tobacco and a novel aid for smoking cessation, with little data to support these claims.[2] For chronic tobacco users, these new devices may lead to harm reduction by reducing exposure to many of the harmful effects of tobacco smoke. On the other hand, novel nicotine users experience increased harm from the known hazards of nicotine consumption. These individuals may also experience unknown adverse health effects of different additives found in e-cigarettes.[3] Physicians throughout the United States began reporting surging cases of vaping-associated severe lung injury in 2019. Vaping-related lung injury commonly causes a severe respiratory compromise in previously healthy individuals, necessitating intubation or intensive care admission.[4] The exact cause of the lung injury remains unknown but has prompted further concern about the safety and regulation of these devices and their additives. An additional problem lies with e-cigarette use among adolescents and young adults. Early research suggests that e-cigarette use poses a higher risk for subsequent tobacco use later in youth and adulthood.[5] Other studies show increased respiratory symptoms, ie, chronic cough, wheezing, and bronchitis, with long-term use.[6] Nicotine alone correlates with negative cardiovascular outcomes, including hypertension, coronary artery disease, and heart failure.[7] Most e-cigarette companies are subsidiaries of large tobacco companies. Perhaps the most nefarious concern lies with the ongoing efforts of tobacco corporations to rebrand themselves to target the developing market, which is the vulnerable adolescent population.[8] Given the potential for benefit in specific populations and harm in others, more research is needed to delineate the true benefits of e-cigarettes as a smoking cessation aid versus the potential harm associated with long-term use.

Interprofessional cooperation and education can positively benefit patients and improve outcomes. The more healthcare team members ask about e-cigarette use and educate patients, the better. Most interventions occur in primary care, where physicians and pharmacists discuss smoking cessation with patients. Each team member needs to be educated regarding the risks and benefits of electronic nicotine delivery devices. When questioning patients about their social history, all team members must ask specifically about e-cigarette use, as patients may not consider e-cigarettes to be harmful or in the same category as traditional cigarette smoking and thus may not disclose their use. Asking and educating about e-cigarettes during well-child exams are crucial due to the rising popularity of these devices in the pediatric population. Some adolescents who would not have smoked may try e-cigarettes, which correlate with higher levels of smoking later in life. Interventions with adolescents aimed at smoking have demonstrated effectiveness in decreasing rates of e-cigarette users who later convert to traditional smoking.[21] Currently, traditional cigarette use has far more proven negative health consequences than e-cigarettes, partly due to a lack of research on the latter. However, e-cigarettes are not benign. The adverse health effects of nicotine in e-cigarettes on the cardiovascular system and childhood neurologic development require emphasis. Clinicians should recommend that the public quit smoking altogether. Smoking offers no health benefits, and individuals interested in vaping should instead be offered methods for quitting smoking entirely. Not only does smoking discontinuation improve health, but it also saves money for both the individual and the healthcare system. Only through a concerted effort by clinicians at all levels can smoking-associated morbidity decrease. Patients require ongoing education that smoking is harmful to their health, and a coordinated effort from all members of the interprofessional team can contribute to that goal.

Clinicians are essential in collecting and updating patients' social histories and relaying any e-cigarette use to the healthcare team. The healthcare team needs to be aware of the risks of e-cigarettes and how they relate to patient care and health.