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The Lung Association of Nova Scotia is urging caution when it comes to using vaping devices, particularly for youth.

Mohammed Al-Hamdani, director of health initiatives with the Lung Association, said on Wednesday that there are still many unanswered questions about the long-term effects of using the devices, which can deliver nicotine or other substances through an aerosol delivery system. Many use the so-called e-cigarettes as a substitute for traditional cigarettes or as a means to help wean themselves off cancer-causing tobacco.

“The thing about teen usage is that there is mixed research on whether teens are using it just to experiment with it and never use it afterwards or use it and then keep using it in the long term,” said Al-Hamdani, who has a PhD in psychology and some training in addictions.

“There’s more of an issue with the latter. So if teens use it and become addicted and continue to use it then we have a problem with that — a bigger problem than just experimenting with it.”

One teen who was using a vaping device off the grounds of a high school in Bedford on Wednesday said he does it because he finds it relaxing.

“Because with school it’s a lot of stress,” said Noah, a 16-year-old student at Charles P. Allen high. He didn’t want his last name published because he is underage.

“If you’re just feeling really overwhelmed, it can kind of help you cool off. It just takes the stress away for a bit.”

He said he knows about the nicotine content and he’s not worried about health effects.

“For me, I’m not an avid user. I do it occasionally and I do it in moderation so I’m not too concerned about that. I know that if you do it every day and you’re constantly using it, then that could be an issue. But for me, I try and like moderate it and control (it).”

Noah said he uses it roughly once every other day. His friend Joseph, who also didn’t want his last name used, also said he is a rare user.

“If he wants to, (I) just come out with him because obviously you don’t want to be alone,” Joseph said.

Noah said he doesn’t feel like he’s becoming addicted and said he would never turn to regular cigarettes.

“I’ve had family (who) have been addicted to it and I see what it can do to people, so I would never do cigarettes.”

Noah also said his parents know that he occasionally vapes.

“They are relatively supportive of it as long as I don’t do any other actual drugs like pot. I will never do that. This is the only thing I actually do.”

Al-Hamdani said teens are vulnerable to the cache such devices carry. He pointed out the rise of a newer model of e-cigarette known as Juul, which carries a higher nicotine content and delivers it more efficiently. He called it “crack nicotine.”

“They look like a USB stick,” Al-Hamdani said. “They look fashionable, trendy, tech-like, so teens tend to gravitate towards those products, which just recently have penetrated the Canadian market.

“So that’s where I believe our organization and many other public health organizations are concerned.”

The devices contain a liquid, usually propylene glycol, as well as a quantity of nicotine. A battery heats up the liquid and it is dispersed as an aerosol. They may also contain flavouring agents, which is also an issue in attracting youth, Al-Hamdani said.

The relative newness of the products on the market has led to a gap in knowledge about the general long-term health risks, Al-Hamdani said.

There have been some concerns raised about a condition called “popcorn lung,” an inflammation damaging the smallest airways, but even with that, Al-Hamdani said there simply isn’t enough definitive evidence from randomized, controlled trials.

“Most of the effects that you see right now are things like discomfort, nausea, things that don’t quite materialize into serious, long-term harms. I think time will tell and we just need to wait for some more studies to be able to identify those harms,” he said.

“But a good perspective to take when it comes to e-cigarettes is to take a precautionary approach. Be careful, have those strict laws and regulations. It can be available but it shouldn’t be commercialized so that people don’t start using this too much and then 10 years from now we’ll end up identifying those harms. So put some strict parameters to it and 10 years from now if really there are no tangible harms from e-cigarettes then we can re-think our policies and maybe decide that it might be a good option to make them loose (not as strict), especially if these products prove in the long term to be effective in helping smokers quit.”

He wants to see if vaping can help people quit smoking and then if they can follow that success with also getting off the e-cigarettes. That’s another aspect that has yet to be determined with proper long-term study, he said.