May 1st - The Dangers & Addiction of Vaping

Episode Transcript

Speaker 1 (00:03):
Welcome to the Wellness and Healthy Lifestyle show on your VOCM. Now,
here's your host, Doctor Mike Wall.

Speaker 2 (00:13):
Welcome to the show. I'm your host, Doctor Mike Wall.
Today we're diving into the risks of vaping, a growing
public health concern that's affecting more and more of our
youth and young adults. Vaping is often seen as a
safer alternative to smoking, but as you're hear today, the
science tells a different story. Joining us is doctor Leslie Phillips,
a professor of Memorial University, a pharmacist and a mental

(00:34):
health specialist who leads a quit smoking and vaping program
and spent years researching the impacts of nicotine and addiction.
We'll explore what makes vaping so addictive, especially for teens,
the misconceptions around its safety, and what policies in programs
could help people quit. Plus one cover the shocking statistics
of how many youth are vaping daily here in the

(00:55):
province and how this number continues to climb. So we
have lots to cover. Let's get to our interview with
doctor Leslie Phillips. Hi, Doctor Philips, Welcome to the show.

Speaker 3 (01:05):
Hi, it's a pleasure to be here.

Speaker 2 (01:07):
I was really really looking forward to this conversation because
we are talking about something that a lot of people
have some information on, but I don't think they have
the full picture. But this is literally what your mission is.
Let's start off with a little bit of a background
on yourself. Maybe you could tell us what you do,
where you were, what you research.

Speaker 3 (01:26):
Sure, So, I'm a professor at Memorial in both the
School of Pharmacy and the Faculty of Medicine. With medicine,
I have a joint appointment with the discipline of psychiatry.
So first and foremost, I guess I'm a mental health
pharmacist and I've been one now for some thirty one years,

(01:47):
and I have a cross appointment with the new Plan
Health Services in that capacity where I have a mental
health practice about one day week. I've done a cute
care more recently ambulatory care first episode psychosis, and I
think that's where I sort of got my passion for
smoking cessation because it kind of struck me, you know,

(02:10):
one day, that I was doing all this stuff to
help people with their antipsychotic medication and try and mitigate
a lot of the weight gain and high cholesterol and
those types of side effects from their medication, and it
struck me that I wasn't really doing anything about the
thing that was killing them, which was smoking. It kind

(02:31):
of mush rowed from there. So I run a quit
smoking vaping program one day a week in the school's
Medication Therapy Services Clinic, which is a pharmacist led clinic,
and I also do one day a week now working
for New Pland Health Services Smoking Cessation Program and teach

(02:52):
and do research.

Speaker 2 (02:54):
You got a few hats out, is what you said.
I've been hitting and that's good because everybody I've ever
met in life, it's really fulfilled, has something that they're
passionate about, and this is something you're obviously passionate about.
Now I want to go right to it for the
people that are tuning in, How do the health risk
of vaping compare to traditional cigarette smoking acute but also
in the long term.

Speaker 3 (03:14):
Yeah, so a great question, A great way to get started.
A gide up from a public health perspective. These cigarettes
are vapes as they're sometimes called, are definitely less harmful
than smoking. But the emphasis here is less harmful and
less harmful does not mean harmless. So when it comes

(03:36):
to the long term health effects of vape being. To
be honest, we're not going to know what they are
for probably another twenty years because they haven't been around
that long. And when you think about it, it takes
a long time for us to see chronic disease developed.
Just like with cigarettes, it took us forty years to
figure out they cause lung cancer, although the big tobacco

(03:59):
companies no sooner. It's going to take us a while
really to figure out the long term health effects. As
far as the short term health effects, I can tell
you what we know so far. Certainly common among people
who vape regularly. Chronic cough for sure, wheezing, shortness of breath,
reduced exercise capacity, a lot of mouth and throat dryness,

(04:23):
and irritation because nicotine is irritating. There's some significant evidence
that puts you at a higher risk for infections, particularly
in the long so some weak in the immunity as
a consequence of ad being it impacts your oral health.

(04:43):
It looks certainly like it's starting to damage blood vessels
in the way that cigarettes damage blood vessels, and in
a way that looks like it's a precursor for cardiovascular disease.
So fully expect we're going to see probably similar rates
of disease with vape being and of course poor mental

(05:03):
health outcomes in youth in particular. We're going to talk
about that, hopefully a little bit later in the show,
about depression and anxiety for sure, and potentially cancer not
really sure. But you know, think about what's in it,
because I think there's a lot of parents out there, Mike,
who think that this is just harmless and or it's

(05:26):
just water. It's okay, yeah, there's no tobac. Minute. Well,
let's think about what is in it. So that vaping
liquid is not water. It is a mixture typically of
propelline glycol and vegetable glycerine, and that's what gives it
its viscosity or its thickness, and that is what particularly
propelline glycll went heated. It's really theatrical smoke, is what

(05:49):
it is. It's phantom of the opera stuff. Huh. You know,
when you heat it up, it it vaporized. And these
products are not innocuous. Their respired tory irritants, propaly glacol,
when you heat it up, turns into formaldehyde. You know
that stuff in the Grade eleven science lab and the
fetal pigs in the jar. Yeah, that kind of stuff.

(06:12):
There's a bunch of flavorings in them, and everybody thinks, oh,
the flavorings ore, Okay, they're you know, Health Canada approved,
and that's true. But they're a proof for ingestion, for inhalation.
So a lot of these things are respiratory irritants, a
lot of them suppress the immune system, a lot of

(06:34):
them look like they're increasing again the risk for heart disease,
and they're causing some cellular mutations which sort of you know,
twig us out that this could be a precursor to cancer.
And in particular, I think the one that people always
talk about with vaping is popcorn alone. Bathing causes popcorn alone,

(06:55):
and that was from a chemical. It was a flavoring
in vapes. Diacetyl was the chemical name for it. It's
a bottery flavor, and acetol was used in microwave popcorn
plants because it imparted that buttery flavor to the microwave popcorn.

(07:16):
Of course, it's circulated in copious amounts in the ear
of these plants, and the workers there developed a severe
form of emphysema called bronchiolitis oblitterans, which got nicknamed popcorn lung.

Speaker 2 (07:35):
See, that's interesting. Those are the things I had no
idea about.

Speaker 3 (07:38):
YAH typically severe respiratory illness, typically requiring a long transplantation
or death. It's end stage respiratory disease. Now, diacetol has
been banned in Canada, but that's not to say it's
not in the products because there's less regulatory control of
these products and a lot of people can continue to

(08:00):
purchase them online from outside the country. But there's a
lot of other flavors that are nasty to vanilla, cinnamon, mint, strawberry,
banana all have health concerns related to them when you
inhale them. And then finally, I think the other ingredients
of concern for me are heavy metals, and I don't

(08:20):
mean of the sort of rock band variety. I'm talking
about aluminium, cadmium, a copper, tin, silver, lead. We're not
sure how they get in there. They may be in
there as contaminants in the processing, or some of them

(08:42):
may be leeching off the coil. Because these products have
a heating coil, so that the vaping liquid heats the coil,
it warms up the liquid and turns it into an aerosol.
Where do they go, Like, where do these heavy metals.

Speaker 2 (08:58):
Go, I'm going to our blood or our lungs.

Speaker 3 (09:01):
Yes, out there, macrifileges get full of them, you know,
and yeah, the trash compactors of the body, the micropaths.

Speaker 2 (09:13):
So yeah, wow. So when you say, yeah, maybe not
as harmful, but far from harmless, I could see what
you're talking about. I think, but everybody is aware that's
smoking cigarettes is really bad for our health. But when
you hear it put that way, there's a lot of
even unique and different challenges when it comes to vaping.

(09:35):
That's really interesting. With the popcorn lung I'd never I
never knew the origin of why it's called that, but
a lot of that makes a lot of sense to me.
And you're right, it's not just this sort of two
synocuous substance. These are different things. And you also mentioned
from aldehyde. I work with the anatomy lab. I definitely
wouldn't want to be inhaling that. We actually have special
tables to keep those chemicals away from us so we

(09:56):
don't end up inhaling them. So I think you talked
of this, Why do people persist with this attitude that
it's healthier with it may be in a certain way,
but it's still very dangerous for us. It's not like
having something that's not going to it's going to substitute
it and be like this perfect solution at all in
any way.

Speaker 3 (10:16):
Well, I think that the tobacco companies have really done
an outstanding job of marketing these products, and perhaps we
haven't done quite as well a job at educating people
about their potential risks. And we certainly don't have the limited,

(10:37):
the unlimited amount of capital that big tobacco has. And
one of the things in particular I think that was
harmful was this and you've probably heard this and you've
probably seen this statement on those portable readerboard signs. You
know they're outside of businesses, so outside local vape shops.

(10:59):
For a long time there were a number of them
that had on these sort of these you know, rusty
metal reader board signs. E Cigarettes ninety five percent less
harmful than cigarettes, studies show. So this comes from a
study from the UK that was actually very poorly designed,

(11:23):
very bad science, and has since been debunked. However, it
is a common claim. It continues to be cited so
much so that it has become what I would call
a factoid, you know, unreliable information that gets repeated so
often that it becomes accepted as fact and you can't

(11:46):
kill it. It's like a zombie, you can't. I think
there's a more reliable estimate that comes from a study
that was published in twenty twenty one that suggests that
they probably could be about as third as harmful to
health as smoking.

Speaker 2 (12:05):
Today, we're looking at how vaping and nicotine impacts a
developing brain and why youth are especially vulnerable to addiction.

Speaker 4 (12:12):
We'll be right back after the break.

Speaker 2 (12:20):
Welcome back. Today we're talking with doctor Leslie Phillips about vaping,
youth addiction and what can be done to turn the tide.
Let's get back to the episode. And I think that's
where shows I guests are so important. Having experts like
yourself thought, this is an opportunity for people to tune
in and here the person that's actually able to determine
the value of the science. And you know, for people
that are listening, being able to evaluate the quality of

(12:42):
research is really really challenging, and it requires a specific
skill set. I think that's sometimes where we find convenient
studies that agree with us, but they may not be
designed properly. Is this one of the reasons why you've
called for such stronger regulations around tobacco products, because this
is something that you're actually doing. You're looking for policies
that help prevent access for use to vaping. I think

(13:05):
maybe as we're adults we can make our own decisions,
but for use, it's something you're trying to work towards.

Speaker 3 (13:11):
Well. Definitely, And let me start by saying that if
we even accept, Mike, let's accept that e cigarettes are
less harmful than cigarettes, because I believe that's probably true,
given the fact that the cigarette has killed more people
than any other consumer product. Is declaring e cigarettes as

(13:35):
less harmful really that big of a deal. Really, it's
not a It's not a big thing you have to
be when you think about it. Adding less harmful nicotine
products only reduces health burden if it reduces the number
of smokers, and so far e cigarettes have failed to

(13:55):
do that on a population level in Canada. So important fact,
if you look closely at the nicotine and tobacco surveys,
you will see that nactual fact, there has been no
decrease in the number of smokers quitting in Canada for
twenty years. So the prevalence is going down. But the

(14:18):
prevalence is going down not because smokers are quitting. It's
going down because youths are not initiating. Well, what are
youth doing, Mike, They are vaping. So adult smokers are
not the ones using e cigarettes, and the majority of

(14:39):
them that do are dual users. Now this is another
problem I have because dual use means that you're doing both.
You're smoking some tobacco cigarettes and you're also using e cigarettes,
and we know that that's far more dangerous than either alone. Really, Yeah,
increased exposure to toxicants, increased odds cardiovas given disease, and

(15:04):
respiratory diseases including COPD and lung cancer. So, bringing you
back to what you talked about, the largest impact of
ecrits in Canada has been on uth and young adults.
And there's a study actually that estimates that for every
smoker that equits with an e cigarette, eighty us start

(15:25):
using one.

Speaker 2 (15:26):
Holy cow, that's unbelievable, I I you know, and is
that part of it? I Mean, that's got to be
an intentional aspect of the marketing, the fact that, you know,
a cigarette can be quite uncomfortable. I think for people
to get used to the taste, isn't there things like this?
But then you've got this, you know, really slick looking vape.
It tastes like candy. It's giving you a bit of

(15:47):
a stimulant affect to it. Its just it seems like
it's designed specifically to appeal to use. Am I wrong
about that?

Speaker 3 (15:54):
I don't think you are, because I think that that
bag to bac go or tobacco companies have looked and said, hey,
tobacco indgame is coming. Like we've done a good job
at deterring youth from smoking, done a good job, and
it's worked because they're not smoking, and so sales are down.

(16:19):
What are you gonna do? You're gonna find a way
to get that new population hooked on nicotine. Along comes
this product which is quite different from It's a genius
drug delivery device, is what it is. It has a
different kind of nicotine in it call a nicotine salt,
which is way more palatable on your throat, much less

(16:44):
harsh than a cigarette. It enables or facilitates the inhalation
of much larger amounts of nicotine than you would be
able to stand with a cigarette. You put on these
fruit flavors or candy flavors, you know, twoty fruity gummy beer,
unicorn puke, unicorn milk. You can give dragon's breath, right,

(17:07):
you give these sleek, cool designs and flashy colors. Of
course it's going to appeal to youth. And you know
the health consequences of nicotine, because if you think about
a cigarette, nicotine is not the harmful part of the
cigarette for an adult, right, the nicotine keeps you smoking
because it's the addictive part, but it's the tar that

(17:30):
kills you. No, not so in youths, because the consequences
of nicotine in youth are much greater. And that is
because their brains are still developing. They are a work
in progress, So youth are more susceptible to nicotine addiction.

(17:50):
At by age twelve, an individual's reward pathway, the part
of their brain that's capable of experiencing pleasure from substances
of abuse or addiction, is fully developed. However, what I
will call your prefrontal cortex, your forebrain, the common sense,
the reasonating the judgment, the logic the way in the

(18:12):
pros and cons well, that doesn't develop till you're about
twenty five. So between the ages of twelve and twenty five,
you have this individual who's capable of experiencing all the
pleasure of substances of abuse, but not really quite capable
of thinking, you know, playing it out and thinking about
what the long term consequences of that could be. So

(18:36):
youth much more susceptible to nicotine addiction makes it a
lot more challenging for them to quit later. Nicotine crimes
the brain for addiction to other substances in youth. And
I'm talking about tobacco, I'm talking about alcohol, I'm talking
about cocaine, I'm talking about cannabis. And there are lots

(18:57):
of studies to show strong association with the use of
nicotine and the uptake or future use of these drugs.
Nicotine disrupts brain development. It looks like it produces persistent
changes in the brain, impairments in the wiring up there

(19:19):
in the prefrontal cortex, causing impairments in attention, in learning,
in memory, and in impulse control.

Speaker 2 (19:28):
Not good.

Speaker 3 (19:31):
Also results in increased anxiety and in mood and sleep. Dysregulation.

Speaker 2 (19:38):
Yeah, you know, that's where I was going to go
with this. I was wondering about that. I know that,
you know, we talk about the brain developing, even studies
coming on social media and the addictive nature of that
that the reward center being given this kick on a
regular basis, And we also said that you're able to
ingest higher amounts of nicotine as well. Like this to

(20:00):
just be amplified. I feel like anxiety, agitation, things like that,
which are already high in our youth these days, are
something that would be brought to the sort of the
next level when it comes to them. So the problem
with that these trends. You said that we're getting eighty
new papers for every person that's quitting smoking. I mean,

(20:21):
what's the percentage of people that are actually using these
babes from youth?

Speaker 3 (20:24):
Now, well, that a really great question because, first of all,
let me say that the biggest users of babes are
using young adults, the majority of whom were never smokers.
Let me also say that Canada has some of the
highest rates of youth vaping in the world, and of

(20:45):
course Newfoundland has the highest rate of all the Canadian provinces. Yeah,
so just recently, so over Christmas, the central government released
the results of new survey, the Canadian Substance Youth Survey.
So first edition of that got published in late December,

(21:08):
very robust study looking at a large number of respondents,
including a large sampling of youth and young adults, and
what came out of it was quite alarming. So if
you look at teenagers aged fifteen to nineteen years old,

(21:30):
the number that reported that they vate daily was seventeen percent.
Seventeen percent of our youth faving daily, and that's a
new indicator in this survey. Most surveys look at they
the last thirty days, and that figure is thirty one percent. Wow,

(21:50):
that's up over what the other studies had been reporting
over the past number of years, estimating that to be
thirteen to On this survey it was thirty one percent.
And I think the thirty one percent is is legitimate.

Speaker 2 (22:09):
Wow.

Speaker 3 (22:10):
The number of teenagers who have reported ever try and
invade forty eight percent, Mike have the larming ye, And
I would add that the ways the prevalence of vaping
has clearly gone up a bit. If you look at
this study, it didn't look like it looked like it's

(22:30):
sort of plateaued out in the upper studies, but the
ways in which youth are vaping is changing, so more
youth are evaping daily, and a quarter of the youth
who vape daily do so with in the first five
minutes of waking and a half within the first hour,
So the you know, time to onset of first use

(22:54):
is a strong prognostic indicator of heavy nicotine addiction. Using
within the within the first hour or within the first
five minutes means nicotine addiction is significant. It is extraordinarily high,
and it is higher than what we see for smoking.
And in fact, I just had an individual in my program,

(23:19):
actually a couple of them, young adults, who came because
they could not stop bathing, they could not stop vaping,
and they felt like it was ruining their lives, like
like it was always in their hand. Well not only
was it always in their hand, but for one of
them it was on their bedside. So first thing they
did before that their feet hit the floor in the

(23:39):
morning was vape. So the other one had it under
her pillow even worse, so she would wake up in
the night and vape. And all those youth that vape daily,
a third of them are reporting that they're vaping continuously
throughout the day, and I think, you know, that sort
of jives with what I see. Last week. It was

(24:01):
at a health forum over in the Inco Center at
the university, and it was interesting because I don't know
you've been there, but it's got this big glass foyer
on the second floor, big glass windows you're going to
look out over, and you see all these students about
to come into the Inco Center, and what's the last
thing they're doing before they hit the door. They're having

(24:22):
a hit on that vape because they got a top up,
you know, before they go inside, and they can't use it.
And all these reports that I'm seeing now of youth
yelling adults who are saying, hey, I started this when
I was in high school. I had no idea it
was going to be this addictive. I can't stop it. Well,
in the surveys, two thirds of youth who the ape

(24:45):
actually consider themselves to.

Speaker 2 (24:47):
Be highly addict Today, we're looking at how vaping and
nicotine impacts a developing brain and why youth are especially
vulnerable to addiction.

Speaker 4 (24:56):
We'll be right back after the break.

Speaker 2 (25:04):
Welcome back. Today, we're talking with doctor Leslie Phillips about vaping,
youth addiction and what can be done to turn the tide.

Speaker 4 (25:10):
Let's get back to the episode.

Speaker 2 (25:13):
So it's interesting you give those stats that Newfoundland and
Labrador is leading the way yet again and the health risk.
Why is it? Is it really that bad when it
comes to our participation? No?

Speaker 3 (25:23):
Is it the weather, Mike? They are they bored? I
don't know, but I actually I have some stats. It's
a different survey. So this is the Canadian Student Tobacco,
Alcohol and Drugs Survey twenty twenty one twenty twenty two,
looking at students from grades seven to twelve. The number
of students who vaped in the last thirty days the

(25:45):
national average seventeen percent. For Newfoundland, it's twenty seven if
I just narrow that down to high school because it
starts in about grade seven, but obviously high school grades
ten to twelve has the highest rate. If I look
at the vape in the last thirty days, just that
high school forty one percent of students nationally a national

(26:07):
average reported vaping in the last thirty days. Newfoundland and
At numbers fifty eight percent ever tried any cigarette. Twenty
nine point four percent of students grade seven to twelve
national average in Newfoundland that's forty percent. So we're number
one and not in a good way.

Speaker 2 (26:27):
Yeah. Well, when you think about this, we know that
there's harm associated with this that's quite significant. Even if
it is a lot less than a cigarette, it doesn't
mean it's not harming our people. You've called for these
regulations around alternative tobacco products. What policies you think we
can put in place from a government standpoint that make
it harder to access these for youth that might be vulnerable.

Speaker 3 (26:50):
Yeah, thanks, another great question. So there are a number
of options we could consider. Interestingly enough, last summer August,
I believe it was, the provincial government initiated a series
of expert and public consultation sessions on a number of
proposed strategies to better regulate tobacco on nicotine products, and

(27:15):
I was in favor of all of them. Sadly, no
action on any of these so far. Let me tell
you about what they were and why I think they're great.
So the first one is increase the legal age to
purchase any nicotine product twenty one. There's evidence to show
that has impact. It's not the full solution. None of
these are, but there's good evidence to show it has impact.

(27:38):
It's easy to implement. Just do it. What are we
waiting for? Come on? Number two? Generational ban on nicotine products.
I like this one. This is all our policy that
prevents certain generations younger people from ever being able to
legally purchase tobacco products or nicotine products, including cigarettes and

(28:01):
e cigarettes. So the idea is to create a generation
that never starts. So, for example, we would typically say
something like individuals who are born after two thousand and
nine would never legally be able to purchase so even
when they get into adulthood, would never legally be able

(28:22):
to buy these products. So it's a phased in implementation,
which I like. It doesn't impact the people who are
currently using these products. I don't know why they get
so upset about it. It doesn't impact then. You know
what I thought was really progressive when the Newfoundland government
announced this was that they were talking about not just

(28:45):
tobacco products, but nicotine products. And I think that that
distinction is critical because tobacco along is not going to
have much of an impact because youth are already not
using it right, So it needs to be extended to
nicotine products, and I think that would really shut down

(29:05):
the tobacco companies because they already know that new generation
are not using tobacco users, and they've strategically moved into
more and more novel nicotine products. Like we're talking about vaping,
but I don't know if you're familiar with the nicotine pouch.

Speaker 2 (29:21):
Yeah, so seeing these that really make overseas.

Speaker 3 (29:23):
Yeah, so they're big down in the US and they're
big here now as well. So again owned by Imperial Tobacco.
So look at it. I mean, if you look at
this zonic product, it looks to me like ice Breaker's candy.
It's very active, very attractive. But so I think, you know,

(29:47):
we're gonna have our work cutout for us, because Big
Tobacco are certainly busy doing a lot of lobbying to
try to prevent that from happening. Third one was a
flavored e cigarette band. The federal government has been ragging
their heels on this forty years. There's no reason why
the provincial government can't do it. It was on their list.

(30:08):
What a great strategy because Mike flavors are the things
that are identified by youth as a key reason why
they use these products. I've had people say to me,
if the only they stopped selling flavors, I wouldn't fade.
Fruit candy and mint are popular among youth, and you
know they're talking about keeping two flavors, tobacco flavor and mint.

(30:29):
Why do they want to keep mint? You know, youth
like mint. Mint flavoring has been linked to you know,
lung cancer. It's a respiratory irritant. Let's get rid of it.
Tobacco users don't need flavored cigarettes. Why do they need
flavored vapes? They don't get rid of it. The fourth

(30:50):
one was restricting access to nicotine pouches. The federal government
did that, thank goodness, because up to that point, you know,
preschooler could walk into a convenience store and buy this
product off the shelf, so there were no restrictions on it.
So now it's restricted to behind the counter and pharmacies,

(31:11):
which is great, it's really great. But if you think
about regulating these products according to risk, this one that's
probably from an addictive potential, the lowest risk because it
is an oral product, so it doesn't get into your
brain as quick as nicotine that is vaped or smoked

(31:31):
in a cigarette so the faster something gets into your brain,
the more addictive it is. So this is the least addictive,
but is the most regulated.

Speaker 2 (31:40):
Interesting.

Speaker 3 (31:41):
Interesting, not that we should go back, but we really
need to regulate vapes. They're far more addictive. And you know,
then finally enforcement, we have to increase enforcement. It's critical
to any regulatory change.

Speaker 2 (31:56):
Today we're looking at how vaping in nicotine impacts the
developing brain and why youth are especially vulnerable to addiction.

Speaker 4 (32:02):
We'll be right back after the break.

Speaker 1 (32:06):
You're listening to what we broadcast up the Wellness and
Healthy Lifestyle Show with doctor Mike Wall Listen live Thursday
nights at seven pm and Sunday's at four pm.

Speaker 2 (32:18):
Welcome back. Today, we're talking with doctor Leslie Phillips about vaping,
youth addiction and what can be done to turn the tide.
Let's get back to the episode. Sounds like we've got
a bit of an upgill battle here, you know, and
the rates of use of going up. But that also
leads to different cessation programs, and that's one of the
things I know you're really really passionate about. That's pharmacist

(32:40):
led cessation programs. You know, how can we use them,
and then how can we scale them so that when
individuals do realize, hey, I may not want to do this,
then they're able to wean themselves off because it sounds
like it's highly addicted.

Speaker 3 (32:55):
Yes, So in my study, I actually compared my to
something that is less intensive from a time perspective that
I actually designed with community pharmacists. So the idea was,
what is something that you could manage in a busy
community pharmacy. So we ran these two programs, compared them

(33:18):
to a control group was essentially doing nothing, and both
of my program and this shorter program were both effective
and they were both cost effective. So I think there's
a great opportunity here to roll this out. In twenty seventeen,
there was a Conference Board of Canada report that actually

(33:41):
recommended expansion of smoking sacial programs in community pharmacies and
said that it would bring about significant benefits and cost
savings for every I think dollars spent a return on
investment of nine dollars and ten cents. And you know,
pharmacists are uniquely positioned to these services. Think about it,

(34:03):
They're in every community. Most Canadians live within five kilometers
of a pharmacy. They're open extended hours nights, weekends. There
are typically available without appointment. They see their patients on
average about fourteen times a year. They're trained to provide
smoking cessation, including prescriptive authority, and the quid meds are

(34:26):
right there on site. They are a one stop shop,
and to my way of thinking, that is the best
way to roll this out right across. The reason why
I think it's what's stopping us from rolling it out
is the fact that we're not pharmacists, are not remunerated.

(34:46):
It's twenty dollars a visit for a maximum of three visits. Well,
I would like to see the evidence that says you
can get somebody to quit smoking it in three visits.

Speaker 2 (34:56):
I don't know.

Speaker 3 (34:57):
I don't even know where that came from. Premises are
just not going to do it. It's not it's not
worth the time for the paperwork. So new asked, do
we use the same things to help people quit vabing?
You know what? We were not really sure, however, and

(35:20):
there's not a whole lot of evidence out there. There
was a study recently got published that seemed to suggest
yes we do, and that's what we've been doing because
it's all nicotine. And of course all these quick medications
how they work is they either act like nicotine or
in the case of nicotine replacement therapies, they actually are nicotine,

(35:42):
and so they help manage the discomfort of withdrawal, which
is earned hard initially when you're quitting. So there's four.
We have four options to her prescription. So we have
a verena cline.

Speaker 2 (35:59):
Uh.

Speaker 3 (36:00):
It used to be marketed as Champis, it's generic. Now.
We have the Approprion marketed as zyban Is, an anti
anti smoke agent, but also as well buttrin and antidepressant,
same drug. And we've got two over the counterproducts. We've
got nicotine replacement therapies, but we also had this natural

(36:21):
health product called cytosine or crave. So we've got four products.
They only if you try to quit cold Turkey. If
I took one hundred people made in quit cold Turkey
six months later, only five would still be quit.

Speaker 2 (36:38):
Wow. Yeah.

Speaker 3 (36:39):
If I put them on a quit med six months later,
at least twenty to thirty would be quit. And if
I threw in behavioral therapies on top of that, it'll
probably be closer to forty forty five.

Speaker 2 (36:51):
Yeah, yeah, So the medications are part of it, but
also the psychology aspect of it. The behavior change obviously important.
I mean I used to do some smoking cessationion programming
with some of the heavy industry groups, and it was like,
you know, it's a habit you got to break, You
got to break the habit. It's such a challenging thing
to break free of. I know some people in my

(37:12):
family that struggle with it at certain points, and relapse
is obviously part of this quitting journey. What's your suggestion
to people that are listening that are like I just
can't give it up.

Speaker 3 (37:24):
First, I would say, the more you try to quit,
the more likely you are to quit. So don't quit quitting.
The second thing I would say is don't quit cold turkey.
It doesn't work for most people. The third thing I
would say is take the time and get yourself a
quick plan, and as part of that quick plan, get

(37:46):
a quit medication. Make sure it's dosed properly, because a
big problem is that these products are underdosed and then
people think they're not working and they stop using them.
Make sure that you're using these products correctly, particularly the
short acting nicotine products. If you don't use them correctly again,
they won't work. Get rid of this idea that once

(38:08):
you go on these products you can't smoke. That's another
zombie concept that is just not true that continues to
be perpetuated and people put off quitting because they think,
once I put that patch on, it can never smoke again.
That's not true. It's also not true that you can
only use one patch. Just this week, I had somebody

(38:29):
relapse because their healthcare provider told them they were on
two patches. That's too much. Take one off. Took one off,
they were quit, They went back to smoking, and then
because they were smoking, thought well I'm smoking, I can't
smoke with the patch on, took the other one off.
So now they've completely relapsed.

Speaker 2 (38:50):
Yeah, yeah, that's interesting. And so for somebody who is
listening to this though, and is like, Okay, you know,
forty chances quitting smokeing with the right approach sounds pretty
good to me. And I'm willing to give that a
couple of shots. Like, how do they get a hold
of the right people to avail of a program, to
develop a QUIP plan to be able to finally free

(39:12):
themselves in this addiction.

Speaker 3 (39:14):
Well, that's a challenging part. I think the best place
to go is is your healthcare provider, so your family physician,
your community pharmacist. It's a great place to get start started,
and they know where the other resources are.

Speaker 2 (39:30):
I say this all the time, you know, and unfortunately,
because we are behind the eight balls quite often when
it comes to our health, we have a sick care system.
Prevention is key. The people that listen to this show
are trying to get out of it. They're trying to
get the right information. Today, you have covered the full gauntlet.
You have been able to give us insights on the
risks associated for vaping versus traditional smoking, what needs to

(39:51):
happen in our province, what the best approaches are for people.
And I think we're really lucky to have you here today.
Anything you want to finish up. Before you wrap up, just.

Speaker 3 (40:00):
Say, you know, smoking kills one and two we cannot
afford to do nahhingyah, can't afford it. And our youth,
our youth are taking up nicotine now like never before.
So let's get going. We are more like toothpaste. We
need a push to flow. While I want to be

(40:20):
that push.

Speaker 2 (40:21):
That's great, Well, We're lucky to have you and thank
you so much for joining us. Today was really fascinating
chatting with you. I loved it. Thank you for having
me on giving me the opportunity. I want to thank
doctor Leslie Phillips for joining us today. We've gained valuable
insights into the health risks of vaping, the alarming rise
in youth nicotine use, and the urgent need for stronger

(40:42):
policies and more accessible cessation programs, especially pharmacist led solutions
that meet people where they are. For those interested in
learning more about accessing support to quit smoking or vaping,
be sure to talk to your doctor, your pharmacist or
reach out to New Fland Health Services. There are a
to solutions out there that can help you quit smoking
or vaping and reduce your health risk. I also want

(41:05):
to give a special thanks to my student Luke Sevier
for his help in today's episode. He helped with the
background research and brought these insights to life. Well thanks
for tuning in. I'm your host, doctor Mike Wall. We'll
see you back here next week for another episode of
the Wellness and Healthy Lifestyle Show on the Stingray podcast
network and your vocm