> Magic Escalation Maze

If you vape, you could be on track to start smoking cigarettes.

metals

Metal particles found in vapes: Nickel Tin Aluminum You don't want any of these in your lungs.
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Metal particles found in vapes: Nickel Tin Aluminum You don't want any of these in your lungs.
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Metal particles found in vapes: Nickel Tin Aluminum You don't want any of these in your lungs.
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Metal particles found in vapes: Nickel Tin Aluminum You don't want any of these in your lungs.
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Metal particles found in vapes: Nickel Tin Aluminum You don't want any of these in your lungs.
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> acrolein

Vapes can contain chemicals like acrolein which can cause irreversible lung damage.
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popcorn lung

Popcorn lung! It sounds fun until you have it.
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Popcorn lung! It sounds fun until you have it.
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Popcorn lung! It sounds fun until you have it.
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Popcorn lung! It sounds fun until you have it.
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cigarette box

Did you know many vapes contain nicotine, the same highly addictive drug found in cigarettes? Vaping nicotine can change your brain and lead to addiction.
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Did you know many vapes contain nicotine, the same highly addictive drug found in cigarettes? Vaping nicotine can change your brain and lead to addiction.
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Did you know many vapes contain nicotine, the same highly addictive drug found in cigarettes? Vaping nicotine can change your brain and lead to addiction.
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Did you know many vapes contain nicotine, the same highly addictive drug found in cigarettes? Vaping nicotine can change your brain and lead to addiction.
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vape flavors quiz

congrats quiz - vape flavors

CONGRATS!

You’ve completed all the quiz questions.

How'd you do? If you're trying to make up your mind about vaping, it's good to know the facts.

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vape epidemic

People using screen readers may not be able to fully view information in this file.
VOICEOVER: A teenage girl is sitting in her room at her desk doing homework. The camera slowly zooms towards her as we see what looks like veins protruding out of her face, moving and lingering near the surface of her skin. Quick cut into her body to see the inside of her lungs. There are creatures floating around and landing in her lungs.
SCRIPT: There is an epidemic spreading. It can expose your lungs to acrolein, which can cause irreversible damage. It’s not a parasite. Not a virus. It’s vaping.
The creatures have now filled the screen and transitioned into a yellow-liquid space where there are millions of them. The camera quickly zooms out to reveal the yellow liquid is actually vape juice in a vape pod. The pod then gets picked up by the teenager and clicked into her vape. 
She takes a hit of the vape as we see something moving and lingering just under her skin again, which we can now understand are the chemicals of vaping going into her body. 
We see the creatures in the yellow liquid take over the screen, followed by a black screen with The Real Cost logo appearing and the URL: WhatsInAVape.com.

Vaping is an epidemic spreading amongst teenagers. It can expose your lungs to acrolein, which can cause irreversible damage.

SEE WHAT OTHER CHEMICALS ARE HIDING IN YOUR VAPE.

What Counts As Tobacco?

There's no safe tobacco, but what counts as tobacco? (slideshow featuring types of tobacco including Dip, Cigarette, Roll-Your-Own, and Hookah (Waterpipe)
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Cigarette
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Dip
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Hookah (Waterpipe)
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Cigar/Cigarillo
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E-cig
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And More
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http://bit.ly/2lYQsEy
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> Brain Change

Image of brain hooked up to wires

Nicotine changes the way your brain works

http://bit.ly/2lZ8SF7
LINK IS COPIED TO CLIPBOARD

> Nicotine is highly addictive

GIF of teen with spinning eyes

Nicotine is highly addictive

http://bit.ly/2lZdQl5
LINK IS COPIED TO CLIPBOARD

> epidemic spreading

There’s an epidemic spreading. Can you find all the clues? START LOOKING

> vape cessation

Ready to quit vaping? Click for help

acrolein

  • Goniewicz ML, Knysak J, Gawron M, et al. Levels of selected carcinogens and toxicants in vapour from electronic cigarettes. Tobacco Control. 2014; 23(2):133-139.

  • Cheng T. Chemical evaluation of electronic cigarettes. Tobacco Control. 2014; 23:ii11–ii17.

  • Bein K, Leikauf GD. Acrolein–a pulmonary hazard. Molecular Nutrition Occupational Safety and Health Standards. Medical surveillance – Formaldehyde& Food Research. 2011;55(9):1342-1360. 

  • Occupational Safety and Health Administration (OSHA).. Washington, DC: U.S. Department of Labor, Occupational Safety and Health Administration. https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS.... Accessed May 8, 2018.

Brain Change

  • U.S. Department of Health and Human Services (USDHHS). A Report of the Surgeon General: How Tobacco Smoke Causes Disease: What It Means to You (Consumer Booklet). Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2010.

    0014, 0016, 0097

cigarette box

  • Goniewicz ML, Hajek P, McRobbie H. Nicotine content of electronic cigarettes, its release in vapour and its consistency across batches: regulatory implications. Addiction. 2014; 109(3)500-7. 

  • Marynak KL, Gammon DG, Rogers T et al. (2017), Sales of Nicotine-Containing Electronic Cigarette Products: United States, 2015. American Journal of Public Health. 2017 May;107(5):702-705. https://doi.org/10.2105/AJPH.2017.303660

  • Vansickel AR, Eissenberg T. Electronic cigarettes: Effective nicotine delivery after acute administration. Nicotine & Tobacco Research. 2013; 15:267-270.

  • Hecht SS, Carmella SG, Kotandeniya D, et al. Evaluation of toxicant and carcinogen metabolites in the urine of e-cigarette users versus cigarette smokers. Nicotine & Tobacco Research. 2015; 17(6):704-709.

  • Adriaens K, Van Gucht D, Declerck P, Baeyens F. Effectiveness of the electronic cigarette: an eight-week Flemish study with six-month follow-up on smoking reduction, craving and experienced benefits and complaints. International Journal of Environmental Research and Public Health. 2014; 11:1220-1248.

  • Etter JF. Levels of saliva cotinine in electronic cigarette users. Addiction. 2014; 109(5):825-829. 

  • Hiler M, Breland A, et al. Electronic cigarette user plasma nicotine concentration, puff topography, heart rate, and subjective effects: Influrence of liquid nicotine concentration and user experience. Exp Clin Psychopharmacol. 2017; 25(5)380-392.

  • U.S Department of Health and Human Services (USDHHS). A Report of the Surgeon General: How Tobacco Smoke Causes Disease: What It Means to You (Consumer Booklet). Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2010. 

Magic Escalation Maze

  • National Academies of Sciences, Engineering, and Medicine (NASEM). 2018. Public Health Consequences of E-cigarettes. Washington, DC: The National Academies Press. Doi: https://doi.org/10.17226/24952

    TF0447

  • Berry KM, Fetterman JL, Benjamin EJ, Bhatnagar A, Barrington-Trimis JL, Leventhal AM, Stokes A. Association of Electronic Cigarette Use With Subsequent Initiation of Tobacco Cigarettes in US Youths. JAMA Network Open. 2019; 2(2): e187794-e187794.

    TF0447

metals

  • Williams M, Villarreal A, Bozhilov K, Lin S, Talbot P. Metal and silicate particles including nanoparticles are present in electronic cigarette cartomizer fluid and aerosol. PLoS One. 2013; 8(3):e57987.

    0442, 0244

  • Cheng T. Chemical evaluation of electronic cigarettes. Tobacco Control. 2014; 23:ii11–ii17.

Nicotine is highly addictive

  • U.S. Department of Health and Human Services (USDHHS). A Report of the Surgeon General: How Tobacco Smoke Causes Disease: What It Means to You (Consumer Booklet). Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2010.

    0013, 0017, 0093, 0012

popcorn lung

  • Allen J, Flanigan SS, LeBlanc M, et al. Flavoring chemicals in e-cigarettes: Diacetyl, 2,3-pentanedione, and acetoin in a sample of 51 products, including fruit-, candy-, cocktail- flavored e-cigarettes. Environ Health Perspect. 2016;124. https://ehp.niehs.nih.gov/15-10185/. Accessed March 27, 2018.

    0246

What Counts As Tobacco?

  • Food and Drug Administration (FDA). Harmful and potentially harmful constituents in tobacco products and tobacco smoke: established list. Silver Spring, MD: Federal Register; 2012. 77(64). https://www.gpo.gov/fdsys/pkg/FR-2012-04-03/pdf/2012-7766.pdf. Accessed August 21, 2017.

    0031, 0281, 0282

  • U.S. Department of Health and Human Services (USDHHS). The Health Consequences of Smoking: Nicotine Addiction. A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 1988. 

    0031

  • U.S. Department of Health and Human Services (USDHHS). How Tobacco Smoke Causes Disease. The Biology and Behavioral Basis for Smoking-Attributable Disease (Executive Summary). Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2010. 

    0031

  • U.S. Department of Health and Human Services (USDHHS). The Health Consequences of Smoking - 50 Years of Progress. A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2014. 

    0031, 0005, 0006, 0054