The use of electronic cigarettes and other vaping devices is increasing both amongst smokers and those who have never smoked other nicotine products (e.g. cigarettes) before. A vape/vape pen is an electronic device which simulates tobacco smoking. It consists of an atomizer, a power source such as a battery, and a container such as a cartridge or tank. The container or tank is filled with a liquid containing nicotine, together with flavourings and other chemicals. There is an increasingly vast range of flavours available. The liquid is heated into a vapour which the user then inhales, this giving the term, “vaping”. The act of vaping conveys the nicotine into body via the lungs.
Vaping devices were initially perceived as an alternative to smoking cigarettes, particularly where that is not permitted indoors, such as in a shop in the UK. However, the use of vaping is becoming as prohibited as cigarette smoking, with non-vapours finding the plumes of exhaled vapour unpleasant.
Vaping and young adults
Vaping is becoming popular with children and young adults. According to the US surgeon general, e-cigarette use amongst high school students has increased by 900% and 40% of those had never smoked regular tobacco before. This may account for some of the popular flavours being developed including watermelon, bubblegum and apple pie. It is thought that youths and adults find the lack of smoke and smell (as compared to cigarettes) appealing, as well as the lower cost (per use). However, they can experience similar damaging effects as for smoking. There is some evidence that nicotine can slow brain development in teenagers. Also, it can affect attention, concentration, learning, memory, mood and self-control. In addition, longer term, it can have an impact on impulse control.
Health effects of vaping
The long-term health effects of vaping are unknown. Some people presently do notice an irritation of their lungs. This could lead to more serious lung damage over time. Furthermore, with the chemicals used in the vaping liquid widely varying, the health effects of those chemicals involved is difficult to determine. Some research indicates emerging data may link e-cigarettes to chronic lung disease and asthma. Some of the additives that are used in some e-liquid products are already known to be dangerous. For example, vitamin E acetate, which can be dangerous to inhale. Also, some of the chemicals, when combined, can form new compounds, which, when heated, can be harmful if inhaled. Recent studies report finding substances ranging from formaldehyde and acetone to heavy metals in e-cigarette vapour. Over time, greater research and data will emerge about the effects of vaping on the body. In addition, users are starting to report a range of effects. One newly emerging condition is that of ‘vaper’s tongue’ where there can be a sudden partial or full loss of the ability to taste.
The effects of nicotine on the body have a long history. Nicotine is a toxic substance that raises blood pressure and spikes adrenaline, which increases your heart rate and the likelihood of having a heart attack. Whilst e-cigarettes and regular cigarettes both contain nicotine, many e-cigarette users inhale more nicotine than they would from a tobacco cigarette. This is because it is possible to purchase extra-strength cartridges, which have a higher concentration of nicotine, and users can increase the e-cigarette’s voltage to get a greater hit of the substance.
Another consideration when working with vaping hypnotherapy clients is that some people use e-cigarettes to vape CBD oil, THC oil and other chemicals. These drugs can have a potent effect on how someone thinks, acts and feels. If you are wanting to work with drug users, including those who smoke cannabis and psychoactive derivatives, then we recommend gaining further training after you have gained experience as a hypnotherapy practitioner, as these clients are often more complex to work with.
Vaping and smoking
According to John Hopkins Ciccarone Center for the Prevention of Heart Disease, nearly 7 out of 10 smokers want to stop smoking cigarettes. Perhaps recognising that smoking, with its nicotine and 7,000+ chemicals (many of which are toxic), harms nearly every body organ including the heart. John Hopkins say that nearly one-third of all deaths from heart disease are the result of smoking or passive smoking (second-hand smoke from others). Some smokers are tempted to turn to electronic cigarettes and vaping devices to transition away from smoking cigarettes, with a view to ceasing all forms eventually. However, this seems to be less-commonly actioned, with many people then both smoking cigarettes and vaping, thus increasing rather than reducing the health implications.
Vaping cessation and hypnotherapy
Smoking cessation is one of the approaches most commonly associated with hypnotherapy, alongside weight management and alleviating anxiety. Yet little is seen advertised, as yet, for vaping cessation. It may be that vaping is presently viewed as ‘healthier’ alternative to smoking cigarettes or cigars. It may also be that there are not yet as many people wishing to quit vaping, in comparison to those wishing to quit smoking cigarettes (as vaping is relatively new, and long-term health conditions increase with time).
You might wonder whether it is possible to simply change the words in a ‘smoking cessation script’ and use that with your vaping cessation clients. However, as with smoking, there doesn’t tend to be one ‘generic approach’ that will work. Your vaping cessation session will depend greatly on the client and the reasons they chose to vape, as well as their motivations to stop.
Some clients may have started vaping for the same or similar reasons they started smoking cigarettes, whether that is the perceived benefits of smoking (e.g. relaxing) or peer pressure, or one of many other reasons. They may want to stop vaping for similar reasons that people want to stop smoking. Other clients may have started vaping as an attempt to have a socially acceptable alternative to smoking, and still wish to continue to smoke cigarettes wherever permissible. Others again have never smoked and have a range of reasons for wanting to smoke, some similar to smokers and others not. Interestingly, according to a Twitter survey, the reasons that people vape and use e-cigarettes are changing. Less people now are using them as an alternative to smoking or to help quit smoking, but instead, the survey found that vaping is increasingly being used to boost social image (because it supposedly ‘looks cool’).
Similar to any smoking cessation approach, vaping hypnotherapy is likely to start with a thorough client consultation or ‘intake’. This will help you consider the most appropriate route to take and whether there are any contributing factors, such as anxiety or depression, that may need addressing first. Conducting a thorough client consultation is something that is taught on all good hypnotherapy courses, whether an ‘online certificate course’ or an ‘in-person hypnotherapy diploma course’.
Both a ‘quit’ approach (commonly single session) and the ‘phased reduction’ strategy can be applied to the vaping cessation hypnotherapy session, in a similar way to hypnotherapy for smoking cessation. As a therapist, you will also learn what their triggers and motivations are during the intake process, so that you can address and mitigate these during the therapy session.
If a client both vapes and smokes cigarettes (or other tobacco products) you may wish to address them as separate issues, particularly if there are different triggers for each. Furthermore, you may need to take a more focused and directed approach where someone wishes to stop vaping and continue to smoke cigarettes, or vice versa. In such a case, care is advised when formulating suggestions and if a script is used, it is good to scrutinise it carefully to ensure it is sufficiently directed to meet the needs of the client. As with the majority of hypnotherapy clients, it is often best to create a bespoke solution/script for each individual client, as opposed to relying on a generic script relating to a condition/goal.
Often, a suggestion-based approach, whether direct, indirect or a blend of both, perhaps supported by a metaphor, is all that is required for many clients. However, where a client’s progress may be impaired by unhealthy beliefs, these may benefit from addressing with some cognitive therapy and belief work. In addition, where a client seeks some insight, perhaps as to the reasons they have been unable to remain a non-vaper, then a more analytical approach can help a client move forward to develop a new way of being with greater understanding of their motivations. Less common may be the need for regression, although if a client has a phobia that is connected to their vaping, then this may be a helpful approach when supported by other, less-intrusive techniques.
Just as with smoking cessation, homework and commitment to change are a huge part of the vaping cessation hypnotherapy process. Homework will often relate to changing behaviours around their vaping, as well as dealing with any cravings. There are apps and texting programmes that a client can install on their phone for encouragement and to help overcome or distract away from cravings. As with smoking, vapers can experience withdrawal symptoms too. Common vaping withdrawal symptoms reported include:
Feeling angry, cranky or depressed
Generally, any withdrawal symptoms are most commonly experienced in the first few days, when it can be particularly helpful to avoid triggers, such as emotions, people and places associated with vaping. These symptoms can be anticipated during the therapy session(s) and coping strategies can be developed for the client and future paced (mentally rehearsed), so that a client is confident in their ability to deal with any symptoms that they experience as they go through the quitting process. By setting up strategies in advance, a vaping cessation client is more likely to successfully quit vaping. You may also suggest clients engage in distraction activities such as:
Going for a walk
Climbing some stairs
Taking 10 deep breaths
Engaging the hands e.g. Rubik’s cube or a puzzle
Going somewhere vaping isn’t allowed
Watching a movie or listening to a positive playlist
Ultimately, as a vaping cessation therapist, you will help a client let go of their old habits and behaviours, gain a more positive mindset and develop new healthier coping strategies. If you’d like to learn more about how to effectively work with vaping cessation clients, as well as smoking clients (and many other common client issues), join our upcoming live-online hypnotherapy certificate course, and expand your hypnotherapy skill-set from the comfort of your own home!
We hope you’ve enjoyed this blog, and if you have any more questions about this topic, or anything else for that matter, do please get in touch, because we’re always happy to help!
– written by Dr Kate Beaven-Marks