Ploink!
There she is, in the digital window. Light brown hair pulled back, army green sweater.
“Hey Floor, we did it! How nice to have you here. Welcome, welcome to WeQuit.”
Floor (16) is done with it. She doesn’t want to smoke or vape anymore. She started when she was fourteen: her brother had vapes and she was curious. It became a habit. Before school, at the station, with colleagues from her part-time job during breaks in the alley. Perhaps, she thinks, her parents’ split was a factor. “That did something to my behavior.” Now she notices it in her condition: sometimes she is out of breath while playing badminton. A while ago she saw an advertisement for a quitting course on Snapchat. She thought: this is the moment.
On a Wednesday evening, Floor has her first session. Via a video connection she talks to practitioner Wouter Vlasveld from WeQuit, a platform that helps people get rid of a smoking addiction. Vlasveld is a psychologist and has experience in addiction care. Later, he says, he will tell more about the program. “But first I am very curious about you. Is it the first time you’re going to quit?”
Floor shakes her head. She stopped for a while during the summer holidays. It was quite easy. “Only then school started again and that’s where things went wrong because classmates offered it.”
“Do you have many friends who smoke or vape?”
“Yes, almost everyone, that makes it difficult. It’s hard to say no when you know you can get it anyway.”
“Is school a big trigger for you?”
“Yes.”
“Okay, that’s definitely something we can look into.”
Oxygen tank
At WeQuit they see the number of vapers increasing enormously. Four years ago, there were zero registrations for help in quitting the use of e-cigarettes, compared to around a thousand in the past year, says founder Joris Dullaert. A few hundred of those students are young people.
The company recently started one program for 12 to 24 year olds. They receive personal guidance in six online sessions. More providers have such a one-on-one approach, but as far as we know, this is the only course that specifically focuses on a young target group. Dullaert: “We used to do group sessions with all ages. Sometimes that worked, for example, younger participants saw someone with an oxygen tank and thought: I don’t want to end up like that. But the average 15 or 16-year-old is not so concerned with the long term.”
Anyone who is 16 years or older can register independently. The treatment, which consists of cognitive behavioral therapy and nicotine replacement therapy if necessary, is based on a method that: scientifically proven effective is. The course is reimbursed – at least once a year – by all health insurance companies.
Floor noticed that she was vaping because of her condition: sometimes she was out of breath while playing badminton.
Photos: Bram Petraeus
According to Dullaert, treating vapers is still a bit of pioneering. “We have to offer tailor-made solutions. That is why we always first make a smoke analysis and then a plan of action. For vapers, it is often difficult to determine how much nicotine someone ingests, while this is important when working with nicotine replacements.” Illegal vapes from China make it extra complicated. “Often the wrong dose is stated, or nothing at all. In addition, many vapers also smoke tobacco.”
Studies show that the concentration of nicotine in vapes is variable and unreliable. RTL News had vapes confiscated from Dutch secondary schools tested, almost half of them contained more nicotine than legally permitted. There were vapes with the equivalent of between 200 and 400 cigarettes and harmful substances such as lead, nickel and formaldehyde. Sometimes, it noted RIVM in 2021, there are nicotine salts in vape liquid. These provide a less sharp feeling in the throat, making the vapors easier to inhale.
Doctors made last year fourteen times of children who ended up in hospital after vaping. In many cases, they ingested “shockingly” large amounts of nicotine. They suffered from collapsed lungs and bleeding, among other things.
Lightning fast
There are now in the Netherlands almost as many young people who vape like smoking. Nearly 70 percent of young vapers are ‘dual users’ and also smoke cigarettes. The long-term decline in the number of smoking students has stagnated, it appears figures from the Trimbos Institute and the RIVM. The popularity of e-cigarettes plays a major role, experts think. The number of young people who ever smoked (12 to 16 years) is around 17 percent.
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Whether it is smoke or vapor: regular and electronic cigarettes basically have the same addictive effect. Nicotine is one of the most addictive substances in existence. Your brain absorbs it very quickly, practitioner Wouter Vlasveld explains to Floor. “Within zero to seven seconds.” As soon as the nicotine level in your blood drops again, often after 20 to 60 minutes, you become restless, tense and feel like drinking again. This creates two types of dependence: “The nicotine addiction, which is physical. And the habit, the routine addiction, we will try to tackle that together. We’re going to look at what smoking and vaping is all linked to for you. Do you have questions about this? It’s quite a lot of information.”
Floor smiles. “I’m following it all, I believe.”
Last year, doctors reported fourteen times that children ended up in hospital after vaping, with symptoms including collapsed lungs and bleeding
Vlasveld asks how much she smokes. By smoking, he says, he also means vaping.
Floor finds it difficult to estimate. “Butts about two a day, vaping can’t really be counted.” It’s usually friends or colleagues, she says, who offer it. She has a weekend job in the catering industry and works eight hours straight. “You only get a break if you smoke. And fifteen minutes to eat.”
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“Now the key question,” says Vlasveld as the end of the session approaches. “Have you thought about a quit date?”
“Um, well, my goal is actually to retire after the summer holidays.”
“Ooh… That’s still a long way away.”
“Yes, I overestimated it a bit.”
“I’m going to get straight to the point: WeQuit’s idea is to stop between the first and second sessions. Because then we can immediately see: what are you running into?”
Floor nods gently.
“So yes,” says Wouter. “That would be next week.”
A slip
The quit day went well, Floor says a week later with a smile. She didn’t touch anything on Sunday, actually not all week. Only on Monday things went “a little wrong” when a friend offered her a butt. “I forgot for a moment that I was stopping.”
Can happen, says Wouter Vlasveld. “How did you feel when you smoked? What did it do to you?”
“I immediately felt that this was not the intention. I threw it away pretty quickly.”
Vlasveld: “We call this a slip. The great thing is: you can learn a lot from it. Smoking is a very conditioned addiction. At certain times you can expect that you will be hungry.” Has she already thought about what she can do if friends offer it again, he asks.
The rest of the session is about ‘helping thoughts’ and what to do in ‘risk situations’. While Floor is petting the black and white cat on her lap, she explains that she once really felt like smoking and put her earphones in. “Super good!” says Vlasveld. “So you really started looking for distraction by listening to music. A nice self-control action.”
They discuss the homework (make a top 5 of the greatest risk situations). Then the twenty minutes are over. “Same time next week?”