By Joanna Storey, MD

More and more in my pediatric practice, I hear from parents who are concerned about news reports of a national epidemic of youth vaping and e-cigarette use.  Indeed, studies published in the Journal of the American Medical Association and the New England Journal of Medicine reveal dramatic increases in the number of children who have started vaping over the last 5 years.  According to these reports, most of today’s high school students and many middle schoolers either know peers who vape, or vape themselves.

 The Centers for Disease Control has also detailed accounts of the ICU admissions and deaths associated with e-cigarette use and vaping since June of 2019.  Over the last 6 months, 55 people have died and more than 2500 have been hospitalized with vaping-associated lung injury.  Sixteen percent of these cases have been in teenagers.  And over the long term, e-cigarette use has been shown to increase lung diseases like asthma and chronic bronchitis by 30% in regular users.  

The e-cigarette industry claims to have developed their products as a safer alternative to regular tobacco cigarettes for adults who already smoke.  The popular Juul e-cigarette company’s website states that the company’s “mission” is to “improve the lives of the world’s one billion adult smokers by eliminating cigarettes.” However, a recent survey by the American Academy of Family Physicians revealed that more than 60% of adolescents and young adults who vape are not regular cigarette users.  Vape products often contain high concentrations of nicotine which is a highly addictive substance, and young brains are particularly susceptible to this addiction.  And many e-cigarette liquids have been fruit-flavored, suggesting that they were designed to appeal to youth users.  In this light, the claim from e-cigarette manufacturers that they are unhappy about a dramatic increase in underage use of their products seems duplicitous and insincere.  Once a teen has developed a nicotine addiction, these companies may have a customer for life. 

So what are parents to do in the face of the depressing statistics about the pervasiveness of this problem?  In my practice, I give the following advice:

First and foremost, talk your kids early and often about the dangers of smoking cigarettes and vaping.  Because peers and social media are such huge influencers of adolescent behavior, it’s best to start talking when kids are in elementary school.  Once they enter middle school, ask if kids know any peers who vape and talk to them about ways to refuse an e-cigarette.

Second, know what vaping devices and their parts look like and be actively on the lookout for them in your children’s belongings. Many devices are small and can easily be mistaken for thumb drives or toy parts. Ask the administrators at your child’s school what they are doing to prevent students from vaping at school.

Third, if you discover your child has been smoking or vaping, stay calm.  Ask a few questions about why your child is smoking or vaping.  If it’s peer pressure or stress-related, they may need some counseling to learn how to set boundaries with peers and develop healthier coping strategies. And last, if you think your child is addicted to nicotine, talk to your child’s pediatrician.  He or she can refer your child to behavioral counseling or cognitive behavioral therapy which can help.  Although there is no FDA-approved use of nicotine replacement products like gum and patches for adolescents or for prescription medications to curb teen nicotine addiction, the American Academy of Pediatrics recommends considering these options given the harms associated with teen nicotine addiction.

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