Talk to your teen about vaping, but first learn the facts

More than 20% of high school students have reported using e-cigarettes in the past 30 days.

The teen vaping epidemic may be more difficult to tackle than doctors, public health officials and parents might think because so many teens are already vaping. The myth that e-cigarettes are a safe alternative to smoking and the many ways vaping devices can be hidden in plain sight have also contributed to the emerging health epidemic.

The effort to educate teens and parents about the risks of vaping has taken on higher relevance with statistics that show that more than 20% of high school students have reported using e-cigarettes in the past 30 days, an increase from 1.5% in 2011. Use is even high in middle schools with some pre-teens describing their school restrooms as “vaping lounges.”

Meanwhile, the number of deaths and hospitalizations from a pulmonary illness related to vaping has been increasing in Ohio and across the country.

“We’ve known for quite some time that the high doses of nicotine that can be delivered by vaping are harmful, but we believe that the recent tragic cases may be due to vaping of substances other than nicotine or perhaps in addition to nicotine,” said Dr. Starla Martinez, director of the Robert T. Stone, MD, Respiratory Center at Akron Children’s Hospital.

Dr. Starla Martinez says the vaping industry has led the public to believe e-cigarettes are safer than traditional cigarettes.

Vaping has taken off because of direct marketing to youth with fun flavors and e-cigarette designs that take the guise of pens, fitness trackers, pods, USB chargers and even the strings in a hoodie.

In Adolescent Medicine, providers have learned to be more specific with their screening questions.

“About 25 to 30% of our patients in Adolescent Medicine will say ‘no’ if asked if they use any nicotine or tobacco products,” said Dr. Crystal Cole, an adolescent medicine specialist at Akron Children’s. “But when asked directly about vaping, they will answer ‘yes’.”

Dr. Crystal Cole is interviewed by a reporter from WEWS TV about teen vaping.

The Ohio Chapter of the American Academy of Pediatrics (AAP) has been holding workshops throughout the state this fall to help inform providers, allied health employees, public health officials, and others how to best screen for vaping. Presenters, such as Dr. Michele Dritz, an adolescent medicine specialist at Dayton Children’s Hospital, and Dr. Jangus Whitner, a clinical pharmacist in Columbus, also shared facts about the vaping trend, interventional tactics, screening tools for providers, recommended curriculum for schools and other resources, which can be found on the Ohio AAP webpage.

The northeast Ohio workshop was held at Akron Children’s on Oct. 11 with nearly 200 people in attendance.

A panel of experts led a workshop on vaping at Akron Children’s. The program was sponsored by the Ohio AAP.

Here are some other facts presented at the workshop:

• Many teens do not realize Juul, the leading brand, and other brands of vape juice almost always contain nicotine, even if they say they don’t.

• The vape juice flavors are the “hook” and nicotine then becomes the “need” to keep teens using.

• One Juul pod is equal to smoking 20 cigarettes.

• Nicotine is highly addictive, and rewires the brain so it can worsen anxiety, mood swings and irritability.

• Teens who vape are 4 times more likely to start smoking.

Doctors are still not certain what is causing the recent vaping-related lung illness, but it could be THC (tetrahydrocannabinol), CBC (cannabis oil), vitamin E oil, or inhaling caustic chemical fumes. It’s difficult for consumers to know with certainty what is in these products, as full ingredient lists are typically not available.

“We’re also aware that young people and adults are making home-made vaping solutions using anything they choose,” said Dr. Martinez. “We think that the recent tragic cases are probably related to vaping things that destroy the lungs, either quickly or slowly. It’s too early to be able to say which substances are the worst, but we can say fairly confidently that there are no substances yet identified that are definitely safe to vape.”

Dr. Dritz said providers should always remember that adolescents, by their nature, are wired for risk taking and have short attention spans. So education should be concise and direct.

Parents should start by talking with their child or teen to learn what they know about vaping, and, if they already vape, to try to understand why they chose to do so. Strong, threatening language, like “You better not vape” may backfire because teens often reject such approaches.

“Perhaps by opening an ongoing conversation the child or teen may move toward making healthier choices,” said Dr. Martinez. “We don’t know if there are any ‘safe’ vaping products out there but so far we think not. The thing we do know for sure is that the safest thing to put into your lungs is just clean air with no additives, preservatives or flavorings.”

In this Children’s Channel video, Dr. Cole shares more about the impact these devices may be having on young adults.