E-cigarettes are now the most popularly used tobacco product among adolescents. Recent data compiled by the Centers for Disease Control and Prevention (CDC) shows that 1 in 5 high school students (3.05 million) and 1 in 20 middle school students (570,000) use e-cigarettes, also known as vaping.1

JUUL, a popular vape device among adolescents, looks like a flash drive, making it easy to conceal, and comes in a variety of enticing flavors like creme, fruit, cucumber, and mango. According to JUUL’s website, it was originally created to be a satisfying alternative to cigarettes. A banner warning appears on the site stating that their products contain nicotine and nicotine is addictive. In fact, the nicotine content of one JUULpod is the equivalent of one pack of cigarettes.

In November (2018), the FDA announced a series of restrictions aimed at combating this growing public health issue that many believe has become an epidemic among teenagers.  The agency is on a mission to halt the illegal sales of e-cigarettes to minors and to put an end to the “kid-friendly” marketing of these devices.2

While JUUL is stepping up efforts to prevent teen use, including restricting sales of those coveted favors, parents and schools are still left to figure out how to help teens showing signs of addiction.

The Risks for Teens

There are numerous risks of nicotine use. Research shows that nicotine affects metabolism, increased cancer risk and respiratory problems, and more asthma attacks and symptoms.3 One study of adolescent vape users found increased levels of significant carcinogens in urine samples.

The risks to the physical health of teens are important, but it’s equally important to look at the potential for addiction. While the advertising surrounding vape can be misleading and cause teens to view vape as safer than it is, one study of 12th-grade vape users found that recent vape users were more than four times more likely to report cigarette use at a one year follow up. This study adds to a growing body of evidence that vaping can actually be a gateway to cigarette smoking among youth.

Addiction can negatively affect the ability to focus on a task as cravings trigger fidgeting and irritability. Given that the adolescent brain is still developing, it is susceptible to addiction. Early addiction to nicotine can cause the brain to remodel, changing the threshold for addiction to substances. This makes teens more likely to habituate to nicotine, drugs, and/or alcohol.

In addition to a lack of focus or increased fidgeting, behaviors linked with hyperactivity, nicotine addiction can also exacerbate symptoms of depression and anxiety. This dangerous trend among teens affects both their physical and emotional health.

juul pod next to computer

Juul, a popular vaping device, resembles a flash drive, making it easy to conceal. (Photo: 123rf)

What to Do If Your Teen Is Vaping

Given the record numbers of both middle and high school students are vaping, it’s important to talk early and often with young children about the risks of e-cigarettes. In the event that you discover that your teen is already vaping, it’s never too late to talk about it.

Educate yourself first. Blanket statements about how JUUL will ruin your life won’t work. Adolescents are surrounded by peer influence and creative marketing via social media and other forms of media. Vague statements are no match for a group of friends singing the praises of low nicotine and fast results.

It’s essential for parents to learn about both the risks of vape and why it appeals to teens. Get the facts about vape so that you know what you’re talking about when you start the conversation.

Open the door to honest communication. Establish a safe environment where your kids can talk about their feelings about vape without fear of being judged or given consequences. Social relationships are very important to growing adolescents. If your teen suspects that you will cut off friendships or take away all devices upon admission of trying or thinking about trying vape, your teen will not come forward for help.

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Engage your teen by asking open-ended questions about what’s happening at school and what he or she already knows about vape. Try to gain an understanding of the issues that might trigger vape use in your teen’s friend group. Are teens using it for stress relief? Do they believe it’s harmless? Are they bored?

Make Your Teen Aware of the Serious Health Hazards Associated with Vaping

Blurting out the latest headlines or reminding your teen of the cancer risk within your family might scare your teen for a moment, but it won’t likely translate to better decision making when faced with vape out in the world.

Break it down to the teen level to help your teenage consider the risks. How do you think the need for nicotine might affect your ability to focus in school? What if you get agitated during the school day and find that you can’t listen to the lectures? How might JUUL affect your ability on the soccer field? Do you think it might interfere with your ability to get enough sleep? Engaging in conversation helps teens consider the immediate and long-term risks and provides the opportunity to ask questions.

What If Your Teen is Already Addicted?

The great irony of this vaping epidemic is that e-cigarettes were originally developed to help adults curb their nicotine addiction by replacing cigarettes with a safer alternative. Unfortunately, the nicotine contained in vape juice is every bit as addictive as the nicotine delivered via cigarette.

One issue teen vapers face is that medications used to curb nicotine addiction are generally only approved for adult use. Another problem is that it’s difficult to measure the amount of nicotine inhaled and absorbed through vaping. Though we know that one JUUL pod is the equivalent of one pack of cigarettes, it’s significantly easier to cut back on cigarettes one at a time than to try to track and reduce the use of vape.

Start with your child’s doctor. It’s always a good idea to make an appointment with your teen’s primary caregiver for a complete and physical and to discuss your concerns about vaping and how to seek help. Ask for referrals to resources for teen vaping prevention/treatment in your area.

You can also ask about the following potential options:

Consider cognitive behavioral therapy (CBT). CBT can help patients identify triggers that spur the behavior and teach them relapse prevention skills and effective coping skills to work through feelings that might lead to relapse. While CBT is used for smoking cessation, research into the effectiveness of CBT on vaping needs exploration.

Many teens respond to mindfulness-based treatment. Mindfulness is another treatment option available for smoking cessation, but not yet studied for nicotine addiction through vape. In this therapy, patients attend to the thoughts that trigger cravings and reframe them to increase tolerance. They also learn to work through negative emotions without relapsing to nicotine use.

Group support can be an effective format. Group support can be effective in helping teens work through negative emotions and learn adaptive coping strategies. Ask your teen’s school for a list of referrals for local therapists or outpatient counseling centers that offer group support for teens.

While there’s no clear path to “curing” vape addiction in teens right this moment, parents can seek help through primary care physicians and adolescent mental health practitioners. While withdrawal from nicotine can be overwhelming for teens, long-term use poses significant health hazards. Don’t assume this is a brief phase during the teen years. Get help right away to help your teen make healthier choices.

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Last Updated: May 24, 2019