Middle school and high school use of electronic cigarettes or “vaping” is a huge problem in the US. In 2022, studies show that 3.3-4.5% of middle school children regularly vape, and 14-16.5% of high school kids vape. The vast majority of “vaping” or electronic cigarettes contain nicotine, which is very addictive to kids, but a growing percentage of them also contain THC (marijuana). Why should we care? Isn’t it safer than cigarettes?
Another way to look at the issue is to think about what happens when you make poison more tolerable, feel safer, and taste better. When I was a kid, if we were curious about cigarettes, we had to worry if our parents would find out, mostly because the smell was obvious and easily detectable on our clothes and in our cars. Now kids will only get caught if they are found actively doing it. Also, when most adults tried cigarettes for the first time the experience was awful - you felt ill, coughing, nausea, frankly it was disgusting. Afterward you knew you were doing something unhealthy, but with vaping, the kids feel completely fine afterward. This reinforces the idea to kids that it isn’t dangerous. And now, thanks to the makers of vaping devices, kids can inhale deeper and faster than they could with cigarettes, without feeling sick. When middle school kids are asked why they vape, the top two answers in a recent study were 1) it tastes good, and 2) it is safe. No one can have a rational, persuasive discussion about taste, but I think we can have a good discussion with our kids about the “safety” of vaping.
Nicotine affects the brain at the spaces between brain cells, called synapses. Teens are building many more synapses as their brains are growing, up until their mid 20’s. They also have more active dopamine responses than adults. Dopamine triggers the “That felt great, let's do it again” response, and is activated by nicotine (and tik tok videos, but that is for another day). For these reasons, nicotine has a stronger effect on teen’s brains than on adults. The effect in teens can cause issues with decreased attention, learning, mood, and impulse control. This difference between teens and adults also leads to forming the addiction to nicotine quicker. So who cares if they are addicted to something at a young age? If it doesn’t cause cancer (that we know off, cancer can take decades to develop and vaping is fairly new) and emphysema likes cigarettes, why is Dr. Fisher worked up about it? Because surveys show, most of these addicted teens will eventually move on to cigarettes. Besides that risk, since 2019, there have been over 2000 cases of teens and young adults with lung injuries, some of them permanent and disabling, associated with vaping nicotine and/or vaping marijuana.
So what is a parent to do? The main point is to have the conversation with your teen frequently. No matter how great your kid is, they are going to do some questionable stuff in high school, just like you did. But unlike you, they have a much better chance of not getting caught. So to protect them, you need to arm them with information. Your goal is for your voice to haunt them in the back of their mind when they are offered these choices. When asked why they tried vaping for the first time the most common answer is “Because my friend offered it.” You need to give them a reason to say no. Studies show that frequent discussions between teens and their parents was much more likely to predict less substance abuse, than similar conversations with their doctors and schools. You are the most powerful influence in your child’s life - even if you don’t believe it.
When I ask my patients about drug/nicotine use, I ask, “So, you are going into 7th grade! This is a perfect time to start smoking in the bathroom; when do you think you will start?” This is an effective way to ask because it catches them off guard. Besides looking at me like I am a crazy person, there are two general groups of answers. The first group looks disgusted, and they say that they would never do it. I ask them why, and usually they respond, “Because it’s bad for you.” That is not the kind of answer that will stop them from taking a puff from their best friend; you need to push a little harder and ask why it is bad for them, and if they don’t know, give them some information. The second group is the group that scares me. They pause and think about their answer. Often while their parents are sitting in the room staring at them, dumbfounded! These are the kids that have not been having this talk with their parents. They are a smidge of peer pressure away from starting a lifelong addiction. This group should not exist if we educate our kids before they are exposed to their friends smoking.
Talk to your kids before there is a problem and give them the ability to make good choices even when they know you are not looking. This will be much more effective than yelling at them after there is a problem!
Until next time, good luck parenting,
Dr. William J Fisher, MD
Fisher Pediatrics
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