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What Should Parents and Caregivers Know About e-Cigarettes?

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Dr. Lewis First
  • Dr. Lewis First

Most parents already know the dangers associated with traditional cigarettes and secondhand tobacco smoke. But in the last few years, the use of electronic or e-cigarettes has exploded, especially among teens and young adults.

E-cigarettes go by different names, including "e-cigs," "mods," "vape pens," "pods," "tanks," "tank systems," and "Juuls," the last of which refers to the company, Juul, which makes e-cigarettes in flavors, such as mango and mint, that appeal to kids. Regardless of the name, Dr. Lewis First, chief of pediatrics at Vermont Children's Hospital, wants parents and caregivers to know the health hazards that electronic cigarettes pose to young people.

KIDS VT: How bad is the e-cigarette problem among children and teens?

LEWIS FIRST: According to the U.S. Centers for Disease Control and Prevention, between 2017 and 2018, the use of e-cigarettes among teens increased 78 percent. In 2011, 1.5 percent of teens were vaping nationally. By 2018, it was 20 percent. That includes about one in five high school students, who reported vaping in the last 30 days. Use among middle schoolers has also gone up 48 percent in the last year. So, it's pretty serious.

KVT: Are e-cigarettes an easier pathway into nicotine use than traditional cigarettes?

LF: Yes. Often teens are under the assumption that the carcinogens from combustible cigarettes are not in the vapor of e-cigarettes. The truth is, when you inhale the vapor from a vaping device, it's laced with a variety of carcinogens, many of which are the same as those in combustible cigarettes. Whether they will directly cause cancer, we can't say yet. But that vapor is also usually filled with high concentrations of nicotine, which is highly addictive. One vaping cartridge or pod has as much nicotine as a whole pack of cigarettes. A teenager can go through one in a single school day and have no idea how much nicotine they're getting, putting themselves on a significant pathway to addiction.

KVT: What does nicotine do to a young person's brain?

LF: We know that a young-adult brain doesn't finish developing until around age 25. Nicotine slows brain development in ways that affect memory, focus, concentration, learning, mood and self-control. Nicotine can also cause an increased heart rate, high blood pressure, abnormal heart rhythms and even death. Now, among adults who are already smokers, there are data showing that they may be able to reduce their nicotine and carcinogen exposure by switching to e-cigarettes. But when children or teens have tried nothing before and then try e-cigs, study after study shows that they are a gateway to combustible smoking, and that they're highly addictive in a very short time period.

KVT: What are the risks of accidental exposure?

LF: Some e-cigarette cartridges are refillable. Exposure to as little as half a teaspoon of the "e-juice" in one of these devices can literally kill a small child if they ingest it. In addition, getting that chemical on your skin is akin to absorbing a very concentrated nicotine patch. The number of calls to the national Poison Control Center for e-cigarette exposure doubled in the last two years. Symptoms of nicotine poisoning include sweating, dizziness, vomiting, seizures, high blood pressure and difficulty breathing. So these e-cigarettes and cartridges need to be locked away from children.

KVT: What about the combination of nicotine and other drugs in vaping devices?

LF: Some teens now combine nicotine vape juice with marijuana or synthetic cannabinoids, the latter of which are much more potent and dangerous. We still do not know what the health effects are of adding these substances to vaping devices, but we do know that they're getting the same toxins in the vapor.

KVT: How would parents or caregivers know if their child is using e-cigarettes?

LF: Part of the problem is that many e-cigarette devices look innocuous or like other things, such as computer flash drives. Teachers report turning around from the blackboard and catching kids sneaking a puff from their pocket. They don't generate clouds of smoke and the vapor dissipates quickly. But if kids are using them, parents may notice that their kids are always thirsty and urinating frequently. That's because vaping removes hydration from the mouth and throat and leaves them with dry mouth. These devices can also cause nosebleeds. Kids may have more frequent respiratory infections due to the chemicals in the vapor. Parents may find what look like spare flash drive parts, battery chargers, USB adapters and spent e-cigarette cartridges or pods in the trash.

KVT: What can adults do to prevent kids from trying them?

LF: First, parents and caregivers should begin with a supportive and loving discussion, not a lecture, which should start before their children enter middle school. Hopefully, parents will have ongoing discussions with their kids, perhaps triggered by an e-cigarette advertisement, seeing someone using one in public, or going past a vape shop. Parents should explain to kids that they don't want them using these devices because they want their brains to develop normally. Parents get can additional info at e-cigarettes.surgeongeneral.gov, which is a good, family-centered government website. Consider sitting down and reading the data together to see how dangerous these devices are, how addictive they are, and how expensive this habit is.

KVT: What if a child is already using e-cigarettes?

LF: Parents need to keep their cool, listen and tell their child that they know it's difficult to stay away from vaping. They should also give kids some strategies for avoiding peer pressure. For example, if a teen plays sports, he or she can tell their friends, "Not now, I'm in training." And just reiterate that you love your child and you care so much about their health and will be there for them. Finally, if parents or caregivers smoke or vape themselves, this is a good opportunity to quit and set a good example for their children.

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