^

A Blog from Your Kaiser Permanente Pediatricians in Northern California

Teen vaping

How To Talk with Teens About Vaping

Our kids are vaping. One recent study found that 28% of high school and 11% of middle school kids report using nicotine-containing e-cigs. When I asked my own kids what they observe in their peers the estimate was far higher. Any way you slice it — too many kids are vaping and we’re at risk of raising a new generation of nicotine-addicted people.

As parents it’s tempting to put our heads in the sand and hope that our own children aren’t vaping. Or we’re not sure how to begin the conversation with our kids. Maybe we don’t know enough about e-cigs and vaping to know what to say.

Let’s be brave and start this conversation by reviewing a few FAQs:

What makes vaping so popular with kids?

The short answer is it tastes good, it’s easy to hide from adults, and it’s addictive. When e-cigs first came onto the market around 2007, they were designed to look like cigarettes, cigars, or pipes. But now they’re smaller and look like pens, car key fobs, or flash drives — making them easy for kids to use without anyone noticing.

What are all the different types?

Electronic cigarettes come in many forms and go by lots of names including, e-cigs, vape pens, vapes, dab pens, dab rigs, tanks, mods, and pod mods. They’re battery operated or USB rechargeable and work by heating a liquid that produces a vapor that’s inhaled. The liquid usually contains nicotine (but can have CBD or THC), kid-friendly flavoring, and a “humectant” that uses moisture to create a vapor. Here’s a run down of the types:

  • Refillable devices can be refilled with a liquid.
  • Reusable pod systems that are USB chargeable. Because of the popularity of the brand JUUL – using these is called “JUULing.” There’s some regulation of flavors, but the most popular amongst teens — mint and menthol — are still available. Pod style e-cigs always contain nicotine — a fact that many kids don’t understand. One 2018 study found that, “Sixty-three percent of JUUL users did not know that this product always contains nicotine.”
  • Disposable e-cigs cost less than the refillable or pod versions and have a higher nicotine content. Currently, there’s no regulatory control of the flavors marketed to kids. Some available flavors from the brand Puff Bar are grape, blue razz, watermelon, and O.M.G. (orange, guava and mango.)
  • Heated tobacco products. Tobacco companies are now selling devices that heat (rather than burn) traditional cigarettes to produce an aerosol to inhale.

So what’s the problem with vaping? Use of e-cigs has health risks and have been linked to serious lung illness, can lead to addiction, and is harmful to the environment.

Health risks

Our understanding of the short- and long-term risk of vaping is evolving as more research is done. At this point, there’s growing evidence that the health risks of using of e-cigs incude:

  • Chronic cough, bronchitis, pneumonia, and worsened asthma.
  • Potential increased rates of cancer and heart disease in regular e-cig users.
  • A new “vaping-related illness” that’s caused thousands of vapers to become ill. While many of those affected had vaped THC — not all had. The exact cause of the disease is under investigation.

Using nicotine is especially risky for kids. The Centers for Disease Control and Prevention (CDC) explains that use of nicotine in adolescence can:

  • Negatively affect learning, focus, mood, and impulse control.
  • Decrease ability to form new memories or learn new skills.
  • Increase risk of addiction to other drugs.

Can e-cigs become addictive?

Yes. Nicotine is an addictive substance. We know that kids’ developing brains are more susceptible to addiction. They require a lower concentration of daily nicotine to be addicted. And kids who use e-cigs are 4 times as likely to start smoking traditional cigarettes. This is tragic. Tobacco use remains the leading cause of preventable disease and death in the U.S.

What’s in the e-cigs that causes health problems?

When an e-cig is heated up, it creates an aerosol of particles that are inhaled. This aerosol includes the highly addictive nicotine and particles from the heating coil itself and the liquid solution. Because many of these substances have not been well studied or approved by the Food and Drug Administration (FDA), we don’t know all of the health consequences of regularly breathing them in. One example is the compound pulegone: this is a known carcinogen found in mint extract that is banned in food use but still found in menthol e-cigs.

What can we say to our kids that will convince them?

Some concepts that motivate teens:

  • They don’t like to be controlled so helping them understand that e-cigs (especially the popular JUUL) have nicotine and that nicotine is highly addictive may help. This same line of thinking applies to being manipulated by big company marketing that targets teens.
  • They care about our environment. Discussing the waste of disposable pods and e-cigs makes sense to them. Show them the Puff Bar website that opens with this line: “OPEN. USE. THROW AWAY.” Ugh.

Kids are smart and realize the danger e-cigarette use creates for themselves and the environment. More than half of teens using nicotine report having tried to quit in the last year. But nicotine is highly addictive and quitting usually requires assistance. If your child wants help quitting, have them:

  • Talk with a doctor. If their pediatrician is not knowledgeable about nicotine cessation programs — ask to be connected with a doctor who is and sees young adults.
  • Look at This is Quitting, a successful online and text-based program created by Truth Initiative.

Resources for Parents:

Truth Initiative:
E-cigarette Fact Sheet
E-cigarettes: Facts, stats and regulations

American Academy of Pediatrics:
Vaping: Dangerous, Available & Addicting

Centers for Disease Control and Prevention (CDC):
Quick Facts on the Risks of E-cigarettes for Kids, Teens and Young Adults
E-Cigarette, or Vaping Products Visual Dictionary

My Doctor Online:
E-cigarettes and Vaping

Disclaimer: If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder. This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.