Consider this sobering statistic: vaping among seniors doubled in 2018, according to a national survey, making it the largest-ever recorded youth substance abuse in 43 years, according to the National Institutes of Health Monitoring the Future 2018 Survey Results. 

This means one in five high school seniors vaped in the last 30 days.

Recent news in October 2019 from a CDC analysis showed that there were 34 deaths and 1,604 cases in the U.S. of lung disease from vaping, which disproportionately affected young people. 

In Illinois high schools, according to a CDC risk behavior survey, by 12th grade:

• 68% drank alcohol (38% currently)
• 43% tried marijuana (30% currently)
• 50% tried e-cigarettes (18% currently)
• 36% smoked (11% currently)
• 19% used non medical use of prescription pain meds
• 3% tried heroin
• 6% injected drugs
  

More seniors in Illinois admit to having tried vaping than marijuana. In fact, one out of every two students have tried e-cigarettes – aka JUULs and vape pens – compared to 36 percent of them who have smoked traditional cigarettes.

Kids First’s Dr. Kathy Shepherd says she has noticed an increase in the number of teens in the office admitting to vaping, after what had seemed like a lull in traditional cigarette tobacco use. That was before vaping became popular. “It’s like the tobacco companies noticed so many people had stopped smoking that they came up with something even more attractive to get the next generation hooked.”

What’s so frightening about this trend among teens is that vaping comes with all the dangers of traditional cigarettes, combined with unknown dangers of the new respiratory substances in e-cigarettes. E-cigarettes use a battery to heat up a special liquid into an aerosol that users inhale. The “e-juice” that fills the cartridges usually contains nicotine, which is extracted from tobacco, propylene glycol, flavorings and other chemicals. Studies have found that even e-cigarettes claiming to be nicotine-free contain trace amounts of nicotine. When the e-liquid heats up, more toxic chemicals are formed that researchers are still trying to understand. 

Because the Food and Drug Administration (FDA) has not begun its review of any e-cigarette or its ingredients, nor has FDA issued any standards on the products, e-cigarette composition and effects vary. According to the American Lung ASsociation, what researchers do know is that toxic chemicals and metals have all been found in e-cigarettes. 

Take a look at the ingredients in e-cigarettes that enter directly into the lungs:

• Nicotine – a highly addictive substance that negatively affects adolescent brain development
• Propylene glycol – a common additive in food; also used to make things like antifreeze, paint solvent, and artificial smoke in fog machines 
• Carcinogens- chemicals known to cause cancer, including acetaldehyde and formaldehyde
• Acrolein – a herbicide primarily used to kill weeds, can cause irreversible lung damage
• Diacetyl – a chemical linked to a lung disease called bronchiolitis obliterans aka “popcorn lung“
• Diethylene glycol – a toxic chemical used in antifreeze that is linked to lung disease
• Heavy metals such as nickel, tin and lead
• Cadmium – a toxic metal found in traditional cigarettes that causes breathing problems and disease
• Benzene – a volatile organic compound (VOC) found in car exhaust
• Ultrafine particles that can be inhaled deep into the lungs

Evidence is clear

Even without the official research from the FDA, to pediatricians monitoring teens’ health, the evidence is clear. “Now when teens come into the office with congestion, a cough or even chest pain, I have to ask if they are vaping. Many times, the answer is yes,” says Dr. Shepherd. “This is just not something we saw in the office five years ago.”

No doubt there is more work parents and pediatricians must do to educate teens about the dangers of vaping. Addressing the problem starts with better communication. At Kids First, practitioners try to meet with teens during exams on their own so that they are more comfortable speaking openly about their health and behavior. “We want teens to know we’re a safe place they can explore health and safety,” says Dr. Shepherd.

At home, parents need to bring up vaping in a casual way, similar to any delicate topic with teens. Dr. Shepherd advises asking them about friends’ use and how often they see e-cigarettes in school or at social events. Parents can open the discussion at the home by mentioning an article or a conversation with a friend and then ask if kids know friends or students who are vaping. Ask them what they think of that, why they think people do it and whether they think it’s a bad thing. 

For parents who suspect their teen is vaping, parents should explain the risks and emphasize the rewards of quitting. “Try to refrain from anger but try to listen and help. Point out the risks and the rewards for quitting,” says Dr. Shepherd. 

Nicotine is highly addictive, especially to teens’ developing brains

• Vulnerable to neurotoxic effects
• More likely to become addicted
• Monthly tobacco use can lead to dependence

Early tobacco use

• Results in decreased ability to quit
• Increased amount used
• 90% of tobacco-dependent adults today started when they were younger than 18 years old

“Everyone I know who smokes as an adult regrets when they started young,” says Dr. Shepherd. 

Some effective ways to try to reason with teens include the following: 

• Appearance
• Breath
• Sports performance
• Doesn’t help with weight loss
• Expensive
• The tobacco industry has used deceptive marketing tactics to attract kids to smoking since its inception by using flavors found in cereal and advertising that appeal to youth

Review some common e-cigarette myths and risks with teens

Myth: E-cigarettes are healthy or safe: 

Reality: They contain many toxins and carcinogens, and the long-term effects of e-cigarettes are unknown.

Myth: E-Cigarettes can help you quit smoking 

Reality: Not FDA-approved smoking cessation aids

Youth who would never smoke are now trying and using e-cigarettes

Using e-cigarettes actual leads to dual use of e-cigarettes and actual cigarettes

For e-cigarette users interested in finding resources to quit, following are two places to start: 

Truth Initiative 

Smokefree Teen

As always, we are available to advise and support parents and families as we confront the use of e-cigarettes together.