Help Your Young Patients Break Free from Vaping

One in five Kentucky high school students report using e-cigarettes in the past 30 days.

BY ELLEN CARTMELL, MPA AND JACLYN HODGES, BS, CHES

FRANKFORT E-cigarette use, also called vaping, continues to be the leading form of nicotine use among youth across the United States despite the fact it is not a safe alternative to smoking. Fortunately, there are many resources available for providers to screen, counsel, and support young people who are using e-cigarettes.

Youth vaping has spiked dramatically over the last decade, with the National Youth Tobacco Survey reporting a 1833% increase in youth vaping between 2011 and 2019. JUUL prod- ucts led to a further spike in youth use in 2016 by altering the way nicotine was delivered; nicotine salts, instead of free-base nicotine, made e-cigarette aerosols easier to inhale and delivered concentrations of nicotine levels five to eight times higher than other tobacco products. In addition to the high levels of nicotine, vaping products are frequently sold in youth-friendly fruit and candy flavors frequently combined with menthol to mask throat irritation.

Today, around one in five Kentucky tenth and twelfth grade students use e-cigarettes, a rate higher than the national average. Nearly half (49.7%) of the young people who use these products report trying them when they were younger than 14 years old. According to the U.S. Surgeon General, “The younger people begin smoking cigarettes, the more likely they are to become addicted to nicotine.” Young people who have ever used e-cigarettes have higher odds of becoming cigarette smokers in the future. While stores are not supposed to sell tobacco products to anyone under the age of twenty-one, 23.6% of sixth to twelfth graders report buying them in a store, such as a convenience store, supermarket, discount store, gas station, or vape store.

In addition to the risk of addiction, there is strong evidence that vaping damages the cardiovascular and respiratory system. Furthermore, using nicotine in adolescence can harm the parts of the brain that control attention, learning, mood, and impulse control. Compound these damaging effects with preexisting conditions, and a young person could be on a path to disaster. The Truth Initiative calls this a “colliding crisis” – combining growing rates of youth depression and anxiety with high rates of e-cigarette use, which is proven to worsen mental health symptoms.

The most effective way providers can begin to address youth use is through non-judgmental, strength-based approaches that include motivational interviewing. The resources listed in the attached sidebar can help begin important conversations with young patients about vaping.

The Tobacco Prevention & Cessation Program at the Kentucky Department for Public Health has additional resources on talking to young patients about tobacco use at CHFS.ky.gov.

Ellen Cartmell, MPA, is the manager of the Tobacco Prevention & Cessation Program at the Kentucky Department for Public Health. A graduate of Centre College and Morehead State University, Ellen’s other experience includes working for a local health department and in international public health.

Jaclyn Hodges, BS, CHES, is a health policy specialist with the Kentucky Department for Public Health, where she specializes in preventing youth initiation of all tobacco products. Prior to joining the Department for Public Health, Jaclyn worked at a local health department district in tobacco control and health promotion for 19 years.

MY LIFE, MY QUIT offers young people free, confidential coaching by text, online chat or phone call. Like Quit Now Kentucky, this youth quitline is offered by the Commonwealth of Kentucky in partnership with the respiratory experts at National Jewish Health. Teens who enroll in the program receive free, one-on-one guidance from coaches trained in nicotine addiction and child psychology. Refer a patient at MyLifeMyQuit.org.

Vaping Information, Solutions & Interventions Toolkit (VISIT), by Stanford Medicine, is an online toolkit that provides skill-building information and tools providers need to address vaping- prevention and intervention in a clinical setting. Learn more at med.stanford.edu/visit.html.

The American Academy of Pediatrics’ Tobacco Control & Prevention page at aap.org/en/patient-care/tobacco-control-and-prevention provides numerous resources for talking to youth about tobacco use. This includes the Ask, Counsel, Treat (ACT) model for youth tobacco cessation described at tinyurl.com/ACTmodel.

ACT to Address Youth Cessation, a training from the American Lung Association, is a one-hour, on-demand online course for healthcare professionals who want to provide brief tobacco-related interventions for teens. Thee training teaches the ACT method referenced above and provides guidance, support, and best practices for effectively delivering brief interventions for adolescents who use tobacco. Learn more about the training at: lung.training/courses/act-to-address-youth-cessation.html.