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'It's the Wild West out there:' As teens turn to e-cigarettes, 7 tips for parents to help curb their use

On the ground, Susan Foster, substance use prevention assistant program manager at the Poe Center for Health Education in Raleigh, says she hears that students are regularly vaping at local high schools and fields plenty of concerns from parents.

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Sarah Lindenfeld Hall
E-cigarettes have been "sold" as a safer alternative to smoking, and middle and high school students are falling for the pitch, as Amanda Lamb shared in her post this week about teens and vaping.
Here in North Carolina, studies show that e-cigarette use by high school students increased 888 percent between 2011 and 2015 from 1.7 percent to 16.8 percent. For middle school students, it shot up 600 percent during that same period, according to the N.C. Youth Tobacco Survey. The survey found that nearly 30 percent of N.C. high school students were thinking about using an e-cigarette in the next year. At the same time, traditional cigarette smoking dropped by 40 percent.
Last year, a national survey from the Centers for Disease Control and Prevention found some good news: There's been a dip in the number of teens using e-cigs, but the number of teen users are still in the millions.

“Far too many young people are still using tobacco products, so we must continue to prioritize proven strategies to protect our youth from this preventable health risk,” said CDC Acting Director Anne Schuchat at the time.

On the ground, Susan Foster, substance use prevention assistant program manager at the Poe Center for Health Education in Raleigh, says she hears that students are regularly vaping at local high schools and fields plenty of concerns from parents. When she's leading one of the Poe Center's popular Drugs Uncovered programs, which highlight where and how teens can hide drugs in their room, questions about e-cigarettes always come up.

"This topic tends to get the most questions and the most hands raised," she said. "Often times, we're brought into a school because they know we're going to be covering tobacco and because [e-cigarettes] can be a little easier to hide because of the smells."

Growing in popularity with kid-friendly flavors

Electronic cigarettes have been on the market for about a decade in the United States. Some say they help traditional cigarette and cigar smokers kick the habit, but others say the battery-powered devices are just another delivery system for nicotine and often are targeted at children.

To use an electronic cigarette, users need a liquid-filled cartridge that typically come in sweet flavors that often appeal to kids such as cotton candy, Smurf Cake, Cherry Crush, banana split and Kool-Laid, complete with the font for the popular kids drink that is usually spelled Kool-Aid. The cartridge is then inserted into the e-cigarette, which heats up the liquid and turns it into a vapor, which users breathe in.
As Kids Health reports, "because e-cigarettes don't burn tobacco, people don't inhale the same amounts of tar and carbon monoxide as they would with a regular cigarette. But anyone using an e-cig still gets an unhealthy dose of nicotine and other chemicals."
And, it appears, teens don't even know what they're smoking. According to the National Institute on Drug Abuse, 66 percent of teens say only flavoring is in their e-cig; 13.7 percent say they don't know what's in it and 5.8 percent believe they are smoking marijuana. Just 13.2 percent of teen e-cig users say they are aware that there is nicotine inside.

But, once they do start, teen e-cigarette users are more likely to start smoking, according to the national institute. Nearly 31 percent of teen e-cig users will start smoking traditional tobacco products within six months, compared to 8 percent of non-users.

Foster also says that e-cigs can be a gateway toward marijuana use as users can add THC oils or other weed products to some e-cig devices.

New challenge for parents

E-cigs definitely prevent a new challenge for parents, Foster said. Unlike traditional combustible tobacco products, they let off different smells and the vapors seem to dissipate more quickly, Foster said. No longer do users have to open a window to let out that noxious cigarette smoke. Instead, they can just blame the strawberry scent of the e-juice on a new air freshener or perfume.

What's more, when it comes to regulations and use, Foster said, "It's like the Wild West out there."

"We don't know what the kids are smoking," she added. 'and we don't know what chemicals [manufacturers] are using. In time, we should get a better handle on it."

Other than hammer home the dangers of nicotine use, what can parents do? Foster shared these seven practical tips for parents.
Know the risks: This isn't just a high school problem. Vaping begins as early as middle school, Foster said. The National Institute on Drug Abuse found that 9.5 percent of eighth graders have tried an e-cig in the past month; 14 percent of 10th graders; and 16.2 percent of 12th graders. Boys are two times as likely as girls to use.
Familiarize yourself with e-cigarette products: There are a lot of products on the market. Make sure you know what they look like so when you find one in your child's bedroom or see one in a picture their friend posts on social media, you know what they are. Some look a lot like a regular cigarette, others are as tiny as a USB drive. The Campaign for Tobacco-Free Kids has pictures of various kinds of e-cigs on its website.

In one case, Foster said, a mother reported finding one in the backseat of her car after driving carpool. It had fallen out of the back pocket of one of the teens she drove to school.

"You have to look out for the products," Foster said. "It's not going to be burns on clothes or nicotine-stained fingers."

Pay attention to how your teens and their surroundings smell: If your son starts smelling like cotton candy or some other sickly smelling sweet, there's a chance he's not just treating himself to some candy. And if your daughter smells of strawberry all of the time, it's possible she doesn't have a new perfume. "We encourage parents to monitor their children's spaces," Foster said.
Look out for irritable behavior: Foster admits that's easier said than done with teens, who are known for their moods. But irritability also could be a sign that they are suffering from nicotine withdrawal. Keep your eye on their moods, especially if you suspect use.
Question regular requests for money: If your child always seem to be short of money or always asking you for cash, ask them why they need it. Foster said e-cigs can be a costly habit, especially for users who invest in some of the more expensive devices. If they can't come up with the funds to buy more e-juice or fancier e-cig devices, they may move on to cheaper combustible cigarettes, Foster said.
Educate yourself: Things are changing quickly in this industry. Read up on e-cigarette use and new products that come on the market so you know what to look out for. The Poe Center's Drugs Uncovered program is a great way to learn more about vaping and other drug use among teens. The Poe Centers offers the program for free across the region.
Have regular talks with your kids about vaping: You're not one and done with this one. Foster said it's important to have regular open and honest talks about e-cigs and any other drug use so that kids understand exactly where you stand on the topic and what your expectations are. At the same time, teens should feel comfortable coming to you with questions and concerns. So, if they ask you a question about e-cigarettes, don't launch into a monologue about how bad they are. Listen to them and answer their questions. Developing a plan to extricate themselves from tricky social situations also can help build a healthy dialogue between parents and kids.

"Make it clear that we are here to support you," Foster said. "We realize that this is in your experience. Your brain is developing and growing. We want to protect it and we want your health protected. ... We're not going to support any behavior that's illegal, but we'll do everything we can to support you."


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