Vaping—inhaling a heated, aerosolized liquid through a specially designed device—has become more popular among adolescents than traditional cigarettes. The liquid used in vaping devices may contain nicotine, illicit drugs, or flavoring.
The effects of vaping on young people is not yet well known. However, public and behavioral health experts are concerned that it could lead to health problems and addictive behaviors. Currently, it is illegal to sell any tobacco product, including e-cigarettes, to anyone under 21 in the United States.
What are the trends in vaping?
E-cigarettes have become the most popular tobacco product among teens since 2014. A CDC report found that, in 2022, 14.1 percent of high schoolers and 3.3 percent of middle schoolers reported current e-cigarette use. Research in recent years suggests that vaping and cannabis use in teens has risen, even as use of other substances has declined.
A 2023 analysis published in the CDC’s Morbidity and Mortality Weekly Report (MMWR) found that sales of vaping device units increased by 46.6 percent from January 2020 to December 2022. The report noted that several states have restrictions on the use of vape flavorings, which led to reductions in e-cigarette sales, particularly among young people.
Why is vaping a problem for teens?
Teens who use e-cigarettes, vape pens, or customized vaporizers can still get hooked on nicotine. Vape liquids, even those that do not contain nicotine, may have long-term harmful effects on young lungs. It may also make future substance abuse more likely. As a result, many parents and mental health providers have become concerned about teen vaping.
By itself, vaping carries fewer health risks than traditional smoking. However, a study by researchers at Columbia University Mailman School of Public Health found that adolescents who vape nicotine may be more likely to binge drink and use cannabis. The full results have been published in Substance Use and Misuse.
Some vape brands have marketed their products as calming stress relievers, making them appealing to young people experiencing high levels of anxiety and depression. Many promote vaping as an alternative to traditional smoking, or a pathway to quitting.
How should behavioral health providers approach vaping in teen clients?
In a 2023 Psychiatric News article published by The American Psychiatric Association, Dr. Smita Das warns that mental health professionals may see a disproportionate number of clients who vape. The first step is to screen for use of all substances, including vaping and tobacco products. This will help inform care and encourage discussion of these substances with the client.
If determining whether clients have a substance use disorder, use DSM-5 criteria for further information. For example, ask the client questions such as “Have you used more than intended?” or “Have you tried to quit unsuccessfully?” Clients who are interested in quitting should consider their triggers and work with the therapist to develop a plan for quitting. Of course, the provider should conduct regular follow-up on the client’s progress.
The FDA has created a vape-focused toolkit for professionals who work with youth. This toolkit is available in either English or Spanish. The FDA also offers a vaping education hub as part of its Tobacco Education Resource Library. Providers may consider the U.S. Preventive Services Task Force guidelines for tobacco treatment, although these are tailored specifically for adults.
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