Chapter 7

What Parents Need to Know about Vaping

IN THIS CHAPTER

Bullet Understanding the teen vaping epidemic

Bullet Getting clear on the risks of vaping for kids

Bullet Stopping kids before they start

Bullet Identifying the signs of vaping

Bullet Keeping the communication lines open

Bullet Following some parenting tips

There is an epidemic of vaping among youth. In fact, a recent National Youth Tobacco Survey found a 78 percent increase in reported vaping among high school students from 2017 to 2018. The same survey revealed a 48 percent increase in vaping among middle school students. Today, at least one out of every five current high school students admit to vaping, compared with about one out of 20 middle school students.

The numbers continue to rise. In 2018, 3.6 million American youth reported vaping. In 2019, that number had risen to 5 million; of those 5 million, 1 million reported daily use and 1.6 million admitted to frequent use (20 or more days per month). This rise has occurred in spite of widely publicized incidents of serious lung damage associated with vaping.

It’s important to point out that surveys depend on what’s called self-report data. Lots of people fail to admit to potentially shameful behavior like vaping. That’s particularly true of teenagers. So, actual percentages of teens vaping probably run higher than official survey data tell us.

E-cigarette use among adults is controversial — some consider it a godsend with the potential to help millions of regular cigarette smokers quit smoking and greatly reduce their health risks. Others see e-cigarettes as just as dangerous as regular cigarettes.

Remember However, there is no controversy about e-cigarette use by kids or teens. Any amount of vaping among kids has dangers and risks that exceed those incurred by adults who vape. We need to do everything possible to prevent teenagers from vaping and help those who already vape to stop.

In this chapter, we explain the reasons why the vaping craze has seduced kids. Then we take a look at the special risks vaping poses to youth development. We give parents strategies on how to reduce the risk of their own kids turning to vaping. We also provide parenting techniques for helping teens who have been caught in the vaping trap.

Hooking Up with Colors, Flavors, and Gadgets: Marketing to Kids

Kids like toys, colorful gadgets, and sweet flavors. So, it’s no wonder that vaping, with its cool look and cute devices, is tempting to teens. The variety of scrumptious-sounding e-liquid flavors like grape or strawberry puts icing on the cake. As of this writing, the U.S. federal government is considering restricting vape flavors largely due to their appeal to kids.

There have been precipitous drops in regular cigarette smoking among both teens and adults in the past half-century. The tobacco industry is looking for new customers, so it wants to make the early experience of vaping appealing, smooth, and easy to indulge.

E-cigarettes have the potential to hook users quickly because they avoid much of the unpleasant harshness often associated with early smoking of regular cigarettes. And many have high levels of nicotine. Tragically, kids can graduate from casual e-cigarette users to confirmed nicotine addicts before they know it.

Stealth vaping

Teenagers know that their parents and teachers don’t want them to vape. And vaping manufacturers have given teens a way to deal with this concern. Not surprisingly, many of the pod devices (see Chapter 5) are exceptionally easy to conceal. Even worse, if parents happen to encounter some vaping devices, they’re highly likely to mistake them for something else, such as a USB drive.

Small sleek pod devices don’t produce as much vapor as many other vaping devices. That makes stealth vaping at school pretty easy to accomplish. Some kids report actually vaping during classes. Others generally use the restrooms or vape out on the campus. Vapers hold devices in their fists and take surreptitious hits, then they slowly exhale in small amounts.

Schools have responded to the vaping crisis by installing vape detectors in the restrooms, but there have been some problems with detection:

  • Staff find it difficult to respond before the culprit escapes into the school hallways.
  • Some kids exhale the vapor into the toilet bowl as it’s flushed, creating a suction that pulls the vapor away from the detector.

Taking kids to the market

Manufacturers have denied marketing specifically to adolescents. Whether their contention is true or not, it’s hard not to see the youth appeal in their products and marketing. For example, almost one-third of kids report starting to vape so that they can enjoy flavors (such as cookies and cream or mango). And quite a few anecdotal reports by teens suggest that they’d have considerably less desire to vape if e-liquids didn’t come in flavors.

The design elements of the pod system devices are also appealing to teens. They’re attractive and can be personalized. Kids can purchase so-called pod skins online for less than $10. These skins come in all sorts of colorful, pleasing, and unique designs.

Evidence that the devices are appealing can be found in the fact that teens themselves are responsible for much of the marketing of e-cigarettes. Manufacturers don’t even have to overtly market directly to kids. Teens and preteens post images and videos of vaping to Facebook, Instagram, Twitter, and YouTube in large numbers.

Recognizing the Special Risks to Kids

Adults own the responsibility for protecting kids from unnecessary risks. However, adolescence is often a time that kids experiment with risky behavior. Teens push the limits as they’ve done since the beginning of time. When it comes to vaping, most of them are unaware of the risks they’re really taking. They’re truly playing with fire (or, in this case, vapor).

Taking risks with addiction

Inhaled nicotine travels quickly to the brain. It produces an almost instant jolt of pleasurable and relaxing feelings simultaneously. That’s bad enough for adults. But adolescent brains are not fully developed until around the age of 25. During adolescence, the brain is developing the ability to inhibit impulsive cravings or behavior; it’s learning to put off short-term pleasure for long-term goals and acquiring the capacity to regulate emotions.

Until then, the brain has a limited capacity to put on the breaks and inhibit impulses. Therefore, teens more easily become addicted to almost any addictive substance like nicotine.

That’s really bad news because early addictions prime the brain for later addictions. That’s because an addicted brain before the age of 25 organizes itself differently than it would later, leading to problems with attention, impulse control, learning, and mood. That reorganized brain makes it harder for teens to change or quit vaping even when they reach adulthood. Of note, 90 percent of all adult smokers began smoking as teens.

Walking through the gates to other addictions

We’re old enough to remember the ’60s, when everyone worried about marijuana being a gateway drug into more seriously addicting drugs such as heroin and cocaine. The evidence for that concern was mixed, but not compelling. Most kids in the ’60s who smoked pot did not graduate to harder drugs. That’s not so true of vaping.

Teens who vape do often go on to smoke combustible cigarettes, which are at least as addicting and pose a much greater health risk (see Chapter 3 on health risks of tobacco). Therefore, vaping in this case, appears to be a gateway drug leading to regular smoking. This is especially true among the youngest vapers who go on to regular smoking in even greater numbers. And evidence suggests that among kids who vape, more of them go on to use marijuana or tetrahydrocannabinol (THC).

However, some argue that these data are simply correlational and do not prove causation. They say that kids who vape tend to be high risk takers to begin with and will engage in anything that gives them a thrill. One argument against that contention is that zip codes that previously had extremely low rates of regular smoking now appear to be turning to vaping in large numbers. And they then seem to seek out regular, combustible cigarettes in greater numbers, too.

Another worry about addicted kids is that they can’t buy vaping devices and e-liquids as easily from legal sources. So, they turn to the local vape dealer for their fixes. Some of these dealers peddle counterfeit vaping supplies, which may be contaminated with dangerous substances.

Warning Teenagers and young adults are being hospitalized with serious lung damage with an unknown cause. They aren’t responding to antibiotics, and their only common denominator appears to be a recent history of vaping. Vaping exactly what and with what devices, we don’t know. However, a substantial majority of these people report having vaped THC products, often purchased on the black market. It’s possible that contaminated e-liquids, the toxicity of some ingredients (such as vitamin E acetate), or contaminated devices could offer an explanation. However, at this time, the cause is not known, and investigations are underway. See Chapter 6 for more information about vaping and health risks.

Warning Because these risks are still unknown, the U.S. Centers for Disease Control and Prevention (CDC) has recently recommended that all teens, young adults, and pregnant women refrain from any e-cigarette use. They also tell vapers never to buy products on the street.

Catching Kids Before They Vape

More teens than ever report feeling worried, scared, and anxious. They worry about the future of their planet, they worry about getting shot in their classrooms, and they worry about finding a way to make a living in an ever-changing economy. Glued to their phones, they worry about how many likes they have. No wonder the rate of anxiety among adolescents continues to soar.

And anxious, scared kids are more susceptible to substances that temporarily quell their stirred-up emotions. A quick hit of nicotine can do that for them. So, what’s a parent or other concerned adult to do?

Tip If you’re a parent of a younger kid, your task is to give your child the confidence and skill to say no to temptations. The job of protecting your kids from the temptations they’ll face in their teenage years starts early. Start by doing the following:

  • Make sure your kids have something in their lives that provides a sense of mastery or accomplishment. If your kids aren’t particularly good at school, find a sport, hobby, or activity in which they can experience success. Having something to be proud of helps kids stand up to peer pressure.
  • Don’t overprotect your kids. Give them activities that they’re likely to feel challenged by. That means allowing for minor failures and risks without overwhelming them. Praise them for hanging in with difficult tasks.
  • Talk to your kids about vaping and other drugs early. Kids are being exposed to vaping as early as late elementary school and certainly by middle school. Be factual in your descriptions. Understand that kids may be told by their peers that vaping is harmless. By providing facts early, you can inoculate them from the flawed information they’re likely to get from their peers.

Whether you talked with them at a younger age or not, the conversation needs to continue with older teens. Even if you’re feeling worry bordering on panic about vaping, be sure to keep your conversational style nonjudgmental. Stick to the facts. Threats will only push them away and make them more likely to rebel by vaping.

Knowing What to Look for in Your Kids

Tip If you’re a concerned parent or teacher, you probably want to know how to detect early signs of a nascent vaping habit. Early intervention has a better chance of helping prior to waiting for an addiction to gain a firm foothold. There are important red flags:

  • Isolation: It’s pretty normal for teens to spend lots of time in their rooms. However, if your teen starts retreating far more than usual, it’s cause for concern.
  • Sneakiness: If you get a vague sense that something’s going on with your teen, it probably is. Teens may start lying about where they’re going or who they’ll be with. If you catch one or two lies, there are more lurking in the background.
  • Smell: Vaping does not smell like smoking. Sometimes there’s little or no smell. Other times, the smell can be quite strong, but pleasant (like flowers or candy). Be suspicious if your teen puts an air freshener in his bedroom.
  • Frequent bathroom breaks: Nicotine is highly addictive and requires frequent feeding. If your teen starts going to the bathroom more frequently than usual, suspect something.
  • Increased need for money: Okay, all teens want money. But if your teen suddenly seems to be asking for it more often or even takes money from you surreptitiously, be concerned.
  • Unfamiliar battery chargers and excessive USB devices: Vaping requires power, and most devices need recharging. Some devices look exactly like a flash drive or some other object. Others look like pens or highlighters. Also, look for discarded plastic e-liquid containers — they’re generally small.
  • Increased thirst: Vaping takes away moisture from the mouth and throat, causing increased need for water. It can also dry out the nose and increase risk of nosebleeds.
  • Vaper’s tongue: Some vapers experience a decrease in their sense of taste and compensate by increasing their use of salt and spices.
  • Irritability: When addiction begins to take hold, many addicts demonstrate an uptick in irritability, especially when their urges are frustrated, such as during a long car trip.
  • Stopping or suddenly cutting back on caffeine consumption: Nicotine is a stimulant, much like caffeine. If a teen stops or greatly cuts down on caffeine (for example, coffee, caffeinated energy drinks), pay attention and look for other signs.
  • Declining appetite and/or weight loss: Nicotine pumps up metabolism and suppresses appetite. Weight loss often follows.
  • Declining grades and attitude problems: Rebelliousness, disobedience, and not caring about school all indicate a higher potential for drug use, including nicotine through vaping.
  • Increasing chronic lung infections: Vapers are at higher risk for bronchitis and pneumonia. Many vapers develop a chronic cough, and colds may tend to last longer.

If you see signs that your kid may be vaping, don’t ignore it — and don’t panic. We tell you how to talk to adolescents about vaping in the next section.

Talking with Kids about Vaping

Rebellion and defiance are a hallmark of adolescence. And there’s no more surefire way to elicit that defiance than a harsh, confrontational style. It’s tempting to get angry when you find out that your kid is vaping. You didn’t raise a child to be so foolish!

Example So, imagine you’re in that mind-set right after discovering that your kid has started to vape. You think to yourself that it’s time to take charge, do something, and be a strong parent. Here’s how we’ve seen that approach to parenting go in situations like this:

  • Sam is 13 years old and began eighth grade six weeks ago. He has always had a little trouble making friends, but now seems more isolated than usual. He has also started to cop an attitude with his parents. His appetite has declined, and his grades have dropped. His parents wonder what’s going on. Then they discover a small plastic pod in the trash that’s labeled with “contains nicotine.” His father decides it’s time for a talk.

    “Sam, we need to talk,” his father begins.

    “Yeah, well, I have homework now. How about tomorrow?” Sam retorts.

    “Now. I mean it, now,” his father says, starting to feel annoyed.

    “Yeah, sure, so what do you want?”

    “What’s this exactly, young man?”

  • Sam replies, “I dunno. Some plastic thing, I guess.”

  • Growing more irritated, Sam’s father firmly says, “You know darn well what this is. And so do I. Are you vaping?”

    “So, what if I am? Everybody at school does. It’s no big deal,” Sam retorts.

    “No big deal? Seriously? I’m not having any of this stuff in my house. And we didn’t raise you to be some freaky vaper. What’s next, tattoos and marijuana? Give me your phone. You’re grounded for three months!”

  • Sam picks up his phone and throws it violently across the room, narrowly missing his father’s head. He then charges into his room and slams the door.

That didn’t turn out so well, did it? No one wins. Sam is angry, now more likely to continue vaping, and his relationship with his parents is worse than before. His dad feels guilty, angry, ashamed, and confused. He has no idea what he could have done differently. (See “Supporting optimism,” later in this chapter, for a revised, healthier way Sam and his dad could communicate.)

Remember It’s important to realize that your teen can become addicted to nicotine very quickly. And anyone who’s addicted will go to great lengths to continue using — that includes lying and stealing. Addicted kids also often feel anxious and scared.

Yelling will just send your kid away, to be alone to seek comfort from others. Your teen will probably not stop vaping after being yelled at. Plus, yelling brings on even more rebellion — probably not your goal.

However, a considerable body of research in the past decade or so has told us something very interesting about helping people change. These studies tell us that there is very little to gain and much to lose by confronting people head on about their problems. What works far better are liberal doses of empathy, support, concern, patience, and optimism.

Listening empathically with concern

If you suspect that your child is vaping, take a few minutes and put yourself in her shoes. Is she trying to fit in, under a lot of stress, struggling with school, or experiencing another set of problems? Recognize that her decision to vape probably has nothing to do with you. She’s not vaping to make you mad or disrespect you. The ability to put yourself in someone else’s shoes is called empathy.

But it’s sort of hard to feel and express empathy when you’re mad at someone — especially someone close and important to you. Nevertheless, if your goal is to help your child through a tough situation, empathy will take you further than anger or even irritation.

How do you become empathetic about vaping? For starters, do you know anyone who has ever struggled with addiction? Or have you heard stories of people who struggle with addiction? How about someone who struggled, but managed to get through it?

Remember No one asks for an addiction. But everyone struggles with something at some point in life, whether it be food, drugs, depression, anxiety, relationships, anger, money, gambling, or whatever. Your teen is no different.

Empathy starts with knowing that kids start vaping for many different reasons, but almost all continue to vape because they’re addicted to nicotine. The following statements reflect an empathic response:

  • I understand that you may be vaping, and I’d like to hear more about what that’s been like for you.
  • I hear that lots of kids at your school are vaping. It must be really hard to resist.
  • Sounds like you want to be accepted by your friends. Do I have that right?
  • So, I’m hearing you’re at least a bit worried about what nicotine could do to your health. Is that sort of true?
  • I hear you saying that you really like the feeling you get from vaping. That must make thinking about quitting hard to imagine. Is that how you feel?
  • You seem to be thinking that vaping is harmless. Would you be okay with seeing a few articles about that?
  • I get the impression you’re worried about how your new friends would react if you told them you’re quitting vaping.
  • I want you to know that no matter what decision you make, I will always love you and care about you.
  • I’m wondering if you’re not feeling up to talking about this right now. How about we figure out another time to try it again? Is that okay with you?
  • I know one of your goals is to lead a healthy life. Does it seem like vaping fits in with that?

Tip It’s critically important to have this conversation without feeling angry or frustrated. If such feelings start to emerge, suggest a break and return to the conversation another day. It’s equally important to avoid sarcasm or a derisive tone. If your teen becomes hostile or confrontational, back down and go back to it later. You won’t win by fighting and pulling harder.

Tip It’s also important not to worry about the outcome of the first talk. Don’t even expect a quick resolution. Changes usually occur after a series of productive conversations, and not all attempts will go well. Keeping at it is what matters.

Tip Teens are a lot like gorillas. They’re strong but not always logical and reasonable. When you talk with teens (or gorillas), and you get into a verbal tug of war, logic and reasoning rarely prevail. So, how do you win a tug of war with a gorilla? You drop your end of the rope. Pulling harder simply will not work — and you may fall flat on your face.

Supporting optimism

The most productive talks with your kids will be laced with empathy and support an optimistic perspective. This combo lets your kids know you believe in them and stand on their side, come thick or thin. They may resist hearing that message for a while, especially if it’s a new style for you as a parent. But keep at it. In time, this two-pronged approach can sometimes break through when nothing else has.

Remember Don’t underestimate how difficult it is to give up an addiction. Teens become addicted to nicotine quickly. There is also the social component of vaping — peer pressure is hard to stand up to. The combination of peer pressure and addiction is formidable. It would be daunting to anyone. Combine that with a teen’s immature brain, and the task is even more challenging.

You must become your teen’s greatest cheerleader. Talk about all the things your teen has already achieved. For example, even walking, talking, riding a bike, learning to read all took considerable time and patience to master.

Point out to your teen that most challenging problems require lots of effort, mistakes, and mishaps along the way. It’s normal to fail and then get up and try again. Remind your teen that you’re confident he’ll ultimately succeed.

Expect your teen to resist these messages for a while (or even longer than a while). Be patient and persistent. Never let your teen talk you into the hopeless mind-set that quitting is impossible. You have a good chance of breaking through if you continually express empathy and support an optimistic mind-set.

If, and hopefully, when a less rebellious attitude emerges from your teen, point out that this book was designed to help anyone stop smoking or vaping. Work together on developing a quit plan.

Example Remember the story about Sam and his father at the beginning of the “Talking with Kids about Vaping” section? Sam’s father finds a plastic pod in the trash. Sam has become isolated, and his grades are falling. Let’s take another look at a conversation between Sam and his father using a revised communication strategy based on empathy, patience, and supportive optimism.

  • “Sam, we need to talk,” his father begins.
  • “Yeah, well, I have homework now, how about tomorrow?” Sam retorts.
  • His father feels a bit of annoyance but has practiced keeping a lid on it. He responds, “Sounds like you’re busy, I understand, but this is important. I’d prefer talking now. Okay?”
  • Sam rolls his eyes and sighs, “Okay, fine. What’s so important?”
  • His father responds, “I’m not angry with you — I’m just curious. I found this plastic pod thing with a contains nicotine label on it. I know lots of kids are vaping. Have you experimented with it?”
  • Sam says, “Yeah, what’s it to you?”

  • Reaching deep for patience, Sam’s dad says, “I wonder if you’re feeling like I’m going to jump all over you. Is that how you feel?”

    “Well, you always have in the past. Why would now be any different?” Sam says.

  • Sam’s dad replies, “Fair enough. I have jumped on you, way too many times. I’d like to change that. Can you help me understand what vaping is all about?”

    “Vaping is totally safe, all the kids are doing it. It’s no big deal,” Sam says.

    “I trust you to make good decisions when you have all of the information,” Sam’s dad says. “You always have. Let’s keep talking about this okay?”

Sam’s father didn’t resolve this issue then and there. But he did open the door to a productive dialogue. He and his son talked many times over a period of weeks before Sam was ready to discuss quitting his vaping habit. The bonus was that he and his son developed a much better relationship.

Tip If you find this kind of communication beyond your ability to master, or if your relationship with your teen is just too contentious, consider getting professional help. Many people simply don’t have the temperament to sustain communication like we’ve described. If you fall into this category, a mental health professional (like a counselor, social worker, or psychologist) can help you sort out options and improve your family’s communications.

Getting Helpful Parenting Strategies

Preventing vaping before it begins is always better than intervening after it has already happened. As we explain earlier in this chapter, you can start that process by talking with your kids early about the dangers and allure of vaping. Another prevention strategy is to keep kids occupied and supervised.

Keeping kids busy

Make sure your kids have busy schedules with lots of healthy activities. That doesn’t mean that you need to schedule every free minute for your teen. But teens tend to get in trouble when they have too much unsupervised free time.

For working parents, providing supervision can pose a challenge. If you do have to leave your adolescents alone for long periods of time, check in on them frequently in a nonintrusive, friendly manner. Try to find friends and family members who can take up some of the free time or check on the kids for you. Look into sports, clubs, and other after-school activities.

Tip Keep a positive family environment by encouraging respectful, open communication like that described in the “Talking with Kids about Vaping” section. Teens like to talk, but they won’t talk with their parents if the atmosphere is confrontational.

Setting limits

Hopefully, by the time children are teenagers, parents have instilled a basic set of values and morals that totally prevents any kind of misbehavior. Okay, that’s magical thinking. So, how do you handle the inevitable misconduct a teen is likely to exhibit from time to time?

Tip For younger teens or tweens, consequences set on their misbehavior usually work. So, it’s important to have clear guidelines on what’s expected in terms of schoolwork, chores, grades, attitude, and for that matter, vaping and other drugs. It’s perfectly okay to take privileges such as the use of electronics, TV, time with friends, shopping, and allowances away for infractions of clear household rules. Here are some general rules for limit setting:

  • Don’t make up rules along the way — have an explicit list.
  • Never say never!
  • Be specific with your plan.
  • Keep unpleasant consequences relatively short (usually a week or less). You can always reimpose a consequence if needed.
  • When taking away privileges, keep a calm, nonjudgmental stance (as emotionally neutral as possible).
  • Don’t debate whether a transgression has really occurred. It comes down to your parenting instinct and if you think your teen messed up, assume you’re right. Teens try, and often succeed, in creating “reasonable doubt,” which works okay in court, but not in families.
  • Expect your child to try acting like consequences don’t matter — that’s a ruse you can safely ignore.
  • Be sure to criticize the misbehavior, not your adolescent. For example, if your tween brings home a bad test grade, criticize the lack of preparation and study; don’t say, “You’re lazy.”
  • Avoid harshness but deliver consequences swiftly.
  • Balance negative consequences with praise for positive behaviors and occasional extra privileges or desired items.

We should note that setting limits with reasonable consequences becomes less effective as adolescents get closer to adulthood. They’ve largely formed their values by then and don’t respond to removal of privileges with glee.

Tip If you have an older teen, the focus needs to shift to talking and listening. Follow the guidelines in the “Talking with Kids about Vaping” section as well as you can, and you may still influence the outcome over time.

Accepting your limits as a parent

News flash: No matter how hard you try, you’ll never be a perfect parent. We’ve looked around for decades and still haven’t found one. You’ll sometimes lose your temper. You won’t always know what to do. You’ll say or do something hurtful without needing or wanting to.

In addition, you don’t have total control of anyone, especially your child. Other influences such as school, friends, relatives, health, genetics, and social conditions have a huge impact on how kids turn out. It’s important to realize that child development is not solely up to you.

Rest assured, your kids will mess up. Every single one of them. All you can do is try your best to talk with your kids with as much empathy and supportive optimism as you can muster while setting reasonable limits.