HEALTHY FAMILY
What Parents Need
to Know About Kids
and Vaping
F Unlike traditional
cigarettes, vape
devices lack
tobacco’s telltale
odor, making them
easier to hide.

aint scents of mint and mango
emanate from middle and high
school bathrooms, hallways and
classrooms, from students’ parties and
from bedrooms. These fruity flavors, sub-
tle and designed to hook kids, belie the
harmful effects of their sources: e-ciga-
rettes, or vape devices.

Between 2011 and 2019, vaping increased
1,800% among youth, in large part due
to Juul Labs’ sweet-tasting, flash-drive-
looking e-cigarettes, often advertised as
harmless and cool.

Another reason: “E-cigarette companies
are taking the playbook of conventional
cigarettes and using young, sexy mod-
els and other techniques that they know
worked before because there is little to no
regulation on marketing for e-cigarettes,”
says Dr. Susan Walley, chief of Children’s
National Hospital’s division of hospi-
tal medicine.

Walley, who chairs the American Acad-
emy of Pediatrics’ section on nicotine and
tobacco prevention and treatment, says
that while ads for cancer-causing ciga-
rettes were banned in the 1970s, “it’s a
Wild Wild West” for vaping devices.

According to the American Lung Associ-
ation (ALA), 8,000 kids are starting to vape
every day, leaving them four times likelier
to try regular cigarettes. Here’s what par-
ents should know about kids and vaping.

Dangers of vaping
Juuls and other vape devices—which can
resemble objects like pens, highlight-
ers and chargers—are often marketed as
a healthier alternative to traditional ciga-
rettes, which contain lung-damaging tar,
along with thousands of toxic chemicals.

E-cigarettes haven’t been around long
enough for long-term research, and it is
unknown exactly what chemicals are in
30 Washington FAMILY JULY 2022
them. However, vaping likely exposes users
to fewer toxins than regular smoking.

Yet vaping remains unsafe. One vape
pod can contain as much nicotine, a highly
addictive substance, as a pack of cigarettes.

Worse, vaping is associated with lung
injuries and deaths. In February 2020,
before COVID-19 dominated headlines,
the Centers for Disease Control and Pre-
vention (CDC) confirmed nearly 3,000
cases of e-cigarette or vaping use-associ-
ated lung injury (EVALI), with 68 deaths
attributed to the condition.

In response, the Food and Drug Admin-
istration (FDA) began cracking down
on sales of vaping devices, particularly
fruit-flavored ones widely blamed for
igniting the youth vaping epidemic. Juul
discontinued all of its flavors except for
menthol and tobacco.

Yet the government’s ban on refillable
devices ignited competing brands to pro-
duce prefilled disposable ones, some with
even higher levels of nicotine than Juuls.

Between 2019 and 2020, use of disposables
increased 1,000% among high students
and 400% among middle-school students,
according to the CDC.

“Inhaling these things is very dangerous,
but teenagers don’t understand that,” says
Dr. Okan Elidemir, the chief of pulmonary
medicine at Nemours Children’s Specialty
Care in Pensacola, Florida. (Elidemir is
available by telehealth for patients at the
hospital’s Wilmington, Delaware, campus.)
Vaping can increase users’ heart rate
and blood pressure and can cause cough-
ing, wheezing and shortness of breath—or
bacterial infection and pneumonia.

Stats about vaping
According to the 2021 National Youth
Tobacco Survey, 11% of high school-
ers and 3% of middle schoolers in the
PHOTO COURTESY DR. SUSAN WALLEY/CHILDREN’S
NATIONAL HOSPITAL
BY RUDY MALCOM



Signs of vaping in kids
Unlike traditional cigarettes, vape devices
lack tobacco’s telltale odor, making them
easier to hide. However, signs of use include
irritability or restlessness, faint sweet scents
and unfamiliar technology or spare parts like
atomizers and cartridges.

Other signs include increased thirst, dark
circles under the eyes and desire for spicy
food, all of which come from vaping-induced
dehydration. Since nicotine slows down the
healing of wounds, kids who vape are likelier
to have long-lasting acne and blemishes.

Tips for conversation
The ALA advises parents to ask open-ended
questions and avoid judgment and scare tac-
tics when talking to their kids about vaping.

Even before that, Dr. Panagis Galiatsta-
tos, who directs Johns Hopkins Medicine’s
tobacco treatment clinic, says: “The first
thing I would tell parents is: Talk to your kids
about how they’re handling their stress.”
Opening the door to these conversations
can keep the lines of communication flow-
ing between parents and children. Talking
to kids about vaping before they begin can
help educate them about the dangers of vap-
ing for their health. T
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Additional Resources
Teens and young adults
who want to quit vaping
can join the program
“This is Quitting” for free
by texting DITCHVAPE
to 88709.

Parenting isn’t easy, but there
are strategies that can help.

Find support and resources
at familytreemd.org/flip
or our 24-hour Parenting
HelpLine at 800-243-7337.

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6OKEAN/ISTOCK/GETTY IMAGES PLUS
United States reported they were current
users of e-cigarettes, with 80% using fla-
vored products. That’s more than 2 million
middle and high school students, compared
to 3.6 million in 2020 and 5.4 million in 2019.

These declines could in part reflect young
people avoiding stores and spending more
time under their parents’ supervision due to
COVID-19. At the same time, however, more
current users are using daily than before.

Walley sees this statistic as a “proxy for
addiction,” a public health crisis related to
rising anxiety and depression among youth
due to factors like climate change, mass
shootings and the COVID-19 pandemic.

“A lot of kids are self-medicating by vap-
ing,” says Dr. Mary Garza of the Maryland
Pediatric Group, adding that they also “want
to seem like they’re growing up and like
they’re cool.”
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