Vaping, which is the practice of inhaling the vapor produced by an electronic cigarette (e-cigarette), was declared an epidemic in youth by the U.S. Surgeon General in December 2018. In my therapy practice, which includes specializing in children and adolescents, I have witnessed a stark rise in this behavior, especially among junior high-aged students (i.e., those in 7th and 8th grades).
Many people, even parents, believe that e-cigarettes are a healthier alternative to traditional cigarette smoking, but there are a growing number of studies raising concern that vaping causes the ingestion of toxic chemicals which may be linked to cancer. Parents may think, “What’s the big deal about vaping?” especially if they experimented with cigarette smoking when they were teens. What these parents may not realize, however, is that the nicotine juice pods that are used for vaping have a higher concentration of nicotine as compared to traditional cigarettes, making the risk of addiction greater, particularly for young adolescents whose brains are still developing.
I do not claim to be an expert on the health risks of e-cigarettes, nor have I conducted an exhaustive review of research on teens and vaping. What I am presenting below is a composite of information on this topic collected from my junior high-aged clients, in the hope that this information will be helpful to parents and other teens.
My clients report that the prevalence rate “depends on the school,” with their sense being that it is very common in many public schools. They typically report that over 50% of their 8th grade peers have tried it at least once. For 7th-graders, it is not quite as common, but it still occurs. They share that if the group of kids who are vaping are “loud” (i.e., very outspoken, even popular), it might seem like more kids are doing it than actually are doing so. I am told, “There is usually somebody in the bathroom vaping in a stall. Sometimes that kid will ask you, ‘Do you want to hit this?’ or you could ask, ‘Can I rip that?’ Most kids are open to sharing their vape.” There does seem to be a slightly higher prevalence among boys but it is still common with girls, per my clients.
My clients have “educated” me that there are two main categories of vapes:
What my clients report is that usually there are certain kids whose parents do not monitor what they do, and those kids can buy devices and pods online. They report, “Anybody can buy stuff online with a credit card…you just check a box that you are 18…it gets mailed to you.” Once a teen is identified as being able to procure vaping devices, “word gets out…often it’s the ‘cool’ kids who vape, and those that want to appear cool will ask the ‘cool’ kids for vapes.” Young people also tell me that they often get devices from older siblings or can sometimes purchase them at smoke shops that do not require ID.
My clients report a variety of reasons why their peers vape or they vape. “Kids like to do tricks to manipulate smoke out of your mouth.” A “ghost” inhale is reportedly popular. Teens vape to appear “cool” or because they want to fit in. The other draw is nicotine: “It gives you a head rush that lasts 15- 20 minutes…makes you feel kind of stimulated.” Further, many clients report that the juice in the nicotine pods “tastes good.” Popular flavors include pineapple, mango, lava flow (orange/pineapple), desserts, pizza, chocolate, etc.
According to my clients, because JUULS produce very little smoke, kids are seen in class vaping. They reportedly do this by putting their head down on their desk, taking a hit, and just holding it in their lungs so no smoke comes out. This is considered to be “cool” if one’s friends also vape in class. In addition, during lunch and passing periods, kids report that they will go in groups and vape in the bathroom.
Kids tell me “It’s so easy to hide!” Also, there can be a stigma against “snitching” or telling on people: “If you tell, you are the ‘lowest of the low’.” In group vaping, I am told that one person watches the bathroom door to make sure no teacher is nearby, or no kid who looks like he might snitch. Even if an administrator receives a report about vaping, kids believe that there is no action because “it’s so common and there are more serious things to address.”
Older teens who have experienced a “vaping phase” tell me that parents should have honest conversations with their kids, telling them that there is not scientific evidence of the long-term risks and that we don’t know if vaping is safe or if it will cause lung cancer. One client suggests to say, “While you are under our house and we are paying the medical bills, it’s not allowed!” Teens report that it’s important for parents to have a close enough relationship with their child to be able to talk about this topic, especially if their child is feeling pressure to vape. Kids may believe that “everyone’s doing it,” so they may justify that doing so must not be so bad. I am told, “Anyone cool or popular either has vaped or is vaping.”
Even good kids, with good parents, can experiment with vaping. Kids can be so stealth with vaping; the devices are small, easy to hide, and do not have an obvious “cigarette smell.” I am told by teens that the best deterrent is knowing that their parents might or will “test” them. Just like for traditional drug testing, parents can order urine tests online from sites such as Amazon.com to determine whether cotinine, a metabolite of nicotine, is in their system, which can reportedly stay in the system for a week or so. Kids also tell me that when their parents test them, either randomly or regularly, they have an “out” with their peers. When invited to vape, one teen just says, “Nah, my parents test me,” and there is no further pressure. Additionally, there is no perceived “loss of coolness” since kids as a whole understand that one can’t vape if their parents are going to test them.
In sum, what parents should do is stay connected emotionally with their kids, have the difficult conversations with them about this topic, remain vigilant, don’t assume it can’t happen with your son or daughter, and let your child know that you will urine test them randomly so that they have that “out” and an additional reason to not vape.
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