Laura Lee Samuel, APRN, FNP-BC

Since 2007, e-cigarettes have become a popular recreational product for kids in middle and high school. While research indicates usage levels are slowly decreasing, adolescent tobacco use is still a considerable health epidemic. Research from 2024 shows 8.1% of teens, or about one in 10, report regular tobacco use, with e-cigarettes as the most commonly used tobacco product in middle and high school.

An e-cigarette, also known as an e-cig, mods, vape pen, vape, or electronic nicotine delivery systems (ENDS), is a battery-operated device that heats a liquid, called vape juice, to produce an aerosol that is inhaled. Many kids believe vaping is just flavored water vapor, but vape pens typically contain nicotine, a substance derived from tobacco plants, and other brands may contain cannabis or other drugs. Nicotine is highly addictive and can lead to cigarette smoking and other drug use. It also harms areas of an adolescent’s developing brain that affect attention, learning, and impulse control. Teens often report poor concentration, anxiety, mood disorders, and sleep disturbance issues from vaping.

Vape juice production is largely unregulated, and vape pens can contain other harmful substances, including heavy metals, cancer-causing chemicals, and ultra-fine particles that can go deep into the lungs. This can result in asthma, bronchitis, irreversible lung damage, chronic obstructive pulmonary disease (COPD), and a long-term increased risk for lung cancer, heart disease, and stroke. Another downside to vape use is a decrease in physical fitness levels and overall endurance.

Why do kids and teens start smoking? They report a mix of reasons, including societal pressure, friends and family also smoking, boredom, curiosity, a way to relax and relieve stress, or to manage weight and food cravings. E-cig companies heavily market to teens with a variety of cool flavors, designs, and bright packaging, and they can be cheaper than traditional cigarettes. About 10% of students report using e-cigs to wean off smoking regular cigarettes, but research shows little evidence that vaping actually helps you quit smoking altogether. Many teens think e-cigs don’t do damage to the brain or body, and need education on the many risks and dangers of vaping.

To find out what your child thinks about vaping, approach them at a low-pressure time, such as in the car or when sharing a snack together. Open a conversation with a question like, “I read an article about how many kids vape. Is that a trend at school?”

Vaping is easy to hide, but a few things to watch out for are unfamiliar online purchases or items in the trash you don’t recognize, and a faint sweet or fruity scent that occurs when vaping. There may also be behavioral or mood changes, increased irritability or restlessness, increased thirst, nosebleeds, coughing, or pneumonia.

Many kids report a desire to quit, but they may struggle, since vaping is addictive and socially acceptable in many social circles. If you think your kid might be smoking, stay calm and think through a plan before talking about it with your child. Do the research on the effects of vaping and be prepared to answer their questions. Keep the conversation short to keep them from tuning out. Look for teachable moments and keep conversations open without lecturing, yelling, criticizing, or judging, which can cause a teen to tune out or rebel.

If you learn your child is vaping, address it immediately. First, try to understand why and learn what they think and feel about smoking. Discuss their stressors or any challenges they are dealing with. Listen more and talk less before finalizing a plan with your child if they are using vape pens. Educate them on the health risks. If they are interested in quitting, ask them their thoughts and make suggestions. Let them know there is help and support to quit.

Set clear boundaries about smoking in and out of the house with consequences if they don’t follow the rules. Emphasize the importance of a smoke-free environment on overall health for the family. Schedule an appointment with your child’s health care provider to talk about options for quitting, including medications such as nicotine replacement therapy. Ask for a referral for behavioral health services for more support if needed. If you smoke or vape, it is imperative that you lead by example and quit, too.

It’s important to develop a quitting plan for smoking cessation. Explore online resources available with information on smoking cessation and how to deal with triggers, withdrawals, and cravings. Find tips for family and friends to support someone in the best way, explore how smoking cessation medications work and how to take them, find daily message support, coaching, and more. The Centers for Disease Control is a great place to start and offers information and suggestions on programs with options to call, text, or use an app for help at cdc.gov/quit.

Stopping smoking is not an easy task. It is estimated that it can take up to 30 attempts before a person ultimately quits. Once a person stops using nicotine, physical withdrawal symptoms like irritability, restlessness, trouble concentrating, and difficulty sleeping typically subside in two to four weeks. It usually takes longer for the brain to adapt, but staying busy with physical activity, projects, and developing healthier routines can help. Use any slip-ups as a chance to figure out what works and what doesn’t. Don’t give up, and celebrate all wins, no matter how small.

Exploring resources and strategies, actively listening, offering support, setting clear boundaries, modeling non-smoking behavior, and staying calm during conflict are all things a parent can do to help empower a teen to quit smoking and improve their health for a better future.

Laura Lee Samuel is a Family Nurse Practitioner serving patients at HopeHealth in Timmonsville. For more information, call (843) 667-9414 or visit hope-health.org.