Two Yale pediatricians, Cheryl Anderson, MD, and Annette Cameron, MD, were named the “E-Cigarette Champions” for Connecticut by the state’s chapter of the American Academy of Pediatrics (AAP). The AAP chapter(s) for each state designated one or two pediatricians as champions throughout 2021 to lead programs that will help reduce e-cigarette use in teens, educate doctors on the best ways to approach conversations about vaping with patients, and talk about the dangers of vaping and e-cigarettes with the public. While the pandemic has dominated health news over the last year, it has likely also influenced e-cigarette use for youth who have been isolated and seen the world drastically change. Paired with deceptive marketing about the safety of vaping and e-cigarettes, it is important to know the facts — and keep kids and teens from using these products from the start.
Dr. Anderson explained that in recent years, “E-cigarette use in youth has increased, driven by marketing directed at teenagers and by fruit and candy flavored vaping liquid. This is appealing to teens and even kids as young as middle school.” She added, “E-cigarettes are highly addictive and increase the risk of nicotine dependence as an adult. Inhaling the aerosol has damaging effects to the lungs and vaping should not be thought of as a “safe” alternative to cigarette smoking. In addition, kids who vape are at higher risk of contracting COVID-19 and have more severe symptoms. This is important information given the shifting age demographic as more older adults get vaccinated.”
The past year has been challenging for many people. Some students and young people have had a difficult time dealing with the isolation and changes the pandemic brought. Dr. Cameron said, “There is some data suggesting vaping rates may be up due to increased stress, higher rates of anxiety and depression, and lack of other structured activities.” But there are ways to get help, and parents and teens are encouraged to have open conversations with their pediatricians about it.
To help stem rising vaping rates, some municipalities are taking the issue on themselves. Bridgeport, CT has considered banning the sale of flavored and menthol tobacco products to help prevent use by teens and younger users. State policy actions are also likely. Dr. Cameron submitted written testimony in support of the bill to ban flavored tobacco products before the CT General Assembly, and both doctors plan to use their expertise to advocate in support of similar measures as other opportunities arise.
The question cannot be simply, “Do you vape?” Pediatricians must specifically name the devices to get an accurate answer.
Approaching this topic with kids and teenagers does not come without challenges. Drs. Anderson and Cameron recommend asking intentional questions to teens to get a sense of how many are using these devices — the question cannot be simply, “Do you vape?” Pediatricians must specifically name the devices to get an accurate answer. Some teens will not feel comfortable disclosing for fear their parents or guardians may find out. Other obstacles include adults who use vapes and e-cigarettes advocating to keep fruit and candy flavors available due to their own use, and the fact that social media has tutorials for making flavored vaping juice at home. It is imperative for pediatricians to include anticipatory guidance regarding the harms and addictive nature of e-cigarettes during adolescent visits.
Both doctors hope that as the pandemic slowly winds down, they will have more opportunities to speak directly with young people, in addition to healthcare providers, about the dangers of vaping and e-cigarette usage and to dispel the myths they may have been told about their safety compared to traditional cigarettes. Speaking with pediatrics residents, a key group to inform about best practices around patient conversations and changing rates of e-cigarette use among youth, is also high on the list. For the next year, Drs. Anderson and Cameron are tasked with increasing awareness about the harms of e-cigarettes and vaping among CT-AAP chapter members as well compiling resources for screening, referral, and treatment to help guide pediatricians in their busy practices. The APP offers a curriculum to address youth e-cigarette prevention and cessation based on current evidence and best practices as well.