Lantie Elisabeth Jorandby M.D.

Use Your Brain

Vaping in Teens and Young Adults: Dangerous and Addictive?

Teens and Young adults are at risk. What parents should know

Posted Sep 22, 2019

The teen vaping craze, which took off with Juul, a popular electronic cigarette (e-cigarette) brand marketed to young adults with flavored nicotine liquids such as crème brulee and watermelon, appears to have triggered a mysterious lung disease.

The CDC estimates that there have been 530 cases of vaping related respiratory disease, with now at least 8 deaths attributed to vaping.1 On Friday, September 6, 2019, the (CDC) issued a warning on vaping and e-cigarettes, cautioning teenagers, young adults and pregnant women to avoid e-cigarettes completely and cautioning all users to never buy e-cigarettes off the street or from social sources.

Researchers have found that 80% of those diagnosed with the vaping illness used products that contained THC, the psychoactive ingredient in marijuana, 61% had used nicotine products and 7% used cannabidiol products.

The majority of patients afflicted are young adults, with the average age of 19.2 This comes as vaping among high school students rose 78% between 2017-2018.3 According to the US Surgeon General, one in five teens vapes. Other data show that teen use of e-cigarettes comes with majority of users having never smoked a traditional cigarette.4 Teens and young adults frequently borrow or buy e-cigarette ‘pods’ from gas stations but purchase from friends or peers and are known to alter the pods to insert other liquids, such as cannabidiol and other marijuana products.  

Teens and young adults are at higher risk for vaping complications. Their respiratory and immune systems are still developing. Adding to the recent surge of respiratory illnesses, nicotine is known to suppress the immune system as well, making them more susceptible to viral and bacterial infections and making it harder for them to recover.

Nicotine also hyperactivates the reward centers of the brain which can trigger addictive behaviors. Because brains of young adults are not yet fully developed until at or after age 26, nicotine use before this can ‘prime the pump’ of a still-developing brain, increasing the likelihood of addiction to harder drugs. Nicotine has shown to disrupt sleep patterns, which are critical for mental and physical health. Lastly, research shows that smoking increases the risks of various psychiatric disorders, such as depression and anxiety. My teen and young adult patients have endlessly debated with me the idea that smoking, either nicotine or marijuana, helps their anxiety or gets them to sleep. I tell them in the long run, the data show that smoking worsens these problems.5,6,7,8

Nationally, we are seeing an explosion of multi-state legislation pushing marijuana as a health food. E-cigarettes have followed as the ‘healthy’ alternative to traditional tobacco. The market has found a new way to promote e-cigarettes as the ‘cleaner, harmless’ substitute for smoking.

Finally, what can parents do to protect their teen or young adult? 


1. Model good behavior. Teens and young adults may roll their eyes and pretend they don't hear you, but they are listening and even more, they are watching you. If you want them to avoid tobacco and vapes, don't use them yourself.

2. Be open and non-judgmental. Nothing shuts a young adult down faster than a lecture or scolding. Choose the right moment to talk about tobacco or vapes, such as when you might see a person using it in a movie, or on the street. Be approachable and talk to them without judgment. They will be far more likely to open up.

3. Know your facts. The CDC has great information on their website about vaping products: https://www.cdc.gov/tobacco/basic_information/e-cigarettes/Quick-Facts-o.... Another strategy is to find others in your teen's life who can help. Teachers, coaches, and pastors are good allies who can support you.

References

1.     (https://www.cdc.gov/mmwr/volumes/67/wr/mm6745a5.htm?s_cid=mm6745a5_w). 

2.     https://www.nejm.org/doi/full/10.1056/NEJMoa1911614

3.     https://www.cdc.gov/mmwr/volumes/67/wr/mm6745a5.htm?s_cid=mm6745a5_w

4.     https://www.nap.edu/catalog/24952/public-health-consequences-of-e-cigarettes

5.     Patton, George C., et al. "Is smoking associated with depression and anxiety in teenagers?." American journal of public health 86.2 (1996): 225-230.

6.     Leventhal, Adam M., et al. "Psychiatric comorbidity in adolescent electronic and conventional cigarette use." Journal of psychiatric research 73 (2016): 71-78.

7.     Levine, Amir, et al. "Evidence for the risks and consequences of adolescent cannabis exposure." Journal of the American Academy of Child & Adolescent Psychiatry 56.3 (2017): 214-225.

8.     Leadbeater, Bonnie J., Megan E. Ames, and Ashley N. Linden‐Carmichael. "Age‐varying effects of cannabis use frequency and disorder on symptoms of psychosis, depression and anxiety in adolescents and adults." Addiction 114.2 (2019): 278-293.