How do I help my teen quit vaping? Health advocates admit there aren’t many options


Bailey Loosemore


Louisville Courier Journal
Published 7:21 AM EST Nov 20, 2019

When the Louisville mother first started finding Juul pods around her house, she thought maybe they were thumb drives, something her two sons needed for school.

She picked them up from around her basement and left them on the dining room table for her sons to take with them — not knowing she was returning the nicotine-filled capsules directly to their hands.

By the time the mother realized what the pods contained, her youngest child was already hooked.

He was 17, a junior in high school.

Now, at 19, the college freshman doesn’t know how to quit.

He’s tried nicotine replacement therapies, such as patches and gum that release low doses of nicotine. But with such high levels of nicotine, health experts say e-cigarettes like Juul can get teens addicted faster and be more difficult to give up than smoking tobacco.

And as the health community plays catch-up with the electronic devices, advocates admit little research has been done on cessation for teens.

“What keeps me up at night is I realize we’re at the very forefront of this issue,” the mother, Susan, wrote in a letter to the U.S. Food and Drug Administration. She declined to use her last name in order to respect her son’s privacy.

“There are countless victims like my son who desperately need help.”

Officials with the FDA and the Centers for Disease Control and Prevention have both called for more research into cessation resources for adolescents who vape.

As of now, the FDA has not approved nicotine replacement therapies for use by people under the age of 18. And a small number of clinical trials have suggested the therapies do not work for teens, according to a report from Vox.

In May, the FDA hosted a Youth Tobacco Cessation workshop, where then-acting Commissioner Norman Sharpless announced that the agency was accepting research proposals to conduct more trials and explore the development of drug therapies for youth cessation. 

“For young people who are currently hooked on e-cigarettes, we will support every effort to help them quit,” Sharpless said at the workshop.

“We cannot and will not risk a generation of youth to a lifetime of nicotine addiction.”

Signs of nicotine addiction

Susan said she knew her son had a problem by the sheer number of pods she found at home and in his car.

“I could also see where he was spending his money,” she told The Courier Journal. “He was always spending like $16.95 at the Shell station daily. … He was easily using, at the bare minimum, at least a pod a day.”

According to Juul’s website, one pod of vaping liquid contains the nicotine equivalent of a full pack of cigarettes. And the electronic devices allow users to inhale nicotine faster than through combustible cigarettes, health professionals say.

That presents a big problem for teens, who can get addicted off less exposure to nicotine than adults, Louisville pediatrician Pat Purcell said.

Also: E-cigarettes are especially addictive for teens. Here’s how to help them quit

A person’s brain is not fully developed until around age 25, and nicotine can inhibit development, leading to possible issues with attention and cognition, health professionals say.

Susan said she recognized some of those changes in her son, who became more irritable as his use increased.

“At the height of the worst, he was in the car with me and plugged a Juul into my car,” Susan said. “He said, ‘I’m sorry, I’m so stressed right now, I have to do this.’ It was like a physical urgency.”

Susan said she spoke with her son’s pediatrician and her physician about cessation options for e-cigarettes, but “the problem I learned is patches cannot replace the amount of nicotine that’s in these pods.”

Now, Susan is looking into inpatient therapy programs as an option for her son. 

“He wants to stop,” she said. “I’m telling you, he can’t.”

Tentative treatments for smoking addiction

Purcell said she understands Susan’s frustrations.

The pediatrician has spent the past two years helping educate others in her profession about the risks associated with teen e-cigarette use. And she has been asked to join a national panel through the American Academy of Pediatrics that will discuss cessation for adolescents.

“Education is going to hopefully stop someone from getting to” the point of addiction, Purcell said. “But we also have to put resources toward what are we going to do with these adolescents that are now addicted?”

Several agencies have introduced national cessation programs aimed at teens that allow the youths to text or call a service that provides them support.

In Kentucky, the Department for Public Health on Monday announced such a service called My Life, My Quit.

Teenagers who want to stop vaping can text or call the service’s toll-free number, 1-855-891-9989, to be connected with a “quit coach,” who will provide confidential, personalized support.

What’s happening in our state: For Kentucky schools, preventing e-cigarette use among students requires ‘an army’

“We know how difficult it is for young people to find effective help quitting tobacco products, especially help that is tailored just for them,” department employee Elizabeth Anderson-Hoagland said in a press release. “But we also know that with help and support, young people can successfully quit tobacco, including vaping.”

Purcell said teens who attempt to quit vaping can exhibit nicotine withdrawal symptoms, such as headaches, stomachaches and vomiting. Nicotine replacement therapies can alleviate some of those symptoms, but health experts are not certain if they’re effective for youths.

Still, the American Academy of Pediatrics this month released a fact sheet that recommends pediatricians “consider off-label pharmacotherapy for youth who are moderately or severely addicted.”

For those under 18, the therapies require a prescription, the fact sheet says.

Sharon Levy, director of the Adolescent Substance Use and Addiction Program at Boston Children’s Hospital, is a leader in the efforts to address cessation for e-cigarettes.

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Last month, she told Wired her program uses nicotine patches to ward off withdrawal. But she supports replacement therapies with behavioral counseling on how to manage underlying issues.

Purcell agrees that counseling is often needed for teens who’ve become addicted to nicotine or other substances.

But she says teens also need support from their parents and schools.

“It’s very hard for an adolescent to do,” Purcell said. “Very few are going to quit without support of a parent.”

Bailey Loosemore: 502-582-4646; bloosemore@courier-journal.com; Twitter: @bloosemore. Support strong local journalism by subscribing today: courier-journal.com/baileyl.

How to quit smoking: Vaping cessation tips for teens

E-cigarettes and other vaping products often contain potent doses of nicotine that make them highly addictive and difficult to quit.

For example, a vaping pod from industry leader Juul contains 5% nicotine, which is equivalent to a full pack of combustible cigarettes.

With more adolescents trying the products, experts have recommended the following tips to help them quit:

1. Know the facts

There are plenty of resources available online and through local chapters of health organizations, such as the American Lung Association, that can provide adolescents and their parents with facts on vaping.

One example: Teen.smokefree.gov, a website run by the U.S. Department of Health and Human Services, features information on risks associated with various tobacco products, including hookah and e-cigarettes.

2. Be ready to quit

People of any age will not give up vaping or smoking unless they want to, experts say. So parents of adolescents who use the devices should remain patient until their child is ready to quit.

At that point, the vaper can set a quit date and develop a “plan for success,” according to a fact sheet from the American Academy of Pediatrics.

3. Form a support system

Experts say people are more likely to quit using nicotine products if they have support and encouragement from family or friends.

4. Download an app

The Truth Initiative and SmokeFree.gov both offer apps to help young people, specifically, stop vaping.

This Is Quitting by the Truth Initiative is a free mobile program tailored to those between 13 and 24 years of age. Teens and young adults can enroll by texting DITCHJUUL to 88709. Parents of teen vapers also can receive support by texting QUIT to 202-899-7550.

Similar to This is Quitting, QuitSTART from SmokeFree.gov is a text messaging program aimed at young adults between 13 and 19 years of age. To sign up, text QUIT to 47848 or fill out a form at teen.smokefree.gov/become-smokefree/smokefreeteen-signup.

In Kentucky, adolescents can also use a new service called My Life, My Quit, which is operated by National Jewish Health. Teenagers who want to stop vaping can text or call 1-855-891-9989, toll-free. They will be connected to a “quit coach” who will provide five sessions of personalized support. For more information about My Life, My Quit, visit MyLifeMyQuit.com.

5. Consider counseling

 Health experts recommend adolescents seek counseling or therapy that can address nicotine use as well as underlying problems that could have led them there.

This content was originally published here.

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