When an epidemic is forecast, standard operating procedure is to immediately closely monitor the situation. Communication systems, platforms and procedures are tested to assure operability. Treatments are established, along with forms of local and regional financial assistance and other needed resources. Implementation is hopefully swift and coordinated.
When it was announced earlier this year that vaping jumped dramatically among high school students, creating the biggest one-year spike in 44 years of monitoring substance abuse by young people, the news immediately moved teen vaping from very worrisome to an epidemic. The study found a 78 percent increase in e-cigarette use by teens in just one year. As a result, current major health threats to our young people, such as binge drinking, drug abuse, obesity, stress and cyberbullying, now have a new category joining them: nicotine addiction.
While cigarettes are a combusted or burned product, vaping products release an aerosol that is inhaled and exhaled. Teens are either overlooking or underestimating a key ingredient in the vapors they inhale — highly addictive nicotine. Though it is possible to buy liquid or pod refills without nicotine, you have to look much harder to find them. According to science writer Kathleen Raven, when a teen inhales vapor laced with nicotine, the drug is quickly absorbed through the blood vessels lining the lungs. It reaches the brain in about 10 seconds. Well over 2 million middle school, high school and college teens are estimated to currently use such devices.
"The younger the developing brain is exposed to nicotine, the stronger and more rapid the addiction," Dr. Jonathan Winickoff, a pediatrician at Massachusetts General Hospital in Boston and member of the American Academy of Pediatrics Section on Tobacco Control, recently told Healthline. "The earlier you become addicted, the harder it is to quit."
Health officials have worried for years that electronic cigarettes could lead kids to switch to smoking traditional cigarettes. Shortly following the reported spike in vaping, the Centers for Disease Control and Prevention reported that cigarette smoking rates have stopped falling among young people. This report goes on to say that approximately 2 in 5 high school students who use a vaping or tobacco product used more than one kind. The most common combination was e-cigarettes and traditional burned cigarettes. The majority of teenagers who pick up an e-cigarette have never smoked a traditional cigarette, and now, according to current research, they have become four times more likely to do so.
One of the things that makes young people uniquely vulnerable to vaping is not merely biological but also psychosocial. Dr. Nii Addy, a Yale researcher who specializes in the neurobiology of addiction, tells Medical Xpress that research and human brain imaging studies have shown that "environmental cues," especially those associated with drug use such as nicotine, can change dopamine concentrations in the brain.
"This means that simply seeing a person you vape with, or visiting a school restroom — where teens say they vape during the school day — can unleash intense cravings," says Addy. Vaping devices no longer look like cigarettes; they are easily hidden. Today, they have become ever-present in high schools throughout the country.
"We end up needing to teach kids how they can deal with cravings, how they can identify high-risk situations, how they can actually deal with being surrounded by people who are using these things," says Dr. Sharon Levy, the director of the Adolescent Substance Use and Addiction Program at Boston Children's Hospital. "Because the reality is that, for most kids, we treat them and put them back in school, and then they go to the bathroom, and everybody's Juuling."
The term "Juuling" is used to refer to the recreational use of the industry's most popular device. Electronic cigarettes maker Juul is so insanely fashionable that its name is used as a verb. It controls more than 70 percent of the market share. Its main product fits in one's hand and resembles a USB drive. It is so easy for students to conceal and use in school that it is said to sometimes be used in the middle of class. (The devices also produce less smoke than many other e-cigarette brands.) About 200 puffs of a Juul pod — from a pod system similar to that of a coffee maker — can contain as much nicotine as a pack of cigarettes.
What we are talking about is something that is much more than just a "bad habit." This legitimate medical problem requires a major response. Though the FDA has a long history of prevention programs, they have been unable to keep pace with the vaping explosion. There currently are no FDA-approved nicotine cessation products for e-cigarette users under 18. Nor are there any addiction programs specifically geared toward teens and nicotine use, though the escalating popularity of vaping among teens was a predictable development.
In response to FDA pressure, e-cigarette companies promised in recent years to increase efforts to keep kids from being hooked on e-cigarettes. Instead, FDA head Scott Gottlieb said last week, following a meeting at the Brookings Institution, that the e-cigarette industry has been "overly dismissive" of the risk that kids could become addicted to nicotine through e-cigarette use.
Beyond the chemistry of the nicotine itself, e-cigarette companies have come under fire for adding pleasant, often sweet flavors to their "e-liquid" that are known to appeal to young people. They say that they are designed for adults who are quitting smoking, but with names like "Bazooka Vape," "Candy King," "Glazed Donuts," "Charlie's Chalk Dust" and "Rip Offs," you have to wonder, Who is most likely to find these products attractive?
The FDA recently released draft guidelines of a plan to limit the sales of most flavored e-cigarettes.
Historically, nicotine dependence has been seen as an adult problem. There are no best practice standards. At present, the clinical community is not certain how to treat people of any age who are addicted to vaping. When it comes to support for parents and kids, resources are scarce. For further information on what is being done in your community, contact Parents Against Vaping E-Cigarettes.
Write to Chuck Norris ([email protected]) with your questions about health and fitness. Follow Chuck Norris through his official social media sites, on Twitter @ChuckNorris and on Facebook at the "Official Chuck Norris Page." He blogs at http://chucknorrisnews.blogspot.com. To find out more about Chuck Norris and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate website at www.creators.com.