Several years after vaping, or use of e-cigarettes, became so popular among teens and pre-teens, we are now seeing more and more teens wanting to quit. The issue is, there are no programs or methods that have been standardized for this group. Unlike use of nicotine patches, programs and support of family or healthcare professionals of adults wishing to quit traditional cigarette smoking, there are fewer easily accessible options for teens who vape. A study published in the October 2023 issue of Pediatrics examined the frequency of teens who vape wishing to quit, and what means they are using.
The investigators, based at the University of Nebraska, looked at data from the 2021 National Youth Tobacco Survey, a tool that includes 6th through 12th graders from public and private schools across all 50 U.S. states and the District of Columbia. Over 20,000 individuals completed the survey.
The study authors found that nearly 70% of teens who have been vaping regularly, meaning at least a few times per month, had tried to quit in the past year. Of those, over 60% did not use any resources or support to help with this. Of the ones who did enlist outside support, means of doing so included peer support, internet sources, mobile apps, and parents. Females were significantly less likely than males to seek parental support in quitting. Nearly two thirds of adolescents who tried to quit vaping were unsuccessful.
While there are many FDA-approved cessation medications (such as nicotine replacement) for adults, there are no comparable medical options for adolescents. There are several behavioral tobacco cessation initiatives, such as “CATCH My Breath,” geared towards middle schoolers who use e-cigarettes, and “The Truth Initiative,” aimed at teen and young adult e-cigarette users. But even these campaigns have not been as widely known nor available as are programs geared towards adult tobacco users wishing to quit.
The e-cigarette boon began back in 2015, when the company Juul launched its first campaign. Three years later, Juul products made up over 70% of the e-cigarette market. Many of the users of Juul e-cigarettes were teens, in large part due to easy accessibility and wide variety of candy-flavored products. Teens who vaped were 16 times more likely to use Juul e-cigarettes than other brands.
Within a few years, lawsuits from states, school districts and individuals came in with claims that the company was harmfully and underhandedly targeting the youth market, most of who did not even know that e-cigarettes contained highly addictive nicotine. In fact, a Juul pod contains about 20 times the nicotine of a traditional tobacco cigarette. As of August 2023, Juul had already paid out over $1 billion in settlements, with over 5,000 suits settlements still pending.
It has been shown that any type of cessation of cigarette smoking (e-cigarette and traditional tobacco) is more effective if external sources are used. For adolescents attempting to quit e-cigarettes, those who used assistance were most likely to enlist peers, the internet, or apps. Importantly, a substantial number of youths trying to quit included parental support and guidance as part of their efforts to quit. This final point underscores the need for family engagement in a nurturing and open environment. This has been associated with more positive outcomes in a multitude of areas regarding teen and pre-teen behaviors and challenges.
Fewer than 4% of youth e-cigarette users engaged support or guidance from a physician or other healthcare professional when attempting to quit. This is important for physicians who treat adolescents, as it points to the need to better elicit tobacco or vaping behaviors in teens, so that this patient population can feel comfortable sharing sensitive concerns with their doctors.
Going forward, the authors of the current study on teen vaping cessation note that better access and awareness of cessation support should become more available, especially for adolescents seeking guidance on how to quit.
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