ATLANTA – Of all the pre-teen related parental worries I have about my seventh grade daughter, at the top of my list right now is making sure she doesn’t vape.
This week, New York became the first to report a teen had died from a vaping-related lung injury, and it’s the latest in a rash of vaping-related illnesses and deaths across the country.
But I was concerned even before the headlines. The long-term health consequences of a nicotine addiction are so significant with e-cigarettes that I’m even less worried about her trying regular cigarettes (unless she starts vaping first).
The practice continues to skyrocket among minors, in large part because of the e-cigarette manufacturers’ effective playbook of “cool” ads, fun flavors and downplaying health risks. According to new research, 20% of eighth graders have reported using a vaping product; that number jumps to 36% for high school sophomores and 40% of high school seniors. Just two years ago, those percentages were 10%, 21% and 25%, respectively. Ask teens around the country, and they will likely tell you from their experience those numbers are much lower than what they see every day.
So what’s the best way to go about convincing my daughter and others not to start? Or, for other parents, to get their child to quit?
Do I scare her, or reason with her? Do I bribe her not to experiment? Wait, and then punish her if I catch her? All of the above?
I know one tactic I won’t try: threats. I don’t think they work in general and especially in this case. Kids tend to rebel against their parents in reaction to threats and ultimatums. And we all know a popular pastime for rebellious teens, right? Smoking.
What is clear is that I, along with every other parent out there, can’t procrastinate. Vaping among minors has been classified as an epidemic, and according to the Centers for Disease Control and Prevention more than 5,700 kids start vaping every day. We need to work hard at stemming that tide.
“We don’t have a vaping problem, or an opioid problem or a heroin problem,” said Laura Searcy, the program director of the Georgia Tobacco Free Youth Project who works with students, faculty, health care professionals, parents and community groups on reducing vaping among minors. “What we have in the United States is an addiction problem. We have to stop creating a hierarchy of ‘good drugs’ and ‘bad drugs.’ “
The bottom line is that the farther out you can push the first year of any mind-altering substance — alcohol, nicotine and/or opioids, for example — “the less likely they are to have a lifelong addiction,” she said.
That is the goal: Delay the experimentation and use of these substances for the long-term benefit of our children’s mental and physical health.
If your child is already experimenting with e-cigarettes, “don’t shame and blame,” said Marnie Grodzin, the youth development coordinator for Decatur Prevention Initiative, a nonprofit that provides prevention services to youth and families in Georgia. Nicotine is highly addictive to a still-developing brain, so “come from a place of care and concern, not from a punitive stance,” she wrote in an email to me.
And that’s why, if my daughter does try vaping, we won’t punish her. We’ll help her.
While schools need to be active and self-educating on this urgent matter, their efforts can’t be alone. And don’t look to science to get us out of this, either. There are currently no FDA-approved nicotine cessation products for e-cigarette users under age 18.
For now, the primary answer to this problem lies with parents. Avoiding potentially harmful behavior is one of the many areas where effective, well-intentioned parenting has the biggest impact.
“The opposite of addiction is connection,” said Searcy, who is also a pediatric nurse practitioner at WellStar Kennestone Regional Medical Center. “Parents talking to their kids is one of the most powerful tools we have.”
So, let’s consider what may be effective as you talk to your children about vaping.
Reason with them
When talking to your kids about vaping, Grodzin recommends you “only use language you are comfortable with and be real and authentic. Teens can smell a con from a mile away.”
The conversations (not just one) are best led with non-judgmental curiosity: What’s happening with their friends? What’s going on at school? What do they know about the risks? And so on.
Also “pick some key facts to focus on that you think will grab your teen’s attention,” Grodzin added.
Searcy agreed. When she speaks at schools, kids tell her to “lead with the science. Tell me why I shouldn’t vape.” Here are some starter facts that may help.
- Nicotine is addicting, and moreso for developing brains. Although vaping may be a tool to help some adult smokers wean themselves from cigarettes, for new smokers that road heads in the opposite direction, toward cigarettes and other addictive substances.
- One Juul pod contains as much nicotine as a pack of cigarettes, according to the company.
- We know vaping harms developing lungs, but other effects are largely still unknown. We won’t have the research on the damaging long-term health consequences of vaping until we have long-term users. “In effect, you are human guinea pigs,” Searcy tells kids.
- Peer pressure is usually, but not always, a terrible reason to change your behavior. Following others usually means you’re not following your own path.
- If they make a distinction between smoking cigarettes and vaping, point out how they are the same when it comes to the health risks of nicotine addiction and the methods manufacturers use to get you addicted — namely that these big tobacco companies are duping users with their dishonest advertising campaigns and kid-friendly flavors.
- And, as with any addiction, there’s an enormous financial cost on top of the physical toll: For cigarettes, the average lifetime cost is $1.4 million per person, according to 2015 data.
If you need more facts at your fingertips, the US Surgeon General’s website is a great resource. And before you start these conversations, read through the American Lung Association’s excellent “vape talk” guide for parents.
If your kid agrees that trying is a terrible idea, they may still need tools to help them stick to that view. Ask them to think of what they’ll say if they are offered an e-cigarette by a friend.
And stress the importance of never trying someone else’s e-cigarette. Even if they know the person, they don’t know exactly what other substances are in the chemical liquid they’re inhaling. Pods are not tamper-proof and there could be illegal or dangerous substances added.
If your child wants to quit, start by asking them why they do it and addressing those factors. “Is the drug of choice being used as a coping mechanism?” Grodzin asks. “If it is, then we need to work on adding healthy coping mechanisms.”
They may also confess that they feel hooked, and it’s difficult to stop. Or they may not even be aware that they’re struggling. Ask about their vaping habits and whether they show signs of addiction. Habits are difficult to break, especially when friends or school routines act as triggers. They may need to reroute those habitual behaviors into more benign ones until the desire to vape fades. Help them find solutions; smokefree.gov has a modern interactive guide and free live counselor chats to get people off tobacco products.
Scare the bejeezus out ’em
Reasoning may not always work though. A teen’s prefrontal cortex is still forming, Grodzin points out. Teens “think that negative consequences happen to ‘other people, not me. I’m special. I got this,’ ” she said.
Neither Grodzin nor Searcy think trying to scare kids is the best approach. “There’s a science around prevention,” said Searcy, “and the evidence is that fear doesn’t work.” But “fear can be useful to get their attention,” she added, and the recent reports of vaping-related illnesses and deaths “may be breaking through the noise.”
Talk about the fact that hundreds of people are currently getting very sick, and some are even dying unexpectedly, caused by a still unknown lung illness associated with short-term use of e-cigarettes. Cigarettes often take years of smoking before lung cancer becomes a deadly threat, but vaping could kill you or impair your movement or brain function now and for the long term.
If you think fear is a motivator for your child, perhaps ask them to consider other risky behaviors that could lead to brain or bodily function problems, or even the remote possibility of death. Riding in a car without a seatbelt? Climbing on the roof of their home? Playing with matches? If you focus on behaviors you’re confident they won’t do, ask them why they avoid those actions.
Even if your child doesn’t have a sense of their own mortality yet, they may be influenced by how a vaping-related illness could keep them from playing sports, affect their ability to learn, or prevent them from participating in other activities they love.
Make it worth their while
When my wife was in high school, her mother offered her $1,000 if she didn’t try a cigarette before the age of 21. When my wife reached that age, her mom paid up. She made a similar deal with her son, plus inflation. It worked both times.
A recent study showed that paying people is an effective way to get them to quit smoking. And there is evidence that you can successfully reward your kid to promote a desired behavior, such as trying more vegetables at mealtime.
Yet there is no body of research on incentivizing young people to avoid smoking in particular.
“Rewards for positive behavior can work,” Searcy said, “but bribing to not do [a bad behavior] can backfire.” The argument commonly made against this incentive approach is that we shouldn’t reward our children for behavior they should be doing anyway.
I personally see an advantage in creating one extra (and potentially long-term) incentive to keep their focus on the north star of not vaping or smoking. It may even give them ammo to keep peers from pressuring them into it. It’s pretty hard to argue with, “My parents are actually going to give me money not to.”
Of course, it requires them to be honest about it — but isn’t integrity exactly the kind of virtue we should always be encouraging?
Know your kid
There is no one right way to get through to your kids. Your tactic should align with how you already effectively parent. By the time they are old enough to experiment with smoking, you should have a good sense of what motivates them, what they need to hear and when.
With my daughter, I jumped right in with questions: What do you know about vaping? Are kids at your school vaping? Your friends? I even snuck in, “Have you tried?”
And, when she started replying, every answer was reassuring. But her understanding of how vaping worked was lacking, mainly due to disinterest, it seemed. She listened to my talking points. And when it came to an offer for a pay-off for not trying until age 21, she said we were wasting our money, but she’d take it anyway.
And after this first real conversation on the topic, vaping is no longer a big concern for me. But I’ll keep checking in.
As with all the sensitive topics that you must talk to your kids about (bullying, porn, alcohol, drugs, sex etc.) the most important thing to do is keep the conversation open and ongoing. If you come down too hard or judgmental, you make it scarier for them to talk to you. If you’re too light or flippant, they may not take you seriously.
Look for the balance. Stay open, attentive, loving, curious and helpful while you model clarity and trust. If you can do that, you make difficult topics less difficult for them, and you.
If you try and try again, and it’s not getting through to them for whatever reason, consider enlisting the help of another person they trust or admire. If you and your ally are equally concerned and on message, the village approach may be your answer.
And if you want to do more to help your child and others, Searcy recommends getting active at the local, state and federal levels to push legislators to pass more restrictive laws that reduce access to vaping: Keep raising the legal age, restrict flavors and limit the locations where vape shops can open, especially near schools.
David G. Allan is the editorial director of CNN Health, Wellness and Parenting. He also writes “The Wisdom Project” about applying philosophy to our daily lives. You can subscribe to it here.