The Health Implications of Vaping in Adolescents
From the Show: UK HealthCast
Summary:
Air Date: 8/15/22
Duration: 10 Minutes
Dr. Cathy Martin, a Professor of Psychiatry for the Child Psychiatry Division for UK HealthCare, discusses why vaping has become more prevalent in adolescents and the effects it can have on a young person's health.
Transcription:
Another informational resource from UK HealthCare. This is UK HealthCast, featuring conversations with our physicians and other healthcare providers.
Joey Wahler (Host): Vaping is the use of an electronic cigarette to simulate tobacco smoking, inhaling vapor instead, which has become very popular among teens. But what are the health risks associated with vaping in adolescence? This is UK HealthCare, a podcast from UK Health. Thanks for listening. I'm Joey Wahler. Our guest from UK HealthCare, Dr. Cathy Martin, a child and adolescent psychiatrist and Professor of Psychiatry for the Child Psychiatry Division. Dr. Martin, thanks for joining us.
Dr Cathy Martin: Thank you.
Joey Wahler (Host): So first, in a nutshell, why do you think vaping seems to be so popular among teens nowadays?
Dr Cathy Martin: Well, there are a couple of reasons. One is that the developers really made it very appealing to teens by flavoring it, packaging it in exciting ways. So that would be probably number one. Number two is that kids like to experiment. I mean, that's part of being a teenager and this is a new thing to experiment with. And there are other reasons as well.
Joey Wahler (Host): Plus for some kids, I guess they feel it just looks cool, right?
Dr Cathy Martin: Yes, it is exciting. And it does look cool. That's exactly right.
Joey Wahler (Host): I mean, I remember going back to my days as a kid, I like to -- even as a, I don't know, seven, eight, nine-year-old -- go and buy those bubble gum cigarettes at the store and just blow powder to make myself look cool, right?
Dr Cathy Martin: Yes. And you were imitating someone, you were imitating probably someone in your family. But this is more of a peer shared experience, that mainly kids get these from their friends primarily.
Joey Wahler (Host): Gotcha. So are teens generally more susceptible to vaping addiction than adults would be?
Dr Cathy Martin: Absolutely. Absolutely. So the teen brain is in a very unique stage of development. It's the middle part of the brain, which is called the striatum, where addiction risk lies, but also wanting to experiment and do new things and do exciting things is way ahead of the front part of the brain or the prefrontal cortex. So the balance between making good decisions, thoughtful decisions, and planning and doing exciting things is a bit dysregulated or off center. So kids because of that are more likely to experiment with things and then become dependent on them.
Joey Wahler (Host): So, what are the health risks associated with vaping in younger people?
Dr Cathy Martin: Well, vaping is not benign in itself. The first and most worrisome drug is the nicotine. Nicotine itself is not a concern, but it is very addicting. And once you get starting to use nicotine and, with teens, you rapidly move to dependence. And this is maybe particularly true with vaping, because it's so easily accessible, it's a pleasant experience, it's flavored, it doesn't burn your lungs as much. So it's very easy to yield quickly from occasionally used to really frequent use, maybe many hits during the day. It also has ultrafine particles that can be inhaled deep into the lungs. The flavorings have drug called diatecyl or a chemical that's linked to serious lung disease. They're volatile or organic compounds, cancer-causing chemicals, heavy metals, such as nickel, tin, and lead. And not only do you expose yourself to these toxins, but you're exposing people near you.
Joey Wahler (Host): Gotcha. So how about impact of vaping on an adolescent's brain, for instance, when it comes to their academic performance?
Dr Cathy Martin: Okay. So you have to think about nicotine again. If given in a laboratory setting, it can improve attention. But then as you become dependent to it, you go into withdrawal from nicotine when you can't get the vape 24/7. And then, you lose attention span. So it can interfere with focus in the classroom by the withdrawal symptoms. But the other issue is when you become dependent, you have to have it and you start thinking about where can I get it, when can I get it, you might skip class, you might step out in the hall. So that obviously interferes with your focus and getting your work done.
The other thing is we do know that one addiction is frequently tied to another addiction. And we do know that it's not uncommon for kids to vape and then move to traditional cigarettes, which we do know interfere with focus because of what I just described in nicotine withdrawal, but also you're at increased risk for other drug use. And we do know that it's not uncommon for kids to just not vape nicotine, but also to have marijuana in the vape.
Joey Wahler (Host): Now, you led me beautifully into my next question, doctor, which is just how likely are teens who use e-cigarettes to transition to traditional cigarettes?
Dr Cathy Martin: Very common. It's very common. I couldn't give you the exact number, but it is common.
Joey Wahler (Host): And how much nicotine is actually in e-cigarettes compared to traditional ones?
Dr Cathy Martin: So a pod is equivalent to a pack of cigarettes. Now, the pod size varies. So it's really hard to quantify. And the concentration of the nicotine varies, so it's a bit hard to quantify. But we can say kind of a traditional pod is equal to a pack. The other thing I would add is like 10 hits equals a cigarette. Those are kind of some metrics we could use.
Joey Wahler (Host): Understood. So in terms of addressing teens that are vaping and perhaps vaping too much, what's the best way parents can speak to their children about this?
Dr Cathy Martin: Well, what's interesting is kids do listen to their parents and even like with traditional cigarettes, if the parent is a smoker and they talk to youth about not smoking, they can have a big influence on them. So they need to be straightforward and open about it in a nonjudgmental, a good conversational tone. The team needs to feel they're being supported and they have an ally in their parent or a healthcare provider. And you begin to balance out what are the risks, what are the benefits, what are the cause.
One of the things we found with traditional tobacco is one of the number one reasons kids wanted to stop smoking was their breath stank when they kissed. So you don't know what window you're going to get through. Kids may say, "Oh, I can't run as fast. I get short of breath quicker," so that you help the teen figure out how is the vaping interfering with their life. And they may struggle with that, but that's the first step. What's the risk-benefit to ratio to them. The other thing is parents can be very clear, "I really don't want you doing this and we will come up with a reward system to reinforce you not using."
Joey Wahler (Host): So you're saying there, doctor, that perhaps being a better kisser is the best motivator for quitting vaping, right? Whatever works.
Dr Cathy Martin: Well, we found that for traditional cigarettes. We don't know that for sure with vaping, but I would say that it might be likely. You know, the dentists have a really good window for oral hygiene and cancer risk. I mean, there are a number of ways for people to walk through that door to say it really is going to damage your health.
And one quote that I read was it is safer than traditional cigarettes. But listen, traditional cigarettes kill in one way or another 50% of the people that use them, whether it's cardiac disease, lung cancer, all kinds of cancers. So it's not like you're going, "Yeah, it's less risk, but it's safe." no, it's not safe.
Joey Wahler (Host): And speaking of which, doctor, do you think part of the problem here in combating this among teens is the fact that especially if they've not smoked regular cigarettes prior to vaping and on top of that, especially if their parents are non-smokers, is there a misconception among certain people, particularly kids thinking that vaping is safer than it actually is?
Dr Cathy Martin: Well, I think that's absolutely true. I think they think it's benign, that it's not an issue and that's misinformation.
Joey Wahler (Host): So you talked a little bit about parents' ways of approaching their kids or other professionals and, of course, you are one of those. So in your experience, if you need to get a kid to stop vaping, what's the first step? How do you, for instance, if they need to seek professional help?
Dr Cathy Martin: Well, I think my main message is early use really is high risk for chronic use. And if you look even at traditional smokers, they all started when they were teenagers. So the point is, even though the teen may tell you, "I'm just using it occasionally," or "I just use my friends,'" any use puts you at risk for going down the pathway of addiction. So I would really stress that in a nice conversational let's-share-information tone, not a judgemental or anything like that and you form an alliance with the teen, so let's work on this together. And it rarely happens in one visit, maybe a small percent might, but mainly it's repeated encouragement and discussion.
Joey Wahler (Host): And so if someone is seeing you, an adolescent, for this issue being addicted to vaping, or perhaps being on the verge of becoming, so it sounds like you're saying, am I right, that if nipped in the bud early, that the chances of overcoming it are pretty good, right?
Dr Cathy Martin: Absolutely. And that's what we say is, "Look, you're at a really good spot where you can quit." The other thing you mentioned, if they're seeing me, I am a mental health professional. So the other risk with vaping is people use it to feel better. Nicotine does decrease anxiety. It can improve mood temporarily and transiently. But then when it wears off, those things could get worse. So we have to acknowledge the fact that kids do use this to feel better and that even makes addiction of higher potential or risk.
Joey Wahler (Host): And, doctor, I know you have some resources for those looking to reach out and get more information about vaping and help with vaping. So tell us about those, please.
Dr Cathy Martin: There's some excellent websites that families and teens can access. One is the US Surgeon General's website on teen vaping. Another one is the FDA's web page on using tobacco. And a third one is the CDC's webpage on electronic cigarettes. So I would reach out to those if you want more information.
Joey Wahler (Host): Excellent. So we've talked about some of these various specifics. In summation here, doctor, to kind of put a bow on this, what would your main message be to adolescents and their parents, parents of kids that are vaping? What's the main message from you that you want them to come away with today?
Dr Cathy Martin: Don't start. And if you start, get help right away. Talk to your parents about it. Talk to your doctor about it. One of the most powerful experiences I ever had was working with people that were dying from lung cancer and they left messages for their grandkids, "Don't pick them up."
Joey Wahler (Host): It sounds like that's about as powerful a message as you could provide someone, right, is from someone who's gone down that road themselves.
Dr Cathy Martin: And the issue though is it's hard to convince kids that vaping has the same risk as traditional cigarettes, and we really don't have the data yet to prove that to them. But we do know it is harmful and it leads to dependence and at risk for other drug use. And the other thing I would add is if you vape and use another drug like marijuana or alcohol and you're trying to quit those, if you continue to use tobacco, you are more likely to continue your other addiction. So stopping is a good thing every which way.
Joey Wahler (Host): Just a potential spiral that you want to try to avoid altogether, if at all possible. Well, folks we trust you are now more familiar with the health risks associated with vaping in adolescents. Dr. Cathy Martin, thanks so much again.
Dr Cathy Martin: Well, thank you. It's good to talk to you.
Joey Wahler (Host): Same here. And for more information, please call the UK HealthCare Psychiatric Outpatient Clinic at 859-323-6021. Again, that's 859-323-6021. If you found this podcast helpful, please do share it on your social media. And thanks for listening to UK HealthCast, a podcast from UK Health. Hoping your health is good health, I'm Joey Wahler.
Another informational resource from UK HealthCare. This is UK HealthCast, featuring conversations with our physicians and other healthcare providers.
Joey Wahler (Host): Vaping is the use of an electronic cigarette to simulate tobacco smoking, inhaling vapor instead, which has become very popular among teens. But what are the health risks associated with vaping in adolescence? This is UK HealthCare, a podcast from UK Health. Thanks for listening. I'm Joey Wahler. Our guest from UK HealthCare, Dr. Cathy Martin, a child and adolescent psychiatrist and Professor of Psychiatry for the Child Psychiatry Division. Dr. Martin, thanks for joining us.
Dr Cathy Martin: Thank you.
Joey Wahler (Host): So first, in a nutshell, why do you think vaping seems to be so popular among teens nowadays?
Dr Cathy Martin: Well, there are a couple of reasons. One is that the developers really made it very appealing to teens by flavoring it, packaging it in exciting ways. So that would be probably number one. Number two is that kids like to experiment. I mean, that's part of being a teenager and this is a new thing to experiment with. And there are other reasons as well.
Joey Wahler (Host): Plus for some kids, I guess they feel it just looks cool, right?
Dr Cathy Martin: Yes, it is exciting. And it does look cool. That's exactly right.
Joey Wahler (Host): I mean, I remember going back to my days as a kid, I like to -- even as a, I don't know, seven, eight, nine-year-old -- go and buy those bubble gum cigarettes at the store and just blow powder to make myself look cool, right?
Dr Cathy Martin: Yes. And you were imitating someone, you were imitating probably someone in your family. But this is more of a peer shared experience, that mainly kids get these from their friends primarily.
Joey Wahler (Host): Gotcha. So are teens generally more susceptible to vaping addiction than adults would be?
Dr Cathy Martin: Absolutely. Absolutely. So the teen brain is in a very unique stage of development. It's the middle part of the brain, which is called the striatum, where addiction risk lies, but also wanting to experiment and do new things and do exciting things is way ahead of the front part of the brain or the prefrontal cortex. So the balance between making good decisions, thoughtful decisions, and planning and doing exciting things is a bit dysregulated or off center. So kids because of that are more likely to experiment with things and then become dependent on them.
Joey Wahler (Host): So, what are the health risks associated with vaping in younger people?
Dr Cathy Martin: Well, vaping is not benign in itself. The first and most worrisome drug is the nicotine. Nicotine itself is not a concern, but it is very addicting. And once you get starting to use nicotine and, with teens, you rapidly move to dependence. And this is maybe particularly true with vaping, because it's so easily accessible, it's a pleasant experience, it's flavored, it doesn't burn your lungs as much. So it's very easy to yield quickly from occasionally used to really frequent use, maybe many hits during the day. It also has ultrafine particles that can be inhaled deep into the lungs. The flavorings have drug called diatecyl or a chemical that's linked to serious lung disease. They're volatile or organic compounds, cancer-causing chemicals, heavy metals, such as nickel, tin, and lead. And not only do you expose yourself to these toxins, but you're exposing people near you.
Joey Wahler (Host): Gotcha. So how about impact of vaping on an adolescent's brain, for instance, when it comes to their academic performance?
Dr Cathy Martin: Okay. So you have to think about nicotine again. If given in a laboratory setting, it can improve attention. But then as you become dependent to it, you go into withdrawal from nicotine when you can't get the vape 24/7. And then, you lose attention span. So it can interfere with focus in the classroom by the withdrawal symptoms. But the other issue is when you become dependent, you have to have it and you start thinking about where can I get it, when can I get it, you might skip class, you might step out in the hall. So that obviously interferes with your focus and getting your work done.
The other thing is we do know that one addiction is frequently tied to another addiction. And we do know that it's not uncommon for kids to vape and then move to traditional cigarettes, which we do know interfere with focus because of what I just described in nicotine withdrawal, but also you're at increased risk for other drug use. And we do know that it's not uncommon for kids to just not vape nicotine, but also to have marijuana in the vape.
Joey Wahler (Host): Now, you led me beautifully into my next question, doctor, which is just how likely are teens who use e-cigarettes to transition to traditional cigarettes?
Dr Cathy Martin: Very common. It's very common. I couldn't give you the exact number, but it is common.
Joey Wahler (Host): And how much nicotine is actually in e-cigarettes compared to traditional ones?
Dr Cathy Martin: So a pod is equivalent to a pack of cigarettes. Now, the pod size varies. So it's really hard to quantify. And the concentration of the nicotine varies, so it's a bit hard to quantify. But we can say kind of a traditional pod is equal to a pack. The other thing I would add is like 10 hits equals a cigarette. Those are kind of some metrics we could use.
Joey Wahler (Host): Understood. So in terms of addressing teens that are vaping and perhaps vaping too much, what's the best way parents can speak to their children about this?
Dr Cathy Martin: Well, what's interesting is kids do listen to their parents and even like with traditional cigarettes, if the parent is a smoker and they talk to youth about not smoking, they can have a big influence on them. So they need to be straightforward and open about it in a nonjudgmental, a good conversational tone. The team needs to feel they're being supported and they have an ally in their parent or a healthcare provider. And you begin to balance out what are the risks, what are the benefits, what are the cause.
One of the things we found with traditional tobacco is one of the number one reasons kids wanted to stop smoking was their breath stank when they kissed. So you don't know what window you're going to get through. Kids may say, "Oh, I can't run as fast. I get short of breath quicker," so that you help the teen figure out how is the vaping interfering with their life. And they may struggle with that, but that's the first step. What's the risk-benefit to ratio to them. The other thing is parents can be very clear, "I really don't want you doing this and we will come up with a reward system to reinforce you not using."
Joey Wahler (Host): So you're saying there, doctor, that perhaps being a better kisser is the best motivator for quitting vaping, right? Whatever works.
Dr Cathy Martin: Well, we found that for traditional cigarettes. We don't know that for sure with vaping, but I would say that it might be likely. You know, the dentists have a really good window for oral hygiene and cancer risk. I mean, there are a number of ways for people to walk through that door to say it really is going to damage your health.
And one quote that I read was it is safer than traditional cigarettes. But listen, traditional cigarettes kill in one way or another 50% of the people that use them, whether it's cardiac disease, lung cancer, all kinds of cancers. So it's not like you're going, "Yeah, it's less risk, but it's safe." no, it's not safe.
Joey Wahler (Host): And speaking of which, doctor, do you think part of the problem here in combating this among teens is the fact that especially if they've not smoked regular cigarettes prior to vaping and on top of that, especially if their parents are non-smokers, is there a misconception among certain people, particularly kids thinking that vaping is safer than it actually is?
Dr Cathy Martin: Well, I think that's absolutely true. I think they think it's benign, that it's not an issue and that's misinformation.
Joey Wahler (Host): So you talked a little bit about parents' ways of approaching their kids or other professionals and, of course, you are one of those. So in your experience, if you need to get a kid to stop vaping, what's the first step? How do you, for instance, if they need to seek professional help?
Dr Cathy Martin: Well, I think my main message is early use really is high risk for chronic use. And if you look even at traditional smokers, they all started when they were teenagers. So the point is, even though the teen may tell you, "I'm just using it occasionally," or "I just use my friends,'" any use puts you at risk for going down the pathway of addiction. So I would really stress that in a nice conversational let's-share-information tone, not a judgemental or anything like that and you form an alliance with the teen, so let's work on this together. And it rarely happens in one visit, maybe a small percent might, but mainly it's repeated encouragement and discussion.
Joey Wahler (Host): And so if someone is seeing you, an adolescent, for this issue being addicted to vaping, or perhaps being on the verge of becoming, so it sounds like you're saying, am I right, that if nipped in the bud early, that the chances of overcoming it are pretty good, right?
Dr Cathy Martin: Absolutely. And that's what we say is, "Look, you're at a really good spot where you can quit." The other thing you mentioned, if they're seeing me, I am a mental health professional. So the other risk with vaping is people use it to feel better. Nicotine does decrease anxiety. It can improve mood temporarily and transiently. But then when it wears off, those things could get worse. So we have to acknowledge the fact that kids do use this to feel better and that even makes addiction of higher potential or risk.
Joey Wahler (Host): And, doctor, I know you have some resources for those looking to reach out and get more information about vaping and help with vaping. So tell us about those, please.
Dr Cathy Martin: There's some excellent websites that families and teens can access. One is the US Surgeon General's website on teen vaping. Another one is the FDA's web page on using tobacco. And a third one is the CDC's webpage on electronic cigarettes. So I would reach out to those if you want more information.
Joey Wahler (Host): Excellent. So we've talked about some of these various specifics. In summation here, doctor, to kind of put a bow on this, what would your main message be to adolescents and their parents, parents of kids that are vaping? What's the main message from you that you want them to come away with today?
Dr Cathy Martin: Don't start. And if you start, get help right away. Talk to your parents about it. Talk to your doctor about it. One of the most powerful experiences I ever had was working with people that were dying from lung cancer and they left messages for their grandkids, "Don't pick them up."
Joey Wahler (Host): It sounds like that's about as powerful a message as you could provide someone, right, is from someone who's gone down that road themselves.
Dr Cathy Martin: And the issue though is it's hard to convince kids that vaping has the same risk as traditional cigarettes, and we really don't have the data yet to prove that to them. But we do know it is harmful and it leads to dependence and at risk for other drug use. And the other thing I would add is if you vape and use another drug like marijuana or alcohol and you're trying to quit those, if you continue to use tobacco, you are more likely to continue your other addiction. So stopping is a good thing every which way.
Joey Wahler (Host): Just a potential spiral that you want to try to avoid altogether, if at all possible. Well, folks we trust you are now more familiar with the health risks associated with vaping in adolescents. Dr. Cathy Martin, thanks so much again.
Dr Cathy Martin: Well, thank you. It's good to talk to you.
Joey Wahler (Host): Same here. And for more information, please call the UK HealthCare Psychiatric Outpatient Clinic at 859-323-6021. Again, that's 859-323-6021. If you found this podcast helpful, please do share it on your social media. And thanks for listening to UK HealthCast, a podcast from UK Health. Hoping your health is good health, I'm Joey Wahler.
