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Dr. Stephenie Wallace, Associate Professor in the Department of Pediatrics at UAB, treats a local teen

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What to Do if Your Teen is Using E-cigarettes

An Interview with Dr. Susan Walley

E-cigarettes have risen in popularity the last several years, and, because they are a fairly recent product, more is being learned every day about their dangers. Staying at the forefront of this research is one of Birmingham’s own: Dr. Susan Walley, a pediatrician at Children’s of Alabama and professor of Pediatrics at University of Alabama Birmingham.

Walk into Dr. Walley’s office, and she can show you the collection of e-cigarette devices “donated” by principals from local high schools as well as articles, marketing materials, plus anything else to help this physician get a true picture of how these deceptively innocuous devices can, and do, cause serious harm to adolescents. 

Whether you know them as “vapes” or “e-cigarettes” or perhaps by a brand name such as Juul, these battery-powered devices all do the same thing: they deliver a potent dose of nicotine through a thin aerosol stream, which is then inhaled. Unfortunately, the amount of nicotine gleaned through a single e-cigarette pod is often as much as two packs’ worth of the nicotine in traditional cigarettes! Even more troubling is the fact that companies have little regulation surrounding e-cigarettes, and marketing is rampant with colorful, whimsical vaping devices and fruity flavors that attract younger users. 

“Sadly, e-cigarettes are the most common tobacco products used by youth,” Dr. Walley said. “Many [teens] show signs of severe addiction due to these products having high nicotine concentration. Even if they use it ‘socially,’ we see signs of addiction after just two weeks.”

What to look for

Figuring out if the teenager in your life is using a vaping device can be a bit more difficult than spotting those tell-tale signs of traditional cigarettes. Not only is there no odor or butt left behind, but furthermore, even if an adult sees an e-cigarette or part of one, they might erroneously think it’s a lipstick tube, data storage device or candy container. For example, Juuls, one of the most popular brands, comes with a cap that reveals the flavor of the pen – and parents might not know what a discarded cap is, should they find one.

“A  lot of parents find the flavor-revealing cap, and then [the e-cigarettes] also charge with a USB, so sometimes parents will find the USB and not realize it,” Dr. Wally explained, holding up two Juuls on her Zoom screen that looked suspiciously like lipsticks with fun, loud prints. “They can also buy decorative skins for their e-cigarettes,” she added. 

Given these disguises, it’s important to examine seemingly harmless and unfamiliar items closely and bring them up with the teenager once you realize what you’ve found. Even if you haven’t found anything that vouches as physical proof, ask yourself if your teen is asking for more money than usual or has changed any habits. 

How to address the problem

So how should an anxious, upset parent proceed if they need to discuss e-cigarettes with their teenager? First, cool off from shock or anger, advised Dr. Walley, then casually bring it up in conversation. 

“If you’ve never talked about tough topics, it’s going to be difficult, but it’s never too late,” she said. “Don’t start off accusatory, but say something like, ‘Hey, I read this article about teenagers using something called a Juul — I’ve never heard of that.’ They might roll their eyes and talk a little bit about it, and you can probe with more questions. But make sure you act casual and get them comfortable — which works with any topic, whether it’s sex or whatever else. If you find an actual piece of an e-cigarette, you can say, ‘I found this, and it looks like some photos I've seen,’ et cetera.” 

Parents seeking support and resources should first approach their family primary care provider, particularly if the teen is addicted. And don’t forget to check out other organizations online, perhaps even to become involved and learn about the worthwhile movement to protect kids from e-cigarettes. 

“You can call the 1-800 QUIT NOW line — it’s available in all 50 states and free to the user and paid for by tobacco settlement money,” Dr. Walley pointed out. “In Alabama, it offers free telephonic counseling or strategies to quit.

Other support networks include “This is Quitting,” also known as TIQ — which teens can even enroll themselves into by texting “DITCH JUUL” to the number 88709 – and Parents Against Vaping E-Cigs, or PAVE, a national advocacy group. 

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