The Greater Princeton Area Ask the Doctor Spring Issue March/April 2018

E-Cigs, Flavored Tobacco & Your Kids: What You Should Know With an increase in vape usage among teens, it is important to share validated information and resources. What is an E-Cigarette or Vape? A“substitute”for acigaretteor traditional“marijuana joint”thathasbecomepopularwithteenagersduetoeasyconcealment. Vaping is the act of inhaling and exhaling the aerosol, often referred to as vapor, which is produced by an e-cigarette or similar device. The term is used because e-cigarettes do not produce tobacco smoke, but rather an aerosol, oftenmistaken for water vapor, that consists of fine particles. Many of these particles contain varying amounts of toxic chemicals, which have been linked to cancer, as well as respiratory and heart disease. According to the Center on Addiction, teens are using vaping devices to smoke marijuana or hash oil instead of nicotine liquids. The vaporizedmarijuana smoke has little smell, whichmakes it hard to detect. Why should I be concerned as a parent of a teen? Teenager useof e-cigarettes is on the risedue toaccessibility (internet, stores) andeasy concealment. Teenagers are inhaling a multitude of toxins including nicotine, Volatile Organic Compounds (VOCs), and THC (marijuana) in large quantities using e-cigarettes and vapes. Marketing companies are targeting teenagers by promoting e-cigarettes and vapes as a “healthier alternative”to cigarettes or a traditional joint. In the past fewdecades, anti-tobacco lobbyists including the American Cancer Society’s advocacy organization, havemade great strides in banishing the seductive advertisements that once lured people to smoking. Certainly, fewer people are lighting up conventional (combustible) cigarettes these days. Even our kids -- and that certainly is a great victory. But a new genre of noncombustible, candy-flavored smoking products is hitting the market -- and slick, provocative pinup ads are sneaking up on us once again. The target? Our children. According to the CDC’s National Youth Tabaco Survey, the decline of regular cigarette smoking among our kids has gone together with a sharp jump in the use of e-cigs. "We're seeing alarming number of kids using flavored products of all kinds, such as hookahs and e-cigs," says Cliff Douglas, Vice President for Tobacco Control and Director of the Tobacco Control Center at the American Cancer Society. "The industry is producing theseproducts using thousands of flavors, likewatermelon andgummybear,many of themclearly designedand aggressively marketed to appeal to and reach youth." The U.S. Food andDrug Administration (FDA) has banned all flavoring in conventional cigarettes, except menthol. However, federal regulations to prohibit e-cig promotion and sale to youth are not yet in place. Vaping: Reglamorizing Smoking? E-cigs can be designed to look like a cigarette, cigar, or pipe; however, some resemble a pen or even a USB device, which means students could stash themeasily into a backpack. They deliver nicotine and other chemicals and flavors into the lungs usingwater vapor, not smoke. Manufacturers and users refer to the act as "vaping," not smoking, but Douglas says it looks the same. "The products are designed to create a very visible vapor, even more visible than cigarette smoke. This has created a whole new era of unfetteredmarketing concerning e-cigs that is re-glamorizing the act of smoking." And that's one of the many worries: Vaping ads – along with sweet lollipop-like flavors – are enticing our kids to use the nicotineproducts in the sameway cigarette ads luredus or our parent’s decades ago. According to theNationalYouthTobacco Survey, about 7 in 10 U.S. middle and high school students were exposed to e-cigarette advertisements in 2014. They were most likely to see the ads in retail stores, followed by the Internet, TV andmovies, and newspapers andmagazines. At the same time, battery-operated e-cigs are soaring in popularity among kids. In 2014, nearly 2.4 million of them vaped. Among middle and high school students who used tobacco, about 80% used at least one flavored tobacco product (e-cigs, hookahs) within the last 30 days, according to a survey of kids ages 12 to 17 published early onlineOctober 13, 2015 in Journal of the American Medical Association. Some worry vaping could serve as a gateway to using other tobacco products. The same JAMA survey found that most students startedwith a flavoredproduct before trying any other type of tobacco.Would they ever have done so if theyweren’t introduced to that item first? It’s hard to say. But there’s legitimate concern. More than half of the students who used e-cigs in the last 30 days also usedmultiple tobacco products. Begin talking to your kids about the dangers of tobacco and nicotine starting in elementary school. Tell them about the dangers of addiction andhow tobacco use can hurt their lungs and their overall health. Parents are encouraged to talk to their kids about flavors. Tell them how it can seem like candy, but it’s not. Teach them how to say no and develop ways to reward them for doing so.

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