Cutting Through the Smoke: Tips for Talking with Tweens, Teens and Parents About Vaping and E-Cigarettes

Ruth McDonald, MD
Vice President, Associate Chief Medical Officer, Seattle Children’s

Just weeks ago, U.S. Surgeon General Vice Adm. Jerome Adams issued an advisory on the recent surge in e-cigarette use among our nation’s youth.

Pediatricians can play an influential role in educating kids and their parents about the dangers of vaping, and the alarming uptick in adolescent use of e-cigarettes and vaping devices.

When asking adolescents about their health behaviors, go beyond asking if they smoke or use  vaping devices, and find out what they are inhaling (e-juice or marijuana) so that you can address the specific health dangers.

You are more likely to get honest answers from a teen whose parents aren’t in the room. Though the current recommendation is for patients to have some private consultation with their doctor at age 13, recent research shows that about half of American teenagers have never talked with their doctor without a parent or guardian present.

Tips for talking with youth and parents
Not surprisingly, the messages that resonate with parents differ than those that influence tweens and teens.

According to the Truth Initiative, adolescents are most influenced by messages that smoking and vaping:

  • Make them look unattractive and/or smell bad
  • Diminish their ability to perform athletically or musically
  • Limit their ability to achieve their goals

Parents are often motivated by learning that brain development continues well into the 20s and that using substances like nicotine can change how the adolescent brain develops and possibly set children up for addiction.

Remind parents that their adolescent children still look to them for boundaries and guidance, and that they are still their child’s first line of defense. Research shows that the most successful approach is for parents to walk the thin line between being clear about not using without being draconian and making their child afraid to be honest. While these conversations are best begun in grade school, there is no time like the present. Prevention Works in Seattle Coalition has tips for age appropriate language and messages.

Persistent myths you can help dispel:

  • Vaping is better for people than combustible cigarettes.
  • Vaping isn’t addictive.
  • E-cigarettes and vape juice don’t have nicotine.
  • Vaping helps people quit smoking cigarettes.

Fast Fact #1: There may be more information about the dangers of smoking combustible cigarettes than about vaping, but that doesn’t mean e-cigarettes are less dangerous. There are at least five known cancer-causing compounds released in the vapor.

Fast Fact #2: A single JUUL pod contains as much nicotine as a pack of cigarettes, or 200 cigarette puffs

Fast Fact #3: Vaping devices can also be used to inhale marijuana. If you see any type of yellow residue, it is likely that a marijuana extract has been used in the device.

Fast Fact #4: Recent research shows vaping is associated with initiation of traditional cigarette use.


Editor’s note: Read our December 2018 article about the prevalence of teen vaping to learn more: