TEENS AND TOBACCO USE

Tobacco use was declining… then e-cigarettes came along

By Deborah Jeanne Sergeant

Teens seem to be getting the message on the dangers of smoking cigarettes. However, tobacco use is going up.

“Electronic cigarette [e-cigarette] use among young people is reaching alarming levels,” said Kristen Richardson, registered nurse, director of CNY Regional Center for Tobacco Health Systems at St. Joseph’s Health, part of the Tobacco Action Coalition of Onondaga County.

The appeal of the sleek device, which often looks like a USB flash drive, also attracts teens. Most parents would not identify the device correctly among their teen’s belongings.

Part of the reason for the upswing in use is that teens perceive e-cigarettes as safer than incendiary cigarettes. Originally, they were marketing as a tool for smoking cessation, which has fooled many consumers into thinking they’re safe. Since e-cigarettes emit vapor, it seems safer than smoky cigarettes.

“E-cigarettes pose significant health risks, including exposure to a host of harmful chemicals linked to lung disease and high levels of nicotine,” Richardson said. “Additionally, the ultrafine particles within e-cigarette aerosol can be inhaled deeply into the lungs. More than half of teens falsely believe e-cigarettes are harmless. Research shows that youth who use e-cigarettes are four times more likely to start smoking conventional cigarettes than their peers who do not vape.”

Although tobacco is not safe for anyone, its particular dangers for teens concern Richardson.

“Tobacco product use is started and established primarily during adolescence, with nearly nine out of 10 adults who smoke cigarettes daily first try smoking by age 18, and 99% first try smoking by age 26,” she said. “Nicotine exposure during adolescence can cause addiction and prime the brain for other addictions, including opioid addiction, and harms the developing brain. Awareness and persistence are key to mitigating these alarming trends.”

Research from the department of public health sciences and Center for Community Health and Prevention at University of Rochester Medical Center indicates that e-cigarettes are associated with chronic obstructive pulmonary disease, cardiovascular disease and cancer. And that’s without long-term studies on their health effects.

Deborah Ossip, professor and researcher from University of Rochester Medical Center, stated in a US News & World Reports article in December 2022 that nicotine changes brain development in young people.

“One of the, I think, really sobering sets of findings about the dangers of e-cigarettes is that many diseases take a long time to develop,” Ossip said in the article. “Lung cancer might take 20 years to develop, and e-cigarettes haven’t been around that long, and even at this early stage we’re still starting to see some relationships and increased risk of some of these diseases.”

Lawmakers have identified that flavored vaping liquids primarily target younger people. The US Food and Drug Administration banned fruity vaping liquids in 2020. However, the ban covered only flavored cartridges and pods, not tanks or disposable flavored e-cigarettes. This provided a loophole for tobacco manufacturers.

“We know that every gain or win is followed by the discovery of loopholes and new products to fill the void,” Richardson said. “We can- not be complacent; we need to stay vigilant. We know that strong and effective laws can protect youth from nicotine addiction by reducing access and exposure to tobacco products.”

Most of the vaping liquids on the market are sourced from companies that use less stringent consumer safety standards than those of the US. They’re also far more addictive than people realize. A Hyde vape contains about 1.8 ml. of liquid, which equals 25-50 mg. of nicotine. That’s equal to one pack of cigarettes. Unlike a cigarette, which burns up to indicate that “serving” of nicotine has been consumed, a vaping device has no clear end point. Using a vape is like eating from a carton of ice cream with a spoon compared with the cigarette, which offers portion control more like that of eating an ice cream sandwich.

Prevention is obviously better than quitting. Parents need to take the lead by setting a good example and not using substances themselves. It may seem like teens want to be anything but like their parents, but the parental example ingrains in children early on what is acceptable behavior.

The peer group also matters. To offer a feeling of community to teens and young adults endeavoring to quit, New York’s free “DropTheVape” program allows them to anonymously text the phrase to 88709 to receive interactive daily text messages tailored to their sign-up date or their target quit date if they set one up.

“Messages include encouragement, motivation, tips, skill, and self-efficacy building exercises and coping strategies,” Richardson said.

Parents should talk with kids before they start using by asking what they know about vaping and the myths about it. Approaching the topic as a curious parent can allow tweens and teens to feel you give them credit for what they know.

Teens typically vape because they feel it will help them de-stress. For this reason, it’s vital to promote healthy ways of managing stress and to avoid over-scheduling and heaping up unrealistic demands. Teens need downtime as well as adults.

Screening adolescents to assess use and risk of use represents another means of reducing use. But this only happens if children are seen for well child visits or other doctor’s visits.

Use of Tobacco Products

The New York Youth Tobacco Survey reveals that in 2014, 10.5% of New York high school students use e-cigarettes. That percent has climbed to 22.5% in 2020 and, the most recent figure, is 18.7% in 2022. The percent smoking incendiary cigarettes was 7.3% in 2014, 2.4% in 2020 and 2.1% in 2022. Overall tobacco use (cigarettes, vapes and other types such as cigars, oral pouches and cigarillos) has climbed from 19.5% in 2014 to 25.6% in 2020 and dipped down a bit to 20.8% in 2022.

• Vaping cessation resources from the New York State Smokers’ Quitline: https://nysmokefree. com/FactsAndFAQs/Vaping

• The latest in products attracting youth: https://truthinitiative.org/research-resources/ emerging-tobacco-products/whatzyn-and-what-are-oral-nicotinepouches

Men Die of Overdose 2-3 Times More Than Women

By Deborah Jeanne Sergeant

Men died of opioid and stimulant drugs at a rate two to three times higher than women between 2020 and 2021, according to a recent study. The data looked at fentanyl, heroin, methamphetamine and cocaine.

The study said that men’s higher rates of use do not entirely account for the increase in mortality risk.

The study was published by Neuropsychopharmacology and led by investigators at the Icahn School of Medicine at Mount Sinai in New York City and the National Institute on Drug Abuse, part of the National Institutes of Health.

“Though men and women are being exposed to the modern, fentanyl-contaminated drug supply, something is leading men to die at significantly higher rates,” said Nora Volkow, physician and director of NIDA and one of the co-authors on the study in a press release. “It may be that men use drugs more frequently or in greater doses, which could increase their risk of death, or there may be protective factors among women that reduce their risk of death compared to men.”

The study indicated that further research must be done to determine why more men die from stimulant and opioid overdoses than women.

“I am in agreement with the statistics, with which is hard to argue, as it’s consistent with what we see at the hospital and with emergency services calls,” said physician Gregory Serfer, medical director of Tully Hill Treatment & Recovery in Tully.

“As for the reason, the study said that higher rate of use still does not account for the higher rate of death and that it could be based on biologics and gender-based differences.”

He hypothesizes that it’s likely not biological, but socially constructed beliefs about gender forming the driving differences that result in higher overdose rates. Men are generally more eager than women to take risks, especially when goaded