Teen Smoking E-Cigarette Worries Parent, Part of Growing Trend

Dr. Michael Oberschneider is the founder and director of Ashburn Psychological and Psychiatric Services. Send questions to moberschneider@hotmail.com.

By Michael Oberschneider

Dr. Mike,
I was very upset to find an e-cigarette in my son’s room the other day. At first I didn’t even know what it was but then figured it out. My son is 17, he’s a good boy and this is very surprising and upsetting for us as parents. We have never had to talk to our son about this sort of thing, so my husband and I would certainly appreciate your advice on how to handle this.
- Concerned Parents

Concerned Parents,
Last week, findings from a large-scale European study revealed that individuals between the ages of 15 years and 24 years were most likely to have tried e-cigarettes than any other age group. The study assessed the smoking attitudes and opinions of 26,566 individuals across the life span from 27 countries. These findings are consistent with the Centers for Disease Control and Prevention (CDC), where the CDC found that the use of e-cigarettes doubled for middle school and high school students between 2011-2012.

And Northern Virginia is not immune to this emerging problem. As a psychologist who works with a lot of kids and teens, a number of my older teen clients have either tried e-cigarettes or use e-cigarettes on a regular basis. A few of my teen clients have even shown me their e-cigarettes in sessions and one client recently went so far as to ask me if I minded if he used his vaporizer during our meeting. While these individuals in my practice have all been over 18, the presence of e-cigarettes in their day-to-day lives is concerning for several reasons.
First, none of the teens I’ve spoken with are using e-cigarettes to quit smoking. Rather, these teens already smoke cigarettes and are using e-cigarettes when they cannot use combustible tobacco or as an adjunct to smoking. Thus, for teens, e-cigarettes arguably serve to promote ongoing nicotine use. If that is the case, then e-cigarettes are not dissimilar to methadone for heroin users where methadone as a synthetic opioid is prescribed as a replacement to help heroin addicts quit heroin. The problem, however, is that many heroin users eventually become dually addicted to methadone and heroin. E-cigarettes then can arguably be seen as a “gateway drug” to combustible tobacco and other substances for our youth. The product is already being marketed in ways that would attract a younger crowd (e.g., celebrity use and endorsements and multiple fun flavors).

Safety is another concern regarding e-cigarettes. One can become addicted to nicotine via e-cigarette use and in turn suffer withdrawal side effects when trying to stop – anxiety, restlessness, depression, irritability, etc. Moreover, E-cigarettes have not been fully studied and are not yet regulated by the FDA. We presently do not know if the chemicals being inhaled have harmful short-term or long-term negative effects.

Before speaking to your son, both you and your husband need to agree on your expectations of him. If your position is “zero tolerance” for smoking, or if there is some flexibility, be in agreement as parents before the talk. Keep in mind that the legal age for smoking in the USA is 18-19 (depending on the state), and he is just around the corner from legally being able to use both e-cigarettes and combustible tobacco if he chooses. Because of this, I think your talk needs to focus more on education, safety and your concerns as parents than simply saying “no.”

I propose your being over prepared for the talk. Bring literature to the discussion that details the harmful effects of nicotine use and go over your points with care and concern. If you handle the talk well, it is my hope that your son would open up about his e-cigarette use and perhaps other things that he might be doing (e.g., drinking or pot smoking). Moreover, a good talk should leave your son informed and feeling supported, putting him in a better position to quit.
If, during your discussion, you learn that your son is addicted to nicotine, you will need to come up with a game plan for him to quit. Again, you cannot make him quit without his consent, but if he agrees, you will absolutely want to help. Nicotine addiction is one of the most difficult addictions to overcome.

Lastly, sometimes going through the backdoor to a problem is more productive than going through the front door, so to speak. At 17, your son is likely smoking because he is around others who smoke and he may not be ready to stop right now just because you request him to. Perhaps then you could try to expose your son to more active and healthy activities this summer, and perhaps some of these activities could be away from his routine and every day peer group – a camp, volunteer work or Outward Bound. By exposing your son to new people and environments and healthy active options, he may come around to the correct idea that smoking (in any form) is bad and that he should stop.