By now, many parents have been alerted to the dangers that vaping—or the use of e-cigarettes—pose to their children. However, knowing how harmful this habit is hasn’t brought a halt to its popularity. In 2020, approximately one in five high school students and one in 20 middle school students used e-cigarettes, according to the Centers for Disease Control and Prevention (CDC).
Nicotine is bad for your health and highly addictive for people of any age, but research has shown that it is particularly dangerous for young people (under 25), before the brain and lungs are fully developed.
But, like candy, vaping can seem like a benign and pleasant experience. Because vaping delivers nicotine in the form of a liquid, it doesn’t irritate the lungs like a traditional cigarette. Plus, it comes in an array of flavors that many believe is appealing to teenagers. This combination of smooth delivery and pleasant taste often leads users to underestimate how much nicotine they are consuming.
While public health messaging is focused on spreading awareness about the harm vaping can cause, another problem can feel even more urgent: how to help young people who are already hooked and want to stop. Yale now offers help, with a program that uses cognitive behavioral therapy (CBT) to enable teens to develop skills to deal with stress and cravings to vape, and incentives to motivate them to stop vaping nicotine.
Suchitra Krishnan-Sarin, PhD, co-director of the Yale Tobacco Center for Regulatory Science (TCORS), recently launched this vaping cessation program for 14- to 19-year-olds in Connecticut. The program, which will enroll 120 kids over the course of two years, takes place virtually and includes one-on-one therapy sessions for five weeks.
“Vaping in the U.S. has gone up tremendously in the past few years,” Krishnan-Sarin says. “A big part of the problem is that kids are using e-cigarettes on a regular basis throughout the day, and they don’t know what nicotine concentration they are using. So, they develop an addiction, and they find it hard to quit.”
“There have been a lot of excellent prevention interventions from the FDA [Food and Drug Administration] targeting youth and telling them not to vape, but we have many kids who are vaping a lot of nicotine—and who want to quit—and they don’t have good programs and interventions to help them,” Krishnan-Sarin explains. “We are basing our intervention on one that was shown to decrease cigarette smoking among youth.”
In addition to counseling and education, the program rewards success. “It can be hard to motivate youth to change behavior, so we are using positive reinforcement through monetary incentives to motivate them to quit and stay abstinent,” Krishnan-Sarin says.
The cessation program is part of a timely and high impact research grant that Krishnan-Sarin and faculty from Yale School of Medicine Department of Psychiatry and two other universities received last year from the American Heart Association (AHA) to develop interventions for e-cigarette use in youth. Vaping cessation is seen as a vital health intervention to prevent heart disease (and other harms) later in kids’ lives.
“The AHA is very interested in finding ways to end youth e-cigarette use because chronic nicotine use can produce cardiovascular changes,” Krishnan-Sarin explains. “Nicotine addiction is often considered a pediatric disease because those who start smoking cigarettes prior to the age of 18 not only have a harder time quitting smoking but also experience more health problems from smoking. The youth brain is not only sensitive to the rewarding effects of nicotine, but also to its neurotoxic effects. Youth who use cigarettes have cognitive changes, including with memory and attention.”
Nicotine exposure can also impair lung maturation, she adds, not to mention that the additives used in vaping devices may also not be safe. “EVALI [or e-cigarette or vaping-use associated lung injury] was linked back to the use of cannabis products in vaping devices, specifically an additive called vitamin E acetate,” Krishnan-Sarin says. “These devices aren’t yet regulated. So, no one is controlling what goes into them. Take flavors, for example—they contain many chemicals that are safe when used in kids’ cereals to make them taste better. But we do not know how safe they are when your lungs are constantly exposed to them all day long.”
Teens and parents who are interested in enrolling in the study can text “QUIT VAPE” to 203-361-4267 or take an online survey to see if they are eligible to be in the study. The American Heart Association provided funds for the study through its End Nicotine Addiction in Children and Teens (ENACT) initiative.