How did teen vaping become an epidemic?

it Julian vaping or using East cigarettes. By the time we even realized it was happening, it was already an epidemic. But we're going to begin with America's vaping crisis. The alarming update today from the CDC vaping related illnesses and deaths continue to climb across the US. He sees updating on the numbers of the lung illnesses associated with vaping. They are now up to and twenty six deaths across twenty one states. Now. That's up from about one eighty

last week and eighteen deaths. So this continues to grow and it continues to impact middle and high school kids across the country. I'm sixteen years old. I've been dueling during class and jeweled pretty much every moment where I wasn't in class For those who have missed the onslaught of headlines. Jewels, babes, or e cigarettes are small, battery powered handheld devices used to inhale aerosol produced by heating a pod full of liquid that often contains nicotine flavorings

and other chemicals. Tobacco companies have been developing them since the mid sixties, but they didn't hit the market until two thousand seven and didn't really become widely used until just a few years ago. Initially, they were marketed as a way to help adults quit smoking, but their hip advertising and candy like flavors like bubble Gum, mango and grape entice a lot of kids. The FDA is holding a hearing this morning to address the alarming spike in

teen vaping. Most East Sig brands contain nicotine salts, which exit the blood string quickly, triggering cravings, and that means they're highly addictive. Jewel, the most popular in the category, accounted for just two percent of the market in two thousand sixteen. Three years later, the company captured nearly seventy of the market, with its sexy, sleek and discreet design, jewel quickly became the iPhone of e Siggs. I'm fourteen years old and I'm used the jewel. I'm fifteen years

old and I am a jewel user. I'm fourteen and I've been using a jewel for nine months. Because babes were marketed as less dangerous than cigarettes, many young users didn't even realize they contain nicotine until they were already hooked. All of my friends, like all my best friends are like addicted to It's just a part of my life now that like, I know it's bad, but I can't stop. The number of people smoking cigarettes has reached record lows, but now we have a new generation of nicotine addicts.

So how did this happen? That's my next question, and perhaps more importantly, what can we do about it? The first thing I observed was that whenever I go to the bathroom in the stalls, there would be these plastic squares, and at the beginning I didn't really know what it was, and then I realized that it was the cartridges from the Jewel. Two years ago, Jack Waxman, then a junior at spar Sale High School outside New York City watched

the vaping epidemic unfold firsthand. It was January, and what I noticed was that kind of over the ensuing months, the number of kids that were in the bathroom jeweling and the amount of jewel pods left kind of continued to increase, and it felt like jewel was kind of spreading like wildfire amongst my friends and amongst the entire school, And like so many at the time, he didn't know what to make of this new trend. It was something

that I hadn't really experienced before. When I was a freshman of sophomore, bathrooms and schools were places of education and if any kids were going to be doing drugs, it would be on the weekend. But I think what the jewel did is it took kids and kind of flipped their life backwards and forwards. It's really a twenty four hour, seven day a week addiction in a way

that many other drugs aren't. And what they did is it took bathrooms and classrooms and turned them into places to basically just hit the jewel and fulfill your nicotine addiction. You made a p s a called Jewelers against Jewel that went viral and you haven't stopped. You're now a sophomore at Cornell and the founder of Students Against Nicotine. How did this problem get so big so fast? And do agree that it's an epidemic? Yes, So we called an epidemic in the video last May, and the Surgeon

General called it an epidemic last November. This is what it is as an epidemic. UM rates went from ten percent in one year of youth that vape. And that's the large a single year increase of a drug and recorded history. And that's not just where I'm from, It's in every single school because nicotine doesn't discriminate UM and every single school, every single state, they're experiencing it, just like where I'm from. What motivated you to shoot this

p s A in the first place. After my junior year, in my summertime, I was an intern for Chuck Schumer in the city, and as an intern, I got to write a policy paper, and a lot of my friends chose to write about gun control, climate change, very noble issues, but I just decided to write mine about the jewel because it was something that I had seen a bit during my spring year and what I found it was crazy.

I I found that in two thousand nine, Congress band flavored cigarettes and put all these regulations on cigarettes as part of the Tobacco Act, but all this stuff was exempted. These cigarettes were exempted from this regulation. And I also researched nicotine and found that nicotine, the same thing that was in cigarettes in the twentieth centuries now in eat

cigarettes in the twenty first century. And I presented my findings to Senator Schumer and he was so blown away that he invited me up to do a press conference with him. He encouraged me, and the whole staff encouraged me to continue with it. So I had the idea to make this video and basically recruited some of my best friends who were struggling with this, and they opened up and they were so courageous to tell their stories.

And what's happening now is parents understand the problem, and the younger kids when they're watching his video and classrooms and other places, they're hearing the stories of these older kids, and they're basically saying, these older kids regret that they started jeweling. This is not a cool thing. It's just a flash drive. It's a loving finger, and this is not something I want to be doing. Cigarettes are so stigmatized right now in our country, kids would never pick

up a cigarette. But we're starting to do right now is we're starting to stigmatize these cigarettes in the same way that cigarettes are today. When Jack and I sat down for this interview, it was at the end of August, and the news linking vaping to a variety of health issues, even deaths hadn't broken. Many parents and young vapors were

unaware of the dangers. I spoke to one person who said that their friends were buying jewel for their kids because they thought that the jewel is a safe alternative

to cigarettes, And now we know that's completely ludicrous. But I think what we have to do is just continue to educate parents about what's actually going on and that these products not only have these crazy, you know, long term consequences that researchers are looking at right now, but they rewire the prefrontal cortex in ways that drugs like

cocaine and cigarettes do. It's not a harmless thing. When I think parents are starting to seething at now, and for a lot of kids, unfortunately it's too late, but for millions of other kids, this is a perfect time to, you know, get these prevention mechanisms out of education and then also trying to get kids to think about what they could be doing instead. That was easier said than done. They didn't continue vaping just to be cool. They were addicted. Let me ask you about some of the kids, your

friends who you featured in the video. Were they able to get help? Are they still struggling? So four friends in my video are still vaping um and it's not like they didn't try to quit. I want to say, like I'm surprised, but I'm not right because it's Nicotine is one of the us addictive drugs in the world, and that's the reason why they made the video, because we know how insidious nicotine is, and anyone that smoked in the past cigarettes or has friends that smoke cigarettes,

it's the same thing. Jack knew early what everyone else would soon find out. Jewel was in the hot seat. Within months of this interview, their CEO, Kevin Burns, would be replaced by an executive from tobacco giant Altria. The CEO of Jewel apologized in essence. Recently, I guess to a family who had a child who was addicted, what did you make of that apology. It's not gonna do anything, right, I don't know what to say. You thought the words

were hollow. It doesn't do anything for the three million kids that I've already got addicted to the practs. It doesn't do anything for the parents, doesn't do anything for us. Besides, you create noise that won't move the issue forward at all. And it's just that's really all you can say about it. It's not even a story. Three million kids are addicted. Mhm.

Where did you get that number? C D, C F D A, all these you know, public health agencies, they run these studies and those are the numbers that are out there today. In addition to the flavors, manufacturers seemed to be pretty effective at social media. How big an impact has that had? In sixteen, that's when Jewels social

media was kind of insane. They were featuring like twenty year old models with you know, cool photos, And there was this crazy study done by the Stanford about how Jewels marketing in those two years compared to Marlborough and other big tobacco companies, and it was practically identical. So Jewel basically spent millions of dollars putting these it's it

was the vaporized advertisement. It was all over Time Square of these you know, hit models with all these crazy colors, and they used social media to get kids interested in the products. You can't be doing that. That's just not okay. Well, thank you so much, Jack, Thank you so much for

having me on. Jack wasn't the only one sounding the alarm. Next, we'll talk with one of the first journalists to report on the teenage babing epidemic, as well as the doctor who blew the whistle on the hidden nicotine levels of the cigarettes. This was just one of those stories that it felt like everywhere I turned and everyone I talked to, they were talking about this. They were worried about their kids, or they were kids, you know, children are friends of

mine who were talking about this. Last year, New York Times reporter Kate Cernaki wrote a bunch of articles that covered the vaping crisis in high schools and middle schools across the country, and what she uncovered shocked her as much as her readers. It was really one of those things that you found at every socio economic level. Geographically, it was everywhere California, Rhode Island, Florida. I mean, it was just any when you talked to agreed that this

was a problem. So it was happening almost in every state. This is happening in Middle America, and not just on the coast, not just urban centers. Absolutely, it was everywhere, and it was girls and boys, which I think surprised school administrators as well. What was shocking about it to me was that it had come up on them so quickly. It really was. These things had appeared in the fall, and I guess it was and suddenly by spring it was just everywhere, and the schools did not know what

to do. They were completely unprepared. I think that for a lot of kids, you know, we've raised them to understand that drinking and driving is bad, and cigarettes are bad and they're ugly, but vaping, but jewel in particular, came across as kind of a clean thing to do, you know. It wasn't messy like cigarettes. Almost invariably the schools I talked to would say, you know, a kid comes into my office and says, you know, I've caught someone jeweling, and I said, would you smoke a cigarette?

The kid would be horrified at the idea of smoking a cigarette, but vaping somehow seemed cleaner to them. It didn't seem addictive, it didn't seem like an ugly thing to do or something that was going to make your teeth look bad or make you smell bad. And a lot of kids, when I spoke to them, they would have arguments with me about oh no, there's no there's no nicotine and jewel. So I think there was a

lot of misunderstanding about what exactly it was. You opened your first story with a boy from Cape Elizabeth, Maine confiding in his vice principle tell us a little bit about that conversation. So this was a student who had been caught vaping. I think not once, maybe not even twice, but maybe a third time. I can't remember, but it was several times. And so the principle was saying, you know, what, what is it like? You want to, you know, you

want to understand a teenager why they're misbehaving. And the kid kids said, I can't stop. That was his line, I can't stop. And this was really what was alarming schools. This must be so disruptive, Kate, when it comes to teaching and learning with kids not being able to concentrate. You know, I know that they're calling bathrooms jeweling lounges with toilets. I mean, how how much of a problem is this creating in terms of actually doing the job

schools are supposed to be doing. It's been really huge. I mean, in California, I talked to one high school that had to close two bathrooms so that no more than one student could go into the bathroom at a time because they were going to share jewels. You know. One thing that was interesting to me was that schools felt like this had become such a disruption that they were actually now treating it not as a disciplinary problem, but is the medical problem right where they needed to intervene.

And so one of the schools in Colorado that I spoke to said that there was a young woman who came in and they gave her a treatment plan to try to kick the jewel and part of her treatment plan was standing in the back of the classroom shaking her foot because it was she just needed to get that anxious energy out. So I think schools are really

struggling to figure out is this a disciplinary problem. Is it a disciplinary problem where they need to expel kids or suspend kids, or is this primarily a health issue and do they just need to get these kids some kind of treatment. What needs to happen in your view, Well, I do think you know, look, I think we need to understand that this generation, as I said, has been told, there are so many things they can't do. You know,

we've raised them in such a bubble. In many ways, you've tried to preserve their perfect health, and so I think we need to give them some education around vaping and around nicotine in particular. I think we were very good at saying that cigarettes cause cancer, and it was the tar and the cigarettes, right, it was the smoke, it was all those chemicals. They didn't understand that nicotine was also bad for you, and in this case, it's

getting them hooked. We also don't know all the chemicals that are in vaping devices, So I think really education is a huge part. I think a lot of kids, in particular, if they understood the chemicals that are in these devices, they would look at this and think, I wouldn't you know, I want that in my sunscreen, much less in my lungs. What kind of chemicals are in these besides nicotine? Well, there's uh, some studies have found propylene, glycol,

glycerol um. There's one chemical called I think it's a dia setal. I'm not sure how you say it, but it's It creates popcorn lung, which has been really obviously very dangerous and scary. But the thing that struck me there was a there was an article in the journal Pediatrics I believe it was in March of seen and it found elevated levels of five carcinogenic compounds in the urine of students who vaped. We've done so much research on tobacco and on cigarettes, we know what's in them.

We don't know a lot about vaping devices. We haven't studied them over the long terms. We don't know what the long effects are because it's so new. And to that end, parents are slightly clueless, aren't they. I mean, I'm I'm clueless. I actually our team went out and they bought me a vape. It looks a little like a cross between a big lighter and a thumb drive, right,

I mean, it's really small. It's then this is again the double edged sword of the jewel, which is that it's designed so that someone who wants to quit smoking can take a hit of the jewel and have something that gives them the same you know, buzz of a cigarette, right, because it's a huge dose of nicotine. But that same thing is going to give a kid who's never smoked before that huge dose of nicotine. So there's the addiction is going to come faster. They're eighteen cigarettes in that

eighteen cigarettes in a pod. Right. The other in citious problem with vapy, kids were absolutely clueless about what they were inhaling. We made a survey, an anonymous survey which we gave to just over five kids in our clinical practice over the course of a year, and the survey was based on other national surveys with standard questions about their use of tobacco, electronic cigarettes, and marijuana and so forth. And then we also collected from some of those kids.

We collected urine for what's called biomarker of nicotine, so it reflects the nicotine that they're getting in their body. Dr Rachel Boykin is an Associate Professor of Clinical Pediatrics at Renaissance School of Medicine at Stony Brook University, and she has been doing extensive research on kids and vaping. We wanted to know if what they were saying was

matched in the urine. But we also wanted to get a kind of a sense of how much nicotine they were being exposed to because this kind of study hadn't been done before. So did you find that some of the kids on the first question weren't honest or didn't realize that they were being exposed to nicotine? We found that in general, kids who used electronic cigarettes were truthful about what they said. They said they used them, and

we saw the nicotine byproduct than their urine. But did they appreciate the fact that they were being exposed to not all of them. So when we asked them, does your electronic cigarette have nicotine in it? Some of them said I don't know or know when. In fact, in their urine we saw that marker of nicotine cotnein, which said that they actually were exposed to it. So it didn't mean they were necessarily being dishonest, they just didn't

understand correct. And what did you find in terms of the level of nicotine that they were getting in their bodies through the cigarettes? Number one, that they were getting levels that are comparable, in some cases even higher than kids who used cigarettes. We also found that kids who used the e cigarettes more frequently, like every day, higher levels,

which kind of makes sense. We also found that the kids who were using what we call the ponds like Jewel, which is the latest generation and the most popular of them and also has the most nicotine of all the cigarettes, those kids also had the highest levels, So it kind of makes sense. But it put some objective data, if you will, into kind of what we thought was happening. So you weren't necessarily surprised. Where you concerned when you

saw these levels in these young kids? Absolutely well. Nicotine is bad for a number of reasons. Nicotine in and of itself, we know has bad effects on a teenager's brain. Teenagers brains are not actually developed until about agent It can have effects on your ability to learn and so on cognition. It can affect anxiety, caused depression. Just by itself,

nicotine is dangerous, but nicotine is also extremely addictive. It's the thing that causes people to be addicted to tobacco cigarettes, and so the concern, although these are not tobacco cigarettes, is that these kids are getting addicted. Addiction is concerning in and of itself, but we also know that kids who use the cigarettes are more likely to go on to use regular cigarettes. And here's where addiction and youth

are an especially worrisome combination. Because their brains are still developing, it's easier for teens to get hooked, and using nicotine at a young age can even rewire your brain, making it easier to become addicted to other drugs. How does nicotine addiction lead to other addictions? Is that something to do with your brain and how it impacts the reward system or dopamine. So nicotine does work on the dopamine pathways, and dopamine is the reward pathway, and so that's probably

what it is. How it directly primes the brain for other addictions. I don't know if it's really understood at a very very molecular level, but we know that it happens, and I find it interesting. People have asked me, why is this that kids who use e cigarettes, now we know this one really a lot of good studies, are are four times more likely to go on to smoke. And kids don't like smoking. We finally got rid of that.

You know, we were at an all time low for kids actually smoking in this country until these cigarettes came along. And now it looks like it's starting to move them back towards that. And I'm not sure why, whether it is the addiction, and why they would go from one to the other, but we know that it's happening, and I think that's a concern. The numbers among high school students are really staggering, aren't they. It's crazy. Tell me

about the numbers. So from two thousand seventeen to two thousand eighteen, there was a seventy eight percent increase in the use of these cigarettes by high school students. We have an uphill battle, I think, because one of the problems is it took us decades to get a handle on cigarettes, and I kind of look forward. I'm generally a very optimistic person and I'm hopeful, but I also

see that the train is out of the station. And one of the problems we have now is we have a generation of kids who are addicted and we don't know how to help them. As a pediatrician, we don't have any evidence based methods to help them quit at this point, and so we need to look at that too, And so we're kind of chasing after this problem from so many angles. I hope we can get a handle on it, but I don't want to wait thirty years to find out the long term effects. Thanks so much.

Up next, a desperate mom and a determined educator confront the vaping epidemic. Right now, what we're seeing is really the staff struggling on what to say and how to say it, and when to do the education with their students. Kathy Butler Wit is a tobacco treatment specialist who's been working with the New Jersey Department of Health to try to get a handle on the vaping crisis as it

continues to unfold. They themselves don't know what these products are all about, how are they created, what levels of nicotine are in them? What is a closed pod system? What is an a juice? And so our team comes into the schools and we start with administration. We talked to them about policies, We talked to them about including education in their curriculum, and then we give of them the curriculum to use in their schools. So what kind

of kids are vaping? You know? When I was in high school, even though I did get suspended for smoking in the bathroom once and had to take a smoking seminar and got kicked off the cheerleading squad. But that's a whole another podcast, actually, Kathy, but what kinds of kids are doing this? I think most people who smoked regularly who went to my high school would be considered troublemakers. What about vaping? Does the same profile apply? Absolutely not.

We are finding when we go into these schools that we have students that are very educated, are health driven, our sports players, and it's about just this social aspect of the product, and jewel in particular, which is we know the highest one that's being used right has the market, and these students are seeing their peers use them, and they look at social media and they see advertising that makes it very sexy and appealing and all appear to

be very very safe. Nothing's going to happen. It's just water. And as they use them, they are become addicted to this nicotine. And so going back to thinking about who's using it, you know, again, we have first of all, very young kids as young as fifth grade. Now we're seeing their story as youngest fifth grade is starting to use these products. At the very least I've heard about these products, seeing peers use them in bathrooms and on

the school buses and sometimes even in the classrooms. Well, are they allowed all those places that they know? They do sneak them. And it's easy to sneak because the pod system the jewel doesn't create that very large vapor appearance that we see from other other products. Is that why so many parents are clueless about this? Absolutely? And

I think we have two avenues with parents. We have parents who really absolutely no idea that their kids are using them, But then we have parents who actually know their kids are using them. Like Lorie, who stumbled upon and then tried to rationalize her daughter's vaping habit. That was in her room cleaning, and I found these colorful little plastic things that I actually thought were the end of a pencil holder, the lead pencils, And I thought

it was perplexing because I don't remember buying them. So I took them downstairs and I showed them to her. I'm like, what is all this? She's like, um, from vaping, and I'm like, vaping? What is vaping? I didn't even know what it was. In a weird way, she had to educate me on this horrible thing because I knew what cigarettes were, and I guess I knew what a

cigarettes were, but I didn't know what vaping was. This was two years ago, it was, And initially you were actually relieved that she was vaping because you were a smoker in high school and you thought, well, better that then smoking. Right from what I knew, these cigarettes were created to help smokers quit, so it wasn't as dangerous to your health as cigarette smoking. So I remember being sixteen and at a party and somebody handed me a cigarette. So I thought it was in some ways natural, this

was going to happen. This is experimenting, This is a little peer pressure, and I thought it would be safer. So at first you thought, no big deal. You might have been slightly bothered by it, but you didn't think it was going to be a huge issue. No. I thought it would be the part of learning how to become an adult. And this is one of those things that happened in high school that you experimented with and

you cast away. I was not initially concerned. Initially, Then you realize that this could be a problem, so you started putting restrictions on your daughter's vaping. Yes, so again I saw these pods, and I at that point, at sixteen, I cleaned her room. So I kept seeing more and yes, well that stopped. I started seeing more and more of them, and I thought, well, this is not she owns them, This is not her being at a party. This something's weird here, something's wrong. So we put rules around it.

She said, I do this at parties. I don't go to a lot of parties. It's no big deal. It's not as bad for your health as smoking was. We all know smoking is terrible for you. This is not so bad. And again I bought into that. But when I saw a few more pods that she owned, my husband and I decided to restrict it, which was I took what is now I know is a jewel. I took the instrument away from her, and we said she could have it on the weekends, so that I felt

like I was monitoring her usage. How did that work out? So we had the rule that come Friday after school, when all her home work was done and all her school activities were done, she was allowed to have it from Friday to Sunday morning, thinking that again, how much could she actually intake in a day and a half, less than forty eight hours, And it turns out they can intake a lot in that very short time frame,

So she was puffing away on the weekends. Correct, And did she then say I need to vape more than forty eight hours a week. We never had that conversation, and I never saw her actually do any of the intaking. Again, I found more pods, and I thought it was curious, like, if I have her instrument of vaping, why are all

these pods here? Because she was borrowing them. And what I realized in this vaping community is that it is a community, So whoever has the instrument the jewel shares it, so it's not like everyone owns one is passed around, and it is something that they do activity wise together, so that pen is part of their socialization. And all these pods meant that they were doing it all the time. So it didn't matter that she didn't actually have the device as long as she was supplying some of the

fuel or the pods. Correct, she you know, it was all's fair? Correct? So when did you realize this was a problem? So then the media started to catch on and I started reading articles and I really started to get concerned. Concerned. That accelerated this fall as news of vaping related illnesses began to spread and her daughter left for college, still vaping to this day. My daughter does not buy it. She does not believe it is as

bad for you as all the hype says. Even now, even given the cover stories, even given all the reports and the media, the c d C taking the flavors off the market, all these developments, and she's still isn't convinced that it's not good for her. So we're going to have this conversation. It's interesting. She just turned eighteen last week, and when we had our phone call with her, our weekly check in, she said, would you and Grandma stop sending me all the articles. I'm gonna quit. I'm

gonna quit. What is your overriding emotion right now about this whole thing. I'm scared. I'm scared for her, I'm scared for all the kids. Because with cigarettes it was harder to hide, right, you could smell it, you could see it. Vaping is undercover, so parents who typically regulate that can't see it. They can't see when their child is participating, and we have to. Laurie's far from alone and feeling frustrated and afraid, and her daughter is far

from alone and her struggles to quit. So where do we go from here to a top addiction expert who has some answers. That's next on next question. Hi, Hi, Dr Avery, so nice to meet you. Thanks so much for doing this. I decided to make an appointment with Dr Jonathan Avery. He's the director of Addiction Psychiatry at the Wild Cornell Medical Center here in New York. In other words, he knows what he's talking about when it comes to addiction and nicotine, and he has a very

pragmatic approach to tackling the vaping epidemic. The whole issue completely exploded this fall. Not to point fingers, Dr Avery, but where the hell we're all the health professionals while this was becoming an epidemic. It turns out we're not much different than anyone else. And I think we were may be seduced a little bit too about this idea

of having a safer product potentially than than cigarettes. But I think those on the addiction side were like, you know, we feel like we're doctors in the nineteen fifties when they were smoking with patients themselves and their white in their white jackets stuff in a way, and actually even featured in commercials, right, And so we had a feeling from the beginning, Hey, this is going to turn out similar where the that is going to come out, and it's not going to be positive. I mean, there's no

way it's going to come out positive. At a minimum, it's going to be all negative. And so that's sort of what happened. The numbers of kids using are are just outrageous. Sometimes some high schools tell me that half or more are using it around New York City, and seriously half. And it just became such a part of culture, and um, what we learned if you ask these same kids a year ago, is this harmful? They would say no.

A lot didn't know nicotine was in it. They just sort of knew it was like this flavor, new product that might be fun. And so everyone was sharing it, using it, you know, became a part of um schools and everything else, and so it's sort of everywhere, and parents weren't the wiser. That's where you come in, Dr Avery as a psychiatrist, heer who's a specialist in addiction. You know, you're our man, So what should parents do? Why always commend checking your own pulse first before going

into a conversation with kids. You know, I think where it goes wrong is when you come in hot and you know you're you're both sort of upset, and you know when you've got them in that I got you moment. And what I'm encouraging parents to do really around all substance used behaviors is to have the conversation early and often in a non judgmental way, and so to get to the bottom of what they know about the product,

why they think the kids are using or not. And really, I mean some recommend as early as nine starting the conversation, some a little later. And while that talk might not be easy, Dr Avery says it could uncover factors that might be driving kids to vape in the first place. I think it's just being there from the beginning with your kid, letting them know that how they are as a person, substance use, mental health issues are important to you as a parent. I'll say it's true for everyone.

But if it's true, you know, more important than all this academic stuff and all these other pressures and completing your piano homework or whatever it is, that it really is their development as a person. And this includes checking in on what's going on in terms of substance use and so you're not going to solve it all in one interaction, and you're not gonna, you know, have the magic words at any moment, but just sort of saying this is important to me. We're gonna keep talking about it.

Let's pay attention to what's happening with the news with jewel or these electronic nicote delivery systems, and let's just have this conversation together. And if you're not ready now, I'm ready tomorrow and and we're there in this together. I can see why some parents are panicked. You know, you're reading about popcorn lung you're reading about reduced lung capacity.

I mean, I would be freaked out as a mom if I knew that one of my kids are both my kids or whatever, that they were doing this enough to really damage their health. And to be like, we're ready to talk about it whenever you are. I'm sorry. In my house, that dog would not hunt. I think that's true for you know though, it's it's tough because you want kids to have the information. You don't want to get in trouble, but you don't want to push

these behaviors into the secrets. And my worry about people that come down too strong is that the kids go the opposite direction, and then you're playing catch up years later. Um. So I'm arguing this more almost as prevention. If things do get really bad, then certainly intervening and getting them to help. And and while they're still eighteen, you can sort of do more things against the world than after

their eighteen um. And so if it looks like they're you know, they need, then urgent intervention and then certainly do it. But for most kids, there's this space where you're preventing it or they're experimenting, where you can start the conversation. If you're starting the conversation after they're you know, in trouble, then then everyone's in trouble in that that system.

I feel like the student body needs to get involved because so much is pure pressure, right, and so much of this activity is going on at school or at school functions or outside school functions. So it seems to me there has to be a really holistic approach to

this issue, right. And I think as kids are hearing this news, there is sort of this surge in the other direction of people posting on social media they have quit and that they are motivated to stop using and and I've I've heard because when I asked the question our friends quitting and a year ago, no one knew anyone who had stopped. But now it's increasingly common that people, I mean one thing about it. Also in substance use, as perceived harm goes up, use goes down. Kids don't

want to get hurt. Actually they don't want bad things to happen to them. And you know, as they see their peer group and the momentum shifting in the other direction, I think more will quit. I think why smoking was smoking sort of you know, it came on over a number of years, slowly dissipated. And this is one instance where I think social media and the sort of fast NewSpace that we have today can be helpful because we're getting all this information fast in real time. The CDC

updates that reports every Thursday. It's sort of a just a different way that information is getting out there that I think we can all digest and modify behaviors quicker, hopefully than what took decades with cigarettes. They started doing p S a S. And there are a lot of organizations, parent groups I know on Facebook who really cared deeply about this issue and making sure that kids are not harming themselves. But why is it so hard to kick

this habit? Or is it really hard? Well, I think one of the things that has lost in the hysteria of all this is that most people will quit on their own, and so most people haven't been using in a way that where they'll get stuck and they'll be able to say either from that semi successful intervention I just had with you talking to your parent, or with you know, just sort of the pure environment, they'll be able to, um, say hey, I don't want this for myself,

and they'll actually be able to stop. And one thing I've noticed over the last couple of months is I've gone into different high schools. There's a bunch of people that have stopped on their own, never needed to see me as an addiction provider or even their pediatrician, and we're able to just stop. And so I think that's the good news. So what advice would you give kids like that who are really struggling to kick the habit. Yeah, if they've tried and they can't, and um, I think

the first thing to do is make people aware. Um, that's my advice for kids. Addiction hides in the secrets, if you can be honest and forthcoming about it, you know, talk to your parents and pediatrician, you know, I think help will be there. And you know, not every family

is able to do it. Not every pediatrician sort of aware about this, but I think most are and most want to help regardless, and so if they can just get that secret out, get into the hands of a pediatrician, they can help assess if you I need to refer you to a psychiatrist to help with or therapist to help with the anxiety depression. That's a big step. Though.

What about school nurses, They're they're so available. I think about the school nurse and my daughter's high school that that was just wonderful and was really a part of the school community. I feel like they could be really effective without reach. Now I think that's right. I think they're the ones that are the front line, and and that's why pediatrician sometimes of the front line to they're the ones that should be asking about it, you know,

offering support. School counselors another good resource for people struggling with different things. And then I think where you might need medical attention and not all nurses can do it is if you really need sort of like nicotine replacement to come off it. If you need the patch or the gum to sort of soothe that difficult with those cravings. Well, I was going to ask you, do you recommend the

patch or nicotine gum. It's a little bit of a difficult space because it's not f D approved under eighteen um UM, and there is a way carefully. Often you need parents intervention to help buy it or get permission for the prescription um. But there is We are for those folks that are stuck doing sort of a brief course of of nicotine replacement, the patch or the gum, which we definitely prefer than people going to cigarettes or

other measures. As they become concerned about these devices, you know, better not go to cigarettes again, Better to you know, get tapered off of nicotine if you really need it. Is it better to withdraw gradually or should you go cold turkey? It's different for everyone. Some people can tolerate it, and often those without co occurring mental illness anxiety, and

those you know, without the predisposition for addiction. You know a bunch of kids I've met have said, you know, I just decided to stop one day and it was miserable for a couple of days, but I wrote it out. And then there is that subset that says, this withdrawal was the worst thing I've ever experienced in my entire life. And for those folks, they really need help with a patch more gradually, and stopping all at once will feel

intolerable to them. How long does it take? Generally it takes seventy two hours to get nicotine out of your system, correct as everyone knows who's you're in screen for it or who every parent is is jumping on them. Yeah, you know it can be out that short of time, but we've come to appreciate that withdrawal from all substances

can be a much longer process. And you know, we're increasingly talking about sort of post acute withdrawal symptoms, which you know are those anxiety symptoms, the inability to concentrate and focus, feeling sort of like you've been you know, punched in the stomach and don't have the energy and

breath to to go about your life. And and so those things sometimes become the harder barrier as all these other pressures from life bear down on these kids, right, I mean, they have to go to soccer practice and piano lessons and still want to interact with their friends and do well academically. There's so much academic pressure on these kids, so not to mention social media and all the social pressure that comes with that and living your

life compared to other people, your peers. So I feel bad for kids today with all the comparisons, with all the pressures, and going back to how parents should talk to kids, I mean, we over focus on academics, on doing you know, hitting those marks socially and and and academically, and we really need to be telling our kids it's okay to be them no matter what happens in life. Getting back to vaping, there are some real world consequences,

physical consequences to this habit. How lunch should you be when you're talking to your kids about things like popcorn lung and decreased lung capacity and things like that. I mean, I think you have to be pretty honest, right, Yeah. They need to know the information, and you know, it's and I think a lot of them get it. I mean, kids get info pretty quick these days, and they're hearing it at school and so in an ideal parent kid relations ship, they're giving you the information, and you're not

giving them the information. So I always recommend checking first to see what the kids know, and often they know a lot. You do have to really check yourself first, and if you say mindful parenting, people really realize at you. But there is something about that that I think is important that you You can't, you know, look at your kids behaviors without first looking at your thoughts and feelings and also your own substance use. I have to add, you know, there are parents who you know, want in

all kinds of ways. They've set the model for their kids. Right. They're the ones taking the drink or two when they come home and saying, I'm so stressed, get me a

beer to the kid or whatever. They're the ones that are jeweling and vaping some themselves, including you know, vaping marijuana product that's smoking cigarettes or smoking cigarettes, and so you know, I think often we ask things of our kids we don't ourselves, and and you really have to look internally as a parent before you're you're going to help them, I think. But it's hard, and you'll fail

all the time. And to be a parent is to fail, right, and and the idea is to just get back on the horse and and think about what was going on with you at that moment and try to get things that going in a positive direction. Again, what's the biggest mistake parents make when they're trying to get their kids to stop to view it as a bad kid doing

bad things? And I think the biggest mistake is not sort of appreciating that this does veer into a disease model of addiction and and kids are self medicating psychiatric issues or they're predisposed to addiction, and that you know a lot of people will experiment and not get hooked the way their kid is and and not behave the way their kid is. And there's a reason why it's happening.

And and often it's the sort of idea that it's activated these reward pathways or satisfying this psychiatric need where it becomes the answer to all questions for the kid during the day, how they're going to survive, how they're going to starve off withdrawal, and it's sort of hijacked

their brain. And one saying in recovery that I love especially and and and people who when they stop jeweling or stop using whatever product often identify with is that I'm not a bad person becoming good, but I'm a sick person becoming well. And I think that's one of the key points that these aren't just troublemakers, that these are kids who have had brain hijacked by this you know, seductive product, and now we're trying to you know, feel

right and get the ship on track. Wow. I cannot believe how much has changed between August when we first started researching this episode and today, now that we're finally airing it. You could barely keep up with all the developments.

It's still shocking to me that all of us, from the medical community to educators, to parents and even kids were caught so off guard and why there was definitely a lot of smoke and mirrors when it came to marketing babes as cool, glamorous, even safe, the same way incidentally, cigarettes once were. The advertising was almost as stealthy as

the vapes themselves. But now this epidemic is out in the open, and everyone from local officials to schools to even the Trump administration is trying to figure out what to do about it, from banning flavors to out lawe the devices altogether. We haven't heard the end of this story that at least now we're paying attention. Thanks so much for listening, everyone, and until we meet again, make

sure to follow me on Instagram. I'm at Katie Curik and sign up for my daily newsletter is called wake Up Call, and you can do that by going to Katie Currek dot com. Next Question with Katie Curic is a production of I Heart Radio and Katie Curic Media. The executive producers are Katie Kuric, Lauren Bright Pacheco, Julie Douglas, and Tyler Klang. Our show producers are Bethan Macaluso and Courtney Litz. The supervising producer is Dylan Fagan. Associate producers

are Emily Pinto and Derek Clemens. Editing is by Dylan Fagin, Derrek Clements, and Lowell Berlante. Our researcher is Barbara Keene. For more information on today's episode, go to Katie Currek dot com and follow us on Twitter and Instagram at Katie Couric m. For more podcasts for My Heart Radio, visit the I Heart Radio app, Apple podcast, or wherever you listen to your favorite shows.