In the past, parents would smell a whiff of cigarette smoke, burst into their teenagers' rooms, catch them sneaking a puff of a cigarette, and major grounding would then ensue. Today, here's what will more likely happen: there will be no smoke, or smell. Instead you may stumble across what looks like a James Bond-style pen in your teen's backpack.
Welcome to the world of e-cigarettes, which deliver their nicotine high through heated vapor. A recent study has found that so-called "vaping" is on the rise among teenagers, setting off alarm bells among researchers and parents alike.
According to the Yale study, one in four high school students have tried e-cigarettes. A survey of two middle schools found that 3.5 percent of these kids have also tried e-cigarettes. And even many of those who haven't vaped said they'd consider it.
"Kids are less scared of trying vaping: one report states that less than one quarter thought they'd ever try conventional cigarettes, but close to half said they might try vaping," says Michael Bernstein, MD, the associate director in the division of pulmonology at Stamford Hospital in Connecticut.
Teens' lax attitude toward the devices is blamed on a perception that they're safer than regular cigarettes -- after all, they were originally designed to help adults stop smoking. But while most experts agree that e-cigarettes are safer than conventional cigarettes, safer does not mean they're safe.
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To compare: conventional cigarettes deliver thousands of toxic and cancer-causing chemicals into the body, including tobacco and carbon monoxide. Vaping, meanwhile, contains mostly nicotine, which can also wreak havoc with the cardiovascular system and lead to hypertension and heart attacks. Since nicotine is the substance that gets us addicted and craving more, it works a lot like a "gateway" drug that can easily lead teens down the path to smoking regular cigarettes.
E-cigarettes also deliver high levels of nanoparticles -- tiny particles that can trigger inflammation and have been linked to asthma, stroke, heart disease, and diabetes, warns Michael Genovese, medical director of Sierra Tucson addiction center. In addition, use of e-cigarettes has been linked to higher rates of pneumonia.
Because e-cigarettes are so new, the industry is largely unregulated compared to traditional tobacco products. Although 20 states have banned the sale of e-cigarettes to minors, the majority still allow it -- or else kids can go online and buy with impunity.
Making matters worse, it's really hard for parents to tell if their kid is vaping, since there's no smoke or telltale smell. Here are some signs parents should be aware of:
1. The scent -- "E-cig vapor can have no odor at all, which is part of the appeal," says Laura Offutt, MD, founder of the teen health website Real Talk With Dr. Offutt. That said, the vapor can be flavored, so if you suddenly catch a whiff of fruit punch, bubble gum or mint -- and you can find no juice containers, gum or candy wrappers -- that could be a red flag.
2. "Pens" that aren't pens -- "Another thing that I think is helpful for parents to be aware of is that e-cigarettes or vaporizers can look like many things," says Offutt. "They can look like thumb drives, or pens, or like a stylus." So if you spot something along these lines, take a closer look, and if there are holes on each end, you've probably got an e-cig in your hands.
3. Copious sipping of liquids. One major ingredient in the vaporized liquid in e-cigs is propylene glycol, which is "hygroscopic" -- meaning it attracts and holds water molecules from its environment, like the mouth. According to Genovese, this can lead e-cig users to have a constant state of dry mouth, which can be alleviated by quaffing more drinks. Dry skin is another common side effect.
4. Nose bleeds. The water-holding effect of e-cig vapor can also dry out the nasal passages, leading to bloody noses.
5. Passing on caffeine. Some e-cig users develop a sensitivity to caffeine, and curb their caffeine intake. So if your teen is suddenly passing on the Red Bulls they used to chug often, vaping may be to blame.
As for what to do if you find out your child is vaping, Dr. Bernstein suggests emphasizing to your teen that the terms "vaping" and "smoking" are essentially the same thing in your eyes -- that way, they can't say, "I'm not smoking, I'm vaping!" and get off the hook if you catch them sneaking a puff.
Or, if your teen argues "vaping isn't dangerous," consider this analogy from Dr. Bernstein: "When teens ask me if vaping e-cigs is safer than smoking, I have said the following: jumping out of airplanes using a parachute with holes is better than using no parachute. What's even better? Don't jump out of airplanes."
What would you do if you caught your teen vaping?
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