Spring 2019 News

YOUTH E-CIGARETTE USE IS AN EMERGING PUBLIC HEALTH THREAT

Youth e-cigarette use has risen dramatically in Minnesota in the last 3 years, with an almost 50% increase in high school student use since 2014¹.  This is a major public health concern.  Youth use of nicotine increases their risk of addiction, and can make them more susceptible to addiction to tobacco products and other substances in the future.  The Minnesota Department of Health recommends immediate actions requiring the participation of parents, educators, health care providers and policy makers.

Nicotine Primes the Adolescent Brain  for Addiction

Addiction is a form of learning, where the brain learns to connect a stimulus (for example, smoking a cigarette or vaping an e-cigarette) with a response (feeling of pleasure and calming of cravings).² Each time a new skill or memory is learned, stronger connections-or synapses - are built between brain cells.  Young people build synapses faster than adults. Nicotine changes the way these synapses are formed.  Youth exposed to nicotine are at higher risk for addiction than are adults, because youth brains are still forming and making permanent connections.^{2 3 4 5}  Studies show that symptoms of nicotine addiction can appear among youth within only a few days or weeks after smoking initiation.^{6 7}  

New E-Cigarette Technologies Pose Greater Risks for Youth

Popular e-cigarettes like JUUL have developed new technologies utilizing nicotine salts that are absorbed into the body more effectively and come in record-high levels of nicotine.  According to the manufacturer, a single JUUL pod contains as much nicotine as a pack of 20 regular cigarettes.⁸  E-cigarettes like JUUL, come in a wide variety of fruit and other flavors that appeal to youth.  They are also easily hidden, have limited odor and emit aerosol that disappears quickly enabling people to use them in public places where cigarette use is prohibited.

Opportunity for Action

Given the danger of youth nicotine use, it's important for parents, educators, health care providers and policy makers to be aware and take action.

Parents

• Talk to your kids about the risk of using e-cigarettes. To learn more go to:
              www.health.state.mn.us/communities/tobacco/ecigarettes/index.html
              e-cigarettes.surgeongeneral.gov/
• Be aware of the risks of nicotine and the different products kids are using.  Know that e-cigarettes almost always contain nicotine.
• If your child is using an e-cigarette, get them help:
               Tobacco Cessation resources for Youth

Educators

• Educate yourself to the harms of nicotine exposure, including impact to brain development and risks for engaging in other high-risk activities like use of cigarettes, alcohol, marijuana and other illicit substances.
            www.health.state.mn.us/communities/tobacco/ecigarettes/index.html#schoolkit
• Educate students and parents that nicotine is highly addictive and e-cigarettes almost always contain nicotine.
• Enforce existing prohibitions of tobacco and nicotine product use in schools.

Health Care Providers

• Talk to your young patients about the risks of e-cigarette use.
• Provide education about nicotine including harms to the brain from nicotine exposure and the nicotine in any form  (smoked or vaped) can be addictive.
• Screen parents for use of all tobacco products, encourage cessation and refer patients to cessation services (e.g., in-person counseling and/or quitline).

Policy Makers

• Restrict the use of e-cigarettes in public places where combustible cigarette use is already prohibited.
• Restrict the sale of flavored tobacco to adult-only retail establishments.
• Increase the minimum legal sales age to 21 years of age.