Start the Conversation: How to Talk to Young People about Vaping - - PowerPoint PPT Presentation

Start the Conversation: How to Talk to Young People about Vaping

Find a seat Greet your neighbors We’ll get started soon! Jenny Best, MS, El Paso County Public Health Grace Houser, MD, Children’s Hospital Colorado

Objectives

• Recognize emerging trends, culture, and

health effects of youth use of e-cigarettes

• Use trusted adult principles to have

conversations with youth about the use of e- cigarettes What do you want to learn today or have a question about?

Getting Started

The Data

50% of youth currently use e-cigarettes.

E-cigarettes: 23% Cigarettes: 7% Other Tobacco Products: 10%

The Data

44% of youth have tried e-cigarettes.

Use: E-cigarettes: 44% Alcohol: 60% Marijuana: 39%

The Data

Perceive vaping as risky: 47% Perceive smoking as risky: 87%

70% of youth perceive vaping as risky.

The Data

Youth who can ask a parent for help are 31% less likely to vape.

Youth who can ask a parent for help as 10% less likely to vape.

Discussion- HKCS 2017

What questions do you have about this data?

23% of youth currently use e- cigarettes (7% cigarettes) 44% of youth have tried e-cigarettes 47% of youth perceive vaping as risky (85% - smoking) Youth who can ask parents for help are 31% LESS likely to vape Youth who participate in extracurricular activities are 12% LESS likely to vape. LGBTQ Youth have higher rates of use compared to heterosexual peers.

Current Trends & Culture

What We Know

Curiosity Flavors Belief that they are safer than other tobacco products

43% of young people cite flavors as the reason they first tried vaping Only 47% of El Paso County youth find vaping to be risky

Electronic Devices

• E-cigs
• Vapes
• Pods
• Mods
• E-juice
• Vaping
• JUUL
• Clouds
• Dripping
• Shotgunning
• JUUL’ing

JUULs

“The Smoking Alternative, unlike any E-cigarette or Vape”

Flavors:

• Classic Tobacco
• Virginia Tobacco
• Menthol

Each pod is equivalent to 1 pack of cigarettes

• r 200 puffs

Marketing

• Appealing flavors
• Social media - Instagram, snapchat, twitter,

YouTube

Marketing

“Healthy Alternative” “Made for adults to quit smoking” - JUULs “Stealth” vaping

Stealth Vaping

Stealth Vaping Mods

Health Effects

What’s in them?

E-cig juice / e-liquid / vape juice

• Nicotine
• Artificial flavorings: diacetyl (“popcorn lung”),

mint (allergy/asthma), cinnamon (asthma)

• Solvents: propylene glycol, vegetable glycerin
• Convert to carcinogens when heated and

inhaled

• Other particles, heavy metals
• NOT “water vapor”

Nicotine & The Young Brain

• Brain is still developing until about age 25.
• Nicotine is highly addictive and has neurotoxic

effects on the developing brain

• Disrupts the development of the brain

circuits that control attention, learning, mood and impulse control

• Affects the brain’s rewards system and

can lead to increased potential for addiction to other substances

Aerosol – Not Harmless Water Vapor

Health Impact

• Acute effects: cough, mouth or throat irritation,

anxiety, depressed mood, nausea, insomnia

• Respiratory: link to asthma, altered immune

response

• Cardiovascular: links to endothelial cell dysfunction
• Neurologic: effects of nicotine
• Potential for ingestion, explosions
• No evidence for “safety”

Second hand smoke effects

EVALI (E-cigarette/Vaping Associated Lung Injury)

EVALI

• June 2019; peaked in September
• Symptoms similar to pneumonia or influenza, but

no infectious cause identified

• Vitamin E acetate in fluid samples collected from

lungs of patients with EVALI, but not in controls

• Banned in inhaled marijuana products in

Colorado as of Jan 1, 2020

EVALI (E-cigarette/Vaping Associated Lung Injury)

EVALI

• As of December 2019: about 2200 hospitalized

patients nationally

• At least 55 deaths
• 1 teenager required lung transplant
• At least 2 cases (but < 5) in Colorado; highest

numbers in Midwest

• Treatments: supportive care; maybe

steroids; smoking cessation

Chronic Lung Disease from Vaping

E-cigarette use among adults is a risk factor for development of:

• Chronic obstructive pulmonary disease (COPD)
• Chronic bronchitis
• Emphysema
• Asthma

Statistically speaking – odds ratios

• E-cigarette use: 1.3x
• Combustible tobacco use: 2.5x
• BOTH: 3.3x

Bhatta DN, Glantz SA. “Association of E-Cigarette Use With Respiratory Disease Among Adults: A Longitudinal Analysis.” Am J Prev Med 2019

Policy Efforts

Evidence behind policy change

Raising legal tobacco sales age from 18 to 21 reduces the number of adolescents and young adults who start smoking

• 95% of adult smokers begin smoking before

age 21

• Helps keep tobacco out of high schools

Tobacco tax increases reduce smoking rates

• 10% increase in cigarette prices → decrease in youth

smoking by 7%, decrease in total cigarette consumption by 4%

• Increased state revenue, decrease tobacco-related

health care costs

National

December 20, 2019: Federal law raised the minimum age of sale of tobacco products from 18 to 21 years

• No exemptions for current 18 to 21 year old users, or

for active military personnel

• Effective immediately
• Enforcement plan over next 1-2 years

Partial e-cigarette flavor ban: “coming soon”

• Prohibit e-cig cartridges
• Exempt menthol and tobacco flavors
• Exempt open tank systems
• Health & Human Services
• FDA review process

State

2019 Colorado Legislature

• Updated Clean Indoor Air Act to include e-cigarettes
• Removal of tax penalty for local municipalities to enforce

tobacco legislation

2020 Colorado Legislature

• HB 20-1001: Raise minimum legal sales age of tobacco

purchase to 21; require statewide tobacco retailer licensing system

• Local communities would be able to implement

stronger ordinances

State

Increasing Tobacco Taxes

• Proposed vaping and tobacco tax (multiple versions)

filed last week

• Raise state tobacco tax from 84c to $1.20 - $2.60 (per pack)

and add tax on e-cigarette products

• Federal tax: $1.10 per pack
• Would place an initiative on statewide November

ballot

• Revenue would fund statewide preschool programs

for 4 year olds, as well as:

• Anti-tobacco education programs
• Resources to help smokers quit
• Health clinics

Local

Manitou Springs: Tobacco Retail Licensing Ordinance passed January 2020 (effective Feb 5)

• Raises minimum legal sales age to 21
• Licensing and enforcement provisions

Colorado Springs

• Working with City Council on tobacco retail licensing

and raising minimum legal sales age to 21

Fountain

• Model in Southern Colorado for instituting retail

licensing and compliance checks

• Working to update ordinance to include e-cigarettes

Monument?

Trusted Adult:

a parent, guardian, caregiver, teacher, or mentor that is approachable & open to answering questions with accurate information

• 1. Reflect

Reflect on your personal point of view Reflect on your ability to be a role model Reflect on what you want the result

• f the conversation to be

Reflect on the context of the conversation

• 2. Determine Underlying Question

“What is acceptable behavior?” “Do I have your approval?” “Can I shock you?” “What is your personal belief?”

• 3. Use O.A.R. to Guide the Conversation

Open-ended questions Affirmations Reflective Listening

O.A.R.: Open-ended Questions

Who, What, Where, When, Why and How questions that move the conversation forward

Examples: “What do you think about … ?” “How do you decide when to … ?” “How do you feel about … ?” “Help me understand … ?”

O.A.R.: Affirmations

Statements to focus on strengths and positive behaviors – no matter how small.

Examples: “I appreciate that you’re willing to talk with me about this.” “It sounds like you handled yourself well in that situation.” “That’s a good idea.”

O.A.R.: Reflective Listening

Focus on understanding what the person means by:

• Repeating and rephrasing
• Paraphrasing
• Reflecting a feeling.

Examples: “So you feel…” “It sounds like you…” “You’re wondering if…”

Talking to your youth by age:

Age 10-12

• Concrete thinkers
• Parental modeling and influence

Age 13-15

• High risk takers, unable to anticipate

consequences

• Importance of clear family boundaries and

enforcing rules

Age 16-18

• More independent, but still listening to trusted

adults

• Open ended questions and reflective listening

What We Can Do

Have a Trusted Adult Conversation 1. Resources: Speak Now Colorado TobaccoFreeCO TobaccoFreeKids CDC

What We Can Do

Provide education and cessation resources for youth who use tobacco/ other nicotine products. 2.

Resources:

• Second Chance - online tobacco/

nicotine education program

• Colorado Quitline

○ My Life My Quit

• Smokefree Teen
• “The Real Cost”

What We Can Do

Join local community efforts. 3.

• Tobacco-Free Alliance
• SWAT Club
• Nicotine News

What We Can Do

Engage in policy and advocacy efforts 4.

• Local, state, and federal levels
• Write letters to the editor
• Communicate with local or state legislators
• Vote!
• CHCO Child Health Champions:

www.childrenscolorado.org/community/ child-health-advocacy/

Video

JUULers Against JUUL

Thank You!

Questions? Please contact: HeaTEPP@elpasoco.com