[PPT] - Va ping Pre pa re d b y De b o ra h Ha g le r MD FAAP Pre sid e PowerPoint Presentation

SLIDE 1

Va ping

Wha t Sc ho o ls c a n d o to He lp Our K id s

Pre pa re d b y De b o ra h Ha g le r MD FAAP Pre sid e nt E le c t Ma ine Cha pte r AAP

SLIDE 2

T he Sc ope of the Proble m

1/ 3 of HS stude nts using a ny toba c c o

produc t [1]

L

ife time pre va le nc e e - c ig a re tte use 45% a mong Ma ine HS stude nts with 29% re porting pa st 30- da y use [2]

11.7% 12th g ra de rs using e - c ig s da ily [3] Pa tte rns of proble ma tic use c le a rly

e me rg ing - 21% of e - c ig use rs a t

ut- pa tie nt c linic in NY re porte d

a ddic tion [4]

SLIDE 3

Why Is this a Proble m

E

L

iq uid s c o nta in to xins - L e a d , Nic ke l Ca d mium, Ac ro le in [5]

E

L

iq uid s c hro nic e ffe c ts o n lung s just b e g inning to b e und e rsto o d [6]

Nic o tine o fte n hig hly c o nc e ntra te d / hig hly a d d ic tive [7] Nic o tine a ffe c ts multiple syste ms in the b o d y inc lud ing c a rd io -va sc ula r syste m, immune

syste m a nd GI syste m [7]

Co nc e rning e ffe c ts o n mo o d a nd le a rning , e spe c ia lly in the d e ve lo ping b ra in [8] I

nc re a se d risk o f d e ve lo ping o the r sub sta nc e use d iso rd e rs [9]

I

nc re a se d risk o f switc hing to c o mb ustib le c ig a re tte s / d ua l use [10]

SLIDE 4

Why a re Kids Using

Curio sity [11 ,12,13] F

rie nd s Using [ 11,12,13]

Re la x [11,12,13] F

e e l L e ss Stre sse d [11,12,13]

SLIDE 5

Are T he Kids All Rig ht

Na tio na l I nstitute o f Me nta l He a lth re po rts life time Pre va le nc e o f Anxie ty Diso rd e rs is 32% in Ad o le sc e nc e [14]

2018 Surve y b y the Ame ric a n Psyc ho lo g ic a l Asso c ia tio n - yo uth a g e s 15-21 we re the le a st like ly to re po rt the y e njo ye d g o o d me nta l he a lth [15]

2005-2017 (Na tio na l Surve y o f Drug Use a nd He a lth)

52% inc re a se in ra te o f ma jo r d e pre ssio n e piso d e s

in yo uth a g e d 12-17 fro m 8.7% to 13.2% [16]

Suic id e Ra te in Yo uth ha s e sse ntia lly d o ub le d sinc e

2000. Suic id e is se c o nd le a d ing c a use o f d e a th fo r

yo uth a g e d 10-24 [17]

Yo uth d istre ss, a nxie ty, d e pre ssio n risk fo r use e - c ig a re tte s a nd tra d itio na l c ig a re tte s [11]

T his Pho to b y Unkno wn Autho r is lic e nse d unde r CC BY-SA-NC

SLIDE 6

Are T he Kids All Rig ht

I

n Ma ine 32% HS stud e nts fe lt sa d o r ho pe le ss in la st 2 we e ks [2]

23% HS stud e nts b ullie d in la st ye a r a t

sc ho o l [2]

25% MS stud e nts sa d o r ho pe le ss in la st 2 we e ks [2]

46% MS stud e nts re po rte d e ve r b e ing

b ullie d a t sc ho o l [2]

T his Pho to b y Unkno wn Autho r is lic e nse d unde r CC BY-SA-NC

SLIDE 7

Use to De pe nde nc y-

UCSF / Sta nford study L

oking a t E

NDS 2/ 2019 [18]

173 (13-18yo ) me a n 16.6 - 10 life time use s E NDS

80.3% still using 12 mo nths la te r

Da ily use 14.5% a t b e g inning - 29.8% a fte r 12 mo nths

Only E NDS a t sta rt- 28.8% a lso using c o mb ustib le s

De pe nd e nc e sc o re s a t b a se line 13.3 %- a t e nd inc re a se d 23.3%

De pe nd e nc e sc o re s a nd c o tinine le ve ls inc re a se d

ve r time

T he ~ 20% who q uit site d e sire fo r se lf- impro ve me nt; d iffic ulty/ c o st ma inta ining d e vic e ; g e tting in to o muc h tro ub le .

T his Pho to b y Unkno wn Autho r is lic e nse d unde r CC BY-ND

SLIDE 8

Wha t a re Sc hools to Do

Prima ry pre ve ntio n - inc o rpo ra ting stra te g ie s tha t a c kno wle d g e so me o f prima ry re a so ns

fo r use (stre ss / re la xa tio n / so c ia l e xpe rie nc e with frie nd s)

Distric t T

b a c c o Pre ve ntio n Pa rtne rs

Po sitive Yo uth De ve lo pme nt Stre ss Re d uc tio n Stra te g ie s Yo uth Me nta l He a lth F

irst Aid

SLIDE 9

Distric t T

ba c c o Pre ve ntion Pa rtne rs

Ca n he lp c ura te pre ve ntio n pro g ra ms: Ca tc h My Bre a th Sta nfo rd T

b a c c o

Pre ve ntio n T

o l K

it

L ink sc ho o ls to writte n re so urc e s

He lp with pro g ra mming

L ink to c e ssa tio n re so urc e s

SLIDE 10

Ca tc h My Bre a th

F re e - F und e d b y CVS F

und a tio n

F

ur 30-40 minute se ssio ns

Curric ulum fo r 5-6th g ra d e / 7-8th g ra d e / 9-12th g ra d e

SLIDE 11

Sta nford T

ba c c o Pre ve ntion T
ol Kit

E xha ustive

Re so urc e pa g e ve ry he lpful to ta ilo r pro g ra ms

Pre pa re d po we r po ints o n e - c ig a re tte risks / a d d ic tio n, e tc …

I nte ra c tive ma te ria ls; q uizze s; vid e o s

T e a c he rs Guid e s fro m Sc ho la stic / NI DA

I nc lud e s c e ssa tio n ma te ria ls

SLIDE 12

F

r Youth F
und Va ping On Sc hool

Prope rty

No suspe nsio n pra c tic e s re c o mme nd e d Athle te s pa rtic ipa te in sc ho o l suspe nsio n/ lo se pla y time . Co nfisc a te d e vic e No tify pa re nts Asse ss usa g e - sc ho o l nurse / c linic ia n a sse ss a mo unt/ d e pe nd e nc e o n nic o tine , re a so ns fo r

use / o the r pro b le ms, willing ne ss to c ha ng e - re fe r to lo c a l physic ia ns a nd the Ma ine T

b a c c o He lp L

ine

SLIDE 13

In Sc hool Suspe nsion

1-ho ur Sta nfo rd He a lthy F

uture Curric ulum: fa c ilita te d pre -pa c ka g e d po we r po int to pro mo te c ha ng e 2 a nd 4 ho ur in sc ho o l suspe nsio n c urric ulum a va ila b le .

I

nDe pth - Ame ric a n L ung Asso c ia tio n: 4 50-minute se ssio ns to e d uc a te yo uth a b o ut e - c ig a re tte s a nd ma king b e ha vio ra l c ha ng e ; F a c ilita te d – fre e -o nline tra ining

Distric t T

b a c c o Pre ve ntio n Pa rtne rs [DT

PP] c a n sug g e st o the r a lte rna tive s

De sig n yo ur o wn pro g ra mming with we a lth o f info rma tio n a va ila b le , DT

PP a nd AAP c a n he lp

SLIDE 14

Sc hool Clinic ia ns- In Sc hool Asse ssme nts for Youth Va ping

Asse ss le ve l o f use / nic o tine d e pe nd e nc e - Pe nn Sta te E

Cig a re tte De pe nd e nc e I

nd e x [19] {a va ila b le o n Ma ine AAP we b site }

Co nsid e r using SBI

RT to a sse ss o the r sub sta nc e use (yo uth va ping nic o tine ha ve 3-4 time s the o d d s o f using ma rijua na ) [20]

Und e rsta nd use ; with pe rmissio n d isc uss c ha ng e a nd initia te re fe rra ls fo r furthe r

a sse ssme nts/ c o unse ling / c o nsid e ra tio n o f Nic o tine Re pla c e me nt T he ra py {NRT } [21]

De ve lo p pla ns fo r wo rking with yo uth in the sc ho o l tha t ma y inc lud e ma na g ing nic o tine

withd ra wa l a nd use o f NRT in sc ho o l se tting

SLIDE 15

Re c omme nda tions

T

e a m a d d re ssing me nta l he a lth/ we ll-b e ing a nd sub sta nc e a b use [a ll inhe re ntly linke d ]

Po st lite ra ture / sig ns/ run vid e o s if a b le - T

ruth I nitia tive ha s so me e xc e lle nt o ne s a va ila b le

Ga the r info rma tio n fo r pa re nts/ sta ff - Sta nfo rd T

b a c c o T
o lkit Re so urc e s Guid e ha s

info rma tio n she e ts fro m a va rie ty o f so urc e s in o ne spo t

E

d uc a te e ntire sta ff a b o ut e -c ig a re tte s

De c id e o n pre ve ntio n c urric ulum fo r e ntire c o mmunity

I d e ntify a nd tra in willing pe e r le a d e rs o n pre ve ntio n/ a nd a ssisting yo uth who wa nt he lp pe e rs q uit [ Distric t T

b a c c o Pa rtne rs c a n pro vid e tra ining fo r yo uth to le a d this type o f

inte rve ntio n thro ug h the ” Sid e kic ks” pro g ra m].

SLIDE 16

Re c omme nda tions

Pla n fo r yo uth fo und va ping o r with pa ra phe rna lia o n sc ho o l pro pe rty - I

nc lud e I nfo rma tio n fo r fa milie s; pla ns fo r in ho use suspe nsio n; a sse ssme nt fo r d e g re e o f use a nd whe re yo uth is a ro und usa g e a nd tho ug hts o f c ha ng e

Re vie w Sc ho o l Po lic ie s tha t ma y b e a b a rrie r fo r yo uth who wa nt tre a tme nt Pla n Curric ulum fo r in-sc ho o l suspe nsio ns Pla n fo r re pe a ts - 1-Ho ur se ssio n/ 2- ho ur/ 4-ho ur se ssio n/ Po sitive Yo uth De ve lo pme nt /

Stre ss Ma na g e me nt

De ve lo p lo c a l re fe rra l re so urc e s fo r yo uth who re q uire mo re suppo rt

SLIDE 17

Othe r Conside ra tions

Sc ho o l Clima te / Culture – Anti- b ullying / fo ste ring inc lusio n

Po sitive Yo uth De ve lo pme nt

Build ing Re silie nc e

SLIDE 18

T HANK YOU F OR AL L YOU DO!!!!

T

ha nk yo u to My E xc e lle nt DT PP a t ACCE SS HE AL T H/ a nd the te a m a t Co mmunity He a lth a nd We llne ss a t Mid Co a st Ho spita l

SLIDE 19

Re fe re nc e s

1. Wa lle y S, Wilso n K

, Winic ko ff J, Gro ne r J. A Pub lic He a lth Crisis: E le c tro nic Cig a re tte s, Va pe , a nd JUUL . Pe diatric s. Jun 2019, 143 (6):2741 e 20182741; DOI: 10.1542/ pe d s.

2. 2019 Ma ine I

nte g ra te d Yo uth He a lth Surve y F a c t She e ts https:/ / d a ta .ma ine pub lic he a lth.g o v/ miyhs/ 2019Sna psho ts

3. Culle n K

A, Ge ntzke AS, Sa wd e y MD, e t a l. e -Cig a re tte Use Amo ng Yo uth in the Unite d Sta te s, 2019. JAMA. 2019;322(21):2095–2103. d o i: https:/ / d o i.o rg / 10.1001/ ja ma .2019.18387

4. 27. Bo yka n R, Go nie wic z ML

, Me ssina CR. E vid e nc e o f Nic o tine De pe nd e nc e in Ad o le sc e nts Who Use Juul a nd Simila r Po d De vic e s. I

nt J E nviro n Re s Public He alth. 2019;16(12):2135. Pub lishe d 2019 Jun 17. d o i:10.3390/ ije rph16122135

5. Go nie wic z ML

, K nysa k J, Ga wro n M, e t al L e ve ls o f se le c te d c a rc ino g e ns a nd to xic a nts in va po ur fro m e le c tro nic c ig a re tte s. T

bac c o Co ntro l.2014;23:133-139.
6. Dha rma N. Bha tta , Sta nto n A. Gla ntz, Asso c ia tio n o f E
Cig a re tte Use With Re spira to ry Dise a se Amo ng Ad ults: A

L

ng itud ina l Ana lysis, Am J Pre v Me d 16, De c e mb e r 2019, I

SSN 0749-3797, https:/ / d o i.o rg / 10.1016/ j.a me pre .2019.07.028.

7. U.S. De pa rtme nt o f He a lth a nd Huma n Se rvic e s. E-Cig a re tte Use Amo ng Yo uth a nd Yo ung Ad ults. A Re po rt o f the

Surg e o n Ge ne ra l. Atla nta , GA: U.S. De pa rtme nt o f He a lth a nd Huma n Se rvic e s, Ce nte rs fo r Dise a se Co ntro l a nd Pre ve ntio n, Na tio na l Ce nte r fo r Chro nic Dise a se Pre ve ntio n a nd He a lth Pro mo tio n, Offic e o n Smo king a nd He a lth, 2016. 8.Yua n, M., Cro ss, S. J., L

ug hlin, S. E

., & L e slie , F . M. (2015). Nic o tine a nd the a d o le sc e nt b ra in. T

he Jo urnal o f physio lo gy, 593(16), 3397–3412. d o i:10.1113/ JP270492

SLIDE 20

Re fe re nc e s

9. Ho llid a y E

, Go uld T

J. Nic o tine , a d o le sc e nc e , a nd stre ss: A re vie w o f ho w stre ss c a n mo d ula te the ne g a tive

c o nse q ue nc e s o f a d o le sc e nt nic o tine a b use . Ne uro sc i Bio be hav Re v. 2016;65:173–184. d o i:10.1016/ j.ne ub io re v.2016.04.003

10. Be rry K

M, F e tte rma n JL , Be nja min E J, e t a l. Asso c ia tio n o f E le c tro nic Cig a re tte Use With Sub se q ue nt I nitia tio n o f T

b a c c o Cig a re tte s in US Yo uths. JAMA Ne tw Ope n. 2019;2(2):e 187794.

d o i:https:/ / d o i.o rg / 10.1001/ ja ma ne two rko pe n.2018.7794

11. Je nsse n B, S Wa lle y S, Se c tio n o n T
b a c c o Co ntro l, Ame ric a n Ac a d e my o f Pe d ia tric s. E-Cig a re tte s a nd Simila r

De vic e s. Pe diatric s. F e b 2019, 143 (2) e 20183652; DOI: 10.1542/ pe d s.2018-3652

12. Be rna t D, Ga sq ue t N, Wilso n K

O, Po rte r L , Cho i K . E le c tro nic Cig a re tte Ha rm a nd Be ne fit Pe rc e ptio ns a nd Use Amo ng Yo uth. Am J Pre v Me d. 2018;55(3):361–367. d o i:10.1016/ j.a me pre .2018.04.043

13. Ma tthe w C. F

a d us, T ra c y T . Smith, L ind sa y M. Sq ue g lia , T he rise o f e -c ig a re tte s, po d mo d d e vic e s, a nd JUUL a mo ng yo uth: F a c to rs influe nc ing use , he a lth implic a tio ns, a nd d o wnstre a m e ffe c ts,Drug a nd Alc o ho l De pe nd e nc e , Vo lume 201, 2019,Pa g e s 85-93,I SSN 0376-8716,https:/ / d o i.o rg / 10.1016/ j.d rug a lc d e p.2019.04.011. 14.Na tio na l I nstitute o f Me nta l He a lth Pre va le nc e Any Anxie ty Diso rd e r Ad o le sc e nc e . Be the sd a , MD. No ve mb e r,2017. https:/ / www.nimh.nih.g o v/ he a lth/ sta tistic s/ a ny-a nxie ty-d iso rd e r.shtml

15. Ame ric a n Psyc ho lo g ic a l Asso c ia tio n (2018). Stre ss in Ame ric a : Ge ne ra tio n Z. Stre ss in Ame ric a ™ Surve y

SLIDE 21

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we ng e , J. M., Co o pe r, A. B., Jo ine r, T . E ., Duffy, M. E ., & Bina u, S. G. (2019). Ag e , pe rio d , a nd c o ho rt tre nd s in mo o d d iso rd e r ind ic a to rs a nd suic id e -re la te d o utc o me s in a na tio na lly re pre se nta tive d a ta se t, 2005–2017. Jo urnal o f Abno rmal

Psyc ho lo gy, 128(3), 185–199. https:/ / d o i.o rg / 10.1037/ a b n0000410

17. Miro n O, Yu K

, Wilf-Miro n R, K

ha ne I
S. Suic id e Ra te s Amo ng Ad o le sc e nts a nd Yo ung Ad ults in the Unite d Sta te s, 2000-
2017. JAMA. 2019;321(23):2362–2364. d o i:https:/ / d o i-o rg .pro xy1.lib ra ry.jhu.e d u/ 10.1001/ ja ma .2019.5054
18. Vo g e l E

, Pro c ha ska J, Ra mo D, And re s J,Rub inste in M, Ad o le sc e nts' E

Cig a re tte Use : I

nc re a se s in F re q ue nc y, De pe nd e nc e , a nd Nic o tine E xpo sure Ove r 12 Mo nths, Jo urna l o f Ad o le sc e nt He a lth, Vo lume 64, I ssue 6, 2019, Pa g e s 770- 775, SSN 1054-139X, https:/ / d o i.o rg / 10.1016/ j.ja d o he a lth.2019.02.019. 19.Mo re a n M, K rishna n-Sa rin S, Sussma nS, J F

uld s J, F

ishb e in H, Gra na R, O’ Ma lle y S, Psyc ho me tric E va lua tio n o f the E

c ig a re tte De pe nd e nc e Sc a le , 2018 Ja nua ry 2. Nic o tine & T
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https:/ / d o i.o rg / 10.1093/ ntr/ ntx271

20. . L

e vy S, Willia ms J. Sub sta nc e Use Sc re e ning , Brie f I nte rve ntio n, a nd Re fe rra l to T re a tme nt. Pe d ia tric s; Jun 2016, e 20161211; DOI: 10.1542/ pe d s.2016-1211.

21. Suppo rting Yo uth who a re Ad d ic te d to Nic o tine :Ad vic e fo r Pe d ia tric ia ns. Ame ric a n Ac a d e my o f Pe d ia tric s Oc to b e r
2019. https:/ / d o wnlo a d s.a a p.o rg / RCE

/ F a c tshe e t_Suppo rting _Yo uth_Ad d ic te d _to _Nic o tine .pd f