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Last week, findings from a large-scale study revealed that individuals between the ages of 15 and 24 years old were most likely to have tried e-cigarettes than any other age group. These findings are consistent with the Centers for Disease Control and Prevention (CDC), which found that the use of e-cigarettes has doubled for middle school and high school students.

Northern Virginia is not immune to this emerging problem. As a psychologist who works children and teens, a number of my older teen clients have either tried e-cigarettes or use e-cigarettes on a regular basis. A few have even shown me their e-cigarettes in sessions. One client recently went so far as to ask me if I minded if he used his vaporizer during our meeting. While these individuals in my practice have all been over 18, the presence of e-cigarettes in their day-to-day lives is concerning for several reasons.

First, none of the teens I’ve spoken with are using e-cigarettes to quit smoking. Rather, these teens already smoke cigarettes and are using e-cigarettes when they cannot use combustible tobacco or as an adjunct to smoking. Thus, for teens, e-cigarettes arguably serve to promote ongoing nicotine use. If that is the case, then e-cigarettes are not dissimilar to methadone for heroin users where methadone as a synthetic opioid is prescribed as a replacement to help heroin addicts quit heroin. The problem, however, is that many heroin users eventually become dually addicted to methadone and heroin. E-cigarettes then can arguably be seen as a gateway drug to combustible tobacco and other substances for our youth. The product is already being marketed in ways intended to attract a younger crowd.

Safety is another concern. One can become addicted to nicotine via e-cigarette use and in turn suffer withdrawal side effects when trying to stop – anxiety, restlessness, depression, irritability, etc. Moreover, e-cigarettes have not been fully studied and are not yet regulated by the FDA. We presently do not know if the chemicals being inhaled have harmful short-term or long-term negative effects.

Before speaking to children and teens about the problem, parents should agree on expectations for them. If their position is zero tolerance for smoking, or if there is some flexibility, be in agreement as parents before the talk. Keep in mind that the legal age for smoking in the U.S. is 18 or 19 depending on the state, and teens may soon be able to legally use e-cigarettes and combustible tobacco if they choose. Because of this, parent-to-teen talks need to focus more on education, safety and concerns as parents than simply saying “no.”

Bring literature to the discussion that details the harmful effects of nicotine use and go over your points with care and concern. If parents handle the talk well, teens may open up about e-cigarette use and perhaps other things they might be doing such as drinking or smoking pot. Moreover, a good talk should leave teens informed and feeling supported, putting them in a better position to quit.

If you learn that your teen is addicted to nicotine, you will need to come up with a game plan to help them quit. Again, you cannot make them quit without consent, but if they agree, you will absolutely want to help. Nicotine addiction is one of the most difficult addictions to over come.

Dr. Michael Oberschneider is a clinical psychologist and the founder of Ashburn Psychological Services.