Vaping has generated a wave of negative headlines, as more than 1,000 cases of lung injury have been reported — and the death of a 17-year-old boy last week in New York City raised the national vaping-related death toll to 23.
While it’s unclear which specific chemicals in e-cigarettes are causing these illnesses and deaths, it is clear that American children are at risk. About 16% of the patients with lung injuries have been under age 18. The U.S. Surgeon General has called teen vaping an epidemic, and the secretary of Health and Human Services warned that the government has never before seen such a rapid uptick in the use of a substance by kids.
It’s scary stuff for parents, who may have steeled themselves to talk to their children about drinking, drugs and peer pressure, but not necessarily about a product that didn’t exist when they were kids. Here are some basics.
1. Start young. Think age 9.
“The evidence shows that we really need to be talking about vaping ― and about substance use in general ― well before many parents realize they should,” said Margie Skeer, a professor of public health and community medicine at Tufts University School of Medicine.
“Research shows us that age 9 is the time when we want to start having these conversations in a developmentally appropriate way,” she added. Yes, with your third or fourth grader.
What does “developmentally appropriate” mean? It means you should break down your warning into simple concepts the child can grasp: Explain that nicotine is a chemical that goes into your body and tells your brain that you need it. It makes you lose your sense of control. Skeer suggests that imagery can help. Kids understand that a stoplight cycles from green to yellow to red, so explain that vaping messes with those signals, keeping your brain’s stoplight stuck on green. It’s telling your body go, go, go or more, more, more.
“We really need to be talking about vaping ― and about substance use in general ― well before many parents realize they should.”
It’s important to start having these conversations early because kids try substances at startlingly young ages. In a 2013 survey, about 5.4 million youth ages 12 to 20 reported binge drinking in the past month. If you wait to talk to your children when they’re in middle school, you might be too late.
Skeer emphasizes that it is also about setting expectations while you still have a fair amount of influence.
“When your children are younger, you’re the most important person in their lives,” she said. “By the time they’re teens, that begins to shift and their peers become more important. When you still have their attention, it’s important that you’re leading the conversations.”
2. Know some basic facts, and be honest when you don’t.
Because vaping is relatively new (e-cigarettes really only hit the market in the United States about a decade ago), many parents don’t have a lot of information. Given that they were originally sold as a way of kicking the tobacco habit, people who didn’t smoke may have paid the product little attention. Now, public perception is shifting. More people recognize the potential harms of vaping — but there is still a lot of confusion.
“Parents need to be credible when they talk to their kids about this,” Skeer said.
Before you start any conversation, make sure you know some basics: Yes, vaping is bad for your health. And yes, it is addictive. If your child asks you a question you don’t know the answer to, admit that and then spend some time together looking it up.
3. Open the lines of communication directly and indirectly.
Some parents might think that fear and punishment are their best tools when it comes to keeping kiddos away from e-cigarettes, but experts believe that’s not the case. “I think the most important thing is to have an open, ongoing conversation,” said Dr. Indra Cidambi, medical director of the Center for Network Therapy, an outpatient detoxification program in New Jersey.
Cidambi recommends taking direct steps such as making sure your family sits down for at least one meal together a day and using that time to talk about vaping. Ask your children what they know about it, whether they’ve seen kids doing it and what questions they have. Parents are often surprised, she said, by how curious their children are about substances and how open they can be to such conversations.
“Go out of your way to tell them stories about the mistakes you made when you were younger ... and explain that you still make mistakes every day.”
Foster a broader sense of openness as well by making it clear to your kids that they can always come and talk to you about tough things. Again, start young. Cidambi offers the example of a child who scratches the family iPad and waits to tell you because they’re worried about your reaction. Make it clear that what bothers you isn’t the accident; it’s the fact that they felt like they couldn’t come to you.
And hammer home that lesson every chance you get. Go out of your way to tell them stories about the mistakes you made when you were younger, Cidambi urges, and explain that you still make mistakes every day.
“If they feel they cannot confide in at least one parent,” Cidambi said, “you are at a loss.”
4. Help them practice their responses.
This might be a new one to parents raised in the era of “Just Say No” (which was a pretty resounding failure, for what it’s worth), but experts say it is important to work with kids on how they’ll respond when they inevitably come face-to-face with e-cigarettes or other substances.
Skeer likens it to helping your kids with algebra. You wouldn’t just talk broadly about algebra as a concept, and then think they’ll somehow develop the skills to actually do their homework. Similarly, talking to your kids about vaping isn’t enough. You have to teach them the skills they need to handle peer pressure in the moment. Heck, even sober adults can struggle with how to respond in social settings.
So help your children make a list of things they can say that feel comfortable and natural to them.
“It could be, ‘I have soccer tomorrow,’” Skeer said. “Or ‘My parents would kill me.’ Or even ‘No, thanks.’”
The point is to create a menu of responses they can choose from, so they don’t end up vaping just because they can’t think of a way not to.