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Understanding and Addressing Teen Tobacco Use: A Parent’s Guide 

Written by Evolve's Behavioral Health Content Team​:

Alyson Orcena, LMFT, Melissa Vallas, MD, Shikha Verma, MD, Ellen Bloch, LCSW, Lianne Tendler, LMFT, Megan Johnston, LMFT

Meet The Team >

Choosing to start using tobacco is one of those crucial decisions that can alter the course of your teen’s life. In this guide, we’ll unpack the complexities of teen tobacco use and how it can impact their health and their future. We’ll provide you, as parents, with the necessary tools and insights to navigate your teen’s tobacco use and support them in making healthy decisions. You’ll learn about the dangers of smoking, how to quit, recovery tips, and what to say to your child if you suspect they’re smoking. 

Understanding Tobacco Use in Teens

In recent years, teen tobacco use has become more than just the occasional experiment with a cigarette. Now, it encompasses a range of products, from the traditional cigarette to vaping and e-cigarettes. The latter have seen a meteoric rise in popularity, particularly among the younger demographic. While not technically “smoking,” vaping can have extremely harmful impacts on a teen’s growing respiratory system. Even more concerning, smoking and vaping often leads to experimentation with other drugs. 

Teen Smoking Facts: The Evolution of Tobacco

Tobacco consumption has undergone a metamorphosis, evolving from the straightforward act of smoking a cigarette to embracing a new era marked by e-cigarettes and vaping. The Puff Bar e-cigarette, with its colorful design and sweetly deceptive flavors, stands as a prime example of this evolution, captivating the teen demographic with a product that seems, at first glance, innocuous. Here are a few ways teen tobacco use has changed:

1. Decline in Traditional Cigarette Smoking:

There has been a noticeable decrease in traditional cigarette smoking among teens. Educational campaigns, stricter regulations, and increased awareness of the health risks associated with smoking have contributed to this decline.

2. Rise of Vaping and E-Cigarettes:

Conversely, there has been a dramatic rise in the use of e-cigarettes and vaping products. Brands like Juul have become particularly popular, with their discreet design and variety of flavors. The perception that vaping is less harmful than smoking cigarettes has fueled this trend, although recent studies and health warnings have begun to challenge this notion.

3. Flavored Tobacco Products:

Flavored tobacco, including menthol cigarettes and flavored e-liquids, has attracted teens. These flavors can mask the harshness of tobacco, making it more palatable for young users.

4. Social Media and Influencer Marketing:

The role of social media and influencer marketing has grown, with influencers sometimes promoting vaping and tobacco-related products, knowingly or unknowingly contributing to their appeal among teens.

5. Regulatory Changes:

There have been significant regulatory changes, including raising the legal age for purchasing tobacco products to 21 in many places and banning certain types of flavored tobacco products.

6. Pandemic Impact:

The COVID-19 pandemic has also played a role, with some teens quitting vaping due to concerns about respiratory health, while others may have increased their use due to stress and anxiety.

7. Innovation in Smoking Cessation Tools:

New tools and resources have emerged to help teens quit smoking and vaping, including apps, text-based programs, and online support groups.

8. Changes in Access:

With stricter regulations and enforcement, access to tobacco products, particularly for those under 21, has become more challenging.

Health Consequences of Teen Tobacco Use

The consequences of tobacco use are not a distant future concern; they are immediate and devastating. 

1. Respiratory Issues:

Tobacco smoke contains a cocktail of chemicals that can damage the respiratory system, leading to chronic cough, phlegm production, and a heightened susceptibility to respiratory infections. Teens who smoke may experience stunted lung growth, leaving them with permanently impaired lung function.

2. Addiction to Nicotine:

Nicotine is a highly addictive substance found in tobacco. Adolescents are particularly susceptible to its addictive properties. This addiction can pave the way for prolonged tobacco use into adulthood, exacerbating the risk of long-term health issues.

3. Cardiovascular Damage:

Tobacco use has an immediate impact on the cardiovascular system, increasing heart rate and blood pressure. Over time, this can contribute to the development of heart disease and increase the risk of stroke.

4. Impaired Brain Development:

The adolescent brain is still developing, and nicotine exposure can have detrimental effects on this process. This can result in issues with attention, learning, and impulse control, potentially leading to academic challenges.

5. Dental Problems:

Tobacco use can lead to yellowing of the teeth, bad breath, and an increased risk of gum disease. Over time, it can contribute to tooth loss and other severe dental issues.

6. Increased Risk of Other Substance Use:

Teens who use tobacco are more likely to experiment with and use other substances, including alcohol and illicit drugs.

7. Mental Health Issues:

There is a well-established link between tobacco use and mental health issues, including depression and anxiety. The stress-relief that some associate with smoking is temporary and deceptive, often leading to a vicious cycle of dependency and worsening mental health.

8. Long-Term Cancer Risk:

Tobacco use is a leading cause of various types of cancer, including lung, mouth, throat, pancreas, bladder, stomach, liver, colon, rectum, and cervix, as well as acute myeloid leukemia. Even if a teen quits smoking later in life, their risk of cancer remains higher than if they had never smoked.

9. Reduced Physical Fitness:

Smoking impacts lung function and reduces overall fitness levels, making it harder for teens to stay active and participate in sports.

10. Complications with Future Pregnancy:

Female teens who smoke risk complications in future pregnancies, including preterm birth, low birth weight, and stillbirth.

11. Social and Behavioral Issues:

Since it can be difficult to quit, smokers tend to stay smokers into adulthood. Smokers may face social isolation, as they’re often excluded from smoke-free social gatherings. They might also adopt risk-taking behaviors associated with tobacco use.

Common Types of Tobacco Products Among Teens

The landscape of teen tobacco use is littered with a variety of products, each with its own allure. Cigarettes, cigars, and smokeless tobacco are joined by the newer, and increasingly popular Puff Bar e-cigarettes and vape pens, creating a market saturated with options designed to entice the young and impressionable.

Vaping and E-Cigarettes vs. Smoking: Is it Safer?

While current evidence suggests that vaping might be less harmful than smoking traditional cigarettes, it is not without risks, especially for teenagers and young adults. The safest option is to avoid using any tobacco or nicotine products altogether. 

Short-Term Effects:

Fewer Harmful Chemicals: Vaping products typically contain fewer harmful chemicals than traditional cigarettes. Cigarette smoke has over 7,000 chemicals, including hundreds that are toxic and about 70 that can cause cancer. E-cigarettes have fewer toxic chemicals, but they still contain substances that can harm the body.

Reduced Exposure: For adult smokers, completely switching to vaping might reduce their exposure to harmful smoke constituents, potentially leading to improved health outcomes in the short term.

Long-Term Effects:

Incomplete Data: Vaping products have not been around long enough for us to understand their long-term effects on human health.

Concerns for Youth: The use of e-cigarettes by teenagers is a significant public health concern. Nicotine exposure during adolescence can harm brain development, which continues into the early to mid-20s.

Risks and Unknowns:

Addiction: Both cigarettes and vaping products contain nicotine, which is highly addictive. Teens who use e-cigarettes may be more likely to go on to smoke traditional cigarettes.

Harmful Substances: Vaping liquids can contain harmful substances, including heavy metals like lead, volatile organic compounds, and cancer-causing agents.

EVALI: There have been thousands of cases of e-cigarette, or vaping, product use-associated lung injury (EVALI), some of which have resulted in death. The exact cause of EVALI is not fully understood, but it has been linked to the use of vaping products containing THC, the psychoactive substance in marijuana.

Youth, Pregnant Women, and Non-Smokers:

Health Experts’ Stance: Major health organizations, including the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO), advise that e-cigarettes are not safe for youth, young adults, pregnant women, or adults who do not currently use tobacco products.

Use in Smoking Cessation: Some argue that e-cigarettes could serve as a tool for smoking cessation for adult smokers. However, their efficacy and safety for this purpose are still subjects of ongoing research and regulatory review.

Why They Smoke: Factors Driving Teen Tobacco Use

The allure of tobacco use for teens is multifaceted, with roots stretching into peer pressure, stress, and the desire for social acceptance. In adolescence, the pressure to fit in and seem mature can transform tobacco use from a mere curiosity into a perceived necessity. 

  1. Family Influence on Teen Tobacco Habits

A family’s relationship with tobacco can be a powerful influence, for better or for worse. Teens growing up in a household where tobacco use is normalized are more likely to pick up the habit themselves, adopting patterns that can last a lifetime.

  1. Media and Advertising Impact on Teens

In an age dominated by screens, media and advertising wield unprecedented power. Tobacco companies, well aware of this, craft campaigns that subtly, and sometimes not so subtly, target teens, associating tobacco use with rebellion, attractiveness, and maturity.

  1. Mental Health and Teen Tobacco Use

The turbulent emotional landscape of adolescence can leave teens vulnerable, seeking solace in outlets like tobacco use. Anxiety, depression, and stress are frequent companions of teen smokers, creating a vicious cycle where mental health issues drive tobacco use, and tobacco use exacerbates mental health issues.

  1. Economic and Socioeconomic Factors That Drive Teens to Smoke

The tapestry of teen tobacco use is woven with threads of economic and socioeconomic factors. Teens from lower-income backgrounds are disproportionately affected, often finding themselves in environments where tobacco use is prevalent and resources for cessation are scarce.

Parental Involvement in Preventing Teen Smoking

Your role as a parent in preventing teen tobacco use is paramount. Engage in open, honest conversations, arm yourself with facts, and foster an environment of support and understanding. Tips to quit smoking, more resources for parents, and knowledge on the signs of tobacco use can be your arsenal in this vital mission.

Signs My Teenager is Smoking 

Teen tobacco use often goes unnoticed until the habit has firmly taken root. Here are some indicators that may suggest your teen is engaging in tobacco use:

1. Unusual Odors:

If your teen is smoking, you might notice a persistent smell of smoke on their clothing, breath, or in their room. The scent of tobacco is distinctive and hard to mask completely.

2. Frequent Use of Mints or Gum:

Teens may try to cover up the smell of smoke with mints, gum, or mouthwash. If you notice a sudden increase in their use of these products, it could be a sign.

3. Changes in Physical Appearance:

Look for yellowing of the teeth, fingers, or nails, which can be caused by holding cigarettes and exposure to smoke.

4. Coughing and Throat Issues:

A persistent cough, throat irritation, or a change in their voice can be associated with smoking.

5. Decreased Athletic Performance:

Smoking affects lung function, so if your teen is suddenly struggling with physical activities they used to enjoy or excel at, it could be a cause for concern.

6. Shortness of Breath and Wheezing:

Difficulty breathing or a wheezing sound when breathing could be signs of smoking.

7. Increased Thirst or Appetite:

Nicotine can affect metabolism, leading to changes in eating and drinking habits.

8. Irritability or Mood Swings:

Nicotine withdrawal can cause mood swings, irritability, and anxiety. Pay attention to any sudden changes in your teen’s mood, especially if they seem to be tied to breaks between smoking sessions.

9. Discreet Behavior and Desire for Privacy:

If your teen is suddenly very concerned about privacy, or you notice them making frequent, discreet excursions outside, they may be taking these opportunities to smoke.

10. Finding Smoking Paraphernalia:

This might include lighters, matches, cigarette butts, or even the cigarettes themselves hidden in their room or belongings.

11. Friends Who Smoke:

Peer influence is strong during the teen years. If your teen has friends who smoke, there is a possibility that they could be smoking too.

12. Changes in Social Circles:

A sudden change in their group of friends, especially if the new group is known to engage in smoking or other risky behaviors, can be a red flag.

13. Decreased Interest in Appearance:

Some teens may lose interest in maintaining their appearance and personal hygiene when they start smoking.

14. Financial Inconsistencies:

Smoking is an expensive habit. If you notice money missing or unaccounted for, or if your teen seems to be perpetually short on cash, it could be going towards buying cigarettes.

15. Defensiveness When Asked About Smoking:

If your teen becomes unusually defensive or evasive when you bring up the subject of smoking, it could be an indicator that they are trying to hide something.

16. Changes in Academic Performance

Academic performance can take a nosedive, as the cognitive impairments associated with tobacco use manifest in lower grades, decreased attention span, and a diminished capacity for learning.

Being vigilant and observant can help you catch these signs early, providing a valuable opportunity to talk to your teen about the risks of smoking and offer support to quit if necessary. 

What Should I Do If My Teen is Smoking?

Finding out that your teenager is smoking can be scary for any parent. It’s important to address the issue calmly and constructively. Here’s a step-by-step guide to help you navigate this situation:

Step 1: Stay Calm

Avoid Immediate Confrontation: If you just found out and your emotions are high, give yourself some time to cool down before discussing the issue with your teen.

Gather Your Thoughts: Think about what you want to say and what your goals are for the conversation.

Step 2: Do Your Research

Understand the Risks: Make sure you are fully aware of the health risks associated with smoking, so you can effectively communicate these to your teenager.

Know the Facts: Teens often think they’re invincible, so it’s important to have factual information to discuss the realities of smoking.

Step 3: Find the Right Time to Talk

Choose a Calm Setting: Find a quiet, private time to talk without interruptions.

Be Non-Confrontational: Approach the topic in a calm, non-accusatory manner.

Step 4: Express Your Concerns

Share Your Feelings: Let your teen know that you are worried about their health and well-being.

Use “I” Statements: Frame your concerns in a way that expresses your feelings, rather than placing blame. For example, say “I am worried about your health,” instead of “You shouldn’t be smoking.”

Step 5: Listen to Their Side

Be Open to Their Perspective: Allow them to share their thoughts and feelings about smoking. Try to understand why they started and what they get out of it.

Avoid Interrupting: Let them speak without interruption, showing that you respect their point of view.

Step 6: Share Information

Provide Facts: Share the health risks and other negative aspects of smoking in a clear and straightforward manner.

Discuss Peer Pressure: Talk about the influence of peers and provide strategies for resisting peer pressure.

Step 7: Set Expectations and Consequences

Be Clear About Rules: Make sure your teen understands your expectations regarding smoking.

Explain the Consequences: Clearly lay out any potential consequences for breaking the rules.

Step 8: Offer Support

Help Them Quit: If they are willing, help them find resources to quit smoking.

Encourage Healthy Habits: Promote activities and hobbies that contribute to their well-being.

Step 9: Follow Up

Keep the Conversation Going: Check in regularly to discuss their progress and any challenges they’re facing.

Be Encouraging: Reinforce positive behavior and provide encouragement and support.

Step 10: Seek Professional Help if Necessary

Consider Counseling: If the smoking habit is persistent, it might be helpful to seek the assistance of a healthcare professional or counselor.

Step 11: Be a Role Model

Lead by Example: Ensure that you are setting a positive example through your own actions and habits.

Step 12: Build and Maintain Trust

Encourage Open Communication: Make sure your teen knows they can come to you with their problems without fear of punishment.

Show Unconditional Love: Ensure they know that your love and support are not contingent on their behavior.

Remember, patience and understanding are key when dealing with a teenager. It’s important to build trust and maintain open lines of communication throughout this process.

Seeking Professional Help for Teen Tobacco Use

Recognizing when the situation has escalated beyond your capacity for intervention is crucial. At Evolve, our treatment for teens offers a lifeline, providing expert care and support to guide your teen back to a tobacco-free life.

Get the Support You and Your Teen Need

If you’ve recently discovered your teen’s tobacco use, know that you are not alone. There are resources, support groups, and professionals dedicated to helping parents and teens alike. Take the step, reach out, and discover the benefits of sending your teen to residential treatment, and give them the gift of a smoke-free future.

Frequently Asked Questions About Tobacco Use in Teens

How prevalent is tobacco use in teens?

Teen tobacco use remains a significant concern, with vaping and flavored e-cigarettes contributing to a resurgence in popularity.

How does nicotine addiction develop in adolescents?

Nicotine addiction can take hold quickly in adolescents, with their developing brains being more susceptible to its addictive properties.

What are school-based tobacco prevention programs?

These programs aim to educate students about the risks associated with tobacco use, providing them with the tools to resist peer pressure and make healthy choices.

How can communities help curb teen tobacco use?

Communities play a critical role, fostering environments that discourage tobacco use and providing support and resources for cessation. Educational programs ins schools can also help.

What is the impact of parental involvement in preventing teen smoking?

Parental involvement is key, as engaged and informed parents can guide their teens away from tobacco, setting clear expectations and providing support.

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