We must do more to help California kids resist allure of vaping

OPINION – “Don’t be a butthead.” “Smoke free is the way to bee.” The “ugly truth.” It may have taken 30 years of campaigning, but high school students overwhelmingly believe their peers view cigarette smoking negatively, according to the most recent California Student Tobacco Survey (CSTS). While smoking traditional cigarettes has declined, vapes – a type of electronic cigarette with chemical cartridges – are the number one tobacco-related product used by adolescents.

The Center for Disease Control and Prevention pegs the number of middle and high school students using e-cigarettes at around 2.5 million nationwide. In California, 9.7% of high school students say they currently smoke or use tobacco-related products, with 8.2% specifying vape use. Among those who vape, 96.2% use flavored products.

The 2019-2020 CSTS report authors note this may be the first generation of California youth to be traditionally smoke-free when they reach adulthood, something that seemed impossible to tobacco control advocates just 10 years ago. However, the same cannot be said for vaping or other products.

We know vaping hastens death. Research shows vaping increases inflammation throughout the body, raising the risk for life-threatening health issues such as cardiovascular disease.  Vaping also severely impacts oral health, which is directly related to increased risk for long-term threats of dental decay and cancer and compounds many other health issues.

Importantly, Californians voted “yes” on Proposition 31, banning flavored tobacco statewide, which will undoubtedly impact the more than 70% of high schoolers who are attracted to vaping flavors. But the CSTS report also shows nearly 40% of all high school students who had never used a tobacco product are susceptible to using at least one product in the future. And there is always a new, flashy product.

Vapes replaced traditional cigarettes. Now, heated tobacco products, also known as HTPs and heat-not-burn products, are gaining steam among Americans. Like vape pens and other e-cigarettes, HTPs come in flavors and are marketed as lower risk than traditional cigarettes even though serious health risks remain.

For example, the majority of teenagers report that candy flavors were the reason they first tried an e-cigarette. Perhaps ironic, flavored vapes, such as “tutti frutti” and “cotton candy,” increase risk for cavities and other oral disease just like actual candies. Flavor additives double the growth of bacteria in the mouth that cause tooth decay, while also decreasing the hardness of tooth enamel by 27%, limiting natural protection against that bacteria.

Research shows vaping increases inflammation throughout the body, raising the risk for life-threatening health issues such as cardiovascular disease.

That’s why DentaQuest has worked with America’s Toothfairy to develop and share resources that help parents and teens talk — not argue — about vaping. As an organization focused on prevention, DentaQuest is passionate about educating young people and parents about the risks to everyone’s health.

We know COVID-19 has intensified the problem. Though national data indicates teen substance abuse remained the same or declined overall amid the pandemic, the number of kids using nicotine products jumped. Life changes from COVID-19 may have reinforced vaping as the predominant method of nicotine consumption among young people because vape pens are easier to conceal at home than alcohol or traditional cigarettes.

We can see the impact it on their faces. E-cigarettes contain toxins including formaldehyde, cadmium, nickel and lead that damage the skin. Chemicals in e-cigarettes, like propylene glycol, vegetable glycerin and acetaldehyde, can harm both hard and soft tissue in the mouth, while nicotine reduces blood flow in the mouth, resulting in gum disease and even permanent tooth loss. And HTPs produce nicotine-containing aerosol by heating tobacco, meaning they emit many of the same toxic chemicals present in tobacco smoke. HTP emissions also contain tobacco-specific nitrosamines and aldehydes, which are known to cause cancer, as well as carbon monoxide and acrolein, which are toxic.

Poor oral and overall health in adolescence frequently leads to even worse oral and overall health during adulthood.

We can help by talking about it. Educating youth and empowering them with refusal skills to resist marketing and peer pressure ensures fewer young people are harmed by e-cigarettes. It’s why we must support the national, evidence-based CATCH My Breath school program, which reduces students’ likelihood to experiment with vaping by 45%.

And open conversation with adults outside of school is key to helping teens make healthier decisions for their future. Take the time to educate yourself and then talk about vaping with the teens in your life.

The health of a generation depends on it.

Santosh Sundaresan, BDS, DDS is senior dental director at an LA County federally qualified health center and serves as the current dental director for DentaQuest in California.