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The newest fad for youth is dangerous and addictive. While the prevalence of smoking tobacco by teens decreased significantly over the years, nicotine delivery has resurfaced in a new format. Whether referred to as vaping or juuling, the use of electronic cigarettes has implications for the pediatric nurse as well as for the health of youth.
Key Words: Vaping, juuling, smoking, hookah, e-cigarettes, electronic cigarettes, teens, adolescents.
Smoking and its associated nicotine addiction are back. Not the kind of smoking of the past made of rolled tobacco in a pack of 20, but rather, new electronic devices, some no bigger than a thumb drive. It is the new epidemic affecting adolescents. For decades, healthcare providers fought to decrease smoking among youth, and success was within our grasp, but the tobacco companies came roaring back.
According to the Youth Risk Behavior Survey, the percentage of adolescents experimenting with cigarettes, even one puff, has decreased significantly from 70% in 1991 to 58.4% in 2003 to 28.9% in 2017 (Centers for Disease Control and Prevention [CDC], 2018a); of this latest group of youth of 9th through 12th graders, 9.5% indicated they had tried smoking before they were 13 years of age and 8.8% currently smoked cigarettes. However, that same survey found that 42.2% had tried an electronic vapor product, and 13.2% were current users of electronic cigarettes (CDC, 2018a). These facts have significant implications for the pediatric nurse.
Tobacco
Cigarette smoke contains almost 7,000 chemicals, 69 of which cause cancer (American Lung Association [ALA], 2017). The primary ingredient in cigarettes is tobacco, a known carcinogen that contains nicotine and is sprayed in the growing process with numerous chemicals. Tar is another major component of smoking and occurs when the tobacco is burned or smoked. Tar is a sticky black liquid that sticks to cells in the lung tissue and allows the other carcinogens in the cigarette to stick to it and accumulate in that site. Its amount varies from 1 to 15 mg per cigarette, most of which is in the last third of the cigarette.
Nicotine, which is among the most addictive substances, increases the release of acetylcholine neurotransmitters that suppress the appetite, enhance pleasure, and assist in relaxation. Each cigarette contains 8 to 20 mg...