How to Talk to Teens About Vaping Risks

Although you may want to ask your teenager about vaping, it can be tough to start a conversation. 

But if you’re lucky, your teen might start one for you. 

One afternoon last October, Tricia Dahl lingered in the kitchen as her two sons, then ages 14 and 15, and their friends filled their plates with pizza bites and chips. One of the friends turned to Dahl and said he’d heard a lot of classmates say that a popular vaping device didn’t contain nicotine in its refillable vape liquid. The vaping device the teen referred to was a Juul. 

His comment didn’t come out of the blue. The topic had been in the news; that fall, a national survey that monitors e-cigarette use among young people had reported an alarming leap in the number of middle- and high-school kids who said they vaped. And the Food and Drug Administration (FDA) had recently announced its plans to investigate Juul Labs, maker of Juul, on the grounds that some of its early, candy-hued social media ads seemed aimed at youth.

But the friend of Dahl’s sons had a good reason to be thinking about vaping in her presence. Earlier that month, he’d attended one of her talks about vaping health risks. Dahl works as a research assistant at Yale’s Tobacco Centers of Regulatory Science (TCORS) and has given presentations at more than 50 school and community groups across Connecticut. 

Careful to avoid “lecture mode,” Dahl recalls that she gently pointed out that the classmates were spreading myths. All pods sold by Juul contain nicotine. She kept the conversation going by asking the boys what they thought about vaping. Dahl says that getting teens to understand the contents, both known and unknown, in vaping liquid has been one of the most challenging parts of her job. 

In fact, the vaping liquid in Juul’s pods contains surprisingly high levels of nicotine. Though a 5% nicotine by weight pod contains less than an eyedropper-full of liquid, it delivers the same amount of nicotine as a person would get by smoking an entire pack of regular cigarettes. 

Since late this summer, one hopes that the constant flood of headlines describing vaping-related illnesses and deaths across the country would have alerted kids and adults that vaping with any device containing any liquid can be risky. But many may still miss that message.

As of now, health officials looking for patterns among young and older people hospitalized with lung injuries who said they recently vaped have not found a shared culprit. 

It’s important to note, too, that all the uncertainty around the illnesses that may be related to vaping is in addition to a body of established, factual information on the health risks teens face when they vape.

When it comes to vaping, “it’s not a matter of if your child will get asked, but when,” Dahl says. Students have told her about the intense peer pressure they’re under to try vaping. They get asked in the bathrooms at school, behind the stadium at Friday football games, on the bus on the way to a tennis match. Not to mention at parties. 

Even though Connecticut recently increased the minimum age to 21 for purchasing vaping devices and supplies and all tobacco products, including cigarettes, Dahl says she’s worried that teens will still find a way to purchase these products, just as they did before.  

What parents may not know, however, is that their teens crave a listening ear and a chance to talk freely about this peer pressure. “They need to feel like they are not being judged or questioned about their use, but just need advice on how best to handle these situations,” Dahl says.  

“Parents who have candid conversations with their kids can really make a difference,” says Suchitra Krishnan-Sarin, PhD, who directs TCORS. Parents who engage their children in conversation can actually help protect them against future substance use, she adds.   

With a little preparation, parents can be ready, no matter who starts the conversation. 

Before jumping into any conversation, it’s good to prepare yourself with a solid set of facts. Parents who give inaccurate information risk losing credibility, Krishnan-Sarin says. It’s not helpful to try to scare your teen with erroneous information, such as saying vaping causes cancer, which hasn’t been proven. Start, instead, with a focus on the addictive nature of nicotine. 

“The adolescent brain is very sensitive to nicotine,” Krishnan-Sarin says, adding the chemical is a known neurotoxin that produces changes in the adolescent body and brain.

Not only can nicotine cause physical changes in the brain, leading to difficulty concentrating, these changes can be permanent. Parents can look up resources through the Centers for Disease Control and Prevention (CDC) and the Office of the U.S. Surgeon General. 

The point isn’t to become an expert. You can explain that you’re learning about vaping just like they are, says Deepa Camenga, MD, a Yale Medicine pediatrician who researches youth substance use.

Parents and teens can both have anxiety around talking about peer pressure situations. Parents are worried for their child’s safety. Teens might be annoyed that their parents are invading their privacy, or afraid anything they share will land them in trouble. 

“It’s important to think about the when and the how of the conversation,” says Eli Lebowitz, PhD, director of the Program for Anxiety Disorders at Yale Child Study Center. “As parents, our tendency is to put out fires. When we do that—and limit our conversations to situations when they are in front of us in some alarming way—it means we will always be having those conversations under the most stress.” 

Lebowitz suggests waiting to have a conversation for a time when both parties are calm and relaxed. That way, the parent can also be more aware of basic but helpful aspects of communication, such as ensuring that they are using a calm tone of voice and body language. Sit with your teen rather than standing over them. Once you have some talking points and ideas, rehearse them with someone you trust who can give honest feedback on how you are actually coming across, Lebowitz says. 

A good entry point to a conversation is to use an example from everyday life, like a billboard, advertisement, or news report on TV. This takes the focus off your teen. 

It’s good for these conversations to occur more than once, over time, so don’t feel rushed to cram everything into one session, Lebowitz adds.  

Teens might feel like they are being interrogated and clam up if the questions start out too strong and parents let their worry dominate the conversation, Lebowitz says. Even if you feel alarmed, you’ll do better if you lead with curiosity. Start by asking neutral, open-ended questions, such as: 

• What kinds of things do you and your friends like to do when you get together?   
• In what kinds of situations have you seen people vaping? 
• Do you know anyone who vapes? 

Then, Lebowitz explains, you can move on to more directed, closed questions: 

• How many of your friends are vaping? 
• Have you vaped? 

This can start an open dialogue where the parents can share information and the kids can, too. If possible, parents can offer their own stories about vaping, especially if they currently do it. Parents can talk about the vaping they’ve seen. The conversation can also speak directly to peer pressure. All parents have situations they remember in which they were pressured to do something, like try a substance or cheat on a test. Sharing these stories can help make teens more comfortable and willing to open up about theirs, says Lebowitz. 

Parents may want to keep an eye out for vaping devices, which may be anything from pen-like sticks to Juuls that look like USB devices. Be aware that the designs are getting more disguised—some even look like a watch.  

If parents do find something, they can be supportive by asking how they can help, Dr. Camenga says.  

In her presentations, Dahl encourages kids to have a plan ready for how they will react when they are pressured to vape. Teens can try out different responses, perhaps saying they tried it before and didn’t like it. Or they can blame a parent for being overly strict about vaping. Talk through the response plan with your child. 

You could try role-playing a scenario, but only if your child shows interest, explains Lebowitz. “I suggest offering role-playing, but not insisting on it,” he says.

Peers can have lots of influence over activities. “Instead of hanging out with the kids that they vape with, perhaps there are other activities they could be participating in,” says Krishnan-Sarin. “Encourage your kids to participate in healthy activities like clubs or sports teams.”

However, it’s important to note that athletes aren’t immune to the pressures of vaping. Dahl says some teens compare vaping to drinking an energy drink before an event, and believe—incorrectly—that it will improve their performance. 

These tips might help keep the conversation open and easy, but if you and/or your teen prefer an alternative, feel free to ask the pediatrician to broach the topic. Teens do like their privacy and might feel comfortable talking to another adult, at least in the beginning. And if you hear that your child wants to quit but is having difficulty, the pediatrician can suggest helpful resources, too.

The key is to have these conversations sooner than later. The skill of not caving to peer pressure is one your child will continue to call upon throughout life, so now is a good time to start.