With e-cigarettes, we’re going in the wrong direction

“Don’t be a butthead.” “Smoke free is the way to bee.” The ugly truth. Even with decades of memorable warning campaigns and shocking data, people are still taking up the deadly habit, exposing themselves to the same — and even new — health risks.

A recent study reveals that e-cigarette use among adolescents is a substantial contributor to continued use of nicotine by those young people trying to kick the habit. In fact, failed attempts by teens to quit e-cigarettes in 2020 exceed failed attempts to quit cigarette use in each of the prior 13 years.

We are going in the wrong direction, but it’s not too late to turn it around.

More than 2 million middle school- and high school-aged US teens reported vaping in 2021. In Massachusetts, more than half of high school students have tried vaping, with more than 30 percent saying they had vaped within the last 30 days.

As a member of the oral health community, I suppose this doesn’t surprise me. I mostly remember the tobacco-free campaigns that featured a smoker with yellow teeth or a hole in the throat. Traditional cigarettes in the past few decades have become less popular with teens, perhaps because of those campaigns. But today, e-cigarettes have health risks just as deserving of public health campaigns and just as serious for young people, including risks of mood disorders and addiction, as well as serious impacts on oral health.

We know COVID-19 has intensified the problem. “Adolescents who experienced pandemic-related severe stress, depression, or anxiety, or whose families experienced material hardship during the pandemic, were most likely to use substances,” researchers wrote. 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 and have a false reputation for being safer than regular cigarettes. But nicotine isn’t the only cause of adverse health effects we need to worry about.

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

We can see it on their faces. E-cigarettes contain toxins including formaldehyde, cadmium, nickel, and lead that damage the skin and make it more prone to infections and acne, as well as worsen psoriasis and rosacea. 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 loss of teeth.

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

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 percent. We at Delta Dental helped bring this program to students at 200 Massachusetts schools (grades 5-12) and training for educators across the state for just this reason.

But it’s time to bring in reinforcements. 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. Or ask your dentist to start that discussion.

The health of a generation depends on it.