Addiction to nicotine is the most common addiction in the United States. It is estimated that 90% of those who smoked began by the age of 18. Regardless if it is electronic or in the form of cigarettes, the use of tobacco products is detrimental to the health of adolescents. Vaping is much more popular than smoking nowadays in teenagers, mainly because of its several flavors and relatively low costs. Educating teens about the risks associated with smoking and vaping helps avoid starting this habit in the first place.

Interview with:

Nydia Martinez, MD, FCCP

Associate Director of Advanced Lung Disease Program

Department of Pulmonary and Critical Care Medicine

Cleveland Clinic Florida

Q: It is well established that smoking has deleterious effects. Why do you think some teens are still starting this habit and what can be the effects in this age group?

A: There are multiple reasons that explain smoking in teens:

• Teenagers may be particularly susceptible to marketing campaings that specifically target their population: Tobbaco companies, Vaping and cannabinoid industries have use media, and film industry to portray smoking habits as cool, fun, attractive.

• They usually try smoking simply because they like to try new things, but they aren’t mature enough to think of the long-term consequences. 

• Nicotine and cannabinoids may relieve stress and teenagers underestimate the highly addicting potential of those substances.

• Once teenagers become smokers, they encourage their friends to try cigarettes. 

• They may see smoking as a way of going against the rules and showing independence

Q: Vaping has become popular among teens and many see it as a healthily alternative to smoking. What is your opinion regarding the effect of vaping in teens?

A: Vaping in teenagers is a major public health concern. It started as an alternative to help smokers quit but this was never proven. But the e-cigarette industry realized the lack of regulations directed to them, and the profits generated by their addictive potential, they have used unstoppable marketing strategies, starting with artificial flavors specifically made to attract young population. People in general believe that it is a "healthier alternative" but it isn't. We just don't have robust scientific data because they are newer, but we already are well aware of the toxicity. I personally have had very young patients in the ICU with respiratory failure secondary to vaping lung injury. Some ingredients found in e-cigarettes produce direct toxicity: i.e. propylene glycol, vegetable glycerin and acrolein.

A very serious problem that our nation's health is facing is underage drinking. The most commonly used substance among young Americans is alcohol, which poses serious consequences to not only the people that drink, but the rest of the population. Underage drinking is when people below the nationally established legal drinking age of 21 drink alcoholic beverages. Peer pressure, the desire for independence, and stress are some of the many factors that contribute to underage drinking. 

High-risk drug use is drug use by adolescents that can lead to injury, crime, school dropout, and death. Curiosity, peer pressure, emotional struggles, and stress are some of the reasons why teens start using drugs. Recognizing what drug use entails can prevent these problems from arising.

Marijuana

The legalization of recreational marijuana in some states has led to an increase in use, especially in teenagers. Easier access to marijuana products and the misconception that it is safe to use have also contributed to this. Nevertheless, there is evidence that marijuana leads to several complications, including hallucinations, delusions, schizophrenia, depression, suicidal behavior, heart failure, increased risk of bronchitis, and other lung damage. Marijuana can also affect brain development in individuals younger than 25.

Interview with:

Darby Sider, M.D., F.A.C.P, F.A.A.P

Vice-Chair of Internal Medicine

Program Director

Internal Medicine Residency

Graduate Medical Education 

Q: Is abuse of controlled prescription medications a problem in teenagers?

A: Yes, teens are finding prescriptions in their parents medicine cabinets and are taking them and then developing substance use disorder. Prescription drug abuse is the fasting growing drug problem in the US. According to National Survey on Drug Use and Health (NSDUH) data on youth and young adults, more than 5,700 youth in 2014 reported using prescription pain relievers without a doctor’s guidance for the first time. The majority of adults who meet the criteria for having a substance use disorder started using substances during their teen and young adult years. Youth with substance use disorders also experience higher rates of physical and mental illnesses, diminished overall health and well-being, and potential progression to addiction.

15% of high school students reported having ever used select illicit or injection drugs (i.e. cocaine, inhalants, heroin, methamphetamines, hallucinogens, or ecstasy

• 14% of students reported misusing prescription opioids.

• Injection drug use places youth at direct risk for HIV, and drug use broadly places youth at risk of overdose.2

• Youth opioid use is directly linked to sexual risk behaviors.

• Students who report ever using prescription drugs without a doctor’s prescription are more likely than other students to have been the victim of physical or sexual dating violence.

• Drug use is associated with sexual risk behavior, experience of violence, and mental health and suicide risks.

Q: What is your opinion regarding the use of marijuana in teenagers?

A: Fortunately, the rate of use of marijuana is declining in teens. Teens don’t believe that marijuana is harmful when in fact research shows the effect on the adolescent brain is much more harmful than on an adult brain.