Youth Vaping: What health care providers need to know about a rapidly evolving trend

Webinar presented by Dr. Nicholas Chadi for the Canadian Paediatric Society, April 15, 2021

Learning objectives:

-Discuss the short- and long-term health effects of e- cigarettes and vaping among youth

-Apply a youth-centered approach for screening and treatment of vaping and e-cigarette use

-Describe the importance of reporting illness (and how to do so)

Slides are available at: http://www.cps.ca/en/vaping

Severe vaping-related illnesses and injuries: Why reporting matters

By Nicholas Chadi, Canadian Paediatric Society, April 14, 2021

Initially presented by the industry as a smoking cessation tool for adults, e-cigarettes (or vapes) have become increasingly popular among adolescents, the majority of whom did not previously smoke cigarettes. In 2019, according to Health Canada data, 36% of adolescents aged 15 to 19 reported having tried vaping at some point, with 15% having vaped in the previous 30 days. More recent data from 2020 suggests that these rates have remained largely unchanged since the onset of the COVID-19 pandemic.

The rapid increase in rates of youth vaping is likely due to a combination of factors. Youth-friendly flavours and vaping products, youth-directed advertisements, including social media content from high visibility influencers, low cost, the possibility to vape discretely, easy access through social and online sources, high nicotine content, and low perceived risk are some of the main factors. (Read more)

Let’s talk about vaping/Parlons de vapotage

By Nicholas Chadi, Canadian Paediatric Society, April 14, 2021

It’s 5:30 p.m. I’m an hour behind schedule in clinic. Noah (not his real name), a 16-year-old transgender boy with gender dysphoria, chronic suicidal ideation, and a severe nicotine use disorder is my last patient of the day. “Noah, I’m so sorry I’m late. Is there something you’d like us to talk about today?”

During his last few appointments, Noah talked to me at length about his vape tricks and about how he could vape all day without his teachers (or parents) suspecting anything. He also told me how the high nicotine concentration fruit-flavored vaping pods were “the best thing in the world,” giving him a “head rush, that is also calming at the same time.”

According to the latest national statistics, approximately half of high school seniors have tried a vaping product and nearly one-third report using in the past month. There has never been such a fast-growing trend in the history of adolescent substance use surveys. (Read more)

Article complet disponible en français sur le site de la Société canadienne de pédiatrie (Article complet)

Vaping should not be used to help youth quit smoking, Canadian Paediatric Society warns

By Ben Cousins, CTV News, with comments from Dr. Nicholas Chadi, April 14, 2021

Doctors should not suggest vaping to help youth and adolescents quit smoking, according to new guidance from Canadian pediatricians.

The Canadian Paediatric Society (CPS) recommended on Wednesday that vaping “should not be used as a smoking cessation or harm reduction strategy” in youth, saying that doctors should instead “assess their patient’s motivation to reduce or quit vaping” and come up with a plan to do so.

“Health care providers should address vaping with every adolescent they see, starting at 12 years old,” Dr. Nicholas Chadi, the lead author of the CPS statement and an adolescent medicine and addictions specialist at CHU Sainte-Justine in Montreal, said in a news release. “The earlier a youth begins using nicotine or cannabis, the greater their risk for developing a substance use disorder in the future.” Read more

More resources on vaping (English and French) including a tool for clinicians on the Canadian Paediatric Society webpage

La cigarette durant la grossesse, c’est peut-être la cigarette du futur adolescent (Smoking during pregancy could be the future adolescent’s cigarette)

Par Mathieu-Robert Sauvé, UdeM Nouvelles, le 29 mars 2021

Les femmes enceintes qui fument risquent plus que les non-fumeuses de transmettre une dépendance au tabac à leurs enfants quand ceux-ci parviendront à l’adolescence. Voilà la conclusion d’une étude menée au Québec auprès de 1661 mères et enfants qu’on a observés sur plus de 20 ans.

«Notre étude démontre que le fait de fumer peut avoir un effet transgénérationnel. Devenu adolescent, l’enfant porté par une mère fumeuse a tendance à fumer la cigarette davantage que celui d’une mère qui n’a pas consommé de produits du tabac», explique le DNicholas Chadi, premier auteur de l’étude qui paraît ces jours-ci dans Preventive Medicine. (Article complet)

Le vapotage ne progresse pas, mais ne recule pas non plus (Vaping isn’t increasing, but it’s not decreasing either)

Par Jean-Benoit Legault, La Presse Canadienne, publié dans Le Droit, L’Actualité, Le Soleil et Le Nouvelliste, avec commentaires du Dr. Nicholas Chadi, 22 mars 2021

La première Enquête canadienne sur le tabac et la nicotine avait été réalisée en 2019. La nouvelle étude a été menée en décembre 2020 et en janvier 2021, ce qui donne un aperçu de l’impact de la pandémie sur la situation.

On constate par exemple que 14 % des participants âgés de 15 à 19 ans ont rapporté avoir vapoté au cours des 30 derniers jours, comparativement à 15 % lors de l’étude précédente; ces taux sont respectivement de 13 % et de 15 % chez les 20-24 ans.

«Pour moi, voir des taux qui se stabilisent, oui c’est une bonne nouvelle, mais c’est une mauvaise nouvelle dans le sens qu’on n’a vraiment pas réussi à s’attaquer à ce problème-là», a commenté le docteur Nicholad Chadi, qui est pédiatre et clinicien-chercheur spécialisé en médecine de l’adolescence et toxicomanie au CHU Sainte-Justine. (Article complet)

Les adolescents consomment moins d’alcool et de cannabis, le vapotage augmente (Teens are using less alcohol and cannabis, vaping increases)

Par Pierre Saint-Arnaud, La Presse Canadienne, publié dans La Presse et sur Radio Canada le 11 mars 2021, avec commentaires du Dr Nicholas Chadi

Les jeunes du secondaire sont de moins en moins nombreux à fumer, à consommer de l’alcool ou du cannabis, mais le vapotage connaît une poussée vertigineuse dans ce groupe d’âge et la part de ceux qui consomment de l’alcool à l’excès augmente.

Ce sont là les grandes tendances du rapport 2019 de l’« Enquête québécoise sur le tabac, l’alcool, la drogue et le jeu chez les élèves du secondaire » (ETADJES), rendu public jeudi par l’Institut de la statistique du Québec. Le rapport fait état de la progression des données entre 2013 et 2019.

Selon le docteur Nicholas Chadi, chercheur en toxicomanie pédiatrique au CHU Sainte-Justine, il n’y a là aucune surprise.

« On est dans une très longue trajectoire de diminution des comportements nocifs en toxicomanie chez les adolescents. Ces résultats ne me surprennent pas, si on regarde les tendances aux États-Unis, au Canada depuis 20 à 30 ans. Les conclusions générales du rapport pour moi sont de bonnes nouvelles ». Article complet

Vaping nicotine, smoking cannabis can affect teens’ sex life, school marks: study

By Jean-Benoit Legault, the Canadian Press, published in The Montreal Gazette, L’Actualité and La Presse, February 17, 2021, with comments from Nicholas Chadi

Teenagers who smoke cannabis and/or electronic cigarettes containing nicotine seem more likely to have poor school marks and engage in risky sexual behaviour, a new study suggests.

“We have seen that young people who vape electronic cigarettes, use cannabis or do both are more likely to have poor school grades, report difficulties with concentration and doing their work because of physical, emotional and psychological problems,” said study co-author Dr. Nicholas Chadi, a pediatrician and clinical researcher specializing in adolescent medicine and addiction at Ste-Justine Hospital. (Read more)

Binge-vaping, a dangerous new COVID-19 coping strategy among some teenagers in Montreal

By Cindy Sherwin, CTV News, with comments from Dr. Nicholas Chadi, January 23, 2021

A pediatric addictions expert in Montreal is sounding the alarm about an increase in the number of teenagers referred to his clinic, who are vaping in a more harmful way during lockdown than in pre-pandemic times. He describes it as binge-vaping.

The behavioral changes have resulted in serious nicotine addictions and worsening mental health problems for some teenagers and even pre-teens, according to Dr. Nicholas Chadi, who oversees addiction services at Ste-Justine Hospital.

The adolescent specialist is treating children “who are using a lot of these vape products and cannabis and alcohol, and in a way that is definitely more intense than before the pandemic,” he says. (Read more)

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