Youth substance-use webinar says parents need to talk to kids early about vaping; addresses roles of music, social determinants

By Melissa Patrick
Kentucky Health News

The final webinar about reducing disease and unhealthy behaviors in Kentucky's children focuses on vaping and substance use and offers policies and practical guidance for how to address these issues.  

The webinar, "Stopping Vaping and Substance Use," is part of a monthly series that has served as the Foundation for a Healthy Kentucky's annual policy forum, due to the pandemic. The foundation partnered with Kentucky Youth Advocates on the series, which is available online. 

Abby Hefner

Abby Hefner, a junior at McCracken County High School and a youth advocate for stronger tobacco policies in the state, said her advocacy group is urging the legislature to repeal the 1996 law that bans city and county governments from regulating how tobacco products are displayed, sold and distributed. 

"If this happens, we will be able to advocate to our local mayor and elected officials for change in our area," she said. "It will be a game changer for youth." 

Hefner, who has shared her personal vaping story with state and national legislators while advocating for stricter laws on the sale of flavored tobacco products, was named the 2020 Campaign for Tobacco Free Kids Individual Youth Advocate of the Year. She is also actively involved in a peer-to-peer vaping education program in her school district, which she initiated. 

Two bills have already been filed to let cities and counties regulate marketing and sale of tobacco products. Sen. Julie Raque Adams, R-Louisville, filed Senate Bill 81 and Rep. Kim Moser, R-Taylor Mill, filed House Bill 147. The bills say "A city or county government may impose restrictions or requirements on the use, display, sale, and distribution of tobacco products or vapor products that are stricter than those imposed under state law."

Adams said at a news conference, "Our bills do not mandate that local communities pass tobacco control laws. Rather, the bills give communities the tools that they can use, if they so choose. Also, this measure does not take away any power from the state legislature in any way. If there comes a time that another proven statewide measure to improve health by reducing tobacco use is warranted and supported by my colleagues, the state would still have the right to do that."

Hefner said she started using electronic cigarettes after a friend told her that they just produced flavored water vapor, and soon became addicted. She said she tried quitting several times, but was not successful until her supply was cut off during the summer break. 

"It is still hard at times when I am around friends who still use puff bars and other vaping products," she said. 

According to the American Lung Association, 8,000 teens start vaping everyday. In Kentucky, 26.1% of high school students and 17.3% of middle-school students currently e-cigarettes, the most recent poll found. 

"With those figures in mind, one reason tobacco companies are wanting new customers is that 8,900 people die in Kentucky each year due to smoking," Hefner said. "While their lifelong customers are dying off, tobacco companies have to recruit new ones so they market to young people with slick, alluring ads showing people having fun and living life to the fullest. They don't show the ugly side of addiction with people on their deathbed suffering from lung cancer and COPD." 

Hefner also spoke to the dangers of vaping and the coronavirus.

She cited Dr. Albert Rizzo, chief medical officer of the American Lung Association, who has said "long term smokers and e-cigarette users may have a higher risk of developing chronic lung conditions associated with severe cases" of the virus. Dr. Humberto Choi, a pulmonologist and smoking cessation specialist at the Cleveland Clinic, adds that because cigarette smoking and vaping compromises the respiratory system, "People who smoke or vape are more susceptible to lung infections." 

"The Vape Talk": Tami Cappilletti of the American Lung Association gave an overview during the webinar of how to talk to youth about tobacco use and vaping, and offered a wealth of resources. 

Tami Cappiletti

Cappilletti spoke about the importance of having early conversations about the dangers of vaping, noting that teen use of e-cigarettes has increased 135% in the last two years and that those who use e-cigarettes are four times more likely to try a traditional cigarette and are three times more likely to become frequent smokers. 

"And even though a growing number of youth are vaping, most parents don't think their kids are using," she said. "And because many parents assume that their kids aren't affected, they're not proactive in their conversations with their children about the dangers and then preventing them from starting at all." 

She said the association's new vaping awareness campaign, "Get Your Head Out of the Clouds," is geared toward parents of 10- to 14-year-olds to give them facts about vaping and to help them jump-start conversations with their children while they are still willing to listen. Information about this program can be found at talkaboutvaping.org , www.lung.org or by searching for "The Vape Talk." 

"Be ready to hear that they have vaped," Cappilletti said. "Be ready to hear that they've at least tried it, so that you don't react."  Further, she said, "Blame Big Tobacco and not your kids." 

The campaign's fact sheet reminds parents that vaping companies are largely owned by cigarette makers, and that as cigarette sales decline, so do their profits. "Tobacco companies have repackaged the same product and are targeting our kids," it says. "We have seen this playbook before, and our kids’ health is in the balance."

Cappilletti said the association offers a "Vape-Free Schools Initiative" that includes an alternative to suspension for youth who are caught with tobacco, with four 50-minute sessions facilitated by trained adults to educate students about nicotine dependence and cravings; a youth cessation program called Not On Tobacco; and a vape-free-school policy assessment.  

The association's website also offers several other tobacco education resources and tobacco cessation resources for teens.

Kids, drugs, music and the pandemic: Devine Carama, a Lexington community activist and hip-hop artist, said he saw a "really bad" increase in illicit drug use among youth he serves at the very beginning of the pandemic. He attributed much of that to the closure of schools and support programs that would have otherwise been available to students. Like the state trend, he said he also saw a decrease in illicit drug use near the end of the year. 

Carama spoke about several challenges that young people face when it comes to substance use. 

When it comes to social media and music, he said oftentimes hip-hop music streamed on social-media sites that are frequented by young people "almost glorifies substance use."

He said much of this music comes from oppressed sectors of the population, so a lot of the content "is not going to be pretty." Further, he said it is so readily available, it has great influence on our young people.

Devine Carama

"I'm of the belief that if you want to change the content in the music, you have to heal the wounds in the communities in which the music is coming from," he said. 

Carama said he works to flip the negative messaging that is often found in hip-hop music and to instead produce music that brings positive messages.  

He said the drive to legalize marijuana, even for medicinal use only, is confusing to youth and is often perceived as a "glorification of marijuana" that can embolden their use of it. He added that without proper education and context around this issue, a young person who is already experimenting with drugs may see any talk of legalizing marijuana as a "wave of encouragement" to take illegal drugs. 

"We've got to be careful in our behavior," he said. "And we've got to be more accountable to the language that we use when we're talking about that fight around young people, because I think it's confusing them because they don't have the proper context."

Most importantly, Carama said youth trauma, depression and mental health have to be addressed if we want youth to stop taking drugs, drinking, vaping or engaging in risky behavior. 

"Many of the youth that I serve live in conditions such as poverty, broken homes, experienced extreme violence, abuse, untreated health, mental health issues, family members are incarcerated, and then you add on top of that the marginalization, systematic oppression coupled with a global pandemic, and social unrest," he said. "This deep seated and often untreated trauma pushes many young people towards anything that can give them a temporary reprieve, or even expedition to some type of value." 

One of the programs Carama works with is the Lexington FEND Movement, which stands for Full Energy, No Drugs. FEND is a phone app that incentivizes young people to learn about the negative impacts of opioid use and encourages them to promote that knowledge among their peer groups.  

Pandemic's effect: Van Ingram, executive director of the Kentucky Office of Drug Control Policy, said on the webinar that the state has not seen much change in overdose-death numbers in youth since the pandemic began, and that the largest age group for overdoses continues to be 35-54. 

"During this pandemic, the epidemic that we were in, of substance use disorder, only worsened," he said. "2020 will be by far our worse year for fatal drug overdoses. . . . It's just been a horrible year for overdoses in general and in overdose deaths as well." 

However, he said emergency services' calls for opioid abuse have been trending down, and reached pre-pandemic levels in December, "so that's a good sign and one we are taking some hope from." 

Ingram noted two evidence-based programs that are offered in many of Kentucky's schools, including "Too Good for Drugs," which he said was now offered in 240 Kentucky schools serving over 42,000 students, and "Sources of Strength," which he said is offered in over 100 Kentucky schools. 

He said these programs have been offered virtually throughout the pandemic. He added that each of the state's regional prevention centers have prevention programs aimed at youth. 

Click here to view all five webinars in the "Moving Kids Towards Natural Highs: Kentucky Opportunities to Prevent Youth Substance Use, Suicide and Risky Behavior" series, which served as this year's Howard L. Bost Memorial Health Policy Forum.