Rise Above: Clearing the Air on Vaping among Teenagers

In this episode, I talk with Page Feller, the Clinical Operations Supervisor overseeing Mental Health and Addiction Recovery at Rogers Behavioral Health. We look at the physical and mental risks of teen vaping. These include addiction, breathing problems, long-term mental health issues, and more. This episode also offers useful tips for parents, teachers, and teens. It helps them spot signs of vaping, understand its risks, and avoid addiction dangers. Click this link to learn more about vaping, substances, and the impact on teens' mental health.

What is Rise Above: a Podcast From Rogers Behavioral Health?

Rise Above: a podcast from Rogers Behavioral Health takes listeners on a journey of education and inspiration as we sit down with mental health and addiction experts and past patients who are changing how the world views mental health and addiction.

Andy: 00:01

You're listening to Rise Above, a Rogers behavioral health podcast where we sit down with Rogers experts who are changing the way the world views mental health and addiction. Hello, and welcome to another episode of Rise Above. Today, an interesting topic. It's a topic that we definitely wouldn't be talking about twenty years ago. It affects many adults, but it also affects a lot of teens, and that is vaping.

Andy: 00:37

Not only do we see vaping affecting people's physical health, but it also has been affecting people's mental health. And with that, I have with me today Paige Feller, clinical operations supervisor for the mental health and addiction recovery service line at Rogers Behavioral Health. Paige, thank you so much for joining me today.

Paige Feller: 00:55

Thank you so much for having me.

Andy: 00:57

Now for me, when I think of vaping, I really I think of cigarette smoking. I know, back when I was in high school, teenagers smoked cigarettes a lot, but now that's kinda not the case. Right? It's vaping. Yes?

Paige Feller: 01:10

Yep. That's correct. It's kind of the new traditional cigarette.

Andy: 01:14

Sure. And what are similarities to cigarettes? What are differences when it comes to vaping?

Paige Feller: 01:20

Nicotine is the same addictive substance that's in both traditional cigarettes and vaping. So the same health risks that we all know related to nicotine still apply. The biggest differences though that we see between vaping and traditional cigarettes is a change in the concentration of nicotine, the amount used, and the frequency. So typically, the e liquids have a much higher concentration of nicotine compared to cigarettes. People often report using more frequently and using larger amounts.

Andy: 01:53

And I I would say the smell. Right? There's not a smell to vaping?

Paige Feller: 01:58

The smell is different, so they do not smell like traditional cigarettes do. Oftentimes, the smell is very minor and can reflect the flavorings that are added, so they can be fruity, for example, if that's the flavoring of the e liquid.

Andy: 02:11

Sure. Now okay. Now here's a question I think of because I remember well, maybe it wasn't exactly when vaping started, but being under the impression that it wasn't as bad for you. Is that true at all?

Paige Feller: 02:25

So when we talk about traditional cigarettes, again, we think of the thousands and thousands of chemicals, not all of which are present in e cigarettes compared to traditional cigarettes. However, they do contain other harmful chemicals. In addition to the nicotine, the e liquids contain flavorings, which have many potential harmful chemicals.

Andy: 02:46

Uh-huh.

Paige Feller: 02:46

Our our bodies respond differently to those chemicals when we inhale them versus when we ingest them. The Food and Drug Administration does not regulate vape juice or e liquids, so they do require that the manufacturers list out specific ingredients that are in the e liquid, but not the ingredients that are produced when the vapor is heated. So, for example, formaldehyde is a byproduct that results from the e liquids being heated.

Andy: 03:14

I just made a face. I'm like, formaldehyde? Wait. What?

Paige Feller: 03:17

Yeah. Absolutely. And so that's not listed because it's not an initial ingredient, but it is a very dangerous byproduct. There are several other chemicals and toxic metals that are found in the heated vapor, and many of these occur in much higher concentrations than in traditional cigarettes.

Andy: 03:35

So now you mentioned the flavors. I feel like that's gotta be one of the reasons why teens have kind of gravitated towards that versus cigarette smoke. Yes?

Paige Feller: 03:46

It is a big part of the appeal. The marketing tactics are specifically targeted towards adolescents with the flavors. If you look up the flavors, you could find your morning coffee flavor or a cinnamon roll or your favorite smoothie. A lot of that is absolutely targeted towards adolescence, and most adolescents these days think the smell of traditional cigarettes, for example, is disgusting. Sure.

Paige Feller: 04:11

But there's the appeal to both, you know, the flavor, the taste, and the smell of vaping.

Andy: 04:17

You mentioned nicotine. You've mentioned formaldehyde, gross, and addiction. But I guess more specifically, the health risks involved, what are those?

Paige Feller: 04:26

Absolutely. So in addition to the increased risks of nicotine toxicity and the nicotine related concerns that we're aware of, Vaping in particular can cause respiratory problems, heart problems, neurological issues. Specific risks include vaping associated lung injury, which covers a variety of lung in lung injuries that are seen when people are taken in with concerns after vaping, lung scarring or what's known as popcorn lung, poor cardiovascular functioning, increased risk of heart disease, seizures, neurological and cognitive impairment, and behavioral changes, particularly among teenagers who are still going through normal development. Currently, I think one of the scariest pieces is that there isn't research, and vaping hasn't been around long enough to study and understand the long term effects. So what we may find out in five years will be significantly different than what we know now.

Paige Feller: 05:26

And there's mixed and contradictory research available suggesting potential benefits and risks. So it's important to be cognizant of who is funding the studies because sometimes the funders have an agenda in presenting potential risks and benefits.

Andy: 05:42

So we're talking about risks for adolescents. Is there a difference in the risks for adolescents than for adults when it comes to vaping?

Paige Feller: 05:51

Definitely. So adolescents, as most of us know, is a critical time for brain development. Mhmm. And the brain is continuing to develop into our mid twenties. So any substance use can negatively impact brain development and can potentially create long term changes or damage to the brain.

Paige Feller: 06:09

Specifically, nicotine use impacts the areas of the brain that are responsible for things like learning, processing, understanding, attention, memory, decision making, self control, motivation, pleasure, emotional intelligence, the list goes on. And so when you think about all of those things that are continuously changing through adolescence and young adulthood, the brain is particularly vulnerable at that time. Circling back to some of the physical implications that were discussed, the toxic chemicals and carcinogens and e liquids, especially at such a young age, increases risks of the long term health implications like cancer, heart disease, you know, other known potential consequences of nicotine. And there are studies that show that teen vaping leads to an increased risk of asthma, lung problems, heart problems, and even poor bone health. And then I think the last big piece is that beyond the physical health risk, vaping leads to this vicious cycle of maladaptive coping.

Paige Feller: 07:16

So adolescents believe that vaping helps relieve anxiety, helps with mental health symptom management, and the reality is that vaping actually exacerbates those symptoms and leads to repeated patterns of stress. Repeated vaping to relieve the stress, perceiving this temporary decrease in anxiety, and then anxiety and stress spike again. And so adolescents turn to vaping to again relieve that stress, which repeats that pattern. And actually, vaping has been associated with increased anxiety, depression, and mental health dysregulation in youth despite youth believing that it actually decreases those things.

Andy: 07:59

When it comes to vaping, how easy is it for someone to get addicted?

Paige Feller: 08:04

There's so many risk factors, protective factors. The variables really are endless that impact a person's vulnerability or susceptibility to a substance use disorder. So we talk about the biological factors, the psychological factors, the environmental factors, and we discuss it like a whirlpool of risk that there's so many things at play. Some people vape once and might never vape again. Other people can vape occasionally without ever becoming addicted.

Paige Feller: 08:33

And then there's a lot of people, particularly teens, that report feeling hooked immediately after the first time they vape. Nicotine in general is extremely addictive. So within seconds of vaping, that nicotine is hitting our brain, hitting the reward circuits that are directly activated. And then we always talk about dopamine. Right?

Paige Feller: 08:54

That chemical that tells us that was good. Do more of that. When the brain adjusts and gets back to baseline, we are desiring that positive experience, feeling, whatever it was that we achieved, at least temporarily from the nicotine. For some people, life continues as normal. For other people, they go right back to vaping use, and continue those cyclical behavior patterns.

Paige Feller: 09:20

And there's both the physical and psychological components that fuel that ongoing addiction.

Andy: 09:27

And we will be right back.

Andy: 09:32

Real quick, I wanted to take a

Andy: 09:34

moment to talk to you

Andy: 09:35

about WISE, the initiative for stigma elimination. It unites people across the nation to support those touched by mental illness and addiction. The compassionate approach champions personal stories and powerful connections, fostering healing by reducing stigma through evidence based practices. Rogers Behavioral Health supports the work of Wise through their community learning and engagement department. Wise collaborates with a diverse network of organizations and individuals united in the fight against stigma.

Andy: 10:02

You can learn more about Wise, explore their four key programs, and connect with them by visiting the website www.eliminatestigma.org. And now back to the interview.

Andy: 10:19

So what do you think are some of the main reasons that, specifically with teens, why they start vaping? Peer pressure.

Paige Feller: 10:28

Peer pressure. Peer pressure absolutely is applicable, and the research shows that there's been a shift, particularly over the past decade when discussing reasons adolescents vape. So moving more from experimentation to stress relief or relaxation. The taste has mentioned. It's more convenient than cigarettes.

Paige Feller: 10:54

Managing weight is another reason that can be listed. So it has shifted. Boredom, accessibility, concealability of vaping versus cigarettes.

Andy: 11:07

Okay. You mentioned concealability. What do you mean by that?

Paige Feller: 11:10

So traditional cigarettes look a lot different. Again, we already discussed the smell, but even just, you know, visually, there's a lot of differences. They've become really advanced in terms of what vape pens can look like. They're disguised as everyday objects. So a pen, a USB drive, even hoodies that are specifically made to be able to conceal vaping, is particularly appealing to adolescents.

Andy: 11:35

Sure. And then you've got parents like me that don't even know what to look for.

Paige Feller: 11:39

Absolutely.

Andy: 11:40

Yeah. And then speaking of which, as a parent, I've got a teenager going into high school next year. Is there strategies you would recommend for parents of teens to maybe either keep them away from vaping or to recognize the signs of vaping, I guess?

Paige Feller: 11:58

So both prevention and intervention are really effective. So in terms of prevention, staying involved, having conversations with your kiddos, you know, being open and honest, asking questions, so opening up that door for those discussions. If you don't ask, you'll never know. Right? And so maintaining that open communication.

Paige Feller: 12:20

But early identification of the need is particularly important and connecting to resources.

Andy: 12:27

Speaking of resources, what type of resources are out there for people?

Paige Feller: 12:31

There are a variety of resources that are available depending on the need. A lot of times, we talk about these needs like an iceberg. So the tip of the iceberg is a specific behavior. In this case, it's the vaping behavior. And then underneath, right, the surface, there are a variety of other needs.

Paige Feller: 12:50

Oftentimes, mental health needs, trauma, anxiety, relationships, academic stress, peer pressure, etcetera. So really by figuring out what's under the surface, we can identify those needs and then determine the best resources and support. There are a variety of resources from, online resources, applications, professional supports, connection, pro social activities, all of which make a huge difference as well. So really the available resources are endless depending on the specific need.

Andy: 13:27

So okay. There's a parent, they're listening to this, their child is vaping, what advice would you give them?

Paige Feller: 13:35

Early identification and connecting to resources really is critical. So prioritizing the kiddo's mental health and well-being and asking questions to figure out what's needed or maybe the kiddos don't know what's needed, and then we step in and support them in figuring out what might be needed. I think it's really easy to say, fix my kid, fix the behavior, but really we need to look at the whole system. We need to look at the family. We need to look at the bigger picture and what those needs are and really work together to connect to resources to address the challenges to focus on mental health.

Paige Feller: 14:14

And there's a lot of research to show that the opposite of addiction is connection. So really building those relationships both, you know, with parents or caregivers, with healthy peer groups, pro social activities makes a huge difference.

Andy: 14:28

With that in mind,

Andy: 14:30

what gives you hope, for the

Andy: 14:32

future when it comes to vaping and kinda keeping them out of the hands of teenagers?

Paige Feller: 14:36

There is a monitoring the future study every year that's funded by the National Institute of Drug Abuse, and it has actually shown that in recent years, there has been a continuous decline in vaping among adolescents, which in and of itself gives me a lot of hope. Sure. Instead of trying to focus on changing the world or limiting the marketing towards teenagers when it comes to vaping, I really focus on the small wins. So if each of us can help educate, support, and improve the lives of a few teenagers and a few people in general, and then each of those people can do the same, you get the idea. Right?

Paige Feller: 15:14

We'll see the ripple effect here. Looking at the research, we're continuing that downward trend, and that suggests that prevention and early intervention is effective. The younger generation seem much more eager to ask questions and seek information. They have more access to information with technology and everything that's out there, and so they seem more invested in understanding risks to themselves and their health, both short and long term. Hopefully, they'll be more likely to ask questions, to seek information, to look at the evidence.

Paige Feller: 15:51

And I think a big part is that now we've seen about twenty years since the e cigarette was introduced or the modern e cigarette was introduced, which gives us about two decades of data. So if sooner than later research can emerge with more information about the longer term effects because those long term effects currently are unknown and part of what's so scary, then that might help us better understand both the short and long term effects of vaping.

Andy: 16:20

Okay. So you've mentioned there's a lot of resources available, but what would you say to a parent who has a child that they know is vaping but maybe also suspects that there's some other underlying circumstances involved?

Paige Feller: 16:33

So as mentioned, we recognize the iceberg that at the tip of the iceberg, see certain behaviors and underneath the iceberg, there are often many known and unknown mental health considerations and other needs to be addressed. Evidence shows that co occurring treatment that addresses both the substance use concern and the other mental health concerns is particularly effective, and that's where professional support and resources can make a really big difference in being able to holistically evaluate the needs, identify the needs, and provide effective services that target both the mental health and the substance use specific issues.

Andy: 17:15

Paige, this is all really good information. Thank you so much for joining me today.

Paige Feller: 17:19

Thank you so much. It's been great talking with you.

Andy: 17:22

Well, listeners, thank you so much for listening to another conversation. And one thing I do wanna say, there

Andy: 17:28

is some positive news about vaping.

Andy: 17:31

Recent trends are that there's been a decline in vaping, especially among teenagers. This is due to a couple of factors, and one of them being just increased awareness, which I like to think we're taking a part in right now. So thank you again for listening to Rise Above. Be sure to like and subscribe to be notified of new episodes. If you think you know someone who might need to hear this episode, send it along to them.

Andy: 17:57

And as always, if you or someone you care about is struggling with a mental health or substance use disorder, visit rogersbh.org for a free mental health screening.