For Health Professionals

Vaping & e-cigs
Health professional resources

Children’s Minnesota is providing information and resources for health care professionals about vaping among children and young adults.

If you need to consult a specialist, call Children’s Minnesota Physician Access.

Vaping usage

In the past five years, vaping has become increasingly popular among teenagers. Teens often consider vaping aerosols different than smoking combustible products so asking a teenager if they smoke is not sufficient in identifying if there is a vaping concern.

A significant number of eighth-graders in Minnesota report recent experience with vaping, with that number substantially growing by eleventh grade, highlighting the importance of asking all teenagers questions specific to vaping during their appointment and, as a result, providing appropriate guidance.

Teenagers commonly categorize their vaping behaviors into nicotine-based, THC or CBD-based, and so-called flavor-only liquids–often called “zero nic” by sellers, or by the type of device (e.g. mods, carts, or disposables). This is why it’s important to familiarize yourself with the terminology and typical devices to help teenagers feel comfortable when they seek medical options.

Having parents present for the questions can also pose a barrier, similar to typical HEADSS exam questions in adolescent medicine. Ensuring time for discussion during HEADSS exam related questions, or having a medical assistant or nurse ask the patient during rooming intake or pulmonary function testing can be very helpful.

Useful resources for professionals

Dr. Leslie’s series on vaping   @drleslie on Tik Tok @doctorleslie_ on Instagram

Vaping terminology and pictorials

Treatment options

For patients who vape, treatment depends on the scope of the problem. In all settings, empowering youth to make educated choices is crucial. Discussion surrounding which substances have been inhaled, how much and how often as well as screening for signs of dependence can further guide treatment.

Identifying undertreated anxiety or depression is also important. It is not uncommon for teens to endorse vaping as a coping mechanism for stress. Engaging in counseling that specifically addresses future stress management tactics is encouraged, often with the help of a therapist proactively. Having a plan to manage stress and anxiety through new coping skills relies on mental health referral for planning and management.

To date there remains no FDA approved nicotine replacement therapies for minors nor tetrahydrocannabinol dependence pharmacotherapy. Nicotine replacement therapy has been utilized with caution on a case by case basis with risk/benefit assessment and ongoing monitoring by health care providers. It is strongly encouraged to include non-pharmacotherapy based counseling in the management plan of chemical dependence.

Helpful sites on substance use

EVALI treatment

E-cigarette or Vaping Product Use- Associated Lung Injury (EVALI) is thought to be associated primarily with THC- based illicit vaping products and likely the presence of Vitamin E acetate. Symptoms of EVALI have been well described. Initial fever, loss of appetite, gastrointestinal distress and cough are common, but dyspnea upon mild exertion is also quite prevalent.

For further description of presentation, please see the following articles:

Confirmation of EVALI and the ruling out of other possible causes is important as systemic steroids are conventionally prescribed for treatment. The article from The Lancet below was one of the most comprehensive reviews of presentation and treatment of EVALI stemming from the 2019 outbreak. The abstract is available for public access and providers may gain full access to the article through their usual literature repositories and subscriptions.

The article reviews EVALI treatment protocols (see Figure 1 in article) that are in line with our general approach at Children’s Minnesota but should not be applied to individual patients without physician consultation and thorough evaluation.

Related articles

Children’s Minnesota is a leading national voice in raising awareness about the dangers of vaping.

From the Children’s Minnesota blog

Are COVID-19 and vaping connected? A pediatric pulmonologist explains.

For those who vape or smoke, the risks for complications if you get COVID-19 might be even greater. Dr. Anne Griffiths, a pediatric pulmonologist at Children’s Minnesota, explains the possible connection between vaping and COVID-19 complications.

What parents need to know about e-cigarettes and vapes

Nearly 25 percent of teens use battery-powered smoking devices known as e-cigarettes or vapes. Dr. Gigi Chawla shares more about these devices and how to deter your teen from using them.

Tips to quit vaping

Quitting vaping isn’t easy, that’s why Dr. Anne Griffiths, pediatric pulmonologist and vaping expert at Children’s Minnesota, is sharing how parents can help their kids quit vaping and e-cigarette usage this year.

Our experts in the news

Experts Warn About COVID Dangers Those Who Vape Face

WCCO

Teen vapers up to 7 times more likely to get COVID-19 than non-e-cig users, says new Stanford study

NBC News

Some patients with vaping-related lung injuries are being hospitalized a second time

Washington Post

Doctors suspect vaping behind dozens of lung illnesses in US

Associated Press

5 things to keep in mind when talking to your kids about e-cigs

MPR

Doctors and healthcare providers call for 24/7 patient referral, admission and neonatal transport assistance. Learn more.