Experts Caution: Vaping Prevention Critical as Teens Head Back to School During Ongoing Pandemic

The global COVID-19 pandemic has forced many people to live in relative isolation for more than a year. As adolescents return to school, public health experts caution parents to pay close attention to signs of tobacco use among teens. While there has been a decline in smoking traditional cigarettes among youth as well as adults, e-cigarette use continues to increase.

Experts express concern about rising rates of dual- and poly-tobacco product use, particularly among adolescents and young adults.

“Youth have gone through a rollercoaster of changes during the last year and a half during the ongoing global COVID-19 pandemic. These dramatic and persistent changes take a toll and can cause anxiety, depression and stress that lead many to cope through smoking,” said Theodore Wagener, director of the Center for Tobacco Research at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James). “Tobacco products have become much more widely available with the introduction of alternative combustible devices like electronic cigarettes and waterpipes – and research suggests they can be just as addictive as traditional cigarettes. More research is critically needed to put science behind the U.S. Food and Drug Administration’s regulation of these products to protect the public’s health.”

Launched in 2020, the Center for Tobacco Research (CTR) brings tobacco experts from across Ohio State – including psychology, epidemiology, biostatistics, environmental health, health communications, chemistry, biochemistry, cancer biology and law ­– together to conduct collaborative research aimed at increasing scientific knowledge to help regulate tobacco products effectively in a way that best serves individual and public health interests.

The evidence-based tobacco research program enables these teams to study electronic cigarettes (also known as e-cigs or vapes) and other combustible products like waterpipes (also known as hookahs) and cigars, as well as traditional cigarettes.

Researchers with the CTR are investigating everything from buying behaviors influenced by mass media campaigns and the health effects of specific product ingredients to new methods of encouraging tobacco product cessation or preventing youth and young adults from beginning to use tobacco products in general.

One example of this collaboration is the Buckeye Teen Health Study, which explores the differences in e-cigarette and tobacco product use among boys and young men in rural and urban areas, and how marketing and advertising affects their behavior, especially as it relates to the dual use of tobacco products and how vaping could be a gateway to more harmful nicotine products.

A researcher observes someone using a tobacco product inside a state-of-the-art negative pressure lab at Ohio State’s Center for Tobacco Research. This technology allows scientists to monitor biofeedback in real time to better understand the potentially harmful effects of vaping.

“We check in with participants every six months, which helps us track their behaviors over a long period of time and into adulthood,” said Amy Ferketich, an Ohio State College of Public Health researcher and member of the OSUCCC – James Cancer Control Research Program who leads the Buckeye Teen Health Study. “We found that the participants in the study who were e-cigarette users were much more likely to transition to cigarettes or smokeless tobacco.”

Another current study at the CTR discovers links among different tobacco-related products. For example, it is estimated that 38% of young people who smoke hookah also use e-cigarettes. Researchers are now examining how cessation programs for teens that target one product can lead to reductions in the use of all nicotine products. The scientists say this is especially important because studies suggest that youth vape and hookah users are more likely to not only continue to vape but also to smoke traditional cigarettes or use other nicotine delivery products.

Becky Lee has observed the spike in e-cigarette use among her students in recent years but is hopeful that efforts like her’s to offer non-judgmental conversation and education on vaping risks are leading more teens to make healthier choices.

Changing How Tobacco Research Is Conducted

A cross-institutional collaboration based in Ohio State’s comprehensive cancer research program, the CTR is a 7,600-square-foot-dedicated space for tobacco studies. It brings together faculty and staff from six colleges to conduct collaborative laboratory and clinical research studies. The facility has six negative-pressure rooms and a control room that allows for communication between research staff and participant rooms. Biological samples can be processed and stored onsite.

This set-up, said Wagener, allows investigators to measure and observe how people are using cigarette, e-cigarette and hookah products in real time in a controlled environment without risk to staff and other study participants.

“This is a game changer for accuracy of data collected, because it gives a far more accurate picture of nicotine exposures and health risk versus relying on self-reported estimations from the tobacco user as was done in the past,” added Wagener. “Our research center is unique in that it brings together clinical psychologists, public health researchers, chemists and medical oncologists, all working together on the same study. The perspectives of all these different disciplines allow us to find answers to big questions and develop impactful solutions.”

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