‘Why can’t I quit?’: Nicotine use in adolescence comes with challenges, solutions
“Why can’t I quit?” she groaned, and a thousand reasons flooded her mind. “It’s making me cough. It’s expensive. My parents would ground me if they knew I was vaping. I could get suspended and have to quit the soccer team. I’ve tried cutting back, but it makes me feel so sick that I don’t think it’s worth it. At least I’m not as bad as I used to be. Besides, it helps me calm down so I can feel normal in school. How can I quit when all my friends are using? If I quit, I wouldn’t have anyone to hang out with during lunch.”
Nicotine addiction wreaks havoc on a teen’s emotions, ability to learn, social relationships and physical health, leading to a rollercoaster of effort focused on trying to be “normal.” Nicotine dependence interrupts healthy sleep cycles, appetite and mood — and the teen brain is especially prone to addiction.
In 2021, 13.2% of teens in the Weber-Morgan Health District used e-cigarettes regularly, the highest in Utah. The 2021 Student Health Risk and Prevention Survey reported that most students know their parents and peers disapprove of vaping, yet they continue to use. Why? Nicotine is one of the top five most addictive drugs, right up there with heroin, cocaine, methamphetamine and alcohol. Are we expecting teenagers to stop using on their own? Would we expect the same from an adult withdrawing from the most addictive drugs?
Quitting nicotine in adolescence comes with its own set of social, physical, emotional and mental challenges. Most adults make many attempts at quitting before they’re successful, and those who are successful usually have social and medication support. Teens need more than just reasons to quit; studies show they also need ongoing, tangible, nonjudgmental help from parents, peers, school, community and health care providers.
School is where layered and coordinated support is possible. Teenagers spend most of their waking hours in school, and most teens report that school provides a positive environment for learning and growing. Schools and parents, communities, civic leaders and health care providers are invested in keeping students in school healthy and ready to learn. How can we come together to support our youth who want to quit nicotine?
One possible solution is for all invested in teen health and education to partner in providing ongoing, evidence-based quitting support. This support could look like the school district partnering with parents, the health department, and local health and behavioral health care providers to reach students where they spend most of their time.
This layered support is possible as partners share the burden and necessity of supporting teens in a productive, cost-effective and sustainable way. The American Academy of Pediatrics and the American Heart Association have teamed to provide schools and health care providers with evidence-based tools to support youth nicotine cessation. This intervention unites teens, parents, educators, health care providers and the community to support teens in quitting.
School-based health centers or youth health care services offered by a federally qualified health center on location at school are promising possibilities for improving teens’ access to care. More than 2,500 multidisciplinary school-based youth clinics operate in 48 states nationwide. Nicotine cessation support is only one of the many integrated health care services offered in these clinics. Nurse practitioners are uniquely positioned to work alongside mental health professionals, school personnel, parents, teens and community leaders.
Nurse practitioners provide primary, acute and chronic care, mental health services and health education and work collaboratively within these multidisciplinary teams. Weber State University’s Annie Taylor Dee School of Nursing is educating family nurse practitioners with a doctorate in nursing leadership who are already making a difference in community nicotine interventions. For example, recent Weber State nursing graduates Emily Rhodes and Ashlie Flynn recently educated parents, students, teachers and administrators about nicotine by implementing the national CATCH My Breath vaping prevention program.
No one entity can provide all the support teens need to quit nicotine successfully. Let’s come together to support them, each unique partner with strengths and limitations to provide what each cannot do alone.
Dr. Angela Page is a Pediatric Nurse Practitioner faculty member at Weber State University’s Annie Taylor Dee School of Nursing, which celebrates its 70th anniversary this year. She is also an Ogden School-Based Health Collaborative leader who is passionate about helping parents and educators keep teens in school, healthy, and ready to learn.