AAP Policy Cites Harm of E-cigarettes

ENDS (electronic nicotine delivery system), including e-cigarettes, are becoming more and more popular. One reason people are starting to use e-cigarettes is because they are touted to help people quit smoking. Note: ENDS have been shown to pose harms for users and non-users and are not approved by the Food and Drug Administration (FDA) as smoking cessation devices. They are considered a less harmful option, in same cases they are considered totally harmless. ENDS are handheld devices that produce an aerosol from a solution typically containing nicotine, flavoring chemicals and propylene glycol and/or glycerin to be inhaled by the user. ENDS include the wide range of products that are known as electronic cigarettes, e-cigs, e-hookah, vaping devices, vape pens and mechanical mods.

The AAP (American Academy of Pediatrics) is publishing a new policy about these systems, addressing pediatricians’ and pediatric health care providers’ questions about these products and the harms to youths. It is available here and will be published in the November issue of Pediatrics.

In 2014, more youths reported using ENDS than any other tobacco product. It has been found that ENDS contain numerous harmful toxicants and carcinogens. Nicotine is one such highly addictive toxicant. Use of nicotine-containing ENDS solution may lead adolescents to start smoking conventional cigarettes and other tobacco products. E-cigs and other devices normalize and make smoking acceptable culturally which can lead to other drug use.

ENDS secondhand vapor has been shown to contain nicotine, toxicants, metal and silicate particles, and carcinogens that can pose harm to non-users. The ENDS solution, or e-liquid, can contain very concentrated nicotine, which can be lethal when ingested even in small quantities. There has been an astronomical increase in calls to poison control centers from ENDS exposures, and one child died after ingesting concentrated nicotine solution.

Below are some FAQ’s about ENDS (source):

Common questions

How many children and adolescents are using electronic nicotine delivery systems (ENDS)?
Surveys of youths show an 890% increase in ENDS use over the past four years. In 2013, as many as 29% of high school students had tried (ever used) e-cigarettes, with use in the past month (current use) of 18%. In contrast, 8.5% of U.S. adults reported having tried an e-cigarette in 2013.

Why am I seeing ENDS commercials on television?
Unlike conventional cigarettes, there are no current regulations on ENDS advertisements on television, print media or point-of-sale (advertisements where ENDS are sold). ENDS are being marketed heavily; in 2013, 80% of U.S. youths ages 12-17 years were exposed to 13 television advertisements for ENDS.

What is in the ENDS solution (also known as e-juice or e-liquid)?
ENDS solutions are advertised to contain concentrated nicotine, flavoring chemicals and propylene glycol and/or glycerin. There are 7,760 flavors of ENDS solutions advertised, many of which are candy and dessert flavored and appealing to children. In addition to what is advertised, however, ENDS solution has been shown to contain numerous toxicants and carcinogens. The ENDS refillable cartridges also allow for addition of other substances to the solution, including marijuana.

What should I say when someone asks if I recommend ENDS?
ENDS have been shown to pose harms for users and non-users and are not approved by the Food and Drug Administration (FDA) as smoking cessation devices. ENDS should not be recommended to youths or their parents/caregivers. Parents and youths who are interested in tobacco dependence treatment should be directed to evidence-based smoking cessation counseling and FDA-approved tobacco dependence treatments (see resources).

Why Does My Teen Have Trouble Sleeping?

Research shows that teens need at least 8.5 hours of sleep a night, which most teens do not reach nightly. During adolescence, the body’s circadian rhythm (like an internal biological clock) is reset, telling teenagers to fall asleep later at night and wake up later in the morning. This change in the circadian rhythm happens because a teen’s brain makes the hormone melatonin later at night than the brains of kids and adults do. However, your teen may also be suffering from insomnia, which is most commonly caused by stress. While everyone has trouble falling asleep from time to time, if your teen regularly cannot fall asleep and stay asleep, they may have chronic insomnia.

Common causes of chronic insomnia could be other medical conditions, mental-health problems, side effects of medicines, or even substance abuse. If you think your teen may be suffering from chronic insomnia, you can get help from a doctor, counselor, or therapist. However, before seeking professional help, you could attempt reducing the stress your teen feels and make sure they have a comfortable sleeping environment, as these are the usual causes of insomnia.

Is Snacking Good?

Good news, snacking is good for you….as long as they are healthy snacks! During adolescence, the body needs more nutrients to grow which is why teenagers feel hungry a lot throughout the day. This is why snacks are a great way to satisfy that hunger and give the body the nutrients it needs to grow. Although it may be tempting for every teen to have a soda and candy bar after school, the temporary sugar boost it gives will slow them down in the long run. In order to keep energy levels going and to avoid weight gain, choose snacks that are full of fiber and protein such as peanut butter, fruits, or yogurts. However, you have to beware of claims that snack manufacturers make on their products. Just because something is “all natural” or “pure” does not mean that it is nutritious, such as fruit juices which can be filled with sugar which makes it extremely high in calories. Similarly, watch out for snacks with “low-fat” claims, because usually the fat is replaced with large amounts of sugar which is just as unhealthy. In order to judge how healthy a product is for you, look at the nutrition information on the food label.

The Difference Between Sadness and Depression

If you have suspicions that your teen may be depressed, this article may help you determine whether it is depression or just sadness. Feeling sad, down, or disheartened are natural human emotions and reactions to the hardships of life, but depression is different. Depression is a strong mood involving sadness, discouragement, despair, or hopelessness that lasts for weeks, months, or even longer. Depression drains the motivation, energy, and concentration of the person it affects, and it can even cause aches and pains in the body. One sign that your child may be depressed is that they are pulling away from friends, family, or activities that they once enjoyed, which will ultimately make them feel more lonely. People with depression may also feel tired and exhausted and it may take them longer to do everyday activities. And depression also has physical symptoms, such as a loss of appetite or weight gain or loss. If you believe your teen may be depressed, schedule a consultation with your pediatrician to discuss your concerns.

Why Does My Teen Get Acne?

Acne is a problem that many Americans face, approximately 17 million people in the U.S. have acne, so your teen is not the only one. So, why do all these people have acne and where does it come from? Contrary to popular belief, acne is not caused by having dirty skin. Acne is caused by an inflammation of pores due to overactive oil glands and a build-up of oil, dead skin cells, and bacteria. People between the ages of 12 and 24 are more likely to get acne because oil glands become stimulated when hormones become active during puberty. However, having acne can also be genetic, so if people in your family have acne, your teen may be more prone to having acne too.

Even though it is hard to fight genetics, there are ways to help reduce the amount of acne your teen may get!

•Make sure your teen washes their face. Washing your face is extremely important because it helps remove excess oils and dead skin that can clog pores and cause pimples. But be careful, washing the face too much can be harmful by overdrying and irritating existing acne.
•If your teen works out or tends to get pretty sweaty, have them wash their face as soon after sweating as possible, because sweat can clog pores and make acne a lot worse.
•Speaking of clogging pores, it is important to use lotions and makeup that are noncomedogenic or nonacnegenic, which means that the product won’t clog your pores.

Pediatricians Play a Role in Children’s Oral Health

In a revised statement, “Maintaining and Improving the Oral Health of Young Children,” which is featured in the December 2014 issue of Pediatrics, the AAP notes that pediatricians play an important role in improving oral health for young children. Younger children often see a pediatrician more frequently than a dentist, putting pediatricians in a unique position to provide oral health counseling. 

– See more at: http://www.aap.org/en-us/about-the-aap/aap-press-room/Pages/Pediatricians-Play-a-Role-in-Children’s-Oral-Health.aspx

AAP Recommends Fluoride to Prevent Tooth Decay

A recent report by the AAP suggests that fluoride is effective in cavity prevention in children. According to the report published on August 25, 2014, the AAP recommends fluoridated toothpaste in appropriate amounts for children, under the supervision of an adult. For example, a grain of rice sized dab of toothpaste should be used up to the age of three once teeth have erupted and after age three a pea-sized amount is recommended. The AAP also cautions against over-the-counter fluoridated products for children younger than 6 as there is a risk of swallowing high levels of fluoride.

To learn more about this news, read the American Academy of Pediatrics article here:

http://www.aap.org/en-us/about-the-aap/aap-press-room/Pages/AAP-Recommends-Fluoride-to-Prevent-Dental-Caries.aspx