Addressing the intersection between COVID-19 and young people vaping: timely resources needed

Gagnon’s article1 highlights the urgent need for resources to be created so that health care professionals can have discussions with their young patients about vaping. No validated screening tools exist to discuss vaping with young patients, and almost one-third of Canadian pediatricians find it challenging to discuss vaping with patients and their family members.1 Thus, it is clear that health care professionals lack sufficient knowledge and adequate resources when supporting young patients who vape. Also, there are no Canadian guidelines available to guide clinicians’ clinical decision-making on vaping; the only available guideline recommendations concluded that “[t]here is no conclusive evidence on the potential harmful effects of e-cigarettes or whether they can be used in smoking cessation interventions for either adults or youth.”2

Recent research shows a strong association between coronavirus disease 2019 (COVID-19) diagnosis and a history of e-cigarette use in young people.3 Therefore, it is of utmost importance that clinical guidelines and evidence-based tools are created quickly to empower health care professionals and facilitate conversation in clinical encounters on the value of nicotine-free lifestyles for our younger generation, given that both COVID-19 and vaping affect the lungs. The most recent position paper on e-cigarettes, published in the European Journal of Preventive Cardiology,4 encourages public campaigns to raise awareness of vaping’s adverse effects and prevent initiation of vaping, and advises that health professionals inform their patients and the general public about the possible adverse health risks of e-cigarette smoking.

Unsurprisingly, the e-cigarette industry appears to have taken advantage of the COVID-19 pandemic to aggressively market its products.5 Marketing strategies include providing pandemic-related discounts, asserting health claims and assuring consumers that e-cigarette products will not transmit severe acute respiratory syndrome coronavirus 2.5 Such marketing may appear attractive to young people and encourage them to vape.

Physicians urgently need to be educated about the risks of vaping, which requires investment in the creation of suitable Canadian clinical guideline resources. In the meantime, Canadian health care professionals should consider using the US National Institute of Drug Abuse Screening to Brief Intervention tool (S2BI) or the Brief Screener for Tobacco, Alcohol, and other Drugs (BSTAD) tool among adolescent patients.6 These tools take less than 2 minutes to administer and were validated with adolescent populations.6 These tools also offer guidance regarding next steps to support pediatric patients.6

Additionally, the Centers for Disease Control and Prevention has an excellent resource that supports health care professionals in starting conversations on vaping.7 This resource encourages practitioners to empathetically communicate in a nonjudgmental manner and ask all patients about vaping use, recommending that parents be asked to leave the room to facilitate discussions with minors.7 This tool provides guidance on asking questions on vaping using a “what, how and where” framework.7