NAPNAP Recommends Continued Health Provider Efforts to Eliminate Teen E-Cigarette Use


Despite significant decreases in 2020, a large number of adolescents less than 18 years of age continue to use e-cigarettes, with considerable adverse health effects, according to a presentation at the 2021 National Association of Pediatric Nurse Practitioners (NAPNAP) conference. During the session, the speakers discussed the consequences and potential solutions for youth tobacco usage.

According to data from 2020 presented at the 2021 NAPNAP conference, more than 3.6 million youth use e-cigarettes, with 38.9% using them more than 20 days out of 30, and 22.5% reporting daily use. Though the overall number of youths using e-cigarettes dropped by approximately 1.8 million in 2020, Laura Searcy, MN, APRN, PPCNP-BC, FAANP, one of the hosts of the conference session, emphasized that it’s difficult to tell whether this is a sustainable improvement or a consequence of the COVID-19 quarantine resulting in lower access and greater parental supervision.

Searcy emphasized that the effects of nicotine can be especially potent on teenagers, causing decreases in attention, learning memory, and impulse control. Nicotine can also lead to mood disorders, depression, and anxiety, as well as an increased risk of abusing other substances.

“We have a perfect storm for our kids,” Searcy said. “We have so much anxiety, depression, and mental health effects from the coronavirus pandemic, and even before the pandemic we were seeing a huge increase in youth mental health disorders, suicide, and suicidal ideation. Then we have a huge number of kids using a drug–nicotine–that increases depression and anxiety symptoms.”

In order to further reduce the percentage of youth using e-cigarettes and other nicotine products, NAPNAP recommends that health care providers routinely screen infants, children, and adolescents for tobacco product exposure, and provide anticipatory guidance to youth and their caregivers on the risks associated with tobacco use. Further, the organization suggests providing developmentally appropriate cessation resources to any tobacco-using youth.

“This is a great time for anybody that uses any tobacco product at any age to quit,” Searcy said. “If you eliminate smoking and vaping, you return normal immune response to your lungs, you reduce lung inflammation, and your lungs are much more able to reduce the risk for severe COVID disease.”

NAPNAP recommends conducting further research into the short- and long-term health effects of vaping, particularly as it relates to lung health and respiratory illness, as well as developing evidence-based guidelines for tobacco and nicotine prevention and cessation to provide to youth and their caregivers.


Laura Searcy, Alison Moriarty Daley. Stopping the Youth Tobacco Use Epidemic. Presented at: NAPNAP Conference 2021; March 27, 2021; Virtual.

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