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Quitting Resources for Teens

Helping the young person in your life avoid smoking, vaping and other tobacco products is one of the most important things you can do to protect their health.

What parents need to know about vaping

E-cigarette use, or vaping, is rampant among kids, teens and young adults. These products are not safe for young users, and they are easy to get and conceal.

E-cigarettes are electronic devices that heat a liquid and produce an aerosol or mix of small particles in the air. They come in many shapes and sizes. Most have a battery, a heating element and a place to hold liquid.

E-cigarettes produce aerosol by heating liquid that usually contains nicotine, flavorings and other chemicals. This liquid is sometimes called e-juice, e-liquid, vape juice or vape liquid.

Parents should know these important facts about e-cigarettes and vaping:
E-cigarettes are tobacco products. They are not safe for kids, teens or young adults.
Most e-cigarettes contain nicotine. Nicotine is highly addictive and can harm adolescent brain development, which continues into the early to mid-20s.
E-cigarettes can contain other harmful substances besides nicotine.
Young people who use e-cigarettes may be more likely to smoke cigarettes in the future. They are more susceptible to addiction in to other substances as well, because of the changes that nicotine makes to their developing brains.

Although it is illegal for anyone under age 21 to purchase tobacco products, including vaping products, vaping is rampant among preteens and teens.

How can I help my child quit vaping or smoking?

MD Anderson partners with the Truth Initiative to offer This is Quitting to Texas young people ages 13-24. This is Quitting is a text-based program that provides free, anonymous, 24/7 support to help young people stop using e-cigarettes.

Teens can text VAPEFREETX to 88709 to sign up for the program. Once enrolled, they will receive about one message per day with tips, advice and encouragement to quit vaping. Throughout the program, teens can get additional support by texting in COPE, STRESS, SLIP or MORE at any time.

Support for parents of young vapers

Parents of young vapers can text QUIT to 202-899-7550 to receive messages designed specifically for them, including tips and advice to help their young person quit. Your teen does not need to be enrolled in This is Quitting for you to use this service.

How can I prevent my child from vaping or smoking?

You can take steps to help your child stay tobacco-free. Research shows that parental attitude is very important when it comes to youth and tobacco use. If a young person believes that his or her parents would be upset if he or she smoked, they are less likely to smoke. Also, the credibility of a parent's message decreases if he or she smokes or uses e-cigarettes. If you use tobacco, it’s never too late to quit. For free help, visit smokefree.gov or call 1-800-QUIT-NOW.

Communicating with your child is important to help them stay tobacco-free. The CDC has information on how to talk to your teen about e-cigarettes.

Try these tips to help the young person in your life make good choices.

Listen: Don’t do all the talking.
Educate: Inform them about the dangers of tobacco.
Role play: Have them practice what to say if they are asked to use tobacco.
Teach: Help your kids make wise decisions on their own.

How can I tell if my child is vaping?

It can be hard to tell if your child is vaping. The e-cigarette aerosol may have a mild sweet smell, but it won’t cause the tell-tale smoke smell on clothes, hair or in the air like regular cigarettes. Also, e-cigarettes like JUUL are often small and easy to conceal.

Start by finding out what your child knows about e-cigarettes. Ask them if they see people vaping at school or what their friends are saying about e-cigarettes. See where the conversation goes.

Pay attention to your child's behavior. Kids who vape may talk about feeling irritable or lose their temper easily. Irritability can be a sign that your teen is using nicotine because it’s a stimulant like caffeine. They may be irritable between doses.

Behavioral signs

Irritability, anxiety, prone to mood change, lack of impulse control
Difficulty concentrating in school and maybe even slipping grades. If a student is vaping and they are having nicotine withdrawal in class, they may not be paying attention to the teacher but rather thinking of when they can get their next nicotine fix.
Burning candles or incense, or suddenly using perfume or cologne. This could be an attempt to hide the sweet scent from their e-cigarette.

Physical signs

Change in eating patterns, accompanied by weight gain or loss
Mouth sores or irritation around the mouth from being exposed to the chemicals in vapor
Unexplained nose bleeds
Increase in thirst because some of the chemicals found in e-liquid can cause dry mouth

Other signs

Missing phone chargers

What do vape devices look like?

Some e-cigarettes look like regular cigarettes, cigars or pipes. Some look like USB flash drives, pens and other everyday items. Larger devices such as tank systems, or "mods," do not look like other tobacco products. Many of these devices need to be charged, so you may find charging devices that don't look familiar.

Finding unfamiliar objects or devices can be a sign that they may be vaping.

Isn't nicotine a harmless stimulant? Why does it matter if my teen vapes?

Nicotine is not a harmless stimulant. It is a highly addictive toxin.

Nicotine is extremely damaging to developing brains. Using nicotine before age 25 damages the parts of the brain that control attention, learning, mood and impulse control. Using nicotine during this period also makes the brain more susceptible to addiction of all types. These changes last a lifetime.

Many young vapers think that when they vape or JUUL they aren’t consuming nicotine, but most do. One product, JUUL, has as much nicotine on one pod as an entire pack of cigarettes.

Aren't flavored products illegal?

One of the things that makes vaping so appealing to young users is that the products come in a huge array of sweet flavors. The flavor bans enacted in 2020 only apply to closed, pre-filled pods, like JUUL cartridges. The limited flavor ban does not cover disposable e-cigarettes like Puff Bar, Stig and Fogg. Flavors are still allowed and widely available in these disposable products that are cheaper than JUUL.

Is vaping safer than smoking?

E-cigarettes have not been proven as a safe alternative to smoking. The aerosol produced by e-cigarettes has the same harmful toxins found in glue and paint, even if the liquid is labeled as nicotine-free. It is not just water vapor. They also can cause issues similar to cigarette smoking such as coughing, chest pain and a raised heart rate.

How to help your teen quit vaping

When e-cigarettes were first sold, many claimed users would be smokers who wanted to stop smoking regular cigarettes.

But youth oriented marketing, sweet flavors that appeal to kids and the availability of products that are easy to hide has led to an epidemic of use among children who have never tried regular cigarettes.

Up to 25% of high school students say they have vaped within the last 30 days and 10% of middle school students also admit they vape. That is a total of over 5.3 million children.

That’s a problem because most e-cigarettes contain nicotine, which damages young, developing brains.

And the aerosol produced by e-cigarettes has the same harmful toxins found in glue and paint, even if the liquid is labeled as nicotine-free. Researchers are still trying to find out if the toxic chemicals in e-cigarettes have long-term health effects. There have been no long-term studies on the health effects of these chemicals when they are inhaled.

If you suspect your child is vaping, it’s essential you talk to them about quitting.

Is my child using e-cigarettes?

It can be hard to tell if your child is vaping. The e-cigarette aerosol may have a mild sweet smell, but they won’t cause the tell-tale smoke smell on clothes, hair or in the air like regular cigarettes. Also, e-cigarettes like JUUL are often small and easy to conceal.

Maher Karam-Hage, M.D., Medical Director of MD Anderson’s Tobacco Treatment Program, says the first thing to do is find out what your child knows about e-cigarettes.

“You don’t want to come in and blast them with information because they may know more than you,” he says. “Ask them if they see people vaping at school or what their friends are saying about e-cigarettes. Explore and see where the conversation goes.”

You also can look at your child’s behavior.

“Kids who vape talk about feeling irritable,” he says. “They may start to have a short fuse and lose their temper easily.”

Irritability can be a sign that your teen is using nicotine because it’s a stimulant like caffeine.

“Nicotine puts them on hyper drive,” says Karam-Hage.

Withdrawal from nicotine also can cause irritability.

How can I help my child quit vaping?

If your child tells you they are using e-cigarettes or it becomes clear to you they are, approach the issue gently.

“Try to find out where they are with it,” says Karam-Hage. “Are they playing with it because they like the flavors or do they use regularly? Do they know e-cigarettes contain nicotine and flavors, which are both harmful?”

You can explain that it may become difficult for them to quit vaping because nicotine is addictive. It also causes damage to the parts of their brain that regulate mood and attention, and that could have lasting effects.

If they use e-cigarettes, they also may start to feel more anxious or depressed, or have problems concentrating.

Finally, ask your teen if they have tried to quit. If they find they cannot stop, there are support services available that connect with teens through text messaging.

Here are some organizations that specialize in helping children quit vaping:

Aren’t e-cigarettes illegal for teens?

There are a number of laws that may help protect young people from e-cigarettes.

Tobacco 21. It is now illegal to sell tobacco products to people under 21 in the United States. That includes regular cigarettes, cigars and e-cigarettes.

That means that retailers should check buyers’ ID and refuse to sell vaping products to anyone who is under age 21. It also applies to online sales.

Partial flavor ban. All pod based e-cigarettes with flavors are banned. Only tobacco flavor and menthol flavor are exempt. But disposable e-cigarettes are not included and these one-time use products are becoming more popular. They are also cheap, so they appeal to young users.

FDA pre-approval. Finally, by May 2020 all manufacturers of any tobacco product that want to remain on the market must submit an application to be pre-approved by the Food and Drug Administration. Manufacturers now must prove that their product will not be used by children.

Even with these laws in place, underage users will be able to find a way to access e-cigarettes and other vaping products, so it’s important to stay connected to your teen.

“Try to talk with your children before they try vaping, or before they become addicted,” says Karam-Hage. “The longer they use nicotine, the more difficult it will be for them to quit.”

Menthol cigarettes: The FDA's proposed ban and why they’re more harmful

Cigarette smoking has been on the decline for years. But menthol cigarettes are one segment of the tobacco market that has remained strong.

The Food and Drug Administration (FDA) proposed new rules today to prohibit these products and flavored cigars. These proposed rules are in response to public health concerns about the dangers of menthol cigarettes and their huge popularity among young people and Black, Hispanic and Asian American smokers.

We spoke with Jennifer Cofer, director of the EndTobacco® Program at MD Anderson, about the harms posed by menthol cigarettes and why the FDA's decision matters.

What is menthol, and why do manufacturers add it to cigarettes?

Menthol is a flavor additive with a minty taste and smell. In addition to tasting good, it has a cooling and painkilling effect. Cigarette manufacturers add it to cigarette filters to cover up the unpleasant taste of tobacco and make cigarettes more appealing.

What does the FDA decision on menthol cigarettes mean?

The FDA has the authority to regulate ingredients, marketing and new products. It banned flavored cigarettes in 2009, but made an exception for menthols. The FDA is essentially catching up by including menthol as a banned flavor now. Last year, the FDA announced that a plan was in the works to catch up, essentially, by including menthol as a banned flavor.

Now, the public will have the opportunity to comment on the proposed rules this summer before the product standards are finalized. It could be several months before menthols and cigars disappear from shelves.

Who smokes menthol cigarettes?

About 18.5 million people in the United States are regular menthol smokers. That’s 37% of the cigarette market. Here’s a breakdown of their use by race in the United States:

85% of Black smokers smoke menthols
46% of Hispanic smokers smoke menthols
39% of Asian American smokers smoke menthols

Why is race important? Because people who smoke menthols tend to inhale more deeply and have a harder time quitting smoking. That means that the health effects of smoking have a disproportionate impact on those communities with a higher rate of menthol use.

Menthols and mint are also extremely popular among teenage smokers. More than half of cigarette smokers ages 12 to 17 use menthol cigarettes.

The hope is that, once finalized, the rules will help reduce the number of new, young adult nonsmokers and improve the health of people who currently use menthol cigarettes.

What does the research say about the dangers of menthol cigarettes?

Because menthol flavoring masks the harsh taste of cigarette smoke, menthol smokers engage in more intense smoking behaviors than smokers of regular cigarettes. As a result, they suffer greater damage to their health. Here are three reasons menthols are so dangerous:

People who smoke menthols smoke more. The minty coolness of the menthol covers up the harshness of the cigarette, so smoking is easier to tolerate. As a result, menthol smokers inhale more deeply and they smoke more cigarettes. That means over their smoking lifetime, they take in more of toxic chemicals and tar from cigarettes.
Menthols are harder to quit. Research by both the FDA and the Tobacco Products Scientific Advisory Committee shows that those who smoke menthol cigarettes are more likely to be dependent and have more trouble quitting. So, while Black smokers are more likely to try to quit smoking than white smokers, they’re less likely to be successful. That’s because of a higher nicotine dependence related to smoking menthol cigarettes. One result: Black men and women have a higher rate of lung cancer than any other race.
Menthols appeal to young smokers. Studies show that young people who start smoking menthol cigarettes are more likely to become addicted and become long-term daily smokers.

What are the health risks of flavored cigars?

Flavored cigars, or cigarillos, come in flavors like cherry, grape and vanilla. They are typically available at convenience stores and gas stations for a very low price.

Like menthol cigarettes, flavored cigars were not covered by the 2009 flavor ban. Cigars are not regulated in the same way as cigarettes.

Removing these products would be an important step in reducing the overall impact of tobacco on public health, especially in communities where they are popular.

Is there anything else should we know about menthol cigarettes?

There is no safe tobacco product. If you are a smoker or vaper, one of the best things you can do to protect your health and reduce your risk of cancer is to quit. The best way to do that is through a comprehensive program that includes a combination of medications and counseling. MD Anderson offers free research studies for adults in Texas at any stage of smoking cessation. Learn more at SmokeFreeStudy.org.

Youth and young adults who want to quit using tobacco products can text VAPEFREETX to 88709. Parents can text QUIT to 202-899-7550 to get tips and advice for helping their teens and young adults quit using tobacco or vape products.

Request an appointment at MD Anderson online or by calling 1-877-632-6789.