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Teen Vaping is a Public Health Crisis

Dec 08, 2021 06:00AM ● By Emily Freehling

Mary Washington Healthcare urges parents to talk to children about the dangers of e-cigarette use


More than two million American high schoolers and middle schoolers report some degree of e-cigarette use, according to a 2021 survey by the Food and Drug Administration (FDA) and Centers for Disease Control and Prevention (CDC).

Known as “e-cigs,” “vape sticks,” or “vape pens,” these devices’ growing popularity among teens and adolescents presents a serious public health problem, says Dr. Timothy Sherwood, director of the Thoracic Surgery Program at Mary Washington Hospital.

“It’s important to understand the harm associated with e-cigarette usage,” he says, “not only directly from the e-cigarettes, but also from the potential they have to introduce children to tobacco products.”

A growing body of evidence suggests that e-cigarettes are serving as a “gateway drug” that makes teens far more likely to try traditional cigarettes than those who stay away from vaping. 

A 2018 study published in the journal Pediatrics found that kids who tried vaping were more than four times more likely to pick up a regular cigarette. The CDC has stated that teen vaping is the main driver behind rising tobacco usage rates among U.S. middle and high school students.

There may not be smoke, but there’s still nicotine

Nearly all e-cigarette products—including many of the flavored “vape juices” favored by teens—contain nicotine, a highly addictive substance. The U.S. Surgeon General has warned that young brains, which are still growing and developing, are at greater risk for long-term impacts when exposed to nicotine. These can include mood disorders, addiction, the permanent lowering of impulse control, and difficulties with attention and learning.

Sherwood says it’s important for parents to talk with their children about the dangers of nicotine addiction, tobacco use, and e-cigarettes—which the CDC has linked to thousands of cases of acute lung injury caused by chemicals within the vaping fluids.

“It’s difficult because there is so much peer pressure we are fighting,” says Sherwood, a father of four. “At this age, kids feel as though nothing can hurt them. They usually consider this a short-term phase that they are going to be in, and they think they will quit eventually.”

But Sherwood’s experience treating lung cancer patients with a long-term history of smoking tells a different story. He says that even receiving the news that their habit has caused a life-threatening disease is not enough to lure many long-time smokers from the pull of nicotine.

“Unfortunately, nicotine is one of the most addictive drugs that we know of,” he says. “It is very, very difficult to quit, even when you are faced with a lung cancer diagnosis. Avoiding nicotine usage from the very beginning is the key element to preventing these long-term health consequences.”

FDA authorization doesn’t mean it’s safe

In October, the FDA for the first time authorized the marketing of one specific brand of e-cigarette and cartridges specifically to help addicted adult smokers to wean themselves off cigarettes. The FDA stated that the action “does not mean these products are safe or ‘FDA approved.’”

Sherwood says it’s important for parents to understand that the only potential health benefit the FDA identified from e-cigarettes is their potential to help current smokers consume fewer cigarettes. For youth who have never smoked, e-cigarettes can cause only harm.

“For children, it is a completely different set of circumstances,” he says. “It’s a gateway to tobacco usage.”

As a thoracic surgeon, Sherwood feels strongly about the need to curb youth tobacco use of all kinds, because smoking is the No. 1 risk factor for lung cancer, linked to 80% to 90% of lung cancer deaths, according to the CDC. 

Lung cancer is by far the leading cause of cancer death in the U.S., according to the American Cancer Society, which estimates the disease will take more than 130,000 lives in 2021. 

“The best way to combat lung cancer is to eliminate cigarette usage completely,” Sherwood says. 

Talk to Kids About Vaping

(Tips from the American Lung Association)

Maintain an open line of communication with kids about all tobacco use. Remember to put yourself in your kid’s shoes—be aware that they are battling peer pressure.

Avoid judgment when talking to your child. Kids may react defensively or tune out.

Find the right moment to talk—such as when you are passing a vape shop or watching a show on TV. Look for a moment when the conversation won’t be confrontational.

For more tips, visit

Lung Cancer screening can benefit current and past smokers

For the estimated 34 million American adults who are regular smokers, awareness of lung cancer screening capabilities is an important part of fighting lung cancer.

Mary Washington Healthcare’s Lung Cancer Screening Program uses low-dose CT scanning to examine the lungs of individuals who are at high risk for lung cancer due to their smoking history. 

Recently updated federal guidelines state that individuals ages 50 to 80 who have a 20-pack-year smoking history (one pack per day for the past 20 years) and are currently smoking or have quit in the past 15 years should receive annual screenings. Private insurers are required to cover these screenings under the Affordable Care Act, while Medicare enrollees are currently eligible for screenings at ages 55-80 with a 30-pack-year smoking history. 

Sherwood says the scan takes about 10 minutes, and results are read by specially trained radiologists who can identify and classify any lung nodules detected, and refer the patient for next steps, whether that is continued screening, diagnostic imaging or consultation with a specialist. 

Lung screening can detect cancers long before individuals may notice or experience any symptoms. At this stage of early detection, cancers are far more treatable and curable.

Comprehensive cancer care in the Fredericksburg region

Smoking prevention and lung cancer screening are part of Mary Washington Healthcare’s comprehensive approach to lung cancer care. MWHC is constantly seeking the latest innovations in cancer diagnosis and treatment. MWHC participates in several clinical research trials for early detection of lung cancer and lung cancer treatment. One of our studies is designed to collect and analyze blood samples from individuals undergoing low-dose CT lung screening for the development of new drugs, treatments, and testing that could lead to earlier detection of lung cancer. For more information, visit

“We really are on the cutting edge of new technologies for lung cancer diagnosis,” Sherwood says.

Lung cancer treatment through the Regional Cancer Center takes a team approach, with a thoracic surgeon, radiation oncologist, and medical oncologist working together in constant communication to ensure patients receive the most effective treatment.

To learn more, visit 

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