Are nicotine patches for kids who vape a good idea?

VSChildren whose vaping has led to nicotine addiction should be given nicotine patches to help them quit vaping, UK health officials say.

A report from Public Health Wales (PHW) says children in this situation should receive “support, not punishment”. The agency’s incident response group has been investigating the rise in vaping among children and young people in Wales.

According to the month of April report“A growing number of children are experiencing addiction to such a level that it is very difficult to get through the school day without vaping on school grounds.”

“Nicotine replacement therapies, already available to smokers over the age of 12, are one tool that could help,” said Chris Emmerson, consultant at PHW. said the BBC, “…in tandem with other support mechanisms”.

The UK National Institute for Health and Care Excellence States that for children over 12 years of age, NRT treatment should be limited to 12 weeks.

Although vapes are much less risky alternatives to cigarettes and effective tools for quitting smoking, NRT options such as patches are not as controversial as vapes and are considered as being at the lowest end of the nicotine product risk continuum.

“NRT could have a role during the school day, to discreetly prevent withdrawals. »

The PHW patch recommendation for children and adolescents raises questions about where authorities draw the line. harm reduction among young people, and why. Responses from tobacco harm reduction experts are mixed.

“NRT could play a role during the school day, discreetly preventing withdrawals in a school environment where addicted vapers cannot vape,” Dr. Colin Mendelsohn, an Australian defender of THR, said Filtered.

Nicotine addiction is more likely when nicotine is delivered more quickly, he says. said, and the patches deliver nicotine more slowly than others cigarettes or vapes. “After switching from vaping to patches, it’s easier to quit nicotine completely.”

But Mendelsohn added that while the NRT approach may help some young people, “young people have never been enthusiastic about using NRT.”

UK THR advocate Clive Bates of Counterfactual Consulting says a broad application approach Smoking cessation therapies for minors who vape, however, would be counterproductive, because they “contribute to the horrible mess of confusion and ignorance about vaping among young people.”

Fear of vaping among young people, as Mendelsohn had already done wrote For Filtered“far exceeds the objective threat it represents”, while “its benefits are almost universally neglected”. And this fear has always been used by policymakers around the world to restrict access to vapes for smokers.

“The danger of getting it wrong by offering quit vaping advice combined with scare stories about vapes is that we could end up with more smoking and more harm.”

Most teens who use vapes are simply experimenting, Bates said. Filtered, and for most, it is a passing phase. “They won’t become addicted and will probably stop fairly soon.” »

Mendelsohn also cited a rate of between 3 and 8 percent of young Australians suffering from nicotine addiction, based on different surveys of self-reports and vaping frequency. And some of these young people smoke or smoke before.

Bates added that vapes are likely replacing cigarettes among young people and are therefore beneficial to young people who would otherwise smoke. As Mendelsohn and other experts have noted, common social, psychological or genetic factors appear to predispose young people to vaping and smoking.

“The danger of anti-smoking activists jumping into quit-vaping advice combined with scare stories about vapes is that we could end up with more smoking and more harm in general,” Bates said.

“Given that vaping is low risk and cigarettes are high risk, the net effect of vaping among youth is likely to be strongly positive for public health,” he concluded. “The real challenge is to understand why there is demand, assess what would happen in the absence of vapes, and respond proportionately – and preferably without doing more harm than good. »

Whether misguided or not, the widespread adoption of NRT in children, if it occurs, would seemingly contradict years of grandiloquent declarations of World Health Organization and other health authorities on the dangers of nicotine for young people (even though NRT is on the WHO list). list of essential medicines).

“There is no evidence that nicotine damages the human brain of adolescents,” as the WHO and others have claimed, Mendelsohn said. Research on generations of people who smoked cigarettes has shown no such link. “Some vape for relaxation, to improve focus or ADHD, or other benefits.”

“If we don’t address the cause, we’re just playing whack-a-mole with the outcome of that cause. »

Skip Murray, defender of THR, in the United States, said Filtered that the underlying causes of vaping among young people (and the use of other drugs) should receive greater attention. “Are they trying to relieve stress or depression? » she asked, adding that “not everyone rebels or experiments.”

“If we don’t address the cause, we’re just playing whack-a-mole with the outcome of that cause,” said Murray, who writing For Filtered on the intersection of youth mental health and school vaping policies. “I find it deeply concerning that we are not having more conversations about what is happening in young people’s lives.”

Young people who vape or smoke can be indicators of problems such as ADHD Or mental health problemsshe also pointed out.

Michelle, originally from Florida, started smoking at the age of 9, after listening to adults say cigarettes helped them “relax.” As a child with an undiagnosed anxiety problem, he was always told to do just that. And it was thanks to the nicotine in cigarettes that this was possible.

In 9th grade, “my grades improved when I could smoke before class,” she said. Filtered. “I finally felt like I fit in with the other members of my class.—I was no longer the outcast for always getting into trouble.

As an adult, Michelle was diagnosed with anxiety. “I researched what anxiety was and found out how and why the nicotine in cigarettes helped me—it all came together!

Michelle then tried to quit smoking with NRT, but I discovered that it did not suit him. Her doctor recommended vaping instead, and it worked.

THE Public Health Wales The report also calls for a ban on disposable vapes and flavor names known to attract minors. This fits with recent political hostility towards vaping in the UK, previously known as one of the most important countries in the world. compatible with vaping countries.

The imminence Bill on tobacco and vaping will bring restrictions on flavored vapes, which many people find essential to quitting cigarettes. A new tax on vaping, reduce the financial incentive to change, was also announced in March. NRT for children suggests a principled openness to harm reduction, just as access is restricted for those at much higher risk.

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Photograph by RegBarc via Wikimedia Commons/Creative Commons 3.0