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Teenage vaping is already a global epidemic affecting 3.6 million children who use Juul and other electronic cigarettes. But nobody knows what is the best way to help adolescents who may be addicted to nicotine.
The electronic cigarette is today the most risky substance used by adolescents, according to US authorities, who claim that Juul and similar products spread faster than cigarettes, alcohol, marijuana and other substances.
Electronic cigarettes heat a liquid solution that usually contains nicotine and produces inhalable vapor.
In countries such as the United States it is forbidden to sell these cigarettes to children under 18, but they say they have them with friends or on the Internet.
While some measures have been taken to prevent electronic cigarettes from reaching the hands of minors, there is almost no question of how to treat nicotine addiction in children up to 11 years of age. Some may be able to leave the cigarette without anyone's help, but experts say that many will cost and have symptoms of anxiety, irritability, problems with concentration and loss of appetite.
Doctors treating young patients have different dilemmas: anti-smoking therapies, such as patches and nicotine gum, can not be sold to minors because they have not done enough experiments and the results are mediocre. Furthermore, young people tend to think that it is impossible to become addicted to electronic cigarettes and have no incentive to quit.
The bad taste and the bad experience of smoking when you try it for the first time can discourage many young people and prevent them from taking the habit. But this does not happen with the vapor of the electronic cigarette, which is easier to inhale, according to experts.
Overcoming an addiction requires discipline, patience and a willingness to follow a treatment plan, which is not easily given to minors, experts say.
"Teens have their own ideas about what works with them and do what they want," said Susanne Tanski, tobacco prevention expert at the American Academy of Pediatrics. "We desperately need studies that say what can work in this population."
Since its release for sale in the United States in 2007, electronic cigarettes and other vaping machines have spread excessively and have a turnover of 6.6 billion dollars. Its propagation helps the existence of small, easy-to-hide appliances such as Juul, which vaporize a sufficient amount of solution with high levels of nicotine and is used with flavors such as vanilla, mango and cucumber.
The US authorities have not vetoed the sale for now.
Electronic cigarettes are a scourge in US schools. One in five high school students said they vaped last month, according to government statistics.
Juul and other brands are offered to adults as a way to quit smoking, but there are not many studies on the effects of their long-term use, especially on young people. Nicotine can influence learning, memory and the attention of adolescents. There are no studies on their impact on the lungs, which do not end up maturing until after 20 years.
"It scares me as a pediatrician because I feel that there is an experiment without any control among young people," said Tanski. "They do not realize the damage and we can not show them what will happen to them".
Quitting smoking is very difficult. More than 55% of adult smokers tried to resign last year and only 7% could do so, according to US government data.
No method to quit smoking has yielded satisfactory results for now, as well as psychological therapies.
Psychiatrist Jonathan Avery, who specializes in addictions, says that a big problem is the fact that many doctors have never heard of Juul and do not recognize the vaping devices their patients carry.
Teenagers, on the other hand, are "suspicious" when they are told that they are inhaling a highly addictive substance, according to Avery, who works at Presbyterian Hospital in New York.
About two-thirds of teens in the United States do not know that Juul contains nicotine, according to a recent study by the Truth Initiative, a group that opposes smoking.
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