Vulnerable Populations

Tobacco use and vaping among children and adolescents

Nearly all tobacco use, including E-cigarettes (vaping), begins during youth and progresses during young adulthood. Tobacco use, vaping, or exposure to secondhand smoke among children and adolescents can cause serious health problems. Continued efforts are needed to sustain the progress and to prevent and reduce all forms of tobacco product and nicotine use in children and adolescents. Tobacco prevention and cessation must be addressed with youth and their families. During visits with your patients:

• Provide education and/or brief counseling to prevent initiation of tobacco use including the use of e-cigarettes (vaping) among children and adolescents.
• Provide counseling to children and adolescents who use any form of tobacco or vaping products.
• Provide counseling for parents/caregivers who smoke about the harms of secondhand smoke and how to mitigate them.

For more information on clinical recommendations and guidelines visit:

• USPSTF Recommendations for Tobacco and Nicotine Use and Prevention in Children and Adolescents
• The American Academy of Pediatrics:
  • Screening Adolescents for E-cigarette Use in Clinical Practice
  • Counseling and Motivational Interviewing for Teens
  • Addressing E-cigarettes and Tobacco with Parents

Quitting Resources for Adolescents

There are many quitting resources that are tailored towards adolescent patients. Make sure to share these resources with your adolescent patients to support them on their quitting journey.

• NOT for ME: A self-guided online program that leverages the American Lung Association’s Not On Tobacco (N-O-T) program to help teens quit tobacco, whether they vape, smoke, or use other tobacco products. The program can be accessed through a tablet, computer, or phone. Patients can learn more here. 
• SmokefreeTXT for Teens: A text messaging program for people between 13 and 17 years old. The program provides support in quitting tobacco. Patients can learn more here. To get started, patients can text QUIT to 47848.
• This is Quitting: A text messaging program for people between 13 to 24 years old. It is designed to help young people quit vaping. Patients can learn more here. To get started, patients can text DITCHVAPE to 88709.

Learn more with California Tobacco Control Program Youth-Specific Factsheets

• Youth Tobacco Use Infographic 2020
• American Indian and Alaska Native Youth Fact Sheet 2022
• LGBTQ+ Youth Fact Sheet 2022
• Rural Youth Fact Sheet 2022

Tobacco Cessation Services for Pregnant Tobacco Users

Tobacco use and secondhand smoke expose the pregnant person and the pregnancy to a wide range of health risks. Therefore, pregnant persons should be advised about the significant perinatal risks of using tobacco during and after pregnancy. In addition to the steps you would follow for all patients, be sure to highlight the following recommendations for those who are pregnant:

• Ask all pregnant patients if they use tobacco products or are exposed to tobacco smoke.
• Offer one-on-one counseling for pregnant patients using tobacco products.
• Offer assistance with quitting throughout the pregnancy.
• Document counseling and available cessation-aid services provided at each prenatal and postpartum visit in the electronic health record (EHR).

For more information, check out the U.S Preventive Services Task Force (USPSTF) recommendations.

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