Health professionals say the number of teenagers using e-cigarettes is at a crisis level.

“Obviously, we’re concerned about this,” Jill Selzle, a physician assistant with Nebraska Medicine, said Tuesday at a presentation on the devices.

According to the U.S. Food and Drug Administration, e-cigarette use grew 78% among high school students and 48% among middle school students between 2017 and 2018. The FDA also said that, among the 5 million youths who use tobacco products, 3.6 million of them use e-cigarettes, making it the most-used tobacco product among teens.

E-cigarettes and vapes can have serious effects on brain development in teenagers, Selzle said at the Science Cafe presentation. Frequent e-cigarette use can affect attention and learning ability in young users, as well as create mood disorders and lower impulse control, she said.

Selzle also said treatment of nicotine addiction in teenagers can be a gray area.

“We mentioned how do we help kids, and it’s such a tough problem, because there’s no clinical trials that support” nicotine replacement therapy medication in youths, she said. “We just don’t have clinical support to trust that in young kids.”

Instead of turning to nicotine patches, gums or lozenges to treat the addiction, Selzle said, caregivers can use cognitive behavior therapy as a means to help.

Experts nationwide have tried to address the issue. This week, the FDA released an ad campaign about the similarities between e-cigarettes and traditional tobacco products. Thursday, a U.S. House subcommittee accused Juul Labs of deploying a program to target teens and children at schools and summer camps.

The subcommittee said Juul operated a division that persuaded schools to allow the company to present its programming to students and paid the schools in several instances at least $10,000 to gain access to the students during classes, summer school and weekend programs. Juul officials said the effort ended last fall and involved about a half-dozen schools and youth programs.

In May, Nebraska legislators took action against e-cigarette use among minors by passing a bill that changed the legal age to buy or use tobacco or electronic nicotine delivery systems from 18 to 19.

Selzle, who also is a certified tobacco treatment specialist and registered vascular technologist, sat down with The World-Herald to talk about e-cigarettes.

Responses have been edited for clarity.

Would you say the sale of e-cigarettes and vapes has led to a resurgence for the tobacco industry?

It’s a new kind of wave of addiction. If you look at who owns electronic nicotine delivery systems, it’s tobacco companies. They want to keep customers, and they want to make money. They’re smart. And if you look back at the marketing campaigns between old tobacco and electronic, they kind of mirror each other, scarily.

Why is it worse for a teenager to vape or use e-cigarettes than it is for an adult?

That’s just purely regarding brain development. That period of time where we’re making new synapses and our brain is growing, all of this is then done under the context of nicotine, and it changes the way that a brain functions. I think, sadly, the best-case scenario with these (e-cigarettes and vapes) is a consumer who has been smoking a pack a day for 30 years and now we’re reducing their harm by transitioning them to an electronic device. It’s much different than an 8-, 10-, 12-, 15-, 18-year-old who’s never been a smoker and introducing them to nicotine.

You said there’s no long-term data on e-cigarettes and vapes. What are the biggest questions still unanswered?

I think time’s going to tell us. I think the medical community is fairly comfortable saying these are going to be less harmful (than other tobacco), but we’re not saying they’re going to be harmless at all. We just don’t have the long-term data to suggest what outcomes will be yet … And I would say legislation. For us to understand if these are safe and how we can best use them for the public is going to require us to study them and regulate them.

What do you tell a teen who is considering using an e-cigarette?

That’s a hard question, and I think it’s where a lot of us are at right now … I don’t know what I need to tell kids. I wish they would tell me, like what do I need to tell you to convince you this isn’t safe, this isn’t in your best interests? What can we tell them and how can we present the information so that it is meaningful to them?

This report includes material from the Washington Post.

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