What Parents Should Know About Smoking, Vaping, and Hookah Pipes | Your Teen’s Health Podcast Series #3

Posted on Aug 19th 2014 by Kate Warnock

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On the teen-smoking front, there’s good news and bad: according to a recent report by the Centers for Disease Control, smoking among U.S. high school students is at its lowest rate in 22 years. Fantastic, right? Here’s the bad: each day, approximately 4,000 kids under age 18 try their first cigarette. And products like flavored tobaccos and e-cigarettes are being marketed specifically to kids.

At Florida Blue, we feel it is imperative to know how to counsel teens who are exposed to pro-smoking influences. In our third episode of Your Teen’s Health, we interview Sr. Medical Director Carmella Sebastian, M.D., who shares her advice on what parents should know about teens and smoking. http://www.brainshark.com/bcbsf/podcast/588926020.mp3

According to the American Cancer Society, nearly 9 out of 10 adult smokers had their first smoke by age 18. Don’t let your teen become a statistic! Talk with them today about the dangers of all forms of smoking. How else can you keep your teen healthy? Start with our podcast episodes on teen vaccinations and car safety, and stay tuned for more episodes covering prescription drug abuse, bullying and social media addiction.

The complete transcription of the podcast begins here:

Welcome to Florida Blue Radio where we explore health care topics important to you. Whether you own a business, are a health practitioner or are an individual interested in how health care is evolving experts from across Florida Blue will keep you in the know. In today's session, we begin our series on teen health with Florida Blue's Senior Medical Director, Doctor Carmella Sebastian. Doctor Sebastian will share information on the most common health issues concerning our teens, and empower parents with ways to talk to their teens about them.

Our host is Kate Warnock, Social Business Strategist at Florida Blue. Now, here's Kate.

Kate Warnock: We're back today with Doctor Carmella Sebastian, Senior Medical Director at Florida Blue, and we're continuing our series on teen health. Today's topic, Doctor Carmella is going to be on smoking. And I wanted to start with a quick story that I have with where I was with me seventh grade daughter, we were just at the beach, it was the 4th of July weekend, and just a little bit of stretch of the beach down from us was a young woman who was sitting on her beach towel, a beautiful young lady, and she pulled out an e-cigarette smoker. And Abby's eyebrows shot up and she looked at me and said, mom, what is she doing? And I had to explain to her this is the new way for smoking. So, Dr. Sebastian, I wanted to hear from you. I know the statistics say that actually the traditional cigarette smoking, where you light up the end of the cigarette and everything, it's actually on the decline. What can you tell us about this new smoking. Some people might know it as vaping because they vaporize the nicotine smoke. What can you tell us about that, and specifically, how it's going to impact our teenagers?

Dr. Carm: Well, you know, smoking is one of these things that has always been a real button pusher for me because my father died from smoking. Maybe he'd be alive today. He was really healthy and I tried to get him to stop smoking from the time I was about six or seven years old. So, I spent most of my life trying to do that to no avail. And by the time he actually did quit, of course, by that time the damage was done. So very early in my life with my children driving around I would make it very clear that, if we saw someone who was smoking, it was very dangerous, and those people were probably going to be very, very sick or die from using tobacco. And so, sometimes I had to watch what they would say in public because they would point at somebody who was smoking and say, well you know she's going to die. I don't want to get into any fights, but it was very effective, and nowadays you don't know what to do because there's so many different types of products out there. And right now, 380,000 12 to 13-year-olds, and almost four million 14 to 17-year-Olds have at some point smoked traditional cigarettes. The tobacco use really has decreased substantially over the last 40 years in our adolescents, but nearly one in 10 high school seniors were daily smokers in 2013. So we still have a problem. There's different racial, and ethnic, and regional differences. Among high school students, white teens are more likely than black or Hispanic peers to smoke. Smoking rates are typically higher in rural areas, and in the southern and Midwestern regions of the country. And what's really scary is that more than 80% of adult smokers begin smoking before 18 years of age, and 16% of high school seniors reported smoking in the last month. And if they start smoking before the age of 21, statistically, these adults have the hardest time quitting later in life.

Kate Warnock: I mean that really kind of blows your mind doesn't it. There is still a very, very big problem. It is a big problem. As much as you think, oh my gosh, nobody does that any more, clearly the teens, especially these young teens who were giving it a try, like your father, might be the ones that simply, when they want to give it up, it's beyond the point that they really get the health benefit from quitting. Right, and I mean most of the decrease in traditional cigarette use has come because of taxes levied on the cigarettes. That has been the number one deterrent to smoking, and the second one is the use in restaurants and other places. But you can still smoke, and basically there's hospitals that have smoking sections outside. And we always pass by one and we'll see somebody in their hospital garb with their IV smoking a cigarette. So it's still accepted in a lot of places, and so this message gets passed on.

Dr. Sebastian: But not only the traditional cigarettes we have to worry about. There's other things. Smokeless tobacco is incredibly dangerous. Not because it's been linked to the lung diseases, but the head and neck cancers, and the cancers of the mouth. Incredibly devastating. I mean, it is physically devastating, and very, very deadly. So smokeless tobacco is a problem. It's very disfiguring, too, from the ad campaigns. Oh, terrible. It's the worst I've ever seen in my life really. I've seen a lot of devastation from different diseases, but this is a really horrible. And the thing is that it used to be very closely linked with baseball players, and several of them have ended up on posters as poster children for not using smokeless tobacco. So that's something to keep your eye open for. People have traditionally thought it's less harmful than smoking a cigarette, but it's very deadly, and very dangerous. The other thing is what you were talking about a little earlier, and it's more commonly referred to as the hookah lounges. The lounges where people go to use these hookahs, and they're basically this big long pipe, and they originated in India and some of those places. But what happens is they have a coal, and the coal burns. And then you have different flavors of a tobacco, and it's passed over vapors. And so it can deliver very high levels of toxic substances. So it may not be linked directly the way cigarettes have been to some lung diseases, but is definitely full of carcinogens which cause cancer. So hookahs are no safer than any other form of tobacco smoking.

Kate Warnock: One thing that I read too, Doctor Sebastian, is that typically in that hookah lounge you're there with your friends and it's a very social experience, that you tend to be smoking on that pipe maybe for upwards of an hour. And so, over that period of time, I've actually read that it's the equivalent of smoking two to three packs of cigarettes in a single sitting because you are doing it for so long.

Dr. Sebastian: Right, and don't forget it's flavored. You know the things that are happening now with our kids. Now they're putting flavors into it, cherry and vanilla, and all these other that may smell very nice, but it doesn't mean they're any less dangerous. So, little flavored cigars and little flavored cigarettes, middle and high schoolers who smoke, more than 40% are smoking the flavored varieties of these cigars or cigarettes. So, I mean, they're making it more desirable, more attractive to the younger set. The other thing you mentioned was e-cigarettes, and this is startling, but during 2011 to 2012 middle and high school students who had ever used any cigarettes increased from 3.3% to 6.8, more than doubled. The cigarettes themselves do not have the tar in them that's been linked to cancer. However, they do have the nicotine, and they are addictive. The other thing is that it's very, very dangerous if your filling the actual cigarette. Because there's a liquid, and a lot of people fill the e-cigarettes, and if you drop that substance on yourself you're just absorbing through the skin all of that nicotine, and it can be very dangerous. So there's never been legislation up to this point for prohibiting the sale of these e cigarettes to young adults, but now there is legislation under way, and I believe that any time now it's going to be limiting the use of these cigarettes for young adults under the age of 18. Well let's hope that the legislation catches up quickly because this certainly seems to be a population at risk given all that you have shared with us today.  

Kate Warnock: So, I'm really curious. In our next session on teen health, Doctor Sebastian, we're going to be talking about drug abuse. And from what I've read in research, I know that children who start with smoking, whether it's an e-cigarette or whatever, are more likely to try other drugs and illegal substances. So, I'm looking forward to picking up on that topic with you, and all in the name of trying to keep our teenagers healthy, and safe, and happy. So thank you again for your time today. Thank you. All right, we'll talk to you soon. 


You have been listening to Florida Blue Radio, recorded at our Jacksonville headquarters. For notes from today's program, visit is our blog at floridablue.com. Be sure to leave us a comment there with your ideas or suggestions for future programs. Until next time, here's to you in your pursuit of health.

Filed under: Healthy Living  

Kate Warnock

Kate Warnock is a member of the Florida Blue social media team and has loved being at the forefront of the social wave @FLBlue. A marketer with ten years’ experience, Kate is also a wife and mom to two children. When not at work, you’ll find Kate listening to NPR, reading The New Yorker and Cooking Light, and arriving two minutes late to yoga class.

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"...they originated in India and some of those places." That is a very ignorant phrase.

Shanti, since Dr. Sebastian's focus was on the dangers of smoking any tobacco products, and not the history of smoking across cultures, her reference to "some of those places" was a short-hand and not intended to be insensitive. Our sincere apologies for any offense! Please know that we appreciate both your comment and for listening to the podcast.

I'm curious if you will explore the means that children are getting these illegal (for their age group) products. I support legislation that makes sale, use, possession of nicotine products to those under 18 illegal. As a nurse I absolutely do not want children smoking, chewing, vaping nicotine. But, just as with alcohol, we still are not addressing the real reasons that this population gets these things. Peers and parents play a pivotal role in determining not only the desirability but the availability of these things to children. I've yet to hear commentators putting this point bluntly and pervasively to parents and community members. Perhaps you will be the first?

Bruce, we appreciate your point and truly believe that no one plays a more important role in fostering a teen's good health than a parent or caregiver. Florida Blue is committed to educating all Floridians on why a healthy lifestyle includes modeling the right behavior for children who are creating their own identity. Our Teen Health series is a step in that direction. Counting on like-minded health practitioners like yourself to spread the word is another! We hope you continue to find value in our health and wellness stories and look forward to your future comments.

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