Toolkit for Schools

E-cigarettes are battery-powered vaporizers that simulate the action and sensation of smoking. Their use is often referred to as vaping because they do not produce tobacco smoke, but rather an aerosol (often mistaken for water vapor). They are also known as e-cigs, e-hookahs, e-pipes, tanks, mods, vapes, electronic nicotine delivery systems, or ENDS, and more. Some youth refer to vaping devices by their brand name such as JUUL, BO, Blu, and others.

Nearly all e-cigarettes contain nicotine.¹ Nicotine is highly addictive and can harm the developing adolescent brain.^2,3 Because the brain is still developing until about age 25, youth and young adult exposure to nicotine can lead to addiction and disrupt attention and learning.²

Learn more about e-cigarettes and nicotine.

• Get the Facts
• Vaping Products
• E-Cigarette Use Among Youth and Young Adults: A Report of the Surgeon General
• Information on Electronic Cigarettes – Centers for Disease Control and Prevention (CDC)

Learn more about how the tobacco and vaping industries target kids.

• Tobacco Industry Tactics

In July 2018, the Massachusetts Department of Health, Tobacco Cessation and Prevention Program (DPH) launched The New Look of Nicotine Addiction, a public information campaign to educate parents of middle and high school aged youth about the dangers of vapes and e-cigarettes. This Toolkit is one part of that effort to reach parents and youth-serving adults with information and resources about vapes and e-cigarettes.

In April 2019, DPH launched Vapes and Cigarettes: Different Products. Same Dangers., a public information campaign to raise awareness among middle and high school aged youth about the dangers of vapes/e-cigarettes. Below is information about the campaign, resources available to schools and community-based organizations, and ideas for utilizing the resources.

Audience: Massachusetts youth, ages 12-17, who have used e-cigarettes or who may be considering trying them.

Goal: To prevent youth from becoming e-cigarette users by:

• Educating youth about the dangers of vaping
• Making the connection between vaping/using e-cigarettes and smoking combustible cigarettes

Various messages, approaches, and images were tested with Massachusetts middle and high schoolers through focus groups (a research method that brings together people to provide feedback regarding a product, service, concept, or marketing campaign). During these focus groups, youth overwhelmingly expressed the desire for straight facts about vaping. This information, combined with feedback from both parents and youth that vaping is perceived as different than cigarette smoking, informed the message and image for the campaign.

The campaign reached youth directly through a variety of channels:

• Online and social media ads on platforms popular with youth (e.g., Snapchat, Spotify, Instagram) from April – June 2019
• Web page and Instagram account where youth can seek more information and resources
• Through organizations such as schools and community based organizations with posters, fact clings, and a handout
• The campaign began again in late September 2019 and will conclude in February 2020. The campaign also incorporates quitting resources for youth.

There are many ways that you can utilize the campaign and its resources within your school, community based organization, or healthcare practice. Below are just a few ideas that are also reinforced in various sections throughout the Toolkit.

• Reinforce adult education about the topic. The youth campaign and materials are a great way to reinforce educating parents/guardians and staff in your organization about e-cigarettes. If you haven’t already done so, consider a presentation to these audiences with basic information around e-cigarettes. A sample presentation and guidance document for giving this presentation is included in the sections for School Administrators and for Curriculum Coordinators, Health Educators, and Teachers. The presentation has been updated with a few slides about the youth-focused campaign.
• Hang campaign posters. The Vapes and Cigarettes: Different Products. Same Dangers. posters were created to deliver messaging to youth.  Consider hanging them throughout your building where they are visible. Ideas for placement include bathrooms, locker rooms, classrooms, counselor’s office, nurse’s office, coach’s office, bulletin boards, hallways, lunch room walls, concession stands at school events, meeting rooms, etc.
• Hang fact clings. Each of the four main facts on the campaign poster are printed as small “clings” that adhere to windows, mirrors, doors, and other surfaces. Because young people reported during the campaign focus groups that school bathrooms are often a favored vaping location, the clings were developed with school bathrooms in mind – but they can be used in other areas of your organization’s building as well.

• Distribute the campaign handout. A two-sided handout or fact sheet contains more facts about the dangers of vaping/using e-cigarettes.  The handout expands upon the four main facts in the poster and fact clings and provides resources for youth. (The information in the handout is the same information on the campaign’s web page mass.gov/vaping.) The handout can be used in a variety of ways such as a resource for youth in the counselors’ or nurse’s office, or as part of an assembly or health class on the topic of tobacco or other substance use prevention. An updated version of the handout with the addition of quit resources for youth is now available. The handout is also available in Spanish (download only at this time).

All campaign materials are available free of charge to Massachusetts residents and organizations by visiting the Massachusetts Health Promotion Clearinghouse.

• Involve students and incorporate campaign messages in other school activities. There are many ways your organization can involve youth in the implementation of the campaign. One idea is to ask student groups or youth participants to assist in hanging the posters and fact clings (e.g., 84 Chapter, Students Against Destructive Decisions (SADD), Key Club, or Student Council, etc.).
• To more fully integrate the campaign’s messages throughout your school or organization, ideas include:
  • Play the campaign’s brief YouTube ad (video) on monitors where appropriate
  • Use the campaign facts (including those on the handout) as a part of morning/afternoon announcements or assemblies. Ask adult advisors to use them to prompt conversation at club/program meetings. The handout or facts can also be a topic of conversation with youth who meet with school counselors and nurses.

• Use the campaign poster and facts to inspire:
  • Plays or scenes in drama class or a production by the theatre department
  • Art, music, or dance
  • Essays, creative writing, or poetry
  • Articles in the student newspaper or other publication, including a newsletter that is sent home to parents/guardians
  • Word problems in mathematics or a science experiment
  • Student-led conversations during classroom meetings/club meetings/lunch
  • A supportive environment and resources for youth who are addicted to nicotine – let them know where they can go for help

If you use the campaign materials and resources, consider the following:

• Let staff know in advance. By letting staff know in advance of utilizing the campaign’s resources, there is time to educate them with more information about vaping and e-cigarettes, as well as your organizations’ policies and procedures with regard to vaping. Teachers or program managers can incorporate the information into lesson plans. And staff can also be on the lookout for posters and clings to ensure they remain hung and are not vandalized.
• Communicate with parents/guardians about the campaign. Sample language for an email blast or newsletter is included in the section for School Administrators. Letting parents/guardians know that the campaign resources are being utilized in your organization helps them prepare for conversations with youth at home. As mentioned earlier, it is also a good opportunity to provide adult-focused resources and information.
• See information for School Administrators about establishing a chapter of The 84 Movement, a statewide movement of youth fighting tobacco in Massachusetts.
• See information for Curriculum Coordinators, Health Educators, and Teachers for resources to update curriculum to address the harms of nicotine and e-cigarette use and for resources on relevant, youth friendly lesson plans.
• Middle Schools: Please see the information on Project Here in the Curriculum Coordinator section below.
• Update tobacco-related signage with new signs for schools from the Massachusetts Health Promotion Clearinghouse. The updated signage for schools now includes both e-cigarette language and imagery.

Review the Toolkit in its entirety for additional information and resources on student use of e-cigarettes and other vaping products, including a new cessation resource for teens and a presentation designed to educate youth on e-cigarettes.

If you have questions or comments about the Vapes and Cigarettes: Different Products. Same Dangers. campaign and materials, please contact The Massachusetts Tobacco Cessation and Prevention Program through the “Contact” tab at the top of www.makesmokinghistory.org.

The Massachusetts Smoke-Free Workplace Law prohibits smoking in all enclosed workplaces, including public and private schools. In addition, Massachusetts requires that all public schools through high school prohibit smoking on school grounds, on school buses, and at school sponsored events during normal school hours. The law is commonly referred to as the “Education Reform Act” (MG.L. ch. 270, §22(b)(2); MGL c. 71, §§2A, 37H; c. 90, §7B(10)). Governor Baker signed legislation in 2018 that amends the “Education Reform Act” to include e-cigarettes and other electronic nicotine delivery products. This took effect on December 31, 2018.

Schools also have the authority to create their own policies with regard to tobacco use (including e-cigarette use) on school property for students, staff, and visitors.

Here’s what you can do

Review and strengthen current school tobacco policy.

• The Massachusetts Association of Health Boards developed guidance for schools looking to address e-cigarettes in their school tobacco policy. School Tobacco Policies: Applicable Laws and Sample Policy – contains information about applicable laws and sample school tobacco policy language to include e-cigarettes and vaping.
• Public and Private Schools and The Massachusetts Smoke-Free Workplace Law – questions and answers for schools about the Smoke-Free Workplace Law
• Massachusetts Law regarding Student Use of Tobacco Products – a link to state law about use of tobacco products within school buildings or facilities or on school grounds
• Free Signs – Massachusetts Health Promotion Clearinghouse (Note: Signs for schools that incorporate e-cigarette language and imagery are now available)
• NEW! Intervention for Nicotine Dependence: Education, Prevention, Tobacco and Health (INDEPTH) is a new, alternative to suspension or citation that helps schools and communities address the teen vaping problem in a supportive way. Punitive measures can punish young people who have unfairly been targeted by the tobacco and vaping industries, hooking them to their addictive products. Instead of punishing youth, INDEPTH is an interactive program that teaches students about nicotine dependence, establishing healthy alternatives and how to kick the unhealthy addiction that got them in trouble in the first place. Developed by the American Lung Association.

Educate staff.

E-cigarettes and other vaping products are often not easily recognizable. Educating staff about these products and about your school’s policy to address them is an important part of strategy to reduce student use.

• Presentation about E-cigarettes for School Staff /Parents (Updated to include information about quitting resources for youth)
• Guidance for Using the Presentation at a Staff/Parent Meeting about E-cigarettes (Updated to include information about quitting resources for youth)
• Frequently Asked Questions about Vaping
• Vaping Product Overview

Educate parents.

As a school administrator, educating parents with information about the problem of vaping and steps they can take to protect youth is critical.

• Presentation about E-cigarettes for School Staff /Parents (Updated to include information about quitting resources for youth)
• Guidance for Using the Presentation at a Staff/Parent Meeting about E-cigarettes (Updated to include information about quitting resources for youth)
• Flyer to Publicize a Parent Meeting about E-cigarettes – High School
• Flyer to Publicize a Parent Meeting about E-cigarettes – Middle School
• Sample Copy for use in Parent Communication/Newsletter about parent materials
• Sample Copy for use in Parent Communication/Newsletter about the youth-focused campaign 
• NEW! Sample Copy for use in Parent Communication/Newsletter about youth quitting resources
• NEW! Educational video about vaping – a short educational video can be embedded on your school’s website or you can include a link to the video in communication about the topic of vaping

Resources that you can make available to parents:

• Promote GetOutraged.org (Updated to include quitting resources for youth)
• Frequently Asked Questions about Vaping – Massachusetts Health Promotion Clearinghouse (also available as English and Spanish website content)
• How to Talk With Your Kids about Vaping – Massachusetts Health Promotion Clearinghouse (also available as English and Spanish website content)
• Vaping flyer– Available to order or download at the Massachusetts Health Promotion Clearinghouse (English/Spanish)

Know more about tobacco use in your district/school.

Collecting data on types of tobacco products students are using and where they obtain tobacco products can help inform education efforts and decisions about school policies. Sample surveillance questions about tobacco use, as well as questions about how students obtain tobacco products, perceptions of harm, and marijuana use, are included in the document Sample Surveillance Questions about Tobacco Use.

Additional uses of these data include:

• Capturing trends over time in use of conventional and emerging tobacco products, and comparing local use rates with statewide use rates.
• Tracking of marijuana in electronic vapor products, and concurrent use of tobacco and marijuana.
• Increasing support for community-level tobacco control policies which have the potential to decrease youth tobacco exposure, access, and use.

Consider establishing a chapter of The 84 Movement.

The 84 is a statewide movement of youth fighting tobacco in Massachusetts. Youth groups in a high school or community organization who want to fight against the tobacco industry’s tactics sign up to become an 84 Chapter and be a part of the movement.  Chapters educate their peers and adults about the tobacco industry’s tactics; help to create change locally and statewide to reduce the influence of tobacco in their communities; promote social norms messaging around youth tobacco use; and more. Visit The84.org for more information. (The 84 will be expanding into middle school, so please check the website for more information.)

Share resources with staff for quitting tobacco.

While your staff cannot use tobacco on school grounds, that doesn’t mean they are not current tobacco users.  It is important to support staff who use tobacco products by providing them resources to address their own nicotine addiction.

• 1-800-QUIT-NOW – Massachusetts Smokers’ Helpline
• Get Help to Quit – MakeSmokingHistory.org
• Free Cessation Materials – Massachusetts Health Promotion Clearinghouse

Know more about resources in your community.

The Massachusetts Tobacco Cessation and Prevention Program funds eight regional Tobacco-Free Community Partnerships (TFCPs) to provide support, education, and connections to resources to address issues of tobacco use in your community.  Contact your local for guidance and connections to technical assistance about tobacco use in your school or district. Your local TFCP is available to assist you in conducting a presentation about e-cigarettes to parents or staff.

The Centers for Disease Control and Prevention (CDC) provides evidence-based recommendations to help design and implement quality school programs to prevent tobacco use. While the tobacco industry continues to engage schools and offer free tobacco prevention curriculum, industry-sponsored school-based programs are ineffective and may ultimately promote tobacco use among youth.

Here’s what you can do

Educate yourself about e-cigarettes.

Knowing what these products are and what they look like can be a helpful part of addressing student use at school.

• Frequently Asked Questions about Vaping
• Vaping Product Overview 

Update curriculum to address the harms of nicotine and e-cigarette use.

• Tobacco Industry-Sponsored Youth Prevention Program in Schools (PDF)
• Tobacco Use Prevention Through Schools: Guidelines and Strategies
• HECAT: Module T (Tobacco-Use Prevention Curriculum)

Use relevant, youth friendly lesson plans.

• E-Cigarette Prevention: CATCH My Breath – CATCH (Coordinated Approach to Child Health). A youth e-cigarette prevention program targeting ages 11-18.  The program is divided into 4 sessions lasting 35-40 minutes each and uses a variety of educational strategies including: cooperative learning groups, group discussions, goal setting, interviews, and analyzing mass media.
• The Tobacco Prevention Toolkit – Stanford University School of Medicine. A toolkit for teachers with in-classroom units and lesson plans on e-cigarettes, tobacco, and nicotine. The toolkit includes PowerPoints, discussion guides, worksheets, and activities.
• ASPIRE – MD Anderson Center. ASPIRE is a free, bilingual, online tool that helps middle and high school teens learn about being tobacco free.
• smokeSCREEN: A Smoking Prevention Videogame – play2PREVENT
• Get Smart about Tobacco: Health and Science Education Program – Scholastic
• The Real Cost of Vaping: A collaboration between the U.S. Food and Drug Administration and Scholastic; information and lesson plans for grades 6-8 and 9-12.
• Consider incorporating the facts and information from Vapes and Cigarettes: Different Products. Same Dangers. into lesson plans or using them to spark classroom discussion or projects.
• Know the Risks: A Youth Guide to E-cigarettes – A presentation from the CDC’s Office on Smoking and Health to educate youth on e-cigarettes. This resource is intended for adults who educate or serve youth ages 11–18 and includes a document with talking points.

Resources on substance use disorder prevention (not specific to tobacco/nicotine).

For middle schools only: Project Here – Through integrated in-classroom and digital learning experiences, Project Here educates young people about the risks and consequences of using and experimenting with substances, empowers them to help others, and gives them the tools they need to make healthy decisions.

Consider being an adult advisor of an 84 Chapter.

The 84 is a statewide movement of youth fighting tobacco in Massachusetts. Youth groups in a high school or community organization who want to fight against the tobacco industry’s tactics sign up to become an 84 Chapter and be a part of the movement.  Chapters educate their peers and adults about the tobacco industry’s tactics; help to create change locally and statewide to reduce the influence of tobacco in their communities; promote social norms messaging around youth tobacco use; and more. Visit The84.org for more information.  (The 84 will be expanding into middle school, so please check the website for more information.)

Here’s what you can do

Educate students on the harms of nicotine and e-cigarette use.

• Health care professionals: educate your young patients about the risks of e-cigarettes (PDF) – CDC
• Know The Risks E-Cigarettes and Young People– Surgeon General
• Vapes and Cigarettes: Different Products. Same Dangers. Handout – Massachusetts Health Promotion Clearinghouse (Updated to include quitting resources for youth. The handout is also available in Spanish; download only at this time and printed in the near future.)
• Utilize the campaign image and facts to spur conversations with young people visiting your office /utilizing services
• Know the Risks: A Youth Guide to E-cigarettes – A presentation from the CDC’s Office on Smoking and Health to educate youth on e-cigarettes. This resource is intended for adults who educate or serve youth ages 11–18 and includes a document with talking points.
• New! Resource Card to provide youth with information on quitting resources – Massachusetts Health Promotion Clearinghouse

Provide resources to parents about talking to their teens.

• How to Talk with Your Child about Vaping – Massachusetts Health Promotion Clearinghouse (also available as English and Spanish website content)

Share resources for quitting tobacco.

     To help youth

• Smokefree Teen – U.S. Department of Health and Human Services
• NEW! This is Quitting powered by truth® – A free and confidential texting program for young people who vape. Young people can text VapeFreeMass to 88709 to get started.   (See Resources for Quitting section for more information
• NEW! My Life, My Quit™ – Provided by the same vendor as the Massachusetts Smokers’ Helpline, My Life, My Quit has youth coach specialists trained to help young people by phone or text. Young people can call or text Start My Quit to 855-891-9989 for free and confidential help or visit mylifemyquit.com to sign up online. (See Resources for Quitting section for more information)

     To help adults

• 1-800-QUIT-NOW – Massachusetts Smokers’ Helpline
• Get Help to Quit – MakeSmokingHistory.org
• Free Cessation Materials – Massachusetts Health Promotion Clearinghouse

Share other resources for students.

• The 84 Movement
• truth
• The Real Cost of Vaping Campaign (FDA – Food and Drug Administration)

As a healthcare provider for a young person, you play an important role in your patient’s health. Below are a few things you can do as well as resources you can access to help address youth use of e-cigarettes and other vaping products.

Here’s what you can do

Ask patients about their use of e-cigarettes.

Youth do not necessarily equate smoking with the use of e-cigarettes/vaping, so note the language you use when asking your patients if they smoke or use tobacco.  You may need to alter the words on your forms or in your conversations to incorporate e-cigarettes, vapes, vaping devices, e-hookah, etc.  In addition, you may need to be specific about asking what substance is used with these devices – nicotine, THC, or a combination of both.  This may be a sensitive question because both nicotine and THC are illegal to purchase (for those under 21) in Massachusetts. This may also be a sensitive topic if your patient’s parent/guardian is in the room or if your patient does not understand that your conversation is confidential.

Report suspected cases of vaping-related lung illness to the Department of Public Health

On September 11, 2019, Massachusetts Department of Public Health Commissioner Bharel declared that possible cases of unexplained e-cigarette or vaping-associated pulmonary disease reportable to the Massachusetts Department of Public Health pursuant to 105 CMR 300.150. More information is available on mass.gov.

Educate patients on the harms of nicotine and e-cigarette use.

• Health care professionals: Educate your young patients about the risks of e-cigarettes (PDF) – CDC
• Know The Risks E-Cigarettes and Young People– Surgeon General
• Vapes and Cigarettes: Different Products. Same Dangers. Handout – Massachusetts Health Promotion Clearinghouse. Also available in Spanish (download only at this time and printed in the near future).
• Know the Risks: A Youth Guide to E-cigarettes – A presentation from the CDC’s Office on Smoking and Health to educate youth on e-cigarettes. This resource is intended for adults who educate or serve youth ages 11–18 and includes a document with talking points.
• NEW! – Resource Card to provide youth with information on quitting resources
• Coming Soon – Nurse’s Guide to assist in helping youth quit vaping in the school (or healthcare) setting

Share resources for quitting tobacco.

To help youth

• Smokefree Teen – A website with tips, plans, apps and other ways to get ready to quit and be smoke free for good from the National Cancer Institute, S. Department of Health and Human Services
• NEW! This is Quitting powered by truth® – A free and confidential texting program for young people who vape. Young people can text VapeFreeMass to 88709 to get started. (See Resources for Quitting section for more information)
• NEW! My Life, My Quit™ – Provided by the same vendor as the Massachusetts Smokers’ Helpline, My Life, My Quit has youth coach specialists trained to help young people by phone or text. Young people can call or text Start My Quit to 855-891-9989 for free and confidential help or visit mylifemyquit.com to sign up online. (See Resources for Quitting section for more information) Providers can refer patients under the age of 18 to My Life, My Quit through Quitworks.
• Educate young patients about withdrawal symptoms and ways to cope (see pages 17-18).

To help parents of young patients who may use tobacco

• 1-800-QUIT-NOW – Massachusetts Smokers’ Helpline
• Get Help to Quit – MakeSmokingHistory.org
• Free Cessation Materials – Massachusetts Health Promotion Clearinghouse

Provide resources to parents about talking to their teens.

• How to Talk with Your Child about Vaping – Massachusetts Health Promotion Clearinghouse (web content is available in English and Spanish).

Other resources.

• Connect with your membership organizations for more information, resources, and guidance on addressing vaping in your patient population.
  • Massachusetts Medical Association
  • American Academy of Pediatrics
  • American Academy of Family Physicians
• Healthcare Provider Resources – Resources from the Centers for Disease Control and Prevention

There are several resources to help youth who want to quit e-cigarettes and other tobacco products.

Parents/adults can:

• Visit GetOutraged.org for more information about the dangers of vaping for young people
• Encourage young people to ask their school nurse or counselor, athletic coach, doctor, parent or other trusted adult for help
• Educate young people about the quit resources available to them (see more information below)
• Speak with their child’s health care provider
• Be aware of the symptoms of nicotine withdrawal and how to help young people (see more information below)

Young people can:

• Visit mass.gov/vaping for more information about the dangers of vaping or follow the Instagram account @GetTheVapeFacts
• Enroll in This is Quitting powered by truth® (see more information below)
• Enroll in My Life, My Quit^TM (see more information below)
• Visit smokefree.gov for tools and tips to quit
• Be aware of the symptoms of nicotine withdrawal and how to cope (see more information below)

More Information about Quit Resources for Young People

This is Quitting powered by truth®

This is Quitting powered by truth® is a texting program for youth and young adults who want to quit vaping. It is a free, confidential 60-day program during which participants receive texts with information, tips, and support. They receive daily text messages to help them prepare to quit and supportive texts from young people who have been through the program and know what it’s like to quit. They can also text “COPE,” “SLIP,” “STRESS,” or “MORE” at any time for instant support, or “MASSINFO” for information specific to Massachusetts.  Young people can sign up even if you they aren’t ready to quit – the texts they receive will give them strategies and practice quits to help build confidence and help them feel ready to quit.

To enroll in the program, youth text VapeFreeMass to 88709.  Youth can also connect with their school nurse, counselor, or coach to help get them started.

Parents and other adults can text QUIT to 202-899-7550 to sign up to receive text messages designed specifically for parents of youth who vape.

Note:  This is Quitting powered by truth® is a national program. The Massachusetts Department of Public Health, in collaboration with the University of Massachusetts Medical School Center for Tobacco Treatment Research & Training, has partnered with truth® to offer messaging and information specific to Massachusetts youth. For more information on this resource and other information on youth vaping, visit GetOutraged.org.

My Life, My Quit^TM

My Life, My Quit^TM is a specially designed program to help young people quit vaping or other tobacco products. My Life, My Quit^TM provides five free and confidential coaching sessions by phone, live texting, or chat with a specially-trained youth coach specialists. Youth can text Start My Quit to 855-891-9989 or call toll-free 1-855-891-9989 for real-time coaching.  They can also visit mylifemyquit.com to sign up online, chat with a live coach, get information about vaping and tobacco, and activities to help them quit. The program can send out materials and a certificate at the end of the program.

My Life, My Quit^TM   is a program of National Jewish Health, the vendor for the Massachusetts Smokers’ Helpline. The My Life, My Quit^TM   program combines best practices for youth tobacco cessation adapted to include vaping and new ways to reach a coach using live text messaging or online chat.

Specially trained youth coach specialists emphasize that the decision to stop is personal, and provide information to help cope with stress, navigate social situations, and support developing a tobacco-free identity.

For more information about My Life, My Quit^TM  visit mylifemyquit.com and click on Parents/Guardians under the Resources tab.

Nicotine Withdrawal Symptoms and Coping Mechanisms

Some youth may not realize they are addicted to nicotine, but if they experience one or more of the following, they likely are:

• Having strong cravings to vape/use tobacco
• Feeling nervous or anxious when they can’t vape/use tobacco
• Vaping in places they aren’t supposed to (going out of their way to vape/use tobacco)
• Having trouble concentrating
• Feeling like they need to vape/use tobacco to feel better
• Feeling angry, irritable or restless when they haven’t vaped/used tobacco in a while.

Because nicotine is an addictive chemical, when quitting, the body has to adjust to not having it.  This can create physical symptoms. It is important to remember that each person’s body responds a little differently when healing itself from tobacco use. But for most people, these discomforts are short-lived.

• Having cravings for e-cigarettes
• Feeling down or sad
• Having trouble sleeping
• Having trouble thinking clearly and concentrating
• Feeling restless and jumpy or irritable, or grouchy
• Having a slower heart rate
• Feeling more hungry or gaining weight
• Stomach pain
• Headaches or dizziness

How can you help a young person cope with nicotine withdrawal symptoms so they do not start using nicotine again to feel better?  Help them practice these strategies:

• Delay acting on the urge to vape/use tobacco – Wait out the urge –urges only last a few minutes and will lessen with time.
• Deep Breathing – Deep breathing helps by concentrating on breath instead of the craving. Take two deep breaths when there is an urge to vape/use tobacco. Breathe in slowly and deeply; then breathe out slowly.
• Drink Water – Drinking water helps flush out nicotine and other toxins. Sip water slowly and hold it in the mouth a little while to satisfy the need to have something in the mouth.
• Have alternatives to vapes handy – Good alternatives are something to hold and keep the mouth busy. Some of these may not be allowed in the classroom at school, but examples include chewing on toothpicks, or gum. Sucking on hard candy can also help.
• Do Something Else / Find Alternatives – Do something else to take the mind off vaping/using tobacco. Physical activity (going for a walk, run, bike ride, etc.), working on hobbies, calling or texting a friend, or just doing something else when there is the urge to vape/use tobacco can help.  Other ideas include going to places that don’t allow vaping such as the mall or joining an online support community.
• Adjust routines – The brain connects regular places and things to tobacco use patterns – these certain places, events, situations or people can actually trigger the brain’s craving for nicotine.
• Avoid places, situations or even certain people that make it hard to say “no” to a craving or offer to vape/use tobacco. Role play with a young person to practice what they can say if a friend asks them about vaping. For example, help them practice what they can say in social situations when offered a vape.