Tobacco use has often been portrayed as harmless, something the “cool” kids do, especially in popular TV shows aimed at teens, like “Skins” and “Euphoria.” But in reality, commercial* tobacco use is the number one cause of preventable disease, disability and death in the U.S. 

Considering that nearly 90% of adults who smoke daily started at or before 18, the teen years are a vital time to have conversations about preventing or stopping tobacco use with the youth in your life.

It’s very likely that the teen in your life knows someone who uses tobacco. Recent surveys have found that more than 2 million high schoolers used tobacco products in 2021 – about one in 10 students. That means in a typical classroom of 20 students, at least two of them are probably tobacco users. 

To have productive conversations with youth around tobacco use, it’s important to understand why teens smoke, chew or vape. Sometimes it’s because of social pressures – their friends are smoking and they want to fit in. They are usually not thinking about the long-term negative effects of tobacco use on both physical and mental wellbeing. Tobacco use can cause chronic lung diseases, early heart disease, strokes, gum disease and tooth loss. 

According to the Mental Health First Aid (MHFA) curriculum, early tobacco use can be a warning sign of other pre-existing mental health challenges. In fact, current use of a commercial tobacco product use was reported by 14.2% of students reporting severe psychological distress, opposed to 5.5% with no distress.  This may be because nicotine may temporarily lessen symptoms like poor concentration, low mood and stress, making people think it’s helping them manage their symptoms, when it’s really causing more harm long-term. 

You can help. As a Mental Health First Aider, you can use the MHFA Action Plan (ALGEE) to help facilitate conversations and support youth in your life.

1. Assess for Risk of Suicide or Harm: While it is unlikely that smoking tobacco will cause an immediate crisis such as an overdose, the long-term effects can cause considerable harm, and tobacco use may indicate an underlying mental health challenge or emotional distress. It’s important to consider the best way to approach the person — choosing a non-intrusive and calm environment is crucial — and always be alert for any warning signs of suicide. If the person is in crisis, call 911.
2. Listen Nonjudgmentally: Take the time to plan how and when to speak with the young person about their tobacco use. Arrange a time to talk with them in a quiet, private environment when there will be no interruptions and you are in a calm frame of mind. Before speaking with them, reflect on the situation, organize your thoughts and decide what you want to say. During the conversation, try not to express your frustration at them for their tobacco use, and allow them time to think about what you’ve said and express themselves. Do not shame or reprimand them for using tobacco; instead offer them support and guidance on how to quit. 
3. Give Support and Information: Give the young person information about tobacco use and the associated risks to their mental and physical health. Try to find out whether the young person feels they need help to quit and discuss what you are willing and able to do. Encourage the young person to question any assumptions they might have about tobacco use, and help the young person realize that many of their peers are not smoking and can be supportive.
4. Encourage Appropriate Professional Help: Seek information about local services; there are many programs across the country, many of which can be accessed virtually, aimed at helping youth stop using tobacco. Some national resources include N-O-T, Smokefree.gov and the CDC Quitline. Many states have localized government services as well. Ask the youth if they want help and if so, offer to send a list of resources or to help them make and keep their appointments.
5. Encourage Self-help and Other Support Strategies: There are many things that can help a young person stop using tobacco and protect against tobacco use. Let young people who use tobacco to fit in with their peers that the decision to use tobacco is theirs, not their friends’. If they are concerned about being able to say no, offer to help them talk through various scenarios where they can refuse smoking. Encourage them to seek out friends who support their decision to not use tobacco and talk about valuing the important qualities of long-term friends, like kindness and being trustworthy, over temporary things like popularity. 

It is important to remember that there is no one-size-fits-all approach to executing the MHFA Action Plan — you don’t have to run through the steps in order or even use every single one. Each situation is unique. What is important is starting the conversation and working together to make youth tobacco use a thing of the past. To learn more about supporting the mental wellbeing of young people in your life, sign up for a Youth Mental Health First Aid (YMHFA) training today! 

* For the purposes of this blog, we are referring to the use of commercial tobacco and not the sacred and traditional use of tobacco by some American Indian communities.

References

Centers for Disease Control and Prevention. (2021, October 29). Health effects of cigarette smoking. https://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/

effects_cig_smoking/index.htm

Centers for Disease Control and Prevention. (2022, March 10). Tobacco use. https://www.cdc.gov/chronicdisease/resources/publications/factsheets/tobacco.htm  

Centers for Disease Control and Prevention. (2022, March 23). Youth and tobacco use. https://www.cdc.gov/tobacco/data_statistics/fact_sheets/youth_data/tobacco_use/index.htm 

Mental Health First Aid USA. (2020). Mental Health First Aid USA: For Adults Assisting Children and Youth. Washington, D.C.: National Council for Mental Wellbeing.

National Institute on Drug Abuse. (2020 January). Do people with mental illness and substance use disorders use tobacco more often? https://nida.nih.gov/publications/research-reports/tobacco-nicotine-e-cigarettes/do-people-mental-illness-substance-use-disorders-use-tobacco-more-often 

U.S. Food and Drug Administration. (2022, March). Results from the annual National Youth Tobacco Survey. Centers For Disease Control and Prevention. https://www.fda.gov/tobacco-products/youth-and-tobacco/results-annual-national-youth-tobacco-survey 

U.S. Food and Drug Administration. (2020, July). 2020 National Youth Tobacco Survey infographic. https://digitalmedia.hhs.gov/tobacco/hosted/2020-National-Youth-Tobacco-Survey.pdf