Young people with ADHD are at greater risk for e-cigarette nicotine addiction.

By Elizabeth Katz

When Jewish teen Leah was diagnosed with attention-deficit/hyperactivity disorder (ADHD) last year, she finally had a name for the debilitating anxiety, mental distraction and stomach aches she experienced daily. She said she missed a lot of school because of these emotional and physical symptoms.

When her grades began to plummet, her mother asked school administrators what she should do to help her daughter.

“Having ADHD was awful,” said Leah, 15, a high school sophomore. “I had constant anxiety over everything. In my school life, it was paralyzing. The competition at my school is insane. Basically, you’re setting yourself up for the rest of your life based on your ACT and SAT scores.”

Before she began getting professional help, Leah (who did not want her real name used) turned to vaping as a way to alleviate her feelings of crippling anxiety.

“It’s hard to stop vaping,” she said. “It’s just knowing you could use it” that serves as a comfort.

Leah is part of a concerning trend to those in the medical profession who have seen a significant increase in young people using e-cigarettes. According to the Centers for Disease Control, use of e-cigarettes — also called vaping — jumped 78 percent among high school students and 48 percent among middle schoolers between 2017 and 2018.

Medical experts note that individuals with attention deficit disorder (ADD), more commonly referred to today as attention-deficit/hyperactivity disorder, are at an even higher risk of engaging in this health-threatening activity.

Leah said that many of her classmates vape, despite flyers peppered on the walls of her school threatening suspension to anyone caught vaping. She also said it’s easy to get e-cigarettes through friends.

What is ADHD?

ADHD is a brain disorder marked by an ongoing pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development, according to the National Institutes of Mental Health. NIMH reports that most children have the combined type of ADHD versus ADD.

Because of a lack of impulse control, teens with ADHD are at greater risk of becoming addicted to substances, including the nicotine in vaping.

“It’s really staggering the numbers of teens vaping and how vaping has become so commonplace,” said Dana Cohen, Ph.D., a clinical psychologist with the Beaumont Center for Human Development in Southfield. “Vaping is popular in general and when you add the ADHD component, primarily because of the poor impulse control, they tend to be risk takers.”

Cohen said those with ADHD have three core deficits, including not being able to sustain attention to work tasks, hyperactivity and reduced impulse control.

“Whereas most people [have the strategy of] ‘ready, aim, fire,’ those with ADHD are ‘ready, fire, aim,’” she said. “They act without thinking things through.”

Young people with ADHD struggle with social interactions, cope with insecurity issues, worry about the things they say and, in general, try to impress others, according to Brooke Weingarden, D.O., MPH, a child/adolescent psychiatrist with the Birmingham Maple Clinic in Troy.

“There’s so much going on in their brain and they can’t focus on one thing,” she said. “It’s like a marching band in their head.”

Hand holding an electronic cigarette over a studio background.
Photo via Getty Images

Vaping Defined

Many types of electronic cigarettes are sold (legally to those age 18 and older) on the market today, including Juul and Eleaf as well as e-cigarettes sold in independent vape shops. Manufacturers have marketed the product as a way for smokers to quit the habit, but e-cigarettes still deliver nicotine, which is vaporized in a heated oil. Oils come in “flavors” such as bubble gum, candy and gummy bears as well as food flavors like chocolate, cheesecake and caramel.

The oil itself, according to medical experts, contains harmful, cancer-causing chemicals, including butane, and can lead to lung disease.

“Somehow, when vaping first started, there was this misconception that it’s safer,” Cohen said.

One pod of oil contains the same amount of nicotine in a single pack of cigarettes, according to Daniel Schnaar, M.D., a general pediatrician with Child Health Associates, with offices in Troy and Novi. He is also a member of Beaumont Health’s Department of Pediatrics. Schnaar said he asks all his young patients if they vape, though many try to conceal the fact they do.

“E-cigarette companies claim nicotine can help ADHD symptoms,” he said. “The vaping industry has taken parents, pediatricians, health departments and the FDA flat-footed. These companies have been ahead of the curve with marketing the products.

“We’re worried about kids getting addicted to nicotine. Vaping makes them want to crave the drug, so they have to do it. It’s like a legal form of addiction.”

Weingarden said children with ADHD become addicted to substances simply because they want to feel better and less stressed — and nicotine accomplishes this.

“Kids and adults who have ADHD are more likely to become addicted to many different things, including nicotine and vaping, for many reasons,” she said. “One reason being it’s some amount of self-medication and feeling good, another being that these kids are more likely to participate in peer pressured-type of activities, substance abuse and riskier behaviors, due to more disinhibition and higher impulsivity.”

The danger with vaping is that the nicotine targets areas in a young person’s brain that are “unsupported” or still underdeveloped, medical professionals say. This can lead to a greater risk of addiction. Nicotine addiction can affect memory, cognitive function and mood. Physiologically, nicotine has a detrimental affect on heart health, appetite and the cardiovascular system.

And trying to quit vaping can cause the same symptoms that young people with ADHD are trying to fight, namely anxiety, jittery nerves and sleep problems.

What Can Parents Do?

Adequate treatment for children with ADHD is a critical component to helping them cope with their symptoms. When their symptoms are regulated in healthy ways, doctors say, they will not turn to harmful substances, or activities like vaping.

“Make sure you are working with someone who can treat [their symptoms] and can assess addiction,” Weingarden said. “If ADHD is treated as best as possible, the risk of addiction definitely decreases.”

Treatment usually includes a combination of doctor-prescribed medication as well as talk therapy with a counselor. Teaching kids about the dangers of vaping also helps if they are contemplating or already engaged in the activity.

Schnaar says pediatricians, therapists and schools also can play a role in helping kids with ADHD. Additionally, he calls for the FDA to regulate the e-cigarette industry by passing laws as well as taxing vaping products.

“There is a lot of money in advertising e-cigarettes,” he said, “and the FDA is always behind the eight ball.”

One Mom’s Strategy

Parents also play a large part in helping young people with ADHD who are coping with a nicotine addiction through vaping. Leah’s mother, who also wanted to remain anonymous, said she constantly sends her daughter articles about the dangers of vaping and tries to have an open dialogue with her about the issue.

“If you really want to help your kids, you should partner with them,” she said. “It’s hard to do things without partners. I’m in [Leah’s] face all the time about vaping.”

Today, Leah takes medication to control her anxiety and ADHD symptoms. She also talks to a therapist. She said she doesn’t feel the need to vape anymore to deal with difficult life situations.

“I feel great,” she said. “Every single morning, I wake up with a smile on my face. Therapy has helped me so much.”She said her mother has helped her, as well as her boyfriend, who has convinced her to stop vaping.

And, though she works diligently in juggling her schoolwork and symptoms of ADHD, Leah says she would like to get more involved in extracurricular activities, including attending evening classes at her temple.

“My goal is to help in any sort of way I can to make this a better country,” she said.

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