Teens

All Articles in the Category ‘Teens’

Teen Vaping Leads To Cigarette Use


Big news published today in Pediatrics; a new study reports that adolescents who vape are 6 TIMES more likely to smoke cigarettes in early adulthood. Researchers studied 11th and 12th graders during the transition from being US minors to legal adults when they have the right to buy traditional cigarettes (age 18 years) to see the effect using e-cigs had on smoking traditional, combustible tobacco cigarettes. It’s known that if you’re friends use e-cigs you’re more likely to use and it’s known that rates of e-cig experimentation are on a rocket ride for teens across the US. Because we know that more than 80% of all adult smokers begin smoking before the age of 18; and more than 90% do so before leaving their teens, when and why people get addicted to nicotine matters.

Over the last decade there has been great progress in helping teens stay away from tobacco cigarettes but the new vaping trend, e-cigs, hookahs, and chew-able tobacco is unfortunately changing the game and changing risk. Last week the CDC published new data,”Cigarette smoking among high school students dropped to the lowest levels since the National Youth Risk Behavior Survey (YRBS) began in 1991, but the use of electronic vapor products, including e-cigarettes, among students poses new challenges according to the 2015 survey results.” Read full post »

HPV Vaccine Decreases HPV Infections!


Great news about reducing cancer risk. Nothing controversial here…

There is early evidence from a recent Pediatrics study that the HPV vaccine is doing what it was intended to do: decrease the rates of HPV infection in teens and young adults. The study compared HPV in two groups of teen girls and young women–one group during a time prior to the vaccine being used (pre-vaccine era 2003-2006) and another group of similar girls and young women after the vaccine’s introduction (vaccine era 2009-2012). They evaluated prevalence of HPV infection in both groups (from cervicovaginal swabs) to see the effects of the vaccine on the population. The DNA tests from those swabs identified evidence of HPV infection from HPV strains that have been included in the vaccine and also additional strains of HPV infections not previously in the vaccine. Researchers also had information about the girls’ self-reported vaccine status and behavior (sexual activity).

The results are exciting and hopeful when it comes to protection from HPV vaccine.

The study shows a 64% decrease in HPV strains found within the vaccine in immunized girls ages 14-19 and a 34% decrease in HPV in girls ages 20-24 who had received the HPV shot. In my opinion, there are 2 big takeaways to this progress and learning:

  1. The vaccine is effective in protecting teens from acquiring HPV, especially so during teen years. When the shot was given in younger teens they were more likely to have better protection — likely because they are immunized early and thus if/when exposed to HPV infections during their life, they were already protected.
  2. The earlier the HPV vaccine is given, the better the hope for protection against HPV during teen and young adult years. No safety benefit in waiting to be immunized — the risks are the same from the injection but waiting allows more time when a teen could be exposed to HPV. The data out last month may also reflect previous research that the immune response is better when the immunization is given to younger girls and boys (age 11 for example, over age 16 years).

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New Birth Control Laws: Preventing Unplanned Pregnancy

Birth ControlEasy, confidential access to affordable birth control is essential if we’re going to decrease the rate of unplanned pregnancies. The dynamics of birth control access are changing, thank goodness. As we’ve heard about parts of the world simply telling women NOT to have babies (Hello, Ecuador) we really do have to think about how women and men prevent pregnancy when not ideal. And how we support women getting information they need to make the safest and most reliable choice. This can start way before teens are sexually active.

Things are changing here in the US. As of Jan. 1, 2016 women 18 and older in Oregon can get hormonal contraceptives directly from a pharmacy, without having to go to a doctor for a prescription first. Pharmacists who supply birth control are required to complete formal training before being allowed to write prescriptions. In addition, teens and women must take a 20-question health assessment before obtaining the prescription that details risks and family history. This is why I always want parents to tell their teen if there is a family history of blood clots, family history of migraines, etc. That way, they can answer correctly!

The good news, here in the US, contraception is covered by insurance and protected by Obamacare (Thank you, Mr. President). Birth control options covered by the Affordable Care Act include: IUDs, emergency contraception, implants, pills, patches & rings.

California has also passed similar legislation that will take effect in the coming months to make it even easier for women to access birth control. National work is ongoing as well to make birth control over-the-counter. More on that to come!

When it comes to teaching our teens about sexual education, we know the topic is fraught with contentious beliefs and cultural sensitivities, and we also know that it’s really hard to speak about certain topics openly. But over and over, we are told by our kids that it’s us – the parents – their trusted adult community – they want to hear from most. Even when they squirm in the seat, DO KNOW THEY ARE LISTENING. I’ve written about this before for parents preparing those kids going off to college.

But really, talking to your teens about how to protect their bodies from sexually transmitted diseases, unplanned pregnancies, or violence should start much earlier. Normalizing the conversation appropriately for kids as young as five is encouraged in many parts of the world. We can talk about how we time growing our families in age-appropriate contexts. I’m thinking of writing a post, in partnership with a health educator, about what to say to a 5 year-old, an 8 year-old, an 11 year-old, and a 15 year-old. Would that be helpful? Please leave a comment…

I also want to offer a few great resources, thanks in part to my friend, teen advocate and digital educator, Susan Williams (@estherswilliams) for other parents to use as additions to or as guides for helping their kids understand their bodies and their decisions when it comes to sex and relationships.

There are three initiatives underway that I believe are truly shifting how sexual education and access to the right care, contraception, and information is achieved. Being able to get the right information when you need it and then being shown how to act on that information is crucial to preventing unplanned pregnancies and reducing cases of STDs. For adults who love their (our!) kids, we also need resources to help guide how we talk about sex:  Read full post »

Yes To No Tobacco Until Age 21

Teen smokingHear me straight: we don’t want anyone addicted to tobacco products. No question it’s an ugly habit and a terribly complex addiction. Expensive, detrimental to health, so very ugly… So I’m all for WA State House Bill 2313 (SB 6157) supporting moving the purchase age of tobacco from 18 to 21. Yes I know you can vote and enlist in the military at 18, but inconvenient or not, teen brains are not fully developed by the time they enter college-age and the effects of nicotine and the trend towards lifelong addiction are seriously grim. Complain all you want that Washington would be a “nanny state” but the facts are clear: if you start smoking at a young age, odds are that you will still be smoking as an adult. We know that more than 80% of all adult smokers begin smoking before the age of 18; and more than 90% do so before leaving their teens. We need to get tobacco out of reach so we can stop addiction before it starts. This isn’t just about public health it’s also about the health care spending of your tax dollars.

My friend and colleague Dr. John Wiesman (WA Secretary of Health), gave a press conference this week on the new bill. Here are a few staggering excerpts from his speech:

Counting cigarettes, smokeless tobacco, and e-cigarettes together, in 2012, 12 out of every 100 10th graders used these products, and by 2014 that number had risen to 20 out of every 100. That’s a frightening 67%  jump in just 2 years!

Both cigarettes and e-cigarettes set kids up for a lifetime of addiction and poor health.

The most effective way to stop this trend is to stop our kids from smoking before they start.

Middle school, high school and college students are still undergoing significant brain development.

Nicotine exposure during this critical time appears to affect the structure and function of the brain and may lead to lasting cognitive and behavioral impairments.

If that’s not enough reasons to support this work, I don’t know what is. But, here’s one last piece of data that will hit you square in the wallet (ouch). Each year in Washington alone, we spend: Read full post »

Teens Getting High: DXM Cough Medicine

OTC Cough MedsDrug abuse is on every parent’s mind. We simply don’t want our children to ever go down the road of drug addiction. To empower parents to spot the warning signs and help prevent teen abuse of over-the-counter (OTC) cough medicine containing dextromethorphan (DXM), the Consumer Healthcare Products Association (CHPA) is sharing the results of qualitative and quantitative research of teens. The quantitative (numbers-based) research began in 2013 and is conducted three times a year. Here’s some insight from that data: Read full post »

What You Can Do: Children And Safe Gun Storage

Gun Safety family on hillGun violence is a tricky topic to write about. It’s emotionally laden, there are political overtones that bring out passion and I find quicksand when I never expect it.

No matter where you fall on issues related to firearm safety, there is no doubt that we all want the same thing: healthy communities, healthy families, and safe environments to raise our children.

Unfortunately, we continue to have countless reminders about the curiosity of children in the presence of a loaded firearm. No question children and guns are a dangerous combination.

According to the Behavior Risk Factor Surveillance Survey that is administered nationally by CDC, in 2013, there were an estimated 73,000 Washington state children that resided in homes where guns were loaded and unlocked. Nationally, 1.7 million children and teens in the U.S. live in a home with a loaded, unlocked gun.

Kids don’t always know what to do when they find one, but curiosity leads. In a research study entitled, “Seeing Is Believing,” researchers put boys in a room where there were water guns and pistols and watched behind a mirror while they played. The 8 to 12 year-old boys who stumbled upon a gun had a hard time figuring out it if was a toy or a real gun. When they did find it, almost half pulled the trigger. Half pulled the trigger! CURIOSITY is that innocent, protectable right of children that drives this dangerous act.

I don’t need to detail deaths, but quick mentions of gun-related injuries and tragic losses in America can bring fresh energy for necessary safety measures we are all responsible for, gun owners or not. A 3-year-old in New Mexico shot his parents when he grabbed a gun out of his mother’s purse and not the iPod or phone he was searching for. The mother was pregnant and there was also a 2-year-old girl in the room at the time. In the past month we’ve heard about the horrific tragedies with three shootings on college campuses and the unthinkable tragedy of an 11-year-old who shot an 8-year-old this past month over wanting to see a puppy.

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Do You RWDD? Pot At Age 12 And Teen Driving

Teen Driving Pie ChartNew acronym for me this week: RWDD. It’s “Riding With a Drinking Driver.” Not a drunk one, but someone who has been drinking. Risky at any age, but particularly when it’s high school. But before I get to that lemme acknowledge that texting has changed the lexicon, upped the capacity for quick communication in our lives, and earnestly transformed some of our relationships. Clearly we’re all learning a ton about shortcuts in communication. I think about this in my personal life but also what impact texting and digital technology has on how we deliver health care, how we partner and listen to populations, how we hear the worries of parents and caregivers and how we share what we know. Sometimes it seems we’re just always trying to catch up. I learned all sorts of new teen texting acronyms & idoms last week on CNN that extend past “lol” and “ICYMI” (see: OOTD, KOTD, and smash <– phew). But no one mentioned RWDD.

A study out yesterday in Pediatrics is worth a quick mention to any parent or any adult or any family doc or any pediatrician or any nurse practitioner or any medical assistant or any coach or any teacher that has contact/supervision/leadership/influence with a teen. The study, conducted on middle school students in the Los Angeles area, found that positive beliefs about marijuana at age 12 were predictors of later getting a DUI or RWDD when a new teen driver 4 years later. Translation: middle school is a wild time of transition and the time we should check in about marijuana’s lack of safety and risks associated with alcohol. Researchers conclude that 6th grade is when we should be talking with our tweens, that “positive beliefs and ability to resist marijuana in early adolescence, not actual alcohol and marijuana use, had the strongest association with DUI and RWDD ∼4 years later.”

No question that we send a wildly confusing message about pot to children and teens with our state’s legalization. Most teens think legal = safe and that’s where we’re potentially setting up our teens for big mistakes. Getting high seems fun to teens and it may seem more fun with something that appears to be “safer….”

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More Teens Getting HPV Vaccine: Boys And Girls

The vaccine schedule is the same schedule for boys and for girls. The path to today’s human papilloma virus (HPV) vaccine has not been entirely straightforward for parents as recommendations have changed over time. Know this: the clear and simple message is that HPV vaccine is safe and effective for boys and girls. We know it works best when given earlier in the tween/teen years and we know the immunity it produces in our bodies is durable and lasting. HPV vaccines is an anti-cancer vaccine that works best when given to boys and girls at age 11. For me it’s a no-brainer to recommend this vaccine enthusiastically before children head off to 6th grade.

Earnestly, it’s not a “new” vaccine as pediatricians began giving the vaccine back in 2007 and it’s been given well over 50 million times. In the U.S. we starting giving the vaccine to girls first yet because human papilloma virus can infect boys and girls, men and women, HPV vaccine is also recommended for boys age 11 and older. Uptake by boys has been fast and steady since recommendations included them. Three different HPV vaccines are now available: a 2-HPV strain (protects against the viral strains that cause 70% of cervical cancer) or a 4-HPV strain vaccine (same 2 strains plus two more that protect against HPV strains causing warts) and now a 9-strain vaccine (expansion of strains causing warts), upping the number of different viruses that the vaccine protects teens against. The new options improve protection against HPV viruses that cause genital warts and also HPV viruses that can cause cancers of the cervix, mouth, throat, vagina and rarely, the penis.

HPV Vaccine Protecting Teens

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4 Things To Know If Your Son Is Off To College

male college prepYou may have already read yesterday’s blog on preparing your daughter for college. Much of my advice for girls, of course, also pertains to boys (and vice versa). I’m writing two separate posts only for the purpose of getting people to read this content, not to differentiate. I added one section here for boys (on alcohol and risks) not because it’s an issue for boys only. In fact, we know that 1 out of every 5 high school girls binge drinks (see below).

If you have a boy heading off to college this fall there are a few things to know to help improve his safety and success this year. Of anything I know from my experience being a previous school teacher, and now pediatrician and mom to boys (still 10 years away from college!) the transition from HS to college-age is one steeped in emotion for all. In addition to the tips I’ve provided for girls, alcohol and the HPV vaccine are topics to discuss to ensure it’s a better and safer year for your son (or daughter) this year.

ONE: Safe Sex & Birth Control – What Your Teen Son May Need To Know:

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It’s Gotta Be Screen Time Somewhere

Illustration by David Rosenman

Illustration by David Rosenman

My boys always want it to be screen time. I don’t think that is changing anytime soon. These apps, shows, games, and devices are only getting smarter at capturing their attention.

It feels like there isn’t a giant list of new advice to share regarding “screen time.” But because of the recent media focus and deluge of content on “screen addiction,” coupled with recommendations for dealing with screens while parenting this summer, I’m here with a few responses and observations. It seems to me, parents (all of us) are looking for a couple of things in the content we read about parenting with screens: permission and hacks for simplicity. This post will perhaps offer neither. Until the end.

Most of us acknowledge that not all screens are the same, nor is all programming, nor are the stages of life where apps and screens are enjoyed (infants versus an 8 year-old). “Screen time” is an issue layered with complexity. Parenting during this explosive device development era demands simple rules and dictums for limiting their use help, but the rules by themselves limit the development of full-on zealots. No one follows the rules like religion. Parents, grandparents and caregivers aren’t devout to recommendations because we claim the rules just don’t fit into the context of our lives. Most of us figure out a way to make justifiable exceptions. It’s simply too easy to pull out your phone, especially when it delights your child the way it does, and entertain. But no question that with the rules out there stressing non-use and limits, we’re left feeling a little guilty anytime we left our children indulge. Imagine knowing that screens before bed interfere with the “sleep hormone” melatonin (the light emitted from the screen limits secretion) but even so still choosing to let your children “chill out” with a video for a 1/2 hour before bed each night. Or imagine following the no-screen-time-before-age 2 religiously for your first child but then breaking this rule routinely when you have a second one! This just happens all the time. Read Why No TV Before Bed Is Better. Read full post »