2023 Brimming With Optimism!

An Article by Bruce Barcelo

Happy New Year!  There is nothing I would rather do than submit an article this month to 2023 brimming with optimism regarding youth vaping.  National survey numbers told us that youth vaping went down in 2021 but when youth returned to classrooms in the fall of 2021 the conversations, I was having with school administrators from around the country certainly didn’t reflect that. Florida data recently released shows that vaping/tobacco incidents almost doubled in this past school year.

If we look at the sales numbers of e-cigarettes, we might better understand the youth epidemic. Zero percent of disposable e-cigarettes had the highest level of nicotine in 2017, today 90% have the highest level of nicotine.  Nearly half of the high school students who vape do so daily. A number that doesn’t make any sense, the prices for vaping products with nicotine strengths that had a low nicotine level (1-2%), increased in prices ($10.40-$29.20). Products with high nicotine levels (4-5%) dropped ($12.80-$10.10). Why this is so concerning is that youth are price sensitive. The market moved to higher nicotine-level products with a cheaper cost for one reason.

So where do we turn for our New Year’s inspiration? Let us turn to the remarkable citizens of Ohio, who when it looked like Big Tobacco had used all its massive weight to sway politicians to potentially dismantle not only the Columbus flavor ban, but tobacco prevention efforts made around the state, it was you who called and wrote the governor to ask him to veto this effort. Today, Ohio is stronger because we stood together and weathered this storm. It is now a new year and together, we will battle because our youth need our support.

2023-03-28T15:31:19-04:00January 23rd, 2023|Bruce Barcelo, Uncategorized|

Partnering with Parents for Improved Nicotine Cessation Outcomes

Many parents who use nicotine products recognize that there are risks to their health and the wellbeing of their baby. However, efforts to quit are complicated by a myriad of factors, especially for those who Black, Indigenous and People of Color. For instance, in addition to having higher rates of tobacco-related morbidity and mortality, research suggests that smokers who identify as African American also experience disparities in tobacco cessation counseling despite best practices for universal screening and counseling.1,2,4 As providers, we can positively impact the experiences of parents trying to quit using nicotine, especially those for whom health inequities exist. Below are some suggestions for becoming better partners with parents in tobacco treatment settings:

  • Listen to parents. We all know that quitting can be difficult. As providers, it is essential for us to understand the unique challenges of each parent, as well as their available resources if we are going to develop a quit plan that is realistic and attainable for them. If we are not collaborating with clients on strategies that meet their unique needs, quit attempts may not be as successful.
  • Practice cultural humility. A lack of awareness of cultural practices and rituals that are important to parents of diverse backgrounds may give the perception that these things are not valued or relevant to their quit attempts. It is important for us to recognize that culture matters in health care decision-making and behavior change. As such, it is imperative that we are intentional about understanding the lived experiences of those we serve and not imposing our values upon them.
  • Explore implicit biases. Implicit bias occurs when attitudes and perceptions unconsciously affect our behaviors. For providers offering nicotine cessation treatment, it is essential that we explore our implicit biases in working with specific populations and individuals and make appropriate corrections to behaviors that negatively impact care (e.g., decisions about who we offer services and what those services entail, confronting assumptions about treatment adherence). This may be difficult to discern without direct feedback from our clients. However, regular consultation and collaboration with colleagues from diverse backgrounds can support our efforts to be more aware of and reduce bias.
  • Address structural racism within our organizations. If we are to address the impact of structural racism in our organizational policies and practices, we must first acknowledge the systems of racism that exist. Prioritizing continuing education that focuses on anti-racism and cultural humility is an important first step. Ensuring that stakeholders are part of the process in creating nicotine cessation programs and services is also paramount. We should be developing programs with those who are seeking our services, not for

By becoming better partners to parents, especially those for whom health inequities exist, we can positively impact their well-being and the health of their babies. What commitment will you make to become a better partner?


  1. https://www.sciencedirect.com/science/article/pii/S2211335518300421
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5434788/
  3. https://www.cdc.gov/tobacco/health-equity/index.htm
  4. https://www.heart.org/-/media/Files/About-Us/Policy-Research/Fact-Sheets/Tobacco-and-Clean-Air/Structural-Racism-and-Tobacco-Fact-Sheet.pdf
2023-03-28T15:41:09-04:00January 23rd, 2023|Dr. Alfred, Uncategorized|

Vaping is the new smoking

While tobacco products, combustibles as well as dip and chew, continue to be utilized by more than thirty million adults in the United States1, vaping seems to be the new smoking. Research shows that vaping is one of the most popular substances use trends, especially among young adults and teens. Flavors that are enticing to young people, including sweet, fruity flavors and menthol have led to their popularity. Additionally, vaping devices come in forms that are appealing and discreet, making them more accessible than other forms of nicotine.

Vaping has also become popularized as a strategy for tobacco cessation. There is a perception that vaping is a healthier option than smoking. However, despite its popularity, vaping does not come without risks. We share a few myths and misconceptions to help clarify the dangers of using vaping devices and e-cigarettes.

Myth #1 Vaping is safe. While those who vape avoid exposure to tar, carbon monoxide and harmful chemicals that are associated with combustible tobacco, studies show that there are still thousands of toxins, metals, and ultrafine particles that people who vape are exposed to2. Further, the substance that is released from vaping is not a water vapor. The substance released is an aerosol, which over time can result in cardiovascular and respiratory problems. Additionally, it has been estimated that more than 90% of vaping cartridges and liquids sold in the United States contain nicotine, which can be harmful to adolescent brain development and lead to nicotine dependence3. Vaping also presents risks for those who are pregnant. Vaping during pregnancy can result in low birth weight, and problems with lung and brain development in babies4,5. In essence, vaping is not free from health risks for adults, youth, or those who are pregnant.

Myth #2 Vaping can help with tobacco cessation. While some have had success with quitting tobacco after initiating vaping, many who vape also continue to smoke in some capacity. Most American public health agencies discourage vaping and e-cigarettes as a tool for tobacco cessation because there are known, and unknown health risks associated with their use. Certified nicotine treatment specialists can assist those trying to quit in exploring safer options.

Myth #3 Vaping is not addictive. As noted earlier, most vapes contain nicotine, a substance that is highly addictive. Both physiological and psychological addiction are possible consequences of vaping. Working with a nicotine treatment specialist can help with developing strategies for managing cravings and other symptoms associated with nicotine addiction. They can also assist with nicotine replacement therapies that are deemed safe for those who are trying to quit.

In summary, vaping has become a popularized form of smoking, but it is not risk-free. Learn more about the risks of vaping and the impact it can have on you and those around you, especially if you are pregnant.


    1. https://www.cdc.gov/tobacco/data_statistics/fact_sheets/adult_data/cig_smoking/index.htm
    2. https://drugfree.org/article/how-vaping-affects-teens-health/
    3. https://www.cdc.gov/tobacco/basic_information/e-cigarettes/Quick-Facts-on-the-Risks-of-E-cigarettes-for-Kids-Teens-and-Young-Adults.html
    4. https://my.clevelandclinic.org/health/articles/21162-vaping
    5. https://www.cdc.gov/reproductivehealth/maternalinfanthealth/substance-abuse/e-cigarettes-pregnancy.htm
2023-03-28T15:43:52-04:00January 10th, 2023|Dr. Alfred, Uncategorized|
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