Estonia needs more preventive work, honest and calm explanations, and dialogue and cooperation between schools, parents, and specialists, Mesipuu, who is also a parent, goes on.

As a trainer, I have had the opportunity to communicate with young people across Estonia, who have frankly told me how trying e-cigarettes at first felt like some sort of innocent game. The flavors, the vapor, and the shared activity with friends all provided the excitement. "The main thing is the child isn't smoking," the attitude was.

When communicating with parents, another major issue has emerged: that many parents do not perceive vaping in the same way as alcohol or traditional cigarette smoking are, ie. as a threat.

"The main thing is the child isn't smoking" is a sentence I hear at almost every parents' evening. I have also heard: "I buy nicotine-free vapes for them, what's wrong with that?" But why should such products be purchased for a child at all? Especially bearing in mind that users of nicotine-free vapes may very likely become nicotine users.

Another common myth being propagated is that e-cigarettes represent a safer alternative to the traditional cigarette. Once, when I asked the mother of a seventh-grade girl whether she knew her daughter was vaping, she replied, "We have sweet vapes as an after-dinner option." She said this with a sort of stoic calm. At first I thought it was a joke and replied, "Maybe add cigarettes too, for a wider selection!" The girl's mother looked at me severely and said, "Are you stupid? Do you want to make my child a smoking addict?" I have also met a father who said that when his 13-year-old son does not want to go to school, he promises to buy him a vape later on in the evening, to motivate him to attend.

These are real-life examples and reflect a reality in which even adults do not realize that these products are prohibited for minors. Even less awareness exists that in the case of illegal products, such as sweet-flavored vapes, the content is not regulated and may contain nicotine levels higher than those legally permitted in Estonia.

Most parents are in any case deeply concerned. In addition to prohibited e-cigarettes being easily accessible through the black market, their use is also easier to conceal. Unlike regular cigarettes, e-cigarettes do not leave a strong, tell-tale odor of tobacco smoke on the user. They have also physically become increasingly difficult for parents and grandparents to spot. Vapes can resemble USB sticks, chargers, or cosmetic items. At a recent info evening on the harmfulness of e-cigarettes, one grandmother admitted that now she finally understood what she had found in her grandson's pocket when she started washing his clothes.

What should be done if a child is found to be vaping?

First, to understand whether a child is vaping, it is worth paying attention primarily to changes in behavior: irritability which can arise easily, especially in situations where people are together for longer periods and it is not possible to secretly go somewhere to vape; restlessness; poor sleep; secrecy about money issues; secret phone conversations; new items of unclear origin; even a faint, sweet smell lingering on the clothing. Teachers report children suspected of vaping taking more frequent bathroom breaks, even to satisfy nicotine cravings arising during class.

Other tell-tale signs are "muscle memory" gestures taken from vaping when using a pen in class, and even more frequent nosebleeds.

As for parents, the worst thing they can do on discovering that their child has been using e-cigarettes is to go all in with major scolding, banning the devices, grounding, or accusations. I have heard and seen for myself how such an approach simply drives the child deeper into their secrecy. I always recommend starting things calmly — asking, listening, explaining, not being intimidating. Of course, this presupposes a previously established relationship of trust existed between adult and child. This means the key not only to addressing vaping but to communication with a child as a whole lies in talking. If a child is no longer talking, the issue runs deeper than just vaping.

Facts are stronger than bans. If a young person is involved in dealing in vaping, they may not at all understand the legal and life consequences that accompany it. Asking for help — even from the police — is not failure, but responsible parenting. There is no need to fear that the child will receive "a black mark in their copybook." It is also worth making use of smoking cessation clinics and other support services.

We need more prevention work

Years ago, I received a response from a state health-related organization which read: "You must not talk to children about vaping — as then they will find out that such a thing exists." Yet burying our heads in the sand and dealing only with the consequences will get us nowhere. If there is anyone who still does not know what a vape is, it is adults and parents.

The widespread use of e-cigarettes among minors, including prohibited products obtained from the black market, is not only a family concern, but a societal problem. We need more prevention work, honest and calm explanations, and cooperation between schools, parents, and specialists.

My experience has illustrated that young people are ready to listen when they are not labeled or intimidated. That applies to parents too. The spread of prohibited e-cigarettes is not an invisible issue. We simply have to be ready to truly see it and address it before the damage becomes too great. More open explanation and speaking about things in the right words are the foundation for dealing with the problem.

Quite quickly, however, experimentation can transform into a habit. Young people will say: "If I don't have my vape, I can't concentrate" or "If I don't vape, I'll lose my friends." In such cases, this is no longer merely a new trendy fad we are talking about, but an addiction, in whose development products easily obtained from the black market — including various sweet flavors prohibited in Estonia — play a major role.

Whereas previously a minor had to "know someone, somewhere" to obtain a vape, or had to try not to get caught ordering from foreign e-shops via parcel machines, today prohibited products are more easily accessible through various social media channels such as Snapchat and Telegram. Often the reseller is not an adult but another young person. This means it is no longer merely a consumption problem, but also a resale problem: At least 52 percent of e-cigarettes used in Estonia have been bought on the black market.

It is particularly important to dispel the myth that only children from more well-heeled backgrounds living in the larger towns, or only boys, or only academic under-achievers who are vaping. I have given dozens of talks across Estonia, and in every county. Only in one school was it claimed that vaping is not a problem. The e-cigarettes get used also by straight-A students, boys and girls alike.

A recent study among school students revealed that 51 percent of boys and even 59 percent of girls have used e-cigarettes at some point in their lives. Vapes can even be purchased "by the puff," so the thickness of one's wallet or purse is not a determining factor among users either. However, communicating with young people and schools shows that children from lower-income families are often the resellers and intermediaries.

More on the health effects of vaping is here.

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