When I treat adolescents and young aldults who have mental health challenges, it is very common that at some point we also address tobacco cessation. 

Unfortunately, many young people who struggle with anxiety, depression and other issues rely on unhealthy coping strategies. They turn to substances or tobacco to alleviate stress, deal with emotional trauma and mood swings, or to feel more confident and included. 

According to the Centers for Disease Control and Prevention (CDC), in 2015, 25.3 percent of high school students and 7.4 percent of middle school students used tobacco. Electronic cigarettes are the most commonly used product by youth. Today, about 20 percent of all adolescents and teens vape, a 135 percent increase in just two years.

A recent report published by Oxford Academic Journals shows that these numbers are further elevated among young people with diagnosed psychiatric conditions such as attention deficit, conduct disorder, depression, anxiety and substance use disorders. According to one survey of adolescent psychiatric inpatients, 60 percent were current smokers. Another study found that half of 14- to 17-year-olds with anxiety symptoms and two-thirds of those with depressive symptoms used tobacco.

Young people are especially vulnerable to nicotine dependence and three-quarters of teens who use tobacco products go on to smoke as adults, putting them at risk for serious health consequences later in life. (It is estimated that smoking kills more than 480,000 Americans every year.) Research also shows that smoking impacts adolescent and teen brain development and that youth who smoke are at increased risk of developing mental illness compared with nonsmokers, including major depressive disorder, agoraphobia, generalized anxiety disorder, and panic disorder, the Oxford Academic Journals study found.

The research about the damaging impact of smoking or vaping is extensive. Helping young people take action before tobacco-use becomes a lifetime addiction is critical for their long-term health and wellbeing.


Adolescents and young adults have different needs from adults. Just like with any other type of therapeutic intervention, we have to tailor our approach to their specific circumstances and experiences.

Typically, I work to build a close partnership with parents and caregivers. Parents are key influencers for their children and their support is essential. Cessation efforts are most often successful if parents set clear expectations and consequences for smoking and are positive role models. If parents smoke or tobacco products are easily accessible in the home, it is much harder for a young person to stop.

If you are working with a teen to help them stop using tobacco products it is important to support them in developing a cessation plan that is nonjudgmental, pragmatic and positive. Some steps a cessation plan should include are:

1. Encouraging the young person to make a commitment and be accountable. Ask them to choose a quit date, schedule a time to throw out all smoking paraphernalia, or tell a friend about their intention to quit.

2. Challenging them to gain a clear understanding of their habit. Questions they may want to ask themselves are:

  • Why do I smoke or vape? (Parents smoke, peer pressure, curiosity, stress, boredom)
  • What are my triggers? (Awkward social situations, images of smoking or vaping in the media, feelings of loneliness.)
  • How do I feel when I smoke or vape?
  • How does smoking impact my life? (Health, relationships, budget, ability to do sports, etc.)
  • Why do I want to quit smoking? (Wellbeing, friends are quitting, taking back control, staying out of trouble.)

3. Introducing them to healthier coping strategies for anxiety or depression. This could include any number of self-care strategies such as meditation, visualization or breathing exercises, getting outdoors, healthy routines, etc.

4. Assisting them in managing nicotine withdrawal. Your young person may feel cravings, be irritable or suffer physical withdrawal symptoms. Encourage them to stay hydrated, get enough sleep, and eat healthy snacks. Consider getting help from a medical professional.

5. Providing access to resources and supports. Examples include:

  • The National Cancer Institute’s Smokefree.gov website.
  • The American Lung Association’s N-O-T: Not on Tobacco Teen Smoking and Vaping Cessation Program
  • Text message programs like SmokefreeTXT
  • The quitSTART app

6. Encouraging your teen not to give up. Slip-ups happen. Remind your young person that this doesn’t mean they have failed.

7. Celebrating successes. Has your teen stopped smoking for one day, one week or one month? These achievements should be recognized and rewarded.

If you are seeking support in getting your adolescent or young adult to quit smoking or vaping, I’m here to help. Contact me to learn more about treatment options.

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