History:
CC: A 16-year-old male patient presented for evaluation of lungs related to his vaping use and for counseling regarding possible vaping cessation.
HPI: He has been vaping a nicotine solution for almost 2 years, currently daily but less on weekends, averaging the equivalent to a pack of cigarettes per day. Possible impact on academic performance and involvement in sports. No previous quit attempts.
Evaluation:
- Physical exam revealed no signs of e-cigarette or vaping product use-associated lung injury (EVALI) and no GI symptoms suggestive of EVALI (Siegel, 2019) or other lung problems.
- Response to Hooked on Nicotine Checklist screening questions (4-5 ‘yes answers out of 10) together with elicited history of daily use of the equivalent to the nicotine in a pack of cigarettes per day and some withdrawal symptoms when not using suggests moderate nicotine dependence.
Treatment:
- Motivational Interviewing used to help him move from contemplation to ready-to-quit stage.
- Guided him in developing a personalized Vaping Cessation Plan
- Referred him to a texting program that supports adolescents in quitting vaping and the corresponding website as a patient education resource.
Plan:
- Vaping cessation starting in 24 hours following his personal Vaping Cessation Plan
- Follow-up via phone in 2 weeks and office visit one month.
- Invite parents to accompany him to the next appointment for parent education.
