A: The FDA has not approved them as quit aids. Their website says that products such as electronic nicotine delivery systems (i.e. electronic cigarettes) “would need to be proven safe and effective for smoking cessation and regulated as a drug product.” But I think the FDA has been much less active and effective than their website suggests.

Q: What’s the youth appeal of vaping? The flavors? The way it looks?

A: It’s been more than half a century since I’ve been young, so it’s probably best to ask some young folks. However, what we do know from surveys is that adolescents believe that vaping is safe. With the flavored nicotine, the user gets something that tastes like candy and gives a buzz. Plus, with Juul, the user can do it right in class as a way of thumbing their nose at the teacher. Vaping cannabis is about getting a hit. Lung to brain time is very short.

Q: Speaking of that, health officials are doubly concerned about illegal vape pods, some containing THC (the active ingredient in cannabis) — because teens and young adults might not have any idea what is really in them. As a doctor, have you seen some scary outcomes of misuse of vaping devices?

A: Absolutely! This is the big fear, because unidentified chemicals that come with the vaped THC are causing most of the deaths. The bootleg pods are very difficult to distinguish from the legitimate pods, and we have no idea about what is in the bootleg pods.

Q: How do we parents convince our kids we’re not being alarmist?

A: Some parents will try and some won’t. And parents who vape are unlikely to convince their kids of the risk. This is a “yes, and” moment. Yes, this is dangerous and we both need to stop. We need everybody on board to address this looming disaster — parents, teachers, clergy, community leaders. But, frankly, I don’t think that giving advice to people not to vape will stop the current epidemic. Personally, I think what we need to do is what San Francisco has done — prohibit the sale of vaping devices.

Q: Some say it’s harder to quit vaping than smoking cigarettes. Why?

A: I can’t say for sure, but if quitting vaping is like quitting spit tobacco, the user can get much higher levels of nicotine and, with products like Juul, they can do it anywhere and everywhere.

Q: If someone wants to stop vaping, what do you recommend?

A: We know that having a quitting coach and using FDA-approved medications, such as Chantix, Wellbutrin and nicotine replacement products, increases the odds of success. So if they are vaping nicotine, I’d suggest they call 1-800-QUIT-NOW, the smoking cessation quit line. If they are vaping THC and are having a hard time quitting, they should see a primary care physician so that they can be referred to a psychologist or psychiatrist.

Gail Rosenblum/Star Tribune