Helping teens quit vaping

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Natalie Moutafis: 

Hi everyone and welcome back to isPodcast, ISV's show for schools and the wider community. I'm Natalie Moutafis. On today's episode, Parents Website favourite Diane Bourke shares how reading nursery rhymes can delight children while they learn the rhythms of language. But first, Mike Broadstock talks with Melbourne University Associate Professor Michelle Jongenelis about how we can help teenagers who are vaping to quit – and why we should avoid turning it into a lecture. 

Michael Broadstock: 

There's been an enormous increase in the use of e-cigarettes in young people over the last few years. Schools and parents have seen the impact on kids firsthand. In May, Australian Health Minister Mark Butler announced that the government is going to invest almost $737 million in reforms and programs to reduce smoking and stamp out vaping, particularly among young Australians. But a lot of young people have already started vaping. Many will find it difficult to stop. Today on isPodcast, we're joined by Michelle Jongenelis, Associate Professor at the Melbourne Centre for Behavioural Change at the University of Melbourne, to talk about what we can do, parents and schools, to help them quit. Michelle, welcome to isPodcast. 

Michelle Jongenelis: 

Thank you so much for having me. 

Michael Broadstock: 

It's fair to say that you're passionate about doing something to stop smoking and e-cigarettes. 

Michelle Jongenelis: 

Yeah. So, I began working in this area in 2017, so that's six years ago now, and even back then we could see that there was something major happening. The tobacco industry had started spending a lot of money on e-cigarettes. And when the tobacco industry starts spending a lot of money on something, it's never good. So, seeing that six years later, what we were worried about six years ago has come to fruition is quite concerning. 

Michael Broadstock: 

How did you get into behavioural change? 

Michelle Jongenelis: 

Serendipity, actually. So I'm a trained clinical psychologist and did a master's in clinical psychology. And after finishing my PhD, PhDs can be traumatising sometimes, I just wanted to work as a clinical psychologist and help people at the individual level.  

But I'd had a wonderful PhD supervisor who said, "We've got some data here in alcohol, actually, alcohol warning labels and making people more aware that alcohol causes cancer because very few people are aware that alcohol and tobacco are in the same category in terms of cancer-causing agents." So, she asked me if I wanted to look at that data and I said yes, and that started my passion for public health, health promotion, making sure people are aware of the products that they're consuming. As individuals, we have a right to be aware of the chemicals or whatever it is, the poisons that we're consuming. 

But industry seemed to get away with not making people aware of things. So that sort of started my passion and my desire to get into behaviour change more at the population level. And not just behaviour change at the individual level, but behaviour change at the political level. What do politicians need to know to change their behaviour and to change the decisions that they're making in this space? 

Michael Broadstock: 

So, the government's promised close to three-quarters of a billion dollars in reforms to stop teen vaping, where's the money going? 

Michelle Jongenelis: 

So, there's a portion that's going to be spent on mass media campaigns, not just for vaping, but tobacco controls. About 63 million, I believe, has been set aside to educate the public about the harms associated with vaping and also smoking. The reforms that have been announced, the nitty-gritty of the details haven't been decided yet. There's an understanding that the government is also putting in money to support people who are currently addicted to vaping to quit.  

So, more money going to support services, but then there'll be also money going into ensuring that we can enforce the reforms. So, for instance, one of the reforms is stopping importation of these products unless they're coming in under the pharmaceutical scheme. So, this is a pharmacy that's importing these products. So, there'll be money going to Border Force to up the ante on enforcement there. 

Michael Broadstock: 

So, we shared your Conversation article on how to help young people quit vaping on our website for parents. We'll link to that in the show notes. What are your main tips for moms, dads and carers trying to help their kids? 

Michelle Jongenelis: 

Yeah. So, I guess the tips are really dependent on whether or not you have a child who is addicted to the nicotine in the products versus if they have been experimenting and not quite addicted yet. So, if you have a child who you suspect or who they are saying 'I'm addicted to this’, then obviously seeking medical support either from a GP but also contacting QUIT.  

So, there's some resources online or actually contacting the QUITline. QUIT have reported that they are receiving an increased number of calls from adolescents and from parents who has saying, ‘Look, I have a child addicted to vaping. What can we do?’ So, if that's the case, figuring out with a health professional what needs to happen to help with the nicotine addiction. 

In terms of not quite addicted, but starting to use a little bit more, then the standard behavioural change techniques:  

Are they motivated to quit? As a parent, you might want them to quit, but they might not necessarily be motivated just yet. So, what needs to happen to start increasing their motivation? What impact is vaping having on their life?  

Why are they vaping? So, something I always talk to people about is never tear down a wall before first understanding why it's been built. So as a parent, of course, your instinct is to immediately get them to stop vaping. But if they're vaping for anxiety relief – even though it doesn't necessarily help with that – but if they are perceiving that it helps with their anxiety or their depression or it's a way of them to connect socially with other people, if you are taking that away from them, it's going to be really hard for them to want to do that.  

So, understanding first why they are engaging in this behaviour. And if it is because they perceive that it reduces their anxiety, are there other strategies that you can help them adopt. If their anxiety is quite bad, do they need to see a mental health professional? Do they need to get on top of their mental health? Does there need to be some more effort in that space?  

If it's a social thing, what's happening socially? Is it their friends? Is it the peer group? Is this a conversation you need to be having potentially with the school? So, I think boosting motivation is important.  

Often, we tend to go to knowledge. Certainly, as health professionals, we are guilty of this as well. If we just give them the right information, if we just tell them that vaping is bad for them, they'll stop. And actually, that's very rarely the case. We've run focus groups recently with kids and I said to them 'What do you know about vaping?' And they said 'Oh, we've heard it's harmful. We've seen the posters at school, but we just ignore them’.  

So, I think relying on that knowledge can sometimes be a little bit tricky and not helpful. So, what else do we need to rely upon? And it's usually shifting their attitudes. So, making them aware that the costs of vaping outweigh the benefits. 

Michael Broadstock: 

In your article, you talked about the SMART framework, how does that help? 

Michelle Jongenelis: 

Yeah. So, the SMART framework relates to goal setting. So, we're often very guilty of coming up with very vague goals, so, 'Oh, I need to get fitter, or I need to be happier’, and really, really vague.  

So, we encourage people to set SMART goals. So specific, measurable, achievable, relevant, and timed. What this means is you are setting goals that you can actively look at and you know whether you are meeting them or not. 

So, in the fitness space, if your goal is to get fit, very vague, a SMART goal in that instance, "Well, I will go to the gym three times a week and I'll exercise for 45 minutes on each of those occasions." And, of course, we can make that even more specific by saying, 'I'll go to the gym Monday, Wednesday, Friday’. It's about coming up with a similar goal in relation to vaping. And it might be for a child or for an adolescent, it might be, '’I will only vape once a week or I'll only vape twice a week’. And so, I understand, again, as a parent, you want them to be quitting vaping entirely, but it might be that you need to set goals to get them to taper down before you get them to quit full stop. 

Michael Broadstock: 

And how do you help them when they fail? If they say, 'I'm only going to vape on Monday, Wednesday, and Friday’, and at the end of the week I say, 'Well, I vaped on Monday, Wednesday, and Friday'? 

Michelle Jongenelis: 

Yeah. So, it's never really failing. It's a teachable moment. So, I'll always talk to clients around, 'Well, what happened on that day that you weren't going to vape? What prompted the vaping? Was there something happening? If it's anxiety, was your anxiety triggered? Was it that you went to a party and someone offered it to you and you felt pressure to do that?’ 

So, it's never about, well, you failed and start again. It's what was happening for you that made you choose this thing that you wanted to not do. And then it's understanding, 'Okay, well next time, what can we do to make sure that you are better resourced to not do that?' So, if you're going to a party, is it a party that you might skip or do you need to figure out some ways that you can say, 'Actually, no'? So, teaching about refusal to use e-cigarettes, can we come up with some statements that you can say to your friends when they offer you one?  

So again, never a failure, always a teachable moment to figure out what didn't work that day and what can we do next time to make sure you're better resourced to deal with those issues. 

Michael Broadstock: 

What are the challenges when it comes to changing a teenager’s behaviours in particular? 

Michelle Jongenelis: 

Well, I mean teenagers, their brains are still developing. So, there are the normal issues that come with that period of time with sensation seeking and experimentation and impulse control and wanting to fit in with other people. So, we obviously have those issues when it comes to dealing with adolescents. I think taking a punitive approach and lecturing is never really going to help. It always comes down to, again, understanding where they're coming from, understanding the period of life that they are in and supporting that and being aware of that rather than sort of, again, blanketly saying, 'You need to quit' or yelling at them. 

Michael Broadstock: 

Is it easier to change a teenager behaviour than an adult, do you think? Or different? 

Michelle Jongenelis: 

I mean, again, I think the adolescent period is very tricky for the reasons I just mentioned around impulse control and experimentation and sensation seeking and wanting to fit in. I think that is unique to adolescents. That's not to say it's easier in adulthood. We also deal with social norms and we also deal with peer groups and family groups who are engaging in behaviours that aren't helpful. So, smokers tend to congregate with smokers. So, if you are a smoker in a group of smokers and you want to quit, that's going to be problematic. 

Michael Broadstock: 

Because you don't want to miss your smoko... 

Michelle Jongenelis: 

Yeah, exactly. Exactly. So I think it's a different set of challenges.  

I think where it's probably harder for adolescents is actually in the relationship between adults and adolescents. So as a parent trying to understand their teen, I think that's where it gets tricky, because as a parent you can sort of see things a little bit more clearly, and you're probably thinking, ’Why the hell is my adolescent vaping? I don't understand why my teen is vaping. Don't they realise how harmful it is?’ 

So, I think that's where it gets tricky. It's having to sort of set aside your own knowledge, your own beliefs, your own expectations, and putting yourself in the shoes of your child and seeing what they are going through. I think that's where it gets hard. 

Michael Broadstock: 

Yeah. I mean, I ask because I know as an adult I sort of can get a bit fixed in my ways and know that my kids, they're still in a place where they're willing to try new things and to change. 

Michelle Jongenelis: 

Yeah, I mean it sort of works both ways because they are willing to try new things, which is why they're trying e-cigarettes. Let's be honest. It's very innovative, very sexy, they're marketed directly to these teens. So yes, they are willing to try new things, but you raise a great point that the habits that are developed in childhood and in adolescence typically follow people through to adulthood.  

So, if you are a very active teen, chances are you're going to be a very active adult. If you are a very sedentary teen, you're going to be a sedentary adult. 

We know that the adolescent period is actually quite critical for the behaviours that then get set in adulthood, which is why we encourage as much as possible this life course approach to everything.  

So, unfortunately, we're sort of playing catch up at the moment and we sort of go, 'Oh, well, we need to get, for example, older adults engaging in exercise more’.  

And that's actually quite tricky to change those lifelong habits. So, we typically now talk about a life course approach to healthy lifestyle, sort of healthifying your future is what I like to call it. What do you need to do now as a teen to healthify your future and to put you on that right path? 

Michael Broadstock: 

You talked earlier about assessing when a teenager comes to you and says, ‘Oh, I'm a bit concerned about vaping’, determining whether they're addicted to them or not. First, how does nicotine complicate matters when you're trying to help your child change their behaviour? 

Michelle Jongenelis: 

It complicates things a lot. So once an addiction is in place, you can engage in the usual behaviour change strategies, but it's going to be a lot harder given their brain has developed a dependence on a product that it's no longer getting. So it's not impossible. It just means that the behavioural approaches that you're adopting might need to be complimented by, again, perhaps some advice from health professionals. It depends on how addicted they are.  

Does there need to be a nicotine tapering? Do they need to look at other forms of nicotine replacement therapy to help them here? Certainly, that's something that we're starting to explore now that the vaping reforms have happened. How do we support teens who are addicted to vaping get better? And is it that they need to try other forms of nicotine replacement? 

Michael Broadstock: 

What's one thing you wish parents knew about how they can help the kids make changes in their life? 

Michelle Jongenelis: 

So, I mentioned the lecturing earlier, and I think what sits behind the no lecturing is a sense of, I guess, compassion towards children. So particularly in the vaping space, and I mentioned this in my Conversation article, they really are being manipulated by an industry that has billions of dollars. It's very much David and Goliath when it comes to that.  

So, having some compassion, putting yourself in the shoes of your child. I don't think any child goes out and says, 'You know what? Today I'm going to get addicted to vaping, or today I'm going to get addicted to alcohol.' It's very insidious.  

We talk about social media a lot. The stuff that they're exposed to, we are not even seeing our algorithms are completely different. So, they are getting exposed to marketing on Snapchat, on TikTok. I'm not on any of those platforms, so I would have no clue what the kids are seeing, but this is what they're seeing. 

So again, there's the compassion there. But also, I think earlier I said it's important to understand why a wall's being built before tearing it down, and that I think that's probably my one piece of critical advice for parents.  

Again, I know as a parent you just want them to stop vaping and you cannot understand why they are sucking on a battery, but figuring out what it is that they're using this product for before you sort of launch into 'You absolutely must quit. And I'm going to ground you if you don't' or whatever punitive approach you take. 

Michael Broadstock: 

So the difference for you in terms of lecturing is it's coming from a compassionate place first and foremost, and it's about supporting. Because my son, if I sit down and have a quiet chat with him, he'll tell me: 'You're lecturing me, dad’. 

Michelle Jongenelis: 

Definitely. And it's also about making sure that they are consenting to having that chat with you.  

So often we sort of get kids when they're in the car and they have nowhere to go, and we start these tricky conversations. And if they're not ready to have that conversation with you yet, then you're not really going to get anywhere.  

So, I think it's important as well for parents to understand that sometimes you're just planting the seed and it then might go away and grow and then the child might come back and then be willing to talk to you about it. But if you were trying to force it to grow from the start, then they're not going to come back and talk to you later on because they already know what you are going to say. They already know that you're going to... I don't know. 

Michael Broadstock: 

'Oh, this again?' 

Michelle Jongenelis: 

Yeah, 'Not this again.' Exactly. 'Oh, I can't tell mom that I'm using this product because then she'll ground me.'  

So again, just, 'Hey, I've heard that there's this thing called vaping. Is it a thing at your school? Is it something that you want to talk about? I'm here if you want to talk to me, if you need me.' So again, planting the seed rather than forcing it to grow or to completely butcher the analogy, overwatering it, and then killing it. 

Michael Broadstock: 

So where are some places that parents and teenagers can go for credible information and help? 

Michelle Jongenelis: 

That's a really great question because you use the word credible there, and something that I think is important for parents to be aware of is that there are some organisations out there that do present a lot of misinformation when it comes to vaping.  

A general rule of thumb is if there is someone, or if there is an organisation that is advocating for these products to be consumer products, stay away. Often these organisations have links to the tobacco and the vaping industry, so there's an agenda there. So that's who to avoid. 

But in terms of organisations to go on and to follow or to jump on their websites, QUIT has some resources available. Lung Foundation Australia have some great resources as well, so fact sheets, but also I've produced some videos for them that are for educators, so teachers but also for parents. That Unveil What You Inhale campaign, the Cancer Council Federation as well, so Cancer Council Australia, but also the various cancer councils, Victoria, WA, New South Wales certainly as well has done a lot of work in this space. So your typical credible organisations, not for-profit, NGOs, they're the ones that you should be going on, but certainly Lung Foundation, QUIT, VicHealth, and Cancer Council are the four that I know have some really great resources out there for parents. 

Michael Broadstock: 

We'll link to those in the show description. Thanks, Michelle, for joining us. I really appreciate your time and all your great thoughts for parents. 

Michelle Jongenelis: 

Thank you so much. 

Shane Green: 

Diane Bourke loves words and language. She's a former teacher and school leader who brings her passion and expertise to her role as project manager at ISV. One way she does this is through her regular and popular articles for the parents' website where she explores the power of words and language and how they can have a huge effect on the child's development. Her most recent article was on nursery rhymes titled Why Nursery Rhymes Rock. It really struck a chord with readers. 

So, we asked Diane to join us on is podcast to talk about nursery rhymes. At the end of the presentation, she recites her personal favourite and explains why it means so much to her. 

Diane Bourke: 

Nursery rhymes have always been important to me. I guess I'm lucky that I've been involved in schools for 35 years or so and I've realised the value of them for many, many reasons. I collect nursery rhyme books. I love to look at them and think of ways that these rhymes can help children. 

The popularity of nursery rhymes has waxed and waned over time. With the advancement of new forms of media, animated cartoons, interactive apps and videos, the prominence of nursery rhymes for entertainment may have diminished in some circles. Children have access to a wide range of digital content that competes for their attention. Not always lost, however, as many of these videos feature nursery rhymes, albeit with run-of-the-mill animation. 

What does make a nursery rhyme? Put simply, a nursery rhyme can be a traditional or contemporary verse, or even a catchy song always aimed at children. They often feature playful and whimsical themes, animals, counting and moral lessons.  

The exact origin of nursery rhymes is difficult to pinpoint as many have been handed down through oral tradition for centuries. A French verse similar to Thirty Days Hath September was recorded in the 13th century. New rhymes, however, have progressively entered the flow. 

I'm captivated by Julia Donaldson, author of The Gruffalo, who recently wrote a nursery rhyme that conjures up a cacophony of deafening sounds: 'And snapdragons roared and catmint miaowed’. What fun is that? 

The first recorded collection of nursery rhymes in English is believed to be Tommy Thumb's Songbook published in London in 1744. It includes Jack and Jill, Little Miss Muppet, and Baa Baa Black Sheep. These rhymes have interesting historical backgrounds. Hickory Dickory Dock, featured in Tommy Thumb's Songbook, was inspired by the astronomical clock at Exeter Cathedral. The door to the clock room had a hole cut in it so that the resident cat could ensure the clock room was free of vermin. This is where nursery rhymes come to the fore. The list of benefits goes on and on. 

When parents and grandparents recite a nursery rhyme to a baby, toddler, or young child, they're preparing that child for a successful segue into reading instruction. Listening comprehension precedes reading comprehension. And for children to understand what they're reading, they must be able to hear the language first. Nursery rhymes fit the bill perfectly. The rhyme and rhythm abounding in nursery rhymes enable children to develop an ear for our language, which is a precursor for learning to read. Nursery rhymes truly matter because they rhyme. And rhyming helps babies and young children learn about words, sounds and language formation. 

Learning to recognise and produce rhyme is one of the very first phonological skills that children acquire on their way to becoming a proficient reader. I encourage those listening to make up their own rhymes with their children and learn more about the sounds. You'll have great fun. 

Now, once children have masses of these rhymes in their heads, they have a bank of language, words, phrases, and grammar, essential information to bring to the task of learning to read. As Mem Fox says, 'Words in children's heads drift into their daily speech, and soon you have an articulate child’. 

What's even better, when children go on and memorise the entire verse, they're undertaking a mini bootcamp for their ever-growing brain. Think too of the new vocabulary children are learning when hearing nursery rhymes, words such as elegant, dainty, lingered and patiently.  

If encouraged and supported, they'll soon use these in their daily speech. By chanting rhymes, children are also practising how to articulate these words, modulate their voices and enunciate clearly. Adding facial expressions and actions further the enjoyment. 

Nursery rhymes can also help children identify emotions in themselves and others. Think of Jack and Jill falling down a hill, or the frightened Miss Muffet on her tuffet, or even Dr. Foster in Gloucester when he fell in a puddle. Talk openly about these emotions with your children. 

Coordination and balance are consolidating when acting out I'm a Little Teapot or Incy Wincy Spider and dance along to Baby Shark. At one stage, Baby Shark was YouTube's most watched video of all time. Recent research suggests that the repetitive lyrics and the fast tempo of Baby Shark trigger the pleasure centre of the brain, increasing dopamine, which leads to intense feeling of contentment. The rhyme also mentions words like mommy, daddy, grandma, and grandpa. And it's the positive connection that the child has with these people that targets a pathway to the emotion and word centre in the brain. So no wonder Baby Shark is such a hit. I certainly find myself dancing to it when I hear the music. 

There are so many lessons to be learned with nursery rhymes. Mathematics. Ten in The Bed and Little One Said certainly helps with subtraction. Ten in the bed, and the little one says ‘move over, move over’. And a real math quandary could surface if one did not listen carefully to the instructions for when I was Going to St Ives. 

In 1973, when I was teaching in England, I bought my first book of nursery rhymes, the Puffin Book of Nursery rhymes, which was published by Iona, Iona, and Peter Opie 10 years earlier just fascinated me, and I'm still buying them today. Our bookshelves are overflowing with nursery rhyme books. Last month I bought Allie Esiri's A Nursery Rhyme for Every Night of the Year, and I had been waiting for it with bated breath. We still have family favourites. There is often a scurry of texts when a member of our family sees a red sunset or sunrise. In fact, I sent two texts this morning when I saw a red sky rise over the railway station as I waited for my train. Red sky in the morning, however, it's not as promising as red sky at night. This short verse was first mentioned in the Bible, I believe. Anyway, Red sky at night, shepherd's delight continues to resonate with our family and the lion's journey with us. 

The lines A pinch and a punch on the 1st of the month are not always as exciting. I've received ongoing texts soon after midnight on the 1st of the month from either my brother or grandsons on several occasions. I also remember fondly the squeals of delight when my grandsons were prepared to sit on my knee and play, games like round and round the garden like a teddy bear, one step, two-step tickly under there. Going on a bear hunt at the local park was great fun as well. 

My favourite memory, however, was receiving a call from my younger grandson when he was three, and he sang to me to the tune of Twinkle Twinkle, the Alphabet Song, which he had eventually memorised by heart. He had no idea what the alphabet truly was at that stage, but he was over the moon that he managed to get through it in one go. 

The Owl and the Pussycat has always been my favourite. I feel comfortable to call it a nursery rhyme since its featured in Allie Esiri's new nursery rhyme book. In 2014, it was also named the most popular children's poem in the UK. We have several prints of The Owl and the Pussycat featured around our house, and I first read this in a poetry book I was given as a young child. The book was called A Book of a Thousand Poems.  

I love The Owl and the Pussycat for the delicious use of language, rhyme and imagery. It's pure nonsense, a joyful, delightful fantasy. The owl and the pussycat can talk. The owl sings a song and plays the guitar. The pig engages in financial transactions and the turkey officiates at ceremonies.  

And at home, we sometimes fight over who can use the runcible spoon. 

The Owl and the Pussycat, by Edmund Lear 

The Owl and the Pussy-cat went to sea 
In a beautiful pea-green boat, 
They took some honey, and plenty of money, 
Wrapped up in a five-pound note. 
The Owl looked up to the stars above, 
And sang to a small guitar, 
‘O lovely Pussy! O Pussy, my love, 
What a beautiful Pussy you are, 
         You are, 
         You are! 
What a beautiful Pussy you are!’ 
 
Pussy said to the Owl, You elegant fowl! 
How charmingly sweet you sing! 
O let us be married! too long we have tarried: 
But what shall we do for a ring?" 
They sailed away, for a year and a day, 
To the land where the Bong-Tree grows 
And there in a wood a Piggy-wig stood 
With a ring at the end of his nose, 
             His nose, 
             His nose, 
With a ring at the end of his nose. 
 
‘Dear Pig, are you willing to sell for one shilling 
Your ring?’ Said the Piggy, ‘I will’. 
So they took it away, and were married next day 
By the Turkey who lives on the hill. 
They dined on mince, and slices of quince, 
Which they ate with a runcible spoon; 
And hand in hand, on the edge of the sand, 
They danced by the light of the moon, 
             The moon, 
             The moon, 
They danced by the light of the moon. 

Natalie Moutafis: 

isPodcast is brought to you by Independent Schools Victoria. It's produced by Duncan MacLean and presented by Shane Green, Michael Broadstock, and me, Natalie Moutafis. Our podcast theme is composed by Duncan. There are transcripts of our show with links to what we've discussed at podcast.is.education.com.au. Please follow us wherever you get your favourite podcasts. While you're there, we'd love it if you could rate and review the show so more people just like you can find us.