Mayo Clinic Q&A: Youth Health Topics of Today

DEAR MAYO CLINIC: My daughter is turning 7 in a few months, and I am considering getting a tablet for her, especially given the increase in online learning. However, I’m unsure if this is good for her growth and development, and I don’t want her spending all her time on it. Are there ways to balance screen time while still creating a healthy home environment?

ANSWER: Children are spending more time online with hybrid and distance learning thanks to COVID-19. The good news is that there are ways to balance your child’s screen time while also creating a healthy home environment. However, it is important that you take the steps needed to monitor screen time, and allow for physical activity and critical thinking.

Electronics are a prevalent part of everyday personal and school life in today’s culture, which is fine, but there are health benefits related to reducing screen time, such as improved physical health, decreased obesity, and more time to play and explore.

It is important to note that the American Academy of Pediatrics recommends no screen time for children under 2; one hour per day for children 2 to 12; and two hours per day for teens and adults. In your case, if you are worried about how much screen time you should allow your 7-year-old, try limiting it to one hour per day.

Limiting screen time will allow you to keep a closer eye on what your child is experiencing on social media and the internet. It also will combat risks of obesity, sleep disturbances, depression and short attention span.

These tips can help you trim your children’s screen time, and balance time for other healthy growing habits:

• Be accountable. Set expectations and goals with your children about reducing screen time.
• Be realistic. If you start to notice your children spending too much leisure time on screens, start with setting attainable goals. Instead of jumping right to the recommended one hour per day, start by cutting their screen time back a little at a time.
• Control content. There are free and paid apps that parents can use to manage access to appropriate content. Some of these apps also can allow you to set controls based on age, and schedule permissible screen time and automatic lock times.
• Create electronic-free zones in the home, such as family meal areas. This will help manage expectations.
• Maintain a good sleep routine. Sleep is an essential element of success for children. Aim for an early bedtime and a consistent routine of winding down. This includes no screen time leading up to bedtime.
• Identify time for your child to be outside and playing. Getting outdoors and away from electronics is important. Play is good for your family’s health.
• Build in daily exercise. Though this may be during play time, exercise increases your endorphins, boosting your mood and improving physical health. And a healthy active lifestyle, away from electronics, can help your child maintain a healthy weight and prevent other health issues.
• Spend quality time and engage. After work or school, spend time each day talking face-to-face with your child and give them your full attention. Remind your children of the importance of forming strong relationship bonds through in-person interaction. Engaging family time not only helps reduce screen time, but also builds a healthy home environment.

It’s OK for your children to have fun on their electronics here and there. However, it is important to remember implementing small windows of screen time can have great health benefits and allow for quality family bonding. Balancing screen time and a healthy environment can seem like a challenge at first, but taking these simple steps and implementing these tips can be helpful in doing so. — Madhan Prabhakaran, M.D., Family Medicine, Mayo Clinic Health System, Fairmont, Minn.

DEAR MAYO CLINIC: I am a former smoker who began smoking in high school. I quit a few years ago after a lung cancer scare. As a father, I have often shared with my children about the dangers of smoking. Recently, I overheard my son talking to his friends about vaping. Should I be as concerned about vaping as I am about smoking cigarettes?

ANSWER: Vaping is the term often used to describe the act of using an electronic cigarette. E-cigarettes are battery-operated devices that heat a liquid solution — usually, but not always, containing nicotine — turning it into a vapor that can be inhaled. If the base nicotine mixture is not palatable, many flavors, such as mint, apple and others, can make vaping attractive, especially to adolescents.

Unfortunately, today’s teens, and even tweens, often know more about vaping than their parents.

E-cigarettes and vaping are part of a trend going back at least nine years in the U.S. First publicized as a safer alternative to smoking tobacco, vaping caught on because it didn’t contain the carcinogens or tars found in most smoking tobacco products. Also, vaping was supposed to eliminate the dangers of secondhand smoke to those nearby.

It all sounded pretty harmless in theory. However, those theories were wrong. Here are some of the dangers associated with vaping:

• No matter the delivery method, nicotine is addictive.
• Studies have shown that it may be harder to quit a nicotine addiction than a heroin addiction. Most discussions about helping teens stop vaping fail to address that they already may be addicted. In many cases, teens at this phase may need a nicotine replacement product or medications, such as bupropion, to curb the cravings that can be overwhelming.
• If you’ve ever tried to quit smoking, or had a friend or family member try to quit smoking, you know how difficult it can be. Therefore, in certain situations, e-cigarettes are still considered an option for transitioning someone who has smoked tobacco for years to nonsmoking status.
• The flavors and stabilizers in e-cigarettes can cause unknown inflammation to delicate lung tissue.

Recently when you turned on the national news, you’d hear about more and more cases where severe — sometimes irreversible — damage to the lungs, and in extreme cases even death, occurred in teens who were vaping. Adolescents often feel that bad things happen to everyone else, but the risks associated with vaping are real.

Many teens are taking things a step further, adding cannabis, CBD oils and other dangerous additives to vaping devices. When patients show up to the emergency department in respiratory distress from vaping, it can be challenging for physicians to treat them due to the difficulty in correctly identifying what they inhaled, especially when they are intubated or unconscious.

The length of time spent vaping can be much longer than smoking a standard cigarette.

While most cigarettes are smoked within two to five minutes, e-cigarettes can last up to 20 minutes, delivering more nicotine and damaging chemicals to the lungs. In addition, some vaping mixtures can contain 20 times the nicotine that a single cigarette contains.

Nicotine also can affect concentration and brain development, according to information and data from a new report from the surgeon general. And nicotine use in young adults still can lead to other illicit substance use.

Talk with your kids about the dangers of vaping and look for warning signs, including:

• Changes in emotions.
• Trouble sleeping.
• Scents of fruity odors on skin, breath and clothes.
• Strange cylinders, chargers or batteries lying around.

Remember, it’s important to have conversations rather than suspicion and accusations. Encourage your teen to look into the warnings and media stories related to vaping, or reach out to his or her primary care provider with questions.

Many providers ask their patients about alcohol, drug use and smoking, yet forget to ask about vaping. Project for Teens is an example of a local outreach program that provides support and education on the dangers of vaping. Similar programs may be available in your area. Resources are available to help teens quit through the American Lung Association and SmokeFreeTeen.

It’s up to everyone to work together as a community to stop the youngest members of our population from starting or continually using vaping products. — Graham King, M.D., Family Medicine, Mayo Clinic Health System, Mankato, Minn.

Mayo Clinic Q & A is an educational resource and doesn’t replace regular medical care. E-mail a question to MayoClinicQ&A@mayo.edu. For more information, visit www.mayoclinic.org.