Grant funds action against youth e-cigarette usage

With concerns rising over the health effects of vaping, doctors and researchers at Baylor College of Medicine are taking preventative action. The Dan L Duncan Comprehensive Cancer Center’s Office of Outreach and Health Disparities will use a $1.2 million CPRIT grant to engage and educate pediatric healthcare providers and improve tobacco and e-cigarette prevention clinical services in Harris County.

“We know most cancers occur in adults, but a lot of the risk behaviors for cancer are patterned early in life, specifically in children and adolescents,” said Dr. Jane Montealegre, the deputy director of the Dan L Duncan Comprehensive Cancer Center’s Office of Outreach and Health Disparities and co-principal investigator on the grant. “There’s a clear role for pediatricians in combating cancer and risk behaviors.”

This new initiative is an expansion of a CPRIT-funded cancer prevention program to increase HPV vaccination rates among pediatric patients at Harris Health System clinics, as well as other safety net community clinics in Harris County. Over the course of that 3-year program, the vaccination rate among patients aged 11-18 increased to 70.9% from 46.7%. The recently awarded continuation of that CPRIT grant will allow the Office of Outreach and Health Disparities to build on that success and expand this program to tackle growing e-cigarette usage.

“E-cigarettes really blindsided pediatricians,” said co-investigator Dr. Lindy McGee, assistant professor of pediatrics at Baylor and pediatrician at Harris Health System’s Pediatric and Adolescent Health Center in Pasadena. “Traditional tobacco usage had otherwise been going down with adolescents.”

But a 2018 National Youth Tobacco Survey showed a 78% year-to-year increase in the number of high school students using e-cigarettes. While pediatricians ask about tobacco and alcohol use during standard health checks, they do not specifically ask about e-cigarettes, McGee said. As part of the project, she currently is working to change the electronic medical record to include a question about e-cigarettes.

The next step will be to educate pediatricians and family care providers on e-cigarette screening and behavioral counseling. McGee and the OOHD work with doctors on how to have conversations about e-cigarettes with their patients.

“We know from other tobacco use that simple screening and counseling from a healthcare provider is considered one of the most cost-effective interventions in the cancer prevention world,” said Montealegre, assistant professor of pediatrics – hematology/oncology at Baylor.

The Office of Outreach and Health Disparities will partner with the Tobacco Research and Evaluation Team at the University of Texas at Austin to create patient education materials that can be handed out in clinics. They also will work with Texas Quitline, a tobacco cessation program run by the Texas Department of Health and Human Services, to provide intervention options specific to e-cigarettes. That includes methods designed to reach young patients, like a text-to-quit option.

“We really hope the e-cigarette prevention campaign will prove to be as successful as the HPV vaccination program,” said Maria Jibaja-Weiss, co-principal investigator and director of the Office of Outreach and Health Disparities.

Ultimately, their goal is to create a model that can be used in healthcare systems across Texas and the U.S.

This work is funded through a CPRIT grant (PP190051).