(CNN) Millions of young people vape. How aware are their parents? Not very, says a new study.
Parents and guardians are less likely to know or suspect when their children vape or use other tobacco products than they are when they smoke cigarettes, the study, published in Pediatrics, said.
About 70% of the parents and guardians of children who smoke reported being aware or suspecting it. For kids who use e-cigarettes, the percentage is about 40%, the study said.
"When parents think about tobacco, many will picture smoking a cigarette but other tobacco and nicotine products may not come to mind," said Dr. Benjamin Chaffee, a senior author of the study and associate professor at University of California San Francisco School of Dentistry.
"E-cigarettes, in particular, may look like a tech device and don't produce a lasting odor."
Other types of tobacco products more likely to go unnoticed are non-cigarette combustible products or smokeless tobacco. Most e-cigarettes contain nicotine, according to the CDC.
"Any tobacco or nicotine use by children is concerning," Chaffee told CNN. "Any product that delivers nicotine has a high risk of addiction. Nicotine exposure is particularly concerning for adolescents, whose brains are still developing."
Two years ago, US Surgeon General Jerome Adams declared vaping among young people an "epidemic."
In 2020, 3.02 million high school students and 550,000 middle school students reported being current users of e-cigarettes, according to data from the 2020 National Youth Tobacco Survey analyzed by the US Center for Disease Control and Prevention and the US Food and Drug Administration.
During the coronavirus pandemic, the correlation between smoking and vaping and higher risk of severe Covid-19 cases has also been investigated.
In August, lawmakers asked the FDA to clear the market of all e-cigarettes for the duration of the crisis, citing concerns about vapers as young as 13.
The UCSF study used nationally representative data from the Population Assessment of Tobacco and Health Study, and tracked more than 23,000 young people between the ages of 12 and 17.
Parents and guardians were more likely to know or suspect their child uses tobacco or nicotine products if the child was older, male, White and lived with a tobacco user, according to the study.
The study also found that parents with lower levels of education were more likely to know or suspect their child uses tobacco or nicotine products. Mothers were identified as being more aware than fathers.
The study was conducted before the 2019 outbreak of vaping-related lung injuries, which Chaffee said may have raised awareness about the dangers of vaping for young users.
Another focus of the study, along with parental awareness, was the role of household rules in connection with tobacco use.
Children living in homes with stricter rules around tobacco use for kids and adults, as well as visitors, guests and workers, were 20% to 26% less likely to start using tobacco, the study reported.
"Parents are role models for their kids," Chaffee said. "The first thing parents can do is not use tobacco products themselves. For parents still trying to quit, they can make sure that the home always remains a tobacco-free space."
Rules and expectations set in the house were found to be more effective than just talking to kids about not using tobacco, although the study didn't measure for the quality of those conversations.
"While we found that talking with kids alone was not as effective as tobacco-free homes, we still believe parents should engage in high-quality, clear communication with their kids about tobacco and vaping," Chaffee said.