How Parents Discovered JUUL—and Launched a National Movement

Meredith Berkman is a co-founder of Parents Against Vaping (PAVe), an advocacy and education nonprofit created in 2018 by three moms as a grassroots response to the youth vaping epidemic. Run and powered by volunteers around the country, PAVe is the first national parent voice in the fight against the tobacco industry’s predatory behavior. Working at the local, state, and federal levels, PAVe supports ending sales of all flavored tobacco products.

PAVe’s educational training, materials and resources, available in both Spanish and English, empower parents to educate others in their own communities about the dangers of youth tobacco use and industry targeting of young people and priority populations. 

Berkman, a mother of four, is a graduate of Brown University, and the Columbia University Graduate School of Journalism. A former journalist, Berkman has written for publications including New York magazine, Entertainment Weekly, and the New York Post.

https://www.parentsagainstvaping.org/

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Transcript

SPEAKER_01 0:00

Welcome to the Thriving with Addiction Podcast, where we explore how recovery is not just about surviving, but about truly living. Each week we'll dive into the science, stories, and strategies that help people and families heal from addiction and build healthier, more resilient lives. I'm your host, Dr. John Avery. Let's get started. I'm John Avery and welcome back to Thriving with Addiction. Today we're joined by Meredith Berkman. Meredith is a co-founder of Parents Against Vaping, or PAVE, an advocacy and education nonprofit created in 2018 by three moms as a grassroots response to the youth vaping epidemic. Run and powered by volunteers around the country now, PAVE is the first national parent voice in the fight against the tobacco industry's predatory behavior. Meredith is a mother of four and graduate of Brown University and the Columbia University Graduate School of Journalism, a former journalist, Berkman Edgwin for publications, including New York Magazine, Entertainment Weekly, and the New York Post. Meredith, thanks for joining.

SPEAKER_00 1:08

Thank you for having me, John. It's always great to see you.

SPEAKER_01 1:10

And we've known each other since the beginning, since 2018. I remember meeting those three moms that started PAVE when those early scary days. But I don't think I ever knew your background as a as a journalist. Before we talk about what led you to start PAVE, tell me just a little bit about your yourself.

SPEAKER_00 1:28

Sure. I guess the operative for this conversation really is Mother of Four. In the late 80s, early 90s as a uh at New York magazine, Entertainment Weekly. I was at times a freelancing, I was a sports writer, I wrote about movies. Um in retrospect, and when we talk about how we started Parents Against Vaping, um, I uh sort of retired once I had my, I think my third child and and then my fourth child to um to stay home with them. And um but looking back, the skills that I developed as a reporter, sometimes doing investigative work, but enjoying the most the sports work, um, uh, those are skills that led me um to become uh what I like to say is an accidental, a very accidental public health uh activist slash advocate. Um and I uh have used my writing skills definitely now. Um, but it's funny, life takes turns and you just have to follow.

SPEAKER_01 2:34

Right. Was the plan always to have four kids and the transition away from journalism?

SPEAKER_00 2:38

Or I always knew I wanted to have kids until I was actually married and faced with having them. And then, of course, like many women, but nope no one likes to say I panicked, and then um I got distracted and they just kept coming. And they're the joy of my life. I'm very blessed. Um, I never wanted a dog. I have a dog, I wasn't sure about kids. I have four kids, a husband and a dog, and um um I feel enormously blessed. And and it's because I'm seeing the world as a mom. Um, that's what led me, really, it was my own son, and you know the story, which I'm happy to share when you tell me too, uh, that led me to co-found with two other mom friends, uh, Parents Against Vaping.

SPEAKER_01 3:18

Right. I asked because it's for the kids that you do this, that that we do this. And so, yeah, let's let's jump into it. What led you to form Pave and become this national leader that you've become?

SPEAKER_00 3:29

Well, first of all, I just want to say that you, John Avery, are um one of our first and closest and really most important partners. And I know that my co-founders, you know, Dorian Furman and Dina Alesi, and our founding partner, um Mimi Bob, you know, all of them well. Um, you know, it was it was happenstance, as it were, that we met. So I'll try, and you know me well enough to know that I can't make a long story short, but I will try. Um, in April of 2018, um, my ones, I have three daughters and a son, my then 16-year-old son, um, Caleb, uh, came home from his new high school and said, Mom, dad, there's something I need to talk to you about that happened at school today. And I know you have children. Um, I had never heard that before, nor have I heard that really since. But because he clearly wanted to talk to us about something at school, my husband and I, we were sitting at the dining table, we were really listening. And he proceeded to tell us about an anti-addiction talk that had been held for the ninth grade at school. This was a new school for him at his high school, it was the whole ninth grade, and the teachers and administrators left the room, as is very often common practice when you bring in an outside anti-addiction uh specialist so that the kids can ask questions freely. And what Caleb noted was that this young man, this presumed uh educator, began talking to the kids about Jewel. Now, back in April of 2018, I did not, I had never heard of Joule. I didn't know what Joule was, but every single kid student in that room was either Jeweling, had a friend who was addicted to Joule, um, or you know, they knew others who were. And this young man, as Caleb reported to us, began telling this, these students that Jewel was not for kids, but for adults. But as Caleb said, he followed up every statement by saying that Joule was um was quote, totally safe. It was 99.9% safer than traditional combustible cigarettes, and that it would be receiving uh FDA Federal, you know, Food and Drug Administration approval, quote, any day. Now, my son Caleb, um being a skeptic, uh, which is hard for the parent, but good for the kid. I mean, in the end, it's good for everybody. Um, he, along with uh Dina and Dorian's sons, who I think were 14, about to be 15, they went up to ask this guy more questions because they thought it was strange. Um, and that's when this man, this adult, alone with these room full of ninth graders, took out a jewel. He showed these three boys how it worked, and he referred to it as the quote, iPhone of vapes. So when Caleb came home and told me this, I mean, I was shocked and horrified. I didn't know what he was talking about. I called two of the moms I knew best at this new school, Dorian and Dina, and I asked if they had heard the same story. They hadn't. They said, we'll call you back. And within, I think, 10 or 15 minutes, they both called back. They heard from their kids the same story. And within 24 hours, and again, this is because I had been a journalist, I had done investigations, et cetera. I recalled the name of the outside group because the school, uh, to its credit, this New York City private school was getting ahead of a problem that the school could see, but we parents were not yet very much aware of. Um, I recalled the name, I called and I said, you know, there was a really interesting speaker at my kids' school, and this young woman who answered the phone said, Wow, it's so lucky you got me. I'm the one that found the speaker. I was researching Jewel online, was brought to their website. They have like a, they at the time they had um, you know, an education expert. Um, and that woman was very happy to provide uh a Jewel rep who came into the school without the school's knowledge of um for whom he worked. And that night, I remember um the night that the next day we discovered this and we were just shocked. And our first response was, we have to go to the media. I mean, this is insane. You had this, this looks like it's a tobacco product, whatever it is. Um, and there's an email exchange where we decided that no, we were gonna learn everything that we could about what this jewel was and how widespread it was, but that we were not gonna go to the media because it would make a big splash and there would be no action. Um, and so uh we and actually I think I wrote, you know, one day we'll tell the story in front of a congressional committee. And I had never thought in my life that that's where I would be a year later, a year and change later. That's exactly what we did. But in the days and weeks that followed, we began to research this jewel, this company, and this was about nine or ten months before uh the federal government referred to the quote, youth vaping epidemic. But it was so early. And you were one of the first um researchers, specialists, experts who would help us to understand. And we started connecting dots, connecting researchers, you know, and um it's through no fault of our own that we were Googling and we came upon something called the you know, campaign for tobacco free kids, and then we came upon something else called the Truth Initiative. And um, we basically launched a website. My daughter's friend, my daughter had graduated, my older one from high school. I paid one of her friends who needed a summer job to make us a website. And the day our website launched that September after the summer, um, we were just, I mean, I remember staying up all hours of the night. People had, you know, parents who were desperate, they didn't understand what was wrong with their kids, what had they found. Um, so that's not a short story, but a year later, after all of this, as we connected with researchers and experts and clinicians like you around the country and helped to connect various you know institutions, um, we did testify in Congress in July of 2019 about Joule coming into our kids' schools. So the long and the short of it is we successfully in starting what began as a very, very grassroots parents here, parents there. Um we, with our new partners and experts, sounded the alarm about Joule and sounded the alarm about what would later be called the youth vaping epidemic. And we've now um, you know, all it'll be, I think, nine years this fall, right? 2017, 2018, um, or eight years this fall, uh, have grown into a national advocacy and education organization. But at its heart, we are and we remain, I mean, the three of us ran ran this organization for many, many years as volunteers, specifically because we knew, and as we did, we wanted to stand up in Congress, in the state house, in local city councils around the country, here in New York and California and everywhere in between. And when we were confronted with the lies of tobacco company executives being paid by Jewel and the gang, as we'll call them, we could say no one is paying us to say anything. We just want you to stay away from our kids and take your flavored products, only the flavored products, which we'll get to, I guess, um, back into your hole and go back underground. Unfortunately, it's not that simple, but we've all got to try.

SPEAKER_01 10:48

What a story. I mean, it it really should be a movie. I'm I'm waiting for that uh to come out. The the first scene of the jewel rep in the in the high school is is quite a disturbing start to it all, too.

SPEAKER_00 11:00

I'd like Amanda Pete to play me if you had that.

SPEAKER_01 11:03

I know who's gonna play me, geez. The um a young George Clooney, obviously. There we go, there we go. Just shave his head. Exactly. Um, but wow, it was it was quite a story, and and these reps they really were everywhere. I mean, part of what drew my attention to you guys was seeing these reps at our psychiatric meetings, their annual psychiatric meetings. I remember giving a talk uh about nicotine and co-occurring mental health and adolescence, and a jewel rep coming up afterwards and trying to sell me on it the same way um that your your children were sold on it. And you started to feel in this addiction space that something odd is is afoot. And then to connect with you guys, it's sort of it all sort of came together and the advocacy.

SPEAKER_00 11:44

We are so grateful to you, John, as you know. I mean, I remember those very early days, but all of these years that, you know, we're I like to think, I'd like to think that we're sort of uh translational quote scientists that really just translates, I'll just speak for myself, not my partners, into a mom with a big mouth. Um, and basically, you know, um, you made it very easy for us to understand or as much as we can, not not having a a a PhD in in anything.

SPEAKER_01 12:14

It was great to partner with you around this. And and just so people understand, if they if they don't, why why were we confer so concerned? What is some of that science? You know, we went from cigarettes and we all sort of agreed that they cause all this harm and best for adolescents to not use them. What have you come to learn and understand about why we do worry about these these vaping devices, you know, like Joule or the disposables?

SPEAKER_00 12:36

Aaron Powell And the nicotine pouches, which is, you know.

SPEAKER_01 12:38

And now the latest thing with the Zins and the and the nicot flavored nicotine pouches and otherwise. So tell tell us a little bit of what you learned about why we should all be concerned about our kids using.

SPEAKER_00 12:48

Please feel free to correct me if I make a mistake because you know the science. Well, first of all, as you correctly said, this was uh an entire generation of young people um for whom tobacco use would have been you know likely non existent. And we know this because before the introduction of Joule in 2018, and as you said, um, smoking rates in this country were the lowest they had ever been. And I'm older than you, and don't pretend that I'm not, because we know I am. Um but even, you know, my my when I was a teenager at that point, we knew so much about what smoking could do and how bad it was. Only the quote, bad kids or like the wild kids were in the back parking lot in high school smoking clove cigarettes before flavored cigarettes with the very unfortunate, and that's a whole other podcast, exception of menthol cigarettes, um, were taken off the market in was that 2008, I believe. Um so we were not going to have a generation of kids addicted to nicotine, right? All of the work that had been done. What we discovered was that by creating, and people talk so much about Joule appropriately, because it is Joule, it was Joule that, you know, that created by these grad students at Stanford, um, and and certainly now owned by, you know, by Philip Morris International slash Altria, the tobacco, I mean, to big tobacco 2.0. Um, but by creating a new form of nicotine delivery through something called nicotine salts, which, as I learned from you, you know, which means that you're getting, first of all, so much more nicotine in a vape than in a combustible cigarette. So much more. Yes, there are uh fewer carcinogenic toxins, but the toxic brew, even today, has yet to be fully uh exposed for how dangerous it is with flavorings. We'll put that to the side for a moment. But with a faster delivery system of huge, much bigger amounts of nicotine going, and I'll translate, and you'll correct me if I'm wrong, more directly to, in this case, the adolescent brain, um, the addiction w was it it was like wildfire. And adolescent, it's and it's long been known, and I remember, you know, reading these things that you and others gave us that nicotine and the adolescent brain do not mix, right? Because your brain, once your nicotine receptors are activated, even when you quit, they are still, and I think of it as like activated or inflamed. I know that's not the technical term, but you're all always more vulnerable to nicotine addiction. In fact, I believe, and please again correct me if I'm wrong, that if the adolescent brain is rewired for nicotine addiction, essentially your you know, prefrontal cortex, which is not fully developed until 25 or 26, you are rewiring your brain for addiction, period. And you're more vulnerable. And we have seen over time, you know, the rise in co-use, for example, of uh nicotine vapes and marijuana vapes and other substances. And very early on, when we would hear these horror stories about kids going to rehab, people thought we were crazy. Well, what are you talking about? Uh everyone's brain chemistry is unique to them and different, right?

SPEAKER_01 16:18

I think those are the the key points that yes, it doesn't have the tars and the carcinogens that are in in cigarettes. It probably has other contaminants that we'll learn with time.

SPEAKER_00 16:27

Many we've already learned.

unknown 16:29

Yes.

SPEAKER_01 16:30

But the nicotine in itself was given in a high doses in a delivery system that's sleek and undetectable, so you can use all the time. And so it allowed for more use, more constant use.

SPEAKER_00 16:41

At least a cigarette you finish, and everyone knows you're smoking. That was the stealth by design, secretive nature. You remember at the very beginning, people thought they were finding caps from pens or from computers.

SPEAKER_01 16:54

Right. And at first no one knew that nicotine was in them. And then people really didn't quite understand that nicotine was harmful, as you said, that it primes the reward pathway, can lead to other substance use, but it can also lead to worsening mood and anxiety symptoms, comes with a wicked withdrawal state that's tough to navigate. And so it really does hijack a lot of the brain and and especially in the developing brain, like you're saying, it's it's something we we need to avoid.

SPEAKER_00 17:18

The nicotine addiction can trigger all kinds of issues, right? It's the developing lungs, the developing brains. Um, you know, if you have any kind of, I mean, I remember very clearly early on, I think it was the fall of 2018, uh, shortly after we met uh the then Attorney General of Massachusetts, Mora Healy, who is still the governor of Massachusetts. She was very early on this. And her her lawsuit, she was one of the first national AGs to go after Jewel. But she arranged for us to come up, and she got a group of, you know, Massachusetts parents who'd been reaching out to her, and they went around the room, and each family story was unique to them, but it was also the same. And in at the very beginning, um, you know, they all described their children, they were angry, they had a terrible cough, they they could no longer work out, like horrible things, and nobody was connecting the dots. A lot of those kids did have underlying mental health issues, but not all. A lot of those kids had underlying, you know, learning challenges, which makes sense because this is all about impulse control. The problem is that the tobacco industry has only one impulse that it brilliantly, and I say brilliant as an evil genius controls. And that is once their original customers die, they need a new generation. And they have very strategically and methodically pedaled their poison to a new generation. And that's the problem that we all saw at the beginning and that we continue to battle.

SPEAKER_01 18:59

And it's it highlights how your journey has not been an easy one as Pave has developed. I mean, there's been opposition from those who say it's uh to your work, who say it's really meant as a harm reduction effort for adults. And and and I think you and I both say when we speak on this, yeah, there might be a role for some adults who are smoking to use it and it doesn't interact with meds. But our focus really has been on the adolescent brain. But still, a lot of these folks who are sort of pro-vapers, they've zoom bomb, remember being zoom bombed in a in a talk with you and have been pretty vicious online at times, in addition to big tobacco trying to counter some of your efforts. What have you observed in terms of some of the challenges or negative feedback that came your way as you guys were building this?

SPEAKER_00 19:42

Well, there was a lot, as you said, and I'm sure you see this. I mean, I'm I remember being on a CDC partner call, and there was a Zoom bomb uh by a very respected uh uh professor at an Ivy League institution who, if you dig deep, you know, the tobacco industry spreads its seeds, its money, in a lot of places. Another thing about my journalism career that has been helpful is um understanding that a lot of these things were hiding in plain sight. I mean, I think you might remember a moment when we were um we discovered on Quizlet, which is a uh an education platform used by young people, there were marketing, there was marketing information about Joule. And I think it was um someone in Colorado who reported, I mean, we, you know, we went to the the FTC, went to the FCC. There's been a lot of um, there was, and there continues, though I am no longer look at it, really negative um, negative things put out there. It was not easy. My kids were then younger than they are now. It was embarrassing for them at times. Um my son, who all you know, who testified in Congress about Jewel coming into the school, and actually the testimony that my son gave and Dorian's son gave and we gave is at the heart of um of almost every single one of the state uh settlements uh with Jewel, and we're very proud of that. Um we decided, you know, again, we never worked as expert witnesses, we would never take money, you know. So it's that was used. Um we went to the New York AG, we reported what happened, but um, wherever there was um a state AG who wanted to bring a lawsuit against Jewel, we provided parents for free who would share their stories because we knew the more parents that could um describe what we were all seeing, the better it would be. And there, of course, were an enormous amount of money from that settlement, but it's not enough. Um, first of all, a lot of the funds were meant for education, for quitting resources, and every state is different, and the money does not always go to where it should. I think in the 90s, when there was the tobacco. Master settlement against the um cigarette companies, that money still a lot of it went for good, but a lot of it went to build roads. And so um, you know, there's there's just still so much work that needs to be done. But my son, I often say to him, and he's now 24 years old, Caleb, sometimes when I think about how you came home and you changed my life, sometimes I want to hug you and say, thank you. I could never have imagined this journey. And sometimes I want to say, why did you have to come home and tell me I how did I end up in this mess? It's I love you, but what have you done? So depending on how bad the hate was that day, I I always want to hug my kids, even now that they're in their 20s, most of them. But um, you know, sometimes I thought, oh, I wasn't signed up for this, but I'm very lucky to have met people like you who devoted their lives to helping people and helping addiction. And um, I just want to say quickly about the flavors. I mean, we've talked about this extensively. Adults have tobacco flavor. We know that there's been so much research that continues to show that flavors hook kids. And so we always, with the exception of Jewel, where we did advocate for Jules' um application to uh FDA was not going to get approval any day. That was a whole separate, we don't have to go down that policy road of delay, delay, delay by the federal government. Um, but that it's the flavors that were not prohibitionists with the exception of Jewel, because we knew what they had done personally by going into a school. Um, but it's the flavors that addict the kids and the flavors of the problem. So in terms of policy, uh, we're focused on the predatory behavior of the industry towards uh youth and the use of flavors to successfully addict, which they continue to do at those MPL.

SPEAKER_01 23:53

Right. And so now here we are, um, almost eight years later since you guys started. Well, what does everything look like these days in terms of what PAV is most focused on? Maybe it's maybe it's the flavors, but it's also education, I think is a is a big part. Well walk us through where things stand with this youth vaping epidemic and with PAVE uh today.

SPEAKER_00 24:12

So I would say as as you know, we and because you're you are one of the experts that we're um lucky enough to have often speak, you know, we get we have you know an average webinar. We might have, you know, 1,500, 1600 people who sign up for one of our free webinars. We do them, um, we've done them locally, we've done them, you know, the webinar thing that, you know, when I was growing up, Zoom was a TV show that was based in Boston on PBS. And suddenly in 2020, um, the, you know, that's when Zoom arrived. And in some ways, it made our job a lot easier because we could communicate more broadly to more parents. Um, and so we have experts like you and others, sometimes it's local, sometimes it's national level. Um, we still are committed to educating that the more parents know about the signs of nicotine addiction, the more parents know about the new products that are out there, the more parents know about how to get help for their kids. When we started, there was nothing, John. You know that. You were like the only person that we could send people to. I mean, literally, um, and and remain, of course, one of the best. But um, you know, thankfully, over these years, um, you know, there is um, you know, there is new research. And I know this personally with one of my children, um, you know, that uh a combination of medication and cognitive behavioral therapy is the most effective way to help young people quit. So what we continue to advocate at the state and local level for restricting these flavored products, uh, that has become um somewhat more complicated recently. First of all, because of uh federal policies, and of course, then there, you know, there were um slashing of and now some restoration of federal funds that would filter to state health departments for education and prevention. Um so that's very complicated at, you know, at the this is not, and by the way, we're completely nonpartisan, not political. I'm not making any political statements, um, the same difficulties, but also uh good communication that we had with the Center for Tobacco Products at FDA, um, the same difficulties and the same um uh good things, you know, in terms of that we had under a Democratic administration and a Republican administration. But you know, things are very complicated, and frankly, um that means that the work for policy of restricting flavored products at the state and local level, and very broad-based and deep education for parents about um the signs, the products, and how to support quitting resources, um those things at the state and local level are as important, if not more so, than they were when we began. Again, um, you know, right now, um, you know, from the high, the highest numbers of youth use that uh we knew of at the federal level in 2019, you know, from millions of kids, that has gone down, and that is a good sign. And that means that the work we've all been doing together is working, and yet so many young people who have aged out of those um studies, those studies only go up that the studies that are available only go up for middle and high school students. And so if the tobacco age of legal age by tobacco is 21, there's a whole group of kids that we're not really getting information about. Um, and then of course, all of these kids who grew up at the very beginning, the class of 2016, as we call them, because that was right before, um, a lot of those kids, and this is something I don't know how you feel, but I worry that a lot of those kids, and we know there are millions of young people with the CDC, at least in the last few years, like they look at, I think it's um 21 to what is it, the early 30s, but that you know, it's a lot of young people who are addicted to nicotine.

SPEAKER_01 28:21

Yeah, no, the group in the 20s right now might be the the heaviest group of of current nicotine users. It's a great point. But your two-pronged approach is is so perfect, what PAVE does, because you advocate on so many levels to and you have been responsible for driving down these these numbers, and then you educate parents about what to look for, but also that there's treatment. I just want to underscore that that there are great treatments for kids, for adults, you know, medications that have existed long before this even happened that we've we've you know experimented with nicotine and with with cigarettes and you're referring to Varen Klein, which I assume. Yeah, there's varenicline, chantex, there's an antidepressant that helps people stop using, there's other forms of safer nicotine replacement and plans to get people off. There's good therapies, individual therapies, group therapies. And most Department of Health departments have access to these treatments or have phone lines that people can reach out to for help. So there's a lot of help out there for people that are worried about their young one or worried about themselves.

SPEAKER_00 29:21

So I want to ask you a question, even though it's your podcast, um, which is one of the things that we've been thinking, um, and I know this myself, right? Personally, and we hear this from parents all the time, is the struggle. And again, when we started doing all of this, they kept saying, well, there's no research, we know about smoking, we don't know about, and I understand you have to follow the science. I'm not dismissing that in any way, but we had desperate parents, and we had to, you know, now there is a lot more known about the harms, but also about how to treat them. Um what we see, and we think there should be more conversation about sort of at all levels, is how parents can encourage their how do you make a young person want to quit? And I asked that child of mine this morning, knowing that I would be talking to you. And and that child answered, Well, I always wanted to quit the whole time, but I couldn't. Now that's what addiction is, right? It takes you over. Ultimately, it was racing heart and troubled breathing. I said, But was there a moment? I know the moment really was when something fell out of that kid's. Um, I since I have three daughters and one son, I keep saying that kid uh because I don't think they want their story told necessarily. And I haven't asked. Um, and I'm not ashamed of it. I mean, that's another thing that we learned along the way. There is so much shame, wrongheaded shame about addiction. And addiction is an illness. I mean, I learned that from you and many others. That's one of the other things is that working with schools, you know, alternatives to suspension. Um, at the very beginning, you know, you would see schools kicking kids out or putting it on their record, or um, you know, some states and some counties where, you know, kids, it goes on there like they get arrested for having a nicotine vape at school. But these are kids who were preyed upon by an industry that sought to addict them to these products. And addiction is an illness. You don't punish someone for an illness. So we're also we've learned a lot about that. Um, but so you can tell your child why they shouldn't do it. You can tell your child what it will do to their brain, to their lungs, to their sports career, to whatever it is. But unless that child really is wants to or may want to, but isn't ready to, I'd like to ask you if you could tell parents like me who are training other parents, what are best practices? You can't force someone to want to quit, but you can force them to try and quit, but you can't force them to want to quit. So how do we do that?

SPEAKER_01 31:54

Oof, it's a it's a tough one. And we actually have a good podcast episode on parenting for substance use that was one of our uh initial episodes. Um, I mean, to start, a lot of it should be prevention, that we're talking about substance use all the time. They recommend starting to talk to kids about mental health and substance use at age eight or nine, and really creating this family environment, and it should be the same environment in schools or places of worship or wherever people congregate, where it is, as you say, a non-stigmatized thing that we can talk about and know that what our family values are around and that it's sort of a safe thing to talk about. Because what happens often is the first conversation you have with your kid about substance use is when you catch them with some something. And it's better if those conversations have been happening for years and they know how you feel and that you're in a safe spot. And then yeah, when you capture them, it's it's har it's hard. And I think recognizing, as you say, that a part of them doesn't want to use and a part of them wants to use, and it's an internal struggle, and sort of helping them understand why they're using, getting them the right mental health supports if it's if it's there, getting the right addiction support if it's you know gone on beyond um their control, but doing so in a way that recognizes that it is a disease, that they often need help, and we just have to figure out what sort of help, and that people get better. I mean, that's the thing about addiction, and parents worry that it, you know, it's gonna lead to uh you know all sorts of terrible things. But most people get better, and most kids and people in their early 20s are the age when people experiment and um and just helping them, keeping them safe, not judging them, and getting the resources they need so that they can be their best self. But easier said than done. And um I say this and then I'm gonna go home and scream at my tow shelf or something. So so it's it's it's hard though. It's a it's a hard thing to to navigate.

SPEAKER_00 33:40

Well, I the your the point you know that you make is so well taken, is that we really do encourage parents that this is a conversation that you have to start young. This is a conversation that only you know what will impact your child. You know, one of the programs we developed over time, um, we had so many parents saying, My kid doesn't care that it's gonna harm their lungs. They don't care. And what do we knew? And we did some focus groups and we've done this in different states, and and it's a program that we offer is some of the things that we, you know, when we um are contracted by a state health department. But we we started this program in New York called Vapes are Trash. We know that this is a joke, we all should care. But vape, um, the vapes are hazardous waste, liquid nicotine, you know, it's an EPA hazard. And you see so many of these um of these, you know, the lithium batteries, people are throwing them in the garbage, they can go on fire. It's also a huge environmental disaster. Vapes are trash is um a youth-focused program with um with our youth board, like advisory board, um, that looks at those harms, with the idea being that the more we educate kids about how harmful um these products are and and nicotine and you know, tobacco use is for the environment, for animals, for water, um, that what will it do to your personal environment? So we're we're you know, those are things that we think. But we think that, you know, parents, there should be no, there can't be fear. You know, you want a successful one of the things when you said when people were really mean to us was that we were terrible parents, um, that we couldn't control our children, there were no rules. Now, that may be true when it comes to certain, I'm not saying I'm a perfect parent. If anything, I know I'm a flawed parent, and the best parents are the ones who admit it, in my opinion. But um being people are afraid that they're bad parents because their kids got addicted to these products. And to say that um that they were addicted does not mean that there should be no rules, that there should be no values, but open communication, as you said with children about this early and often, and also letting them know that if they need your help, you will help them. I mean, that that we that's the first thing that we have said to parents. We said it day one and we say it now. And as you just said, that's probably the most important thing. But I I remember being shocked when you told me this how small a number of addiction psychiatrists there are in this country. And I found that. I never forgot that. I was so shocked by that. Um, and I think, and I don't want to mis put words in your mouth, but I I think I recall you you're saying that this the this sort of societal stigma about addiction perhaps had led into the field of psychic. Why aren't there more addiction psychiatrists in the world? Like that's so important.

SPEAKER_01 36:31

Yeah, I know. I think stigma prevents parents from speaking out. It prevents doctors from going to addiction. It it allows some of these insidious forces to take over because they often do on a beta, just because you blame yourself or your family member when they're struggling, and you don't recognize this is something that we all need to pay attention to, that none of us are immune, that we're all in it together. Um, and that's why one thing I like about PAVE. You've always brought everyone together to sort of rally around this together. Thank you. Well, Meredith, it was great to have you on today. Thank you for all you're doing, for all that PAVE's doing and and helping parents and kids and really fighting the good fight to improve things around youth nicotine you. So we're grateful for you.

SPEAKER_00 37:14

Oh my gosh, John Avery, we are enormously grateful for you on a personal level, on a professional level. And again, you were one of the first. And that's why I still feel guilty about any time someone would call us, we didn't care where they were, we would direct them to you. And um, and I know you've been a real leader in helping parents and patients, but clinicians and colleagues and researchers. I mean, you've taken a real leadership role. Um, you know, you're in in this kind of addiction. I know that you cover many different kinds of addiction, but in particular, so as a parent in this co with kids in this cohort, I am enormously grateful for your leadership and your focus because you've really helped uh others understand this is a big problem and we need to we need to fight that. So thank you.

SPEAKER_01 38:02

Thanks, Meredith.

SPEAKER_00 38:03

We'll talk soon.

SPEAKER_01 38:04

Thanks for listening to the Thriving with Addiction Podcast. If you found today's episode helpful, please follow and subscribe wherever you listen to your podcast and share it with someone who might benefit. You can also connect with me on Instagram, LinkedIn, and YouTube, or visit thrivingwithaddiction.com to learn more. Stay tuned for next week's episode, and remember Thriving is possible.