From smartphones to e-cigarettes or the problem of addiction among children and young people. Episode 44

Monika Rachtan
Hi there, I would like to welcome you very warmly to another episode of the Patient First programme. I think I can say that from today we are doing special episodes of our programme and also the setting will be a bit different, because we are at the 18th Forum of the Institute for Patients' Rights and Health Education, and today at this forum we will be talking a lot about addictions, but mainly about addictions among adults. I, on the other hand, would like to talk about addiction among children, which I think is a significant public health problem. I will be asking my guest, Professor Grzegorz Juszczyk, about this in a moment. Welcome, Professor, and thank you for accepting the invitation to our programme, to this unique formula we are following during the forum. We talk a lot today about the fact that this mental health of the youngest children is not in the best shape. Data from 2023 shows that there have been more than 2,000 suicide attempts among children and young people. We are aware that child psychiatrists are in short supply. I checked how long the wait to see a child psychiatrist was when we wanted to go on the National Health Service and I checked when we wanted to go privately. Privately it was about six months, whereas on the National Health Service it was up to three years, so we don't have time to wait that long. Do you have any ideas on how to remedy this now, to at least create a patch for this problem, and then to start treating this wound thoroughly?

Grzegorz Juszczyk
I too thank you for the invitation and thank you for raising this important topic. I agree that post-pandemic mental health for both adults and children has deteriorated greatly and we now have a massive challenge. Indeed, four hundred or so child psychiatrists, that is, let's say, 12,000 or so people under the care of people aged 12 to 18, under the care of such a psychiatrist. We like to check certain things sometimes. It is very difficult to provide care for such a large number of people. Therefore, parents and children can benefit from pedagogical and psychological support. But this problem of suicide is particularly important, because it is such a litmus test, the most dramatic consequence of mental health deterioration.

Monika Rachtan
How bad must it be for a child to bargain for his life? Well, what kind of emotional, mental state must he be in to have such thoughts at all, but also to make such an attempt, because it takes enormous courage on the one hand and is a dramatic experience on the other.

Grzegorz Juszczyk
Child psychiatrists also criminologists, say that such a suicide attempt is not because the young person or adult does not want to live, but because they can no longer live. I don't have enough skills to deal with these problems. I believe it is time for a new definition of health. The one we use dates back to 1948, and this new definition of such positive health says that health is the ability to adapt and cope independently with physical, social, emotional challenges, in short, normal life. And when a young person cannot cope with the pressures at school, with peer pressure also the demands of parents, with this influence of social media he simply needs support. He needs someone to guide him through this difficult time. That is, we need to help in a way that provides the right skills, care. And we really need to take any signal of so-called suicidal thoughts very seriously. Roughly 8 out of 10 people who make such an attempt inform those around them beforehand. So I appeal for sensitivity, attentiveness, listening to young people. If they say that they have a problem, that they don't want to live, then this is a very serious matter and let's treat it as such. Let's seek specialist help. There are special hotlines you can call in an emotional crisis or 116 123 or 800 100 100. Let's put it quickly into a search engine, find such a place and contact a specialist. These are very serious risks.

Monika Rachtan
You said that such people inform us that they intend to make such a suicide attempt. But also I think it's worth understanding that it's not always such clear, clear information that. A son comes to his mother and says Mum, I would like to make a suicide attempt. That kind of information is not even there. How can this information be communicated?

Grzegorz Juszczyk
I guess the background to these situations is that we are talking less and less to young people, and we are also talking less and less between us adults. But this is related to the fact that these channels of communication have changed. I mean we exchange a lot of information on social media, by text using instant messaging. But research shows that this type of information is purely neutral. They do not have an emotional message, i.e. we cannot give support by such methods. For this you need direct contact, direct conversation. And this is unfortunately lacking. Already several decades ago, researchers who analysed primates pointed out that they use such three areas of activity. This was collectively called the time budget. That is, they devote a certain part of the day to foraging, to consuming food, a certain part to social activity, Relationships with other people. This, of course, is to get the various bits of unnecessary stuff out of their teeth or out of their fur, the so-called sparking. And then the third part is rest. And nowadays, when we look at this budget, the time we have available to us as parents and children, this equivalent of searching for food and consuming, which is de facto work, has taken up a very large part of it. This unfortunately also creeps into the time for leisure, into the time for social relationships. Well, and we have succumbed to this perception that these social media give us the opportunity to connect with many people quickly, and we lack the time to do so.

Monika Rachtan
Real. The way we sit here and talk to each other. This is what is missing and I am wondering how exactly. Today, we are discussing the problem of addiction and the mental problems of children and young people, but I deliberately did not invite a psychiatrist to this programme, because I would like to talk about this problem in the context of the problem of the whole society, and not just of one individual. And, in fact, it is all of us who are responsible for this problem, because we all build this society, we all create this environment of young people, and often we don't even pay attention to what our behaviours are and how they affect the youngest people. What are your observations? How is today's society this focused on phones? It's a bit pissed off to be honest with other people. A bit selfish, a bit focused only on their own needs. It's influenced by young people who need attention so much.

Grzegorz Juszczyk
Of course, in public health we also consult child psychiatrists all the time, but they also confirm that the problem is, as the editor outlined, much more complex. What conditions are we creating for our children? As we said, first of all, we don't have time for them specifically, but we have a lot of expectations just from this pandemic period. We know that having to teach remote lessons has been a very heavy burden on these children, because after all, the World Health Organisation, for the sake of young people, as recently as 2019, issued such a recommendation that between the ages of five and 17, this time in front of a screen should be no more than two hours. And in.

Monika Rachtan
Pandemic was 10 hours old.

Grzegorz Juszczyk
Exactly, because we had remote lessons and then we had no choice. But we have to remember that this was already something that young people without the right support couldn't cope with, and they also got into this interaction, into conversations more using instant messaging, which doesn't give us such an opportunity for emotional exchange. How did communication move there? A little bit of young people, watching us adults, that we started to meet less and less already after the pandemic with friends, we just spend a lot of time on this kind of exchange of information. They started to move all their conversations and meetings there, unfortunately with many negative consequences, because using instant messaging, which allows us to exchange information very openly with many people, exposes us to the fact that we expose ourselves socially, we compare ourselves with other people. This is another separate topic of social media that we will probably talk about. There is a new phenomenon called Ghosting, which is this kind of complete disappearance from the area of our relationships. Someone simply stops speaking in these media or instant messaging. If someone does not respond to our posts.

Monika Rachtan
Anxiety is emerging.

Grzegorz Juszczyk
Yes, young people feel very concerned. They wonder if this is not already some kind of symptom of rejection of the group. The group can also, unfortunately, in a very violent way this young person.

Monika Rachtan
Reject.

Grzegorz Juszczyk
Delete, reject. And it all happens in such a closed world, when it's much easier to tell someone I don't like you, I don't want to talk to you, it blocks you, than to say it face-to-face. Then we also have the opportunity to react, as someone sees our reaction. And unfortunately, this in my opinion is very negative, because we still don't have an idea of how to change this, how to integrate young people, to talk to them more often. Because it seems that at least the generation of teenagers treats this world as the real world and most willingly there.

Monika Rachtan
So that they want to stay. Well. The conversation about young people has moved for a reason. Our conversation has moved to social media, to the internet. On the internet, in addition to these groups of conversations, conversations, there is another very important figure of the influencer influencer, often God, the most important person in a teenager's life, who unfortunately tells them how to live. And often the voice of the influencer is more important than the voice of the mother, father, grandmother, teacher, lady in the shop anyone. All that matters is him. Do we still have any control over who our children listen to?

Grzegorz Juszczyk
I would venture to say that we do not, do not have the capacity to control social media. In fact, at the moment, there is also a very serious discussion going on in the United States between various institutions and the providers of social media, which is pointing out that the very mechanism of their operation poses a great danger to children and young people, and that there are no mechanisms for protecting and blocking various contents. I will probably talk more about this in a moment, but since we do not have the possibility, we should teach young people how to navigate in this virtual world, the world of social media and influencers.

Monika Rachtan
I'm going to ask the question, because if we ourselves don't know this world, and I'm convinced that most parents don't have a clue what's going on on Instagram. I think that's where most young people are focused. Then there are the various streaming channels where young people show how they play computer games, but they also do other awful things. If these parents don't get into it, how are they supposed to teach their children, take advantage of how teachers don't get into it? If they don't have a clue about it, they don't know the opponent, they don't know who they are up against.

Grzegorz Juszczyk
Yes, of course. There are tools like parental filters, monitoring software, but young people are very adept at bypassing these safeguards. So again, without conversation, without honesty and without openness, we are not able to find out what this young person is interested in. We should talk, we should also watch together those programmes that young people are particularly interested in. We are not able to check all these social media posts, because we know that it happens so quickly and so dynamically that it then causes a certain health problem, which we call FOMO, or fear of missing out. This kind of fear of missing something, of being excluded from the flow of information. This is one of the reasons why a third of teenagers declare that they cannot imagine life without their phone, and if they were to be deprived of it, they immediately start feeling seriously anxious. One more interesting fact: stress levels increase significantly in young people when the battery indicator drops below 50%. And still coming back to influencers, we don't know how the world of social media works. I use such a car example, an automotive example. We may not know how a car functions. We should know how to drive it. That's what proper courses and the driving test are for. But if we do not know, we have someone to ask. That is, we have car mechanics. With the internet, we don't know how it works. We use it every day and we don't particularly have anyone to ask if the things we find there, that we use, are of value. Above all, we should reach out to young people with the message that, however, in most cases, the internet, social media is such a big market.

Monika Rachtan
To make money.

Grzegorz Juszczyk
One of my friends, who is just involved in the world of social media, said that it is very popular among these people to believe that when you open anything, social media or a browser, there are a thousand professionals already waiting to see what you are going to do and what we can offer you. Very often there is simply a marketing message behind these seemingly neutral influencer messages. Anyway, the work of such authorities in charge of this is probably already beginning. But to make sure that the young person has the information that it is a promotion of a product.

Monika Rachtan
In fact, such information appears, but I, for one, am wondering, as we have not actually fixed this question, but I will take the liberty of asking it.

Grzegorz Juszczyk
This is what I feared, that certain questions would not be fixed.

Monika Rachtan
HPV vaccination. We know that a programme has emerged in Poland. I wondered who needed to be educated. On 1 June, when this programme came into force, and I saw that the campaign, unfortunately ministerial, was not taking off, as if it was not enough. I wondered how to reach these young people, whether it was on ICT Tok, whether to speak to them on Instagram, how to do it to get them there, to talk about such things that are important. And the moment we talk about selling some products, well of course you can advertise, I don't know, patches, shoes, whatever you want, but can you also, for example, advertise health and have no interest in it? Can such an influencer persuade children? And he doesn't get any money from anyone for it, so that they get vaccinated against HPV, for example? That could also be valuable content, and it's not there.

Grzegorz Juszczyk
Of course, influencers help a lot in communicating a lot of positive messages. It's not like they're all just making money, it's just young people, often not adults. We also don't know what's behind the message and there's no way to verify a lot of information either. Is the influencer an authority in themselves. Various studies are often cited. I even recently saw a video like this on social media, which shows a man who wants to prepare his breakfast and white bread appears there. And immediately a post by an influencer who says we shouldn't eat white bread, then some other product, never use that product. There's a lot of confusion there. This basic education is missing, because this problem can be solved in the way that we have basic education, universal education in schools. The subject of health knowledge is the foundation. I don't know how else to describe it. The foundation, the base of the pyramid. The basic way we can move. Without it, we really can't go far. When it comes to building such a health message wagon. If we already have the basic skills there, then we are looking for precisely the best channel to reach young people.

Grzegorz Juszczyk
It is social media, since they use it, that is where we are trying to reach. But there is another very serious problem. Let's look at the market for dietary supplements. This is a market that is worth PLN 7 billion. We spend on dietary supplements, but in order to do that, the producers spend, according to various estimates, two, maybe three billion PLN on advertising and on promoting these products. Does anyone know? I have not come across anywhere, never in the world, such an educational campaign, on which someone would spend the equivalent of 3 billion zlotys at least once a year.

Monika Rachtan
Well, rather not.

Grzegorz Juszczyk
A great and popular campaign, plans the long life of the Ministry of Health. I don't know the exact cost either, but there have been media reports that somewhere in there 10 million zloty was spent on public media advertising. Let us compare it to seven. Let us compare the two budgets. We need to commit serious resources in public health. We are very much calling for this. We can even see already where these resources can be found. But for the time being, we can wring our hands a bit, because we know that such tools are effective. Well, but we should find the funding, and as long as we don't have this funding, we can manage just by engaging in this way. The popular ones who are involved, they care about health and such people very often also promote health.

Monika Rachtan
The subject of dietary supplements is probably material for another episode of the programme, because I think we could discuss it for a very long time. I also observe people on the Internet who urge people to take these supplements and without any major control happening. So maybe we will come back to this topic. And I would like to come back to addiction. Do you think that kids in Poland are addicted to content on the Internet?

Grzegorz Juszczyk
Roughly a third of adolescents in studies commissioned by the Ministry of Health have such characteristics of problematic internet use, i.e. they feel restless when deprived of the opportunity to interact with this content, neglect school duties, neglect leisure time. And this is unfortunately related to the fact that the mechanism of social media or computer games is precisely based on what can cause addiction, namely such a strong stimulation of the reward system in our brain. We like to feel good, we like to be rewarded. Our brains have also evolved in such a way that we survive on this savannah that we are constantly on. Although there's a lot more concrete nowadays and internet connectivity on this ancient savannah where humans came from And this system, which is stimulated by dopamine neurotransmitters, causes us to get rewards for what has always historically been beneficial for us. That is, for example, sugar has the power, unfortunately, to give us great pleasure, because the search for just sweet products gave us the opportunity to survive. Now these sweet products are available everywhere. That is to say, what is attractive is what causes a certain hunger for information, endless access to content.

Grzegorz Juszczyk
Our brains also like to learn, so if we endlessly browse social media content or play games that never end. I am of the generation of people who played and still play computer games, but they have a beginning and an end, so-called campaigns. My sons are already playing what I call endless games Open Worlds. Of course, during this time they also talk to their friends, which is some substitute for those interactions we had in the backyard. But it's very strongly immersive. But all the time we get this kind of reward for learning something, checking something out. So that's how these solutions are designed. If we don't have any protective mechanisms in the form of either automatic blocking of access, displaying some kind of information about a potential threat, or well this parental control, when we tell these young people that they should fold up a bit when it comes to media, sometimes even social media or computer games, sometimes you have to do it very firmly, but also without over-stigmatising. Because if you make a young person believe in that way that they are addicted, then there is also shame.

Grzegorz Juszczyk
Withdrawal, and shame is also an unpleasant experience, so we can try to switch it off by activating this reward system again, i.e. reaching even for what this shame has previously caused in adults as well. Unfortunately there is a mechanism that leads to addiction. Anyway, child psychiatrists, child psychologists say that it may not yet be addiction, but already harmful use, that is, using in such a way that is harmful to health in a mental, but also physical dimension. This is very interesting. New disease problems are emerging, such as SMS neck, a text to people who are constantly staring at such diseases.

Monika Rachtan
Because I also thought that, for example, obesity and type 2 diabetes in young people could be diseases caused by computer games or social media.

Grzegorz Juszczyk
Unfortunately, a growing problem probably also for a broader discussion, but according to research by the Institute of Mother and Child, which is regularly conducted among school-aged children and adolescents, more than a third of teenagers are already overweight or obese. There is even more dramatic information for me, like the fitness levels after the pandemic. There was a very interesting PE programme with the AWF. The Warsaw Academy of Physical Education organised such PE lessons to get young people active after they went back to school.

Monika Rachtan
What results?

Grzegorz Juszczyk
And, among other things, such a very simple, standardised test of motor skills was conducted during these lessons. There, you could get from zero to 30 points such simple exercises like throwing, catching a ball Goat, jumping on a skipping rope. And 50% pupils. Several thousand pupils filled in or completed this test? 50% students scored 0 points on this scale from 0 to 30.

Monika Rachtan
It's amazing.

Grzegorz Juszczyk
They can't do such basic motor activities. But at the time of the pandemic, these were people who had spent an eighth of a sixth of their lives in one.

Monika Rachtan
The question that immediately occurs to me is where are the parents? Where are we that such things are happening, that we don't pay attention to the fact that our child can't jump on a skipping rope. A skill that we acquired in the backyard was compulsory. My friends would laugh at me if I couldn't jump on a skipping rope. And here are such worrying test results.

Grzegorz Juszczyk
Well, that's what we have, generational platforms that are becoming more and more different. This generation of already 15 18-year-olds has completely different role models, completely different beliefs about what is important, what is less important, how to talk to each other. We have to look for that understanding. We have this triangle of parent, school and peers in different directions, at different times in our lives. And this attention shifts Across the teenage years, it is peers rather than school and parents who have the most say, but we still have some influence.

Monika Rachtan
OK, so let's go back to addiction. I would like to ask you, because we have talked about the Internet and this addiction is clear to most of us, but I would like to ask you what else children and young people in Poland are addicted to, and I would like to ask you for a fairly honest diagnosis, because I think that many people unfortunately cover their eyes and do not want to see this, and these addictions are and are very important.

Grzegorz Juszczyk
Yes we have already said about social media, we have said about computer games. This is already a recognised medical condition, computer game addiction. This is something we just have to pay attention to, because it's no longer just playing in front of a computer screen, but games on smartphones, on tablets, so you have to be very vigilant. But also this harmful use, which can lead to addiction, affects other areas.

Monika Rachtan
What are these areas?

Grzegorz Juszczyk
It is, however, nicotine for the moment, and that is what I would very much like to talk about, because I think we are at war with disposable electronic cigarettes. I would like to ask whether we still have a chance of winning this war, because I often have the impression that we wait for the problem to swell and only then start to deal with it, for better or for worse. And here we have a chance to do something really preventive, that is, to prevent the problem. So that's nicotine, that's the use of alcoholic beverages, though. This has been a problem. I hope that the current ban on the use of these energy drinks, the excessive use, which is harmful to health, the use of energy drinks and these other behaviours, including behavioural behaviours, which are potentially harmful, but they tend to fall into this world of social media. So basically, what we adults are so concerned about when it comes to preventing and treating addiction is also present among young people. There is one thing I have not yet mentioned, which is also important, and that is the use of other psychoactive substances. It is simply about drugs, legal highs.

Monika Rachtan
Today at the forum, we did not set this question either, but today at the forum, I was approached by one of the representatives of the patient organisations, who said to me, Madam Editor, I have a topic for you. I asked what the topic was. He told me addiction among young people to pornography. That is what you meant when you talked about social media and other things that go on there. And that's probably also a very important issue that should be addressed. But let me come back to alcohol, because this is a very interesting issue: how old are children and young people in Poland on average when they first come into contact with alcohol?

Grzegorz Juszczyk
I hope our viewers, listeners are sitting down now, but from these surveys that I've already cited, it's 13 years old, 13 14 years old. Already a lot of people in these surveys are reporting that they have had their first episode of being so drunk even to the point of unconsciousness.

Monika Rachtan
And how does this look against European data?

Grzegorz Juszczyk
Similarly. Similarly, it is around the age of 15 16 in different countries. This culture of alcohol consumption is arranged differently. It depends on what kind of alcohol is the initiator. In our country, it is usually beer or vodka. But wine doesn't matter either. We have a lot of beautiful expressions for the ethanol solvent, as he used to say. In any case, it's all about that neurotoxic psychoactive substance ethyl alcohol. And when it comes to alcohol in general, we have a serious problem both among young people and among adults, because it is legal, it is not formally available to young people under the age of 18, but we know that they also have no problem accessing these alcoholic beverages, such as monkeys, which is legally available. It is neurotoxic, highly addictive and causes a great many social problems. On the other hand, we live in a country where 85% people according to studies drink alcohol. Of course, not all of them harmfully, but it is a common behaviour. We have 15% 12% men and 18% women who are abstinent. And while we talk a lot about the harmfulness of alcohol. We don't talk about what the benefits of not drinking alcohol are.

Monika Rachtan
Well, yes, it's not talked about much in the space. And what would you. You would list among these benefits?

Grzegorz Juszczyk
That's me, for example, for one and a half. Well, maybe even longer. I have not been drinking alcohol at all for a year and a half and I have encountered a lot of difficulties in my social life, because we naturally ask what must have happened that someone does not drink alcohol. We suspect yes we suspect an illness, taking some kind of medication. Something must be wrong if this person is not drinking alcohol. Are we not teaching young people the benefits of drinking alcohol? Very willingly.

Monika Rachtan
What are the benefits you have felt Over this year and a half What have you noticed?

Grzegorz Juszczyk
I can speak from the scientific side and the Personal side,

Monika Rachtan
or maybe personal first, because it will be. Interesting, because it will be interesting if we can afford it. This personal side.

Grzegorz Juszczyk
Firstly, even when consuming small amounts of alcohol, a glass of wine or one drink there in the evening is useful for relaxation. This makes us wake up in the morning more irritable. Very often we don't call it a hangover in the morning, but we do feel irritable and in a bad mood in the morning. Without drinking alcohol, this phenomenon is practically non-existent. The second aspect is that, after drinking small amounts of alcohol, we find ourselves in such a state of limited control, which makes us think, for example, that we can do more than we actually can. We can then over promise something. We can imagine that we need less time to complete a task than it is.

Monika Rachtan
Full control over what he says.

Grzegorz Juszczyk
You have such confidence that these decisions you make are confident decisions. And there are many such health benefits. You don't have many of the symptoms that are characteristic of drinking, but drinking alcohol at least from the digestive tract. But to not drink in Poland and to be well equipped with skills, Especially when you're a young person in relationships with people who are important to you, because they're your peers and you care about being on good terms with them.

Monika Rachtan
Well. How do you say no here? Well, we have to.

Grzegorz Juszczyk
To teach the problem of our school skills. It's not just about knowledge, it's about skills in changing health attitudes. We have three stages knowledge, motivation and skills. Someone has to know what is harmful. He has to be motivated to avoid it or do something positive. And thirdly, they need to know how to do it. It is not enough to tell a person not to drink.

Monika Rachtan
Because it is. Harmful, Don't drink because you will have the benefits. Just how to do it afterwards? There are very many interesting examples of building such positive associations related to not drinking alcohol. Since 2001 there has been such a campaign in the Netherlands, then in more countries, with the nice name BOB. Bob is the Dutch abbreviation for a person who is a sober driver, as it has been observed. It's similar in our country. Such a phenomenon that young people during a social gathering, a private party. I'll use this kind of historical language or at a disco. And in modern language, at a party, in a club, at a house party, they drink alcohol. And then, already having a car, someone has to drive these people away. And this is a small town where there are no taxis or someone doesn't have the money to take a taxi back. Someone has to be sober. And very often, unfortunately, the one who thinks of himself as the least drunk or the most drunk drives.

Monika Rachtan
Sober, but. Not sober at all. So in those Benelux countries, such a BOB campaign was introduced, that is, a person who is socially identified, who, for example, at a party, when someone is serving alcohol, says I'm not drinking today because I'm a bob. It's okay, you're a bob. A lot of just places where alcohol is consumed, a lot of clubs reward. There are these special stickers that you can stick on yourself with a discount on non-alcoholic drinks. And no one comes up and asks such a person anymore. What's a beer or a drink DLa boba for you?

Grzegorz Juszczyk
There is no need to explain why today. This is, of course, a rotating function. It is not the case that someone always has to fulfil this role. And this type of example should appear in Poland. We should promote an attitude of sobriety not as giving up something, but just the many benefits behind it. We have 85% people who drink. This is the norm in the United States. Soon 80% will be overweight and obese. It's getting harder and harder to talk about weight reduction over there, because everyone around us that we. We meet in the States.

Monika Rachtan
That's the environment I rotate in, so genetically determined.

Grzegorz Juszczyk
It has simply become the norm. As Americans joke, referring to the body mass index, that we are not, not overweight, we are just too short.

Monika Rachtan
We have already talked about this nicotine, and I would like to return to this topic, because it is a very worrying one, because it is becoming increasingly rare to see young people turning to classic cigarettes. I very often meet young people who smoke reusable electronic cigarettes, but recently such colourful cupboards have appeared in chain shops, the kind we pass every few hundred metres in our country. And there are disposable cigarettes there, which, as I have read in research, it turns out that there are up to 700 flavours of these cigarettes available. Are such products addictive to young people? Because they certainly reach the youngest. I do not know anyone who uses them. So they definitely reach the youngest. They are also cheap.

Grzegorz Juszczyk
We can talk a little longer about cigarettes, because that is it, and about nicotine-containing products, because this really is a problem that we need to tackle immediately and firmly. I am specifically talking about war. In war we have to be firm, Many things are allowed. We should not look at whether an action is too strict or not. 85% of the world's smokers started nicotine between the ages of 15 and 24, and half between 15 and 18, which is very early. This period of alcohol initiation takes place in early adolescence. Adults are of course also interested in quitting smoking. About a quarter each year decide to try something or at least declare their intention to quit smoking. But about adults in a moment. And these young people, if they have access to these disposable cigarette products, are exposed to nicotine, which is a highly addictive substance that acts on our brains in such a way that it triggers a calming, relaxing reaction after a certain period of time. And unfortunately young people are reaching for these disposable or electronic cigarettes, but also for traditional cigarettes, according to our research.

Grzegorz Juszczyk
They feel stress for something, they feel tension, they have very many hours.

Monika Rachtan
Yes, we talked about how this life is aggravating.

Grzegorz Juszczyk
Then they still have to do their homework. We don't always compare our schedules, activities with the timetable, because it would appear that the children probably have more activities than the adults trying to relieve this tension. They reach for whatever gives a quick reward. Nicotine reaches the brain within seven seconds and gives us a feeling of relaxation. When they came on the market a few years ago, these electronic cigarettes, the heater with Liquid, this young man had to hide somewhere with this special device he had invested. Parents had some chance of identifying it. Teachers will find similarly. Now a disposable e-cigarette resembles a lipstick, resembles a highlighter and is often imported from China as a torch contains batteries and provides about six hundred and seven hundred downloads there. This is the equivalent of two and a half, three packets of cigarettes, after which it is thrown away, so it is also still electro-waste. The flavours the editor said are clearly planned for young people. Bubble gum. Vanilla ice cream

Grzegorz Juszczyk
Vanilla scents, flavours of different drinks. This is clearly creating a new market. As I said, this is not secret research, but the manufacturers of these e-cigarettes also have access to it and they know that if we tell someone between the ages of 15 and 18 and they use it consistently, they will become addicted more easily and will be a consumer for many, many years afterwards, unless they come across an effective method. Obviously quitting that nicotine is absolutely something that should be banned. What I would also add is that this is in no way tested, certified. It's a bit like that social media. We don't know what's in there. Aha.

Monika Rachtan
I'm still going to ask about that, because we keep saying it's available. What does it mean that it is available? It means that this young person can go into a shop, take a company at 16 years old and no one will ask him for proof, does the fact that it is available mean that the seller does not ask for that proof?

Grzegorz Juszczyk
Across these disposable e-cigarettes, the challenge is that roughly 60% of the total turnover is online sales, which is illegal there millions of units. There is no way to verify the age. A study that we conducted in 20, in 20 21, a study of a very large group of adolescents on the use of these nicotine products showed that 30% had used some kind of nicotine product in the last 30 days of the study, mostly cigarettes and traditional cigarettes, and 10% did so daily. And now if we look further at the information that in Poland there are one million 600 000 pupils of primary school age, over primary school age, that makes a population of 200 000 to 500 000 Poles, young Poles, who use these devices. This is why I am talking about the war against the growing epidemic, that we cannot look at it, calmly, watch and wait to see what decisions will be taken. That is, to ban the European absolutely in favour of a ban.

Monika Rachtan
And we can do it in Poland, independently of the European Union. We do not need to consult the European Union here. We do need to consult, but we simply need to get along.

Grzegorz Juszczyk
This cannot be like the health education we are talking about. I started in public health after my studies already 22 years ago, and at that time we also said that universal health education was needed. The subject of health knowledge we heard from the Ministry of Education. Well, yes, but it will have an effect. Maybe in 10 years we would have double the return, But you have to start sometime.

Monika Rachtan
This is true.

Energy drinks
Monika Rachtan
I would still ask about the last thing that makes young people addicted, namely energy drinks. And as we were talking earlier, I cited a situation where I was in a restaurant and a child asked for a Coke, which the waitress informed me that she wouldn't sell that Coke because it had a high caffeine content and my mother said that for me. Well, how do we combat this problem? Well, just because children can't buy energy drinks in a mainstream retailer today, it doesn't mean that parents won't buy them. And I have the impression that, unfortunately, many parents will just do it for the sake of peace of mind. So again, education. A ban alone is not enough.

Grzegorz Juszczyk
I think there is a happiness epidemic. Everyone wants to be happy. We want children to be happy too.

Monika Rachtan
Well, yes.

Grzegorz Juszczyk
We think they will be happier when they can enjoy what they want. I would have one piece of advice for these people. Maybe we could even close this with a buckle, as we talk about social media and addictions to these media. Imagine giving your child their first smartphone. We're no longer talking when he's 10, 12, 14 years old. And he, that smartphone or she. She will have it for life, she will not be able to exchange it for a new model. And that smartphone is the very health of my child. We're going to repair it, we're going to fix it, we're going to maybe update it as new guidelines come out.

Monika Rachtan
But this is the one smartphone.

Grzegorz Juszczyk
And Wiktor Osiatyński summed it up beautifully in one of his books, saying that the Lord God is like a waiter. When we're young, he'll give us everything smartphones, disposable cigarettes, he'll give us alcohol, he'll give us that pornography we've been talking about, computer games, everything. But just like the waiter will bring us the bill at the end and that bill we will start paying in 20, in 30 years. We know that for a young person, the prospect of what will happen in 30 years is very distant. Neuroscience research shows that for our brain, thinking about ourselves in the future is equivalent to thinking about another person, ourselves. In the future we think more as someone else, not me, just going to be there some 20 years from now. Grzegorz Juszczyk Perhaps different completely from me. And that's why experiences in such educational meetings are needed. It is worth considering such tools, which are already on the market today, so that the young person can feel some limitations. Yes, it is even enough to put on a special mask like the one used for endurance training. It is limited with restricted airflow for athletes to see how I will be breathing in 20 years' time.

Grzegorz Juszczyk
If I smoke traditional cigarettes. And only then can you understand how that person will feel in 20 or 30 years. But it's a comparison to that smartphone that we'll have with us all our lives. You can tell a child like that you can drink that cola-flavoured drink, but in a while your phone will break down. And what I won't buy you a new one then, because you only have this one. Let's use arguments that can reach. As we have already said. Life without a smartphone is unbearable for a young person, so losing a smartphone might be a good comparison for losing your health.

Monika Rachtan
I will ask the three most important things that our viewers should remember from our conversation today. Literally these three pills.

Grzegorz Juszczyk
This is always the most difficult question for people who do some teaching also and like to talk a lot, which I'm sure your editor also diagnosed in me. The first thing is to be attentive and talk. We know that young people will use social media. We cannot forbid them from doing so. This is actually their world, the equivalent of locking us in our homes when we couldn't go out in the yard. It's a very distressing experience for them, but the attentiveness, the conversation, following what they're doing there. With this attentiveness we have the second element, which is identifying problems early. If we notice something of concern in a young person, we should, of course, seek information from reliable online sources. These are run by the Ministry of Health, the National Health Fund on the Patient go w PL portal by the Patient Organisations Foundation. How you can help yourself, but also not to delay getting to a specialist, because prevention is about not letting these difficult situations in life happen to us. And if they do arise, we need to deal with them responsibly. And the third very important piece of advice is to treat young people more as partners.

Grzegorz Juszczyk
Let's accept that they are exposed to what we call the risk factors, which is what can make them addicted, to disposable cigarettes, to alcohol, and let's talk to them about how they can refuse in a way that makes them feel comfortable. It's difficult if it's going to be a lie, if they have to say that they've been treated in a clinic abroad for asthma and that's why they can't use e-cigarettes now, because if they pulled something like that, they could fall over here on the spot. And yet you probably wouldn't want to call an ambulance.

Monika Rachtan
It is also a good answer.

Grzegorz Juszczyk
If it leads to. OK, OK, well that's fine, we understand, and it won't take away those opportunities. However, relationships with people that young people want to have cool relationships with.

Monika Rachtan
We, I think, want to have a cool, young society, that kind of society. We are fighting because then, when we are old, we will live better in this society. It's a war against addiction, against smoking, against drugs, against alcohol. This is the responsibility of all of us today, parents, people in the media, educators, but also those people who sell such stimulants to the youngest. So an appeal to all of us to take care of the health of our society decisively today.

Grzegorz Juszczyk
And let's remember that all the things we warn young people about are reaching for a reason. So let's talk and try to find out what the problem is. Is it in the fact that they don't have time to relax or they don't have the opportunity to enjoy physical activity to help relieve stress? Let's look for healthy choices.