Dr. Bonnie Halpern-Felsher: Professor of Pediatrics and Adolescent Medicine at Stanford University School of Medicine and a developmental psychologist who is a world expert in adolescent risk behaviors. She develops tobacco, cannabis and vaping prevention curricula used in schools nationwide.
What this episode covers
Andrew Huberman and Dr. Bonnie Halpern-Felsher dig into the risk behaviors of adolescents and young adults, with a heavy focus on nicotine e-cigarettes, cannabis, and nicotine pouches. They cover why teens start (marketing, flavors, kid-targeted device designs, peer use, and stress) and why they keep going (the high nicotine load of modern salt-based devices drives fast addiction). The conversation expands into cannabis potency and its possible causal link to psychosis, fentanyl-contaminated drugs, risky driving, and sexual behavior. Halpern-Felsher argues that 'just say no' fails and that ongoing, non-confrontational conversations plus comprehensive/harm-reduction education are far more effective. Despite an alarming landscape, she remains optimistic about the creativity, social conscience, and willingness of today's youth to change the culture.
Recommended on this episode
Narcan (Naloxone)
Emergent BioSolutions
“I care AR cam with me all the time do you really I do I have it in my backpack all the time... should everyone carry a naram I think everybody should have Naran”— Bonnie Halpern-Felsher
Also referenced (named, not recommended)
Volcano Vaporizer
Storz & Bickel
“ecigarettes with cannabis in there... that's been around for a long time with volcano vaporized and specific cannabis vaporizers”— Bonnie Halpern-Felsher
Big reveals from this episode
- National data say teen e-cigarette use is under 10%, but schools tell her 40 to 60 percent of students are using.
- Elementary school teachers are now catching second and third graders using nicotine e-cigarettes.
- A single modern pod can hold the nicotine of one to two packs of cigarettes; heavily addicted teens use one to four pods a day.
- Any nicotine harms the developing brain (which matures to ~25) and rewires it to make addiction far more likely.
- High-THC cannabis use in youth may be causal, not just correlated, with psychosis that can be permanent.
- Halpern-Felsher carries Narcan in her backpack at all times and believes everyone should have it.
- She floats a 'fantasy' of schools offering bowls of condoms, Narcan, and fentanyl test strips for teens.
- She pushes back on framing teens as dysfunctional, calling them creative, passionate, and the most engaged generation on the environment and social justice.
Worth remembering
- Conventional cigarette smoking among teens has dropped well below 5%, but e-cigarette use has surged.
- Devices are disguised as USB drives, highlighters, boba tea straws, Star Wars shapes, and juice boxes to target kids.
- Flavor names like 'unicorn poop,' 'sugar booger,' and 'honey dew' are aimed squarely at children, not adults.
- Salt-based nicotine (Juul, 2015) uses benzoic acid to smooth the throat hit, making it easier for nicotine-naive teens to start.
- Pods can cost $1 to $2 versus $10 to $15 for a pack of cigarettes, and teens resell puffs for 50 cents to a dollar in bathrooms.
- The US legal age to buy nicotine became 21 in December 2019, but enforcement is weak.
- Dabbing can be around 80% THC versus 20 to 30% for mainstream cannabis products.
- Inhaled substances reach the brain in about 7 to 10 seconds via the lungs and bloodstream.
- About one in six people who use cannabis under age 25 become addicted.
- Many teens are delaying or skipping getting a driver's license, partly because ride-shares are cheaper than under-25 insurance.