At the time current administrators and teachers were preparing to work with students, vaping was not something they were expecting to face.

At the time parents of today’s teenagers had their children, “juuling” wasn’t a term.

In fact, while many of those educators were working towards their degrees, vaping or “juuling” was not even in their vocabularies.

They did know, though, that teen drug use would likely be something they would have to deal with at one point or another. The good news was that teenage use of cigarettes was on the decline.

According to the American Lung Association, after a spike in cigarette smoking among teenagers from 27.5-percent in 1991 to 36.4-percent in 1995, efforts to educate teens on the dangers of smoking began to take hold throughout the early 2000s as those percentages dropped to 8.8-percent of teen cigarette use in 2017.

Around that same time, vaping or “juuling” exploded onto the market.

Promoted as the cigarette that “Tastes and Feels Better Than a Real Cigarette,” vaping requires a battery-powered device, an e-cigarette that heats a liquid for consumption. Once inhaled, the substance inside the vapor is released into the body.

With the elimination of tell-tale signs of cigarette smoking, the e-cigarette device was advertised as a way to “Smoke In Style” as a cigarette box was converted into a device that often resembled a USB drive and the odor associated with smoking was replaced with flavored liquids.

While it remained illegal in all 50 states for children under the age of 18 to purchase and consume nicotine, by 2018, 37-percent of high school seniors reported vaping, according to News In Health.

What the FDA (Food and Drug Administration) now calls an “epidemic” is seen in junior high and high schools across the nation, including in East Central Illinois.

Mahomet-Seymour Education Association’s President James Heinold said high school teachers have brought up concerns with allowing students to go to the bathroom during class because they may use the space to vape.

Oakwood High School’s Principal Tim Lee said that in 2018, staff were “overwhelmed with students going to the bathroom frequently, causing tardies to class and a variety of other issues.”

St. Joseph-Ogden High School’s Principal Gary Page said that while bathrooms are problematic, they have also had to “address issues with (vaping) happening inside of classrooms and the hallways.”

“Vaping devices are so easily concealed, look similar to USB devices and pens, and they can be concealed so easily, there are some students that have the brass to do it in the very short moment it takes for a teacher to turn around to help another student,” Page said.

“I have a friend that teaches in another school district that told me of a student that wore a sweatshirt that used the drawstring of the hood as a delivery device. The student vaped as they were talking to the teacher. The teacher only knew of it because another student later told them about it.”

While adults, administrators, teachers and parents alike were learning about the new trend, marketers targeted teens with colorful ads, young consumers and flavored cartridges.

Today it is estimated that 5.3 million children under the age of 18 are vaping, according to NPR.

“Outside of the concerns everyone has, the biggest concern is that young people have been lied to and in some cases have convinced themselves that there are not health or addiction risks associated with vaping or at least the health risks are not as detrimental as smoking,” Page said.

Christie Clinic’s Dr. Jeanelle Murphy, who practices Family Medicine in St. Joseph, said that 7 in 10 teens are exposed to e-cigarette advertising which increases the likelihood that the teen will try e-cigarettes and possibly become addicted.

The long-term side effects of vaping are still something to be experienced, but the short-term effects have doctors warning parents and educators to educate their students on how vaping will immediately impact them.

Heritage Community School District Superintendent Tom Davis said the conversation has taken place at Heritage High School for several years.

“We discussed changing our policies as far as discipline, but decided to take a different approach instead,” Davis said. “We emphasized prevention and warning kids especially in our health classes and we also put up a variety of posters, some with some pretty direct messages, about the dangers of vaping.”

Keeping in mind that a student’s long-term health is most important, Oakwood also thought it would be a good idea to place the posters where students were most likely to vape, near bathrooms and locker rooms.

Davis said, “the posters highlight the health issues (vaping) can create. This is a teen health issue foremost, so we wanted that message out there along with enforcing our handbook steps for disciplinary action.”

According to Murphy, research has shown that vaping is more dangerous than smoking.

“The most popular vaping device known as Juul has the same amount of nicotine as 20 regular cigarettes,” she said.

“Juul contains nicotine salts, which allow high levels of nicotine to be inhaled more easily with less irritation of the throat.

“Juul always contains Nicotine even if it is claimed that it doesn’t. Nicotine harms the developing brain and the brain is still developing until the age of 25 years, so the more nicotine, the more harm.”

Murphy said that the e-cigarette aerosol is also full of chemicals that “do not release harmless water vapor, but very dangerous chemicals that can lead to illness and death in the user.

“When e-cigarette aerosol is inhaled many harmful substances fill the user’s lungs including Nicotine, ultrafine particles that can penetrate deep into the lungs causing damage; flavorings such as diacetyl which is a chemical linked to a serious lung disease, volatile organic compounds, cancer-causing chemicals, and heavy metals such as nickel, tin and lead,” Murphy said.

Alongside being linked to an increased risk of depression in teens, vaping has also been linked to damaging the developing brain, causing memory loss, problems with learning, impulse control as well as mood and attention disorders, according to Murphy.

“Depression is already a big problem in teens with suicide being the second leading cause of death in young people ages 12-18 years,” she said.

Recently, doctors have been diagnosing cases of a life-threatening condition, EVALI, an e-cigarette/vaping associated lung injury that can present with fever, chills, cough, shortness of breath, chest tightness, belly pain and loss of appetite.

“It is unclear how many chemicals in E-cigarettes cause EVALI but it seems vitamin E acetate is a cause.”

Since Dec. 27, 2019 — little more than a month ago — there have been 2,561 hospitalized cases of EVALI and 55 deaths in the United States and U.S. territories.

Vitamin E acetate is found in cartridges with THC or marijuana. The National Institute on Drug Abuse released a study on Dec. 18, 2019 and reported that 20.8-percent of 12th-graders and 19.4-percent of 10th-graders had vaped marijuana. Those figures were nearly doubled from the 2018 study.

___________________________________________________________________________

According to the CDC e-cigarette usage among teens is higher than cigarette usage:

Grade	E-Cigarettes	Cigarettes
8	9.5%	3.6%
10	14%	6.3%
12	16.2%	11.4%

• 5.8% of teens using e-cigarettes report using marijuana in their e-cigarettes
• 66% of teens using e-cigarettes report using just flavoring in their e-cigarettes however it was found that 99% of e-cigarettes contain Nicotine even if the manufacturer claims the device does not contain nicotine.

___________________________________________________________________________

Vapers are also using liquid laced with DMT (N-Dimethyltryptamine), Spice, or synthetic marijuana, and Flakka.

Health professionals are also learning that it is not only the user that is affected by the vapers, but much like with cigarette smoke, those nearby can be subject to second-hand exposure.

“When an e-cigarette user exhales into the air they are exposing those around them to the harmful aerosol thereby putting others at risk for the lung, heart and brain damage,” Murphy said.

“E-cigarette aerosol is more dangerous to children and teens than adults, so an adult using an e-cigarette around a child or teen is putting that young person at significant risk.”

Murphy added that 50-percent of calls to poison control centers for e-cigarettes are for children ages five years and younger.

Teens who try e-cigarettes are also more likely to start smoking in the future.

“30.7 percent of teens using e-cigarettes start smoking within 6 months compared to 8.1 percent of teens who are not using e-cigarettes,” Murphy said.

“We know that Nicotine is a highly addictive substance and that cigarettes cause cancer and life-threatening lung and heart diseases. We know that half of all people who smoke long term will die because of smoking-related illnesses.

“E-cigarettes also contain nicotine which makes them addictive as well and teens and young people who vape are more likely to start smoking cigarettes.  Studies are ongoing on the harmful effects of e-cigarette use. We likely don’t know as much as we will in the future, so it’s best not to start using e-cigarettes, just like it’s best not to start smoking.”

Schools are taking the message to the classroom. Heritage, Oakwood, Mahomet-Seymour and St. Joseph-Ogden have made sure that the effects of vaping are covered in their health courses, alongside conversations in other classes.

Page said that St. Joseph-Ogden has added educational conversations about vaping in advisory class alongside sending student mentors around to classes to educate their fellow students on vaping.

“A great resource is https://e-cigarettes.surgeongeneral.gov/.  We utilized this website as a starting point for conversations. Last year we shared this link with our parents as well,” Page said.

According to Mahomet-Seymour High School Principal Chad Benedict, the school district modified its policy so that “students violating the policy have to complete a webquest on vaping.  They have to read various articles and complete questions. Our goal is to continue to educate students on the dangers of vaping.”

Educating students only comes with educating the staff, too, though. Several school districts have provided training for teachers and staff to recognize vaping devices and have equipped them with ways to talk to their students.

“Last year we had training on vaping, which exposed the staff to the various paraphernalia to look out for, so much of it looks like ordinary school equipment that the teachers were surprised and were sure they had seen them in their classroom but didn’t know what they were,” Lee said. “There is much less of that now that the staff is more aware.”

Page said St. Joseph-Ogden has taken a similar approach.

“We have done training on identifying different types of vapes as well as disseminating information to teachers on the dangers of vaping to promote education through conversation between teachers, as well as arming teachers with information to be able to have conversations with students.”

The training comes in handy as teachers and staff, and at times students, are the ones monitoring the vaping activity during the school day or at extracurricular activities.

“We monitor it at (Oakwood) by the same old tried-and-true methods of having adults be visible in all the places where this may occur,” Lee said.

Davis said having a School Resource Officer is also an added benefit.

All four school districts have looked into vape detectors to install in designated areas throughout the school, but the price per unit and the effectiveness of the detectors raises additional questions among staff.

Davis said he has seen the collective efforts Heritage has made over the last couple years impact students.

“I will say that we feel the efforts school-wide have made a difference as the number of reports and actual offenses tracked for discipline has dropped significantly over the past 2.5 years,” Davis said.

“A student, (whom) I will, of course, not identify, was forthright with us that he/she had stopped vaping because of the effect it had on their lungs and breathing and their sports.”

School officials hope that education efforts are also taking place at home. Davis said that anytime a student has been caught at Heritage, parents have partnered with the school.

“I have been gratified that when we have had a case of a student caught doing this that the parents are our allies in addressing it with their child,” Davis said. “School is about learning in all facets of life, including making health decisions, so this is another aspect of that we try to teach.

“It is rare that the parent(s) are not supportive in what the discipline will entail, but also joining us in sending the student a message that this can have negative long term effects and we are here to help stop it.”

Lee said even parents who don’t think their child has vaped can step up to the plate.

“I would urge (parents) to talk to their kids,” Lee said. “I was blown away by some of the percentages that students would tell me were vaping last year. If they were right — and they probably know more than I do — then there is a good chance their student had at least tried vaping. It is a serious epidemic that could affect this generation far into the future if we don’t get them to stop soon.”

Just like educators, parents need to know what to look for. For many school districts, recognizing sweet fragrances is often a sign that vaping has occurred.

If a child exhibits behavioral changes, mood swings, agitation, shortness of breath, poor performance, weight loss, nausea, vomiting, mouth sores, abnormal coughing or throat-clearing, chest pain or seizures, it may be time to seek help.

“It is important for (parents) to be diligent in monitoring their children and know what to look for,” Page said. “Too many parents — me included — either choose to bury their heads in the sand or not want to believe that this is something their child would do or at least is feeling the pressure to do.”

Murphy said it is important that parents should avoid criticizing or lecturing their child, but instead help educate the child about the dangers associated with e-cigarette and cigarette use.

“Parents can start the conversation by asking their child or teen what they think about seeing someone smoking or vaping, or when they pass a vaping shop or an e-cigarette or cigarette advertisement.”

“As an educator, I hope that schools can help be a catalyst to address the vaping epidemic that faces our youth, but the responsibility cannot rest completely on the schools,” Page said. “It is going to take diligent parenting, help from community leaders, and government legislation that has real impact in order for this issue to be properly addressed.

“Schools should continue to educate and be a part of the conversation, but until our society says enough is enough schools are chasing their tails trying to address vaping.”

Citations:
American Lung Association. (2020, 02) Overall Tobacco Trends: Tobacco Trends Brief. https://www.lung.org/our-initiatives/research/monitoring-trends-in-lung-disease/tobacco-trend-brief/overall-tobacco-trends.html

News In Heath. (2019, 03). Vaping Rises Among Teens. https://newsinhealth.nih.gov/2019/02/vaping-rises-among-teens

NPR. (2019, 11). More Teens Than Ever Are Vaping. Here’s What We Know About Their Habits. https://www.npr.org/sections/health-shots/2019/11/06/776397270/more-teens-than-ever-are-vaping-heres-what-we-know-about-their-habits