It used to be easy for school administrators to catch teens smoking.
The smell of cigarettes lingered in the air and on their fingers, and the smoke set off fire alarms.
But now, students are shying away from traditional tobacco and are drawn more often to vaping, and although administrators know that a large portion of their students are using e-cigarettes, they are finding them harder to detect. The mist and odor dissipates quickly and the device itself can look like a pen, a lipstick or a USB stick.
According to the U.S. Department of Health and Human Services, in 2018, more than 3.6 million middle and high school students reported using e-cigarettes in the past 30 days, amounting to 4.9 percent of middle school students and 20.8 percent of high school students; compared to 2016, when 2 million students reported vaping in the past 30 days, including 4.3 percent of middle school students and 11.3 percent of high school students.
Last year, there was a 78 percent increase nationwide in youth vaping and more than one in three high school students has tried vaping products at least once. That number is rapidly approaching one in two students nationally, according to Summit County Public Health.
“[Vaping] is at levels we have not seen. It’s erased all the progress we made in 20 years in anti-tobacco campaigning. These spikes are going up every year,” said Summit County Public Health Population Health Director Cory Kendrick.
What is it?
Electronic cigarettes were first introduced to the U.S. in the mid-2000s, but did not become popular until the mid-2010s, with the introduction of Juuls, a brand of e-cigarettes that owned 49.6 percent of the market as of January 2018, according to the Ohio Department of Health.
“Juul” is sometimes used as a catch-all for all e-cigarettes, much like “Kleenex” is used to describe all facial tissues. E-cigarettes can also be called e-cigs, e-hookahs, mods, vape pens or vape tanks. They can come in all shapes and sizes, but most have a battery, a heating element and a place to hold liquid.
“The two most popular liquids are nicotine and marijuana. Each Juul pod [liquid cartridge] contains as much nicotine as 20 cigarettes, and it’s delivered as a freebase which is more powerful than smoke,” said Carly Wilbur, a pediatrician at University Hospitals.Vaping on the rise in Portage
Why do teens want it?
According to the Center for Disease Control and Prevention, kids are more likely than adults to be e-cigarette users, which is in part due to advertising targeted at children, Wilbur said.
“There’s flavors like birthday cake, bubblegum and the like that are meant to attract a younger audience,” she said.
E-cigarette advertising also tends to present itself as a “healthier” option to traditional tobacco. While vaping does not contain tar or tobacco and has fewer killer chemicals than cigarette smoke, scientists have identified formaldehyde in the vapor, among other unsafe chemicals, Wilbur said.
There are also vaping cloud competitions that offer incentives like Instagram notoriety and prizes worth thousands of dollars, which attracts younger users.
Additionally for many students, especially high school freshmen and sophomores, vaping can give them a sense of identity and adulthood, Streetsboro High School Principal James Hogue said.
“Sometimes experimenting with things like this plays a part in finding themselves which is why we think it’s so important that we let them know this is not something you want to experiment with,” he said.
Is this a local issue?
In Summit County, 25 percent of high school students and 8.7 percent of middle school students vaped at least once in the past 30 days, according to a survey by Summit County Public Health. Even more students reported trying e-cigarettes: 42.3 percent of high school students and 16.3 percent of middle school students. The last time this survey was completed in 2013, the question was not even asked because vaping had not yet been popularized.
At least one Summit County school has seen an increase, with Hudson High School Principal Brian Wilch noting that by January of this year, they had already surpassed the number of vaping incidents from the entire previous school year.
Portage County’s 2016 health assessment found that 17 percent of youth vaped in the past year. A new health assessment is expected to be completed in the next few months.
Portage schools are reporting annual increases of the number of vaping incidents. Crestwood High School has had 32 incidents this year, Ravenna High School has had 25 to 30 in the past few months and Crestwood has had 18 since October.
The problem also extends to middle schools, including Kent’s Stanton Middle School. Kent City Health Department Accreditation Coordinator Mike Anguilano said that eight middle schoolers went through the department’s vape education program through November 2018, and 10 to 15 additional middle schools have gone through the program since November.
Is vaping addictive?
According to NEOMED Associate Professor of Psychiatry Dr. Doug Smith, nicotine, one of the most popular substances in e-cigarette liquid, is a highly addictive substance that has more power over the brain than sex or food.
“Addiction is an illness, not a moral failing and addiction to nicotine is no different. It’s a brain disease,” he said.
He continued that because everyone’s brains are different, each individual person can be affected differently by the same stimulant.
The problem, he said, is that you can’t know what your brain could become addicted to until that substance is introduced to your brain. And as more and more students try vaping, more and more will find out that they are predisposed to become addicted to nicotine.
“So once that happens, if they have a genetic predisposition, then juuling, vaping, nicotine becomes their new No. 1 survival instinct. Your animal brain believes you need it to survive,” he said.
How do teens get it?
While the legal age to purchase tobacco and e-cigarettes in Ohio is 18, 16.3 percent of Summit County middle schoolers have tried it. More than a third of students reported purchasing vapes in stores by themselves and 25 percent reported having someone else purchase it for them, Kendrick said.
Aurora High School Principal Paul Milcetich noted that students could also be getting them from their homes, as many parents and guardians use e-cigarettes. While youth are more likely to use e-cigarettes than adults, 2.8 percent of adults were e-cigarette users in 2017, according to the Ohio Department of Health.
How are schools responding?
Public schools in Portage and Summit counties typically have no-smoking policies for their campuses and for school-affiliated functions, whether they are on or off campus, and several have rewritten their student handbooks to specifically address vaping.
Some schools, like Maplewood Career Center and Crestwood High School have purchased items to help them better detect e-cigarettes.
Crestwood purchased a metal detecting wand specifically to find e-cigarettes, Vice Principal Craig Boles said. Maplewood has purchased about $8,000-worth of vape sensors, Superintendent Randy Griffith said, and is planning to install them in public restrooms by the start of the 2019-20 school year. The sensors do not ring, but rather send an alert to administrators’ phones.
Many of the schools, including Aurora High School, Crestwood High School and Hudson High School, have included vape education into their regular health classes.
“But most juniors and seniors, when they were freshmen taking health, this wasn’t in the curriculum. It’s being covered now, but for half of our student body, when they took health this wasn’t an issue,” Wilch said.
Crestwood, Streetsboro High School, Theodore Roosevelt High School and Windham High School require students who are caught vaping, or even caught with e-cigarettes on their person, to take vape education courses.
Windham Assistant Principal Zach Burns said that his students who are caught have to take three days worth of vape education, and on the fourth day are required to do a presentation in front of their parents, the health teacher, a school board member and the principal.
“That started in October and we had 13 kids go through it from October to January and since then it’s been on the decline: three in February, one in March and one in April. I don’t know I would credit that with kids going through it. I think it’s more them spreading the word that they’ll have to do this if they get caught,” Burns said.
At Streetsboro High School, education is focusing on the health risks, but also the financial risks involved.
“They don’t always worry about their health, but they do think about their money. Money matters to teens, so we tell them why would you spend $50 on something that you have a 50/50 chance of losing this weekend or getting taken away from you. It’s not a good investment,” Principal James Hogue said.
How are communities responding?
In addition to educating students, schools are also working to educate parents about the dangers and warning signs of vaping. Hudson hosted a vaping informational session in the spring, and Rootstown included the topic in a recent county-wide Hot Topics program.
Many communities are also passing Tobacco21 laws, which raise the legal age to purchase tobacco and e-cigarettes from 18 to 21.
“I’ve been to many communities and spoken to many kids and they say that kids sell Juuls on the bus to middle schoolers because they’re 18 and they have access. By moving the age to 21, you take it out of the social circle, and if they don’t do it by the time they’re 21, they’re 95 percent less likely to ever start,” Kendrick said.
“Needham, Massachusetts was the first community to pass Tobacco 21, and even though their students were mobile and were surrounded by other communities that didn’t have it, their youth adoption rate plummeted. It was cut in half, even though students could drive to other communities to purchase them,” Kendrick said.
In 2018, Akron, Kent, Mogadore, Richfield and Green adopted Tobacco21 ordinances, and in 2019, Summit County passed the ordinance, which affects 31 townships and villages in the county.
Tobacco21 targets businesses who sell to minors, rather than the minors who use and purchase, so a large piece of the ordinance is enforcement. Part of that enforcement involves secret shopping, Aguilano said, and of the 27 tobacco vendors in Kent, eight failed the compliance check.
What are the long-term health risks?
Because vaping is so newly popularized, there are few scientific studies on the long-term health risks associated with the practice. However, scientists do know that nicotine can harm the developing adolescent brain, which continues to develop until about age 25.
“It took decades for scientists to find the connection between smoking and major health risks,” Wilbur said. “The possible consequences of vaping won’t be recognized for generations.”
Reporter Krista S. Kano can be reached at 330-541-9416, firstname.lastname@example.org or on Twitter @KristaKanoRCedu.