Teen e-cigarette use concerns school and health officials

LOGAN - Several government agencies have been working to address tobacco use for decades, especially among young people, but technology is disrupting these efforts in the form of e-cigarettes.

According to the Centers for Disease Control and Prevention (CDC), e-cigarettes are now the most commonly-used tobacco product among young people in the United States, and high schools are on the front lines of dealing with this trend.

Rob Ramage, Logan High School Assistant Principal, said that while tobacco use on school grounds has declined, there has been a dramatic increase of students using e-cigarettes in the past several years.

"The number of tobacco violations where we catch kids with smokeless tobacco or cigarettes has decreased," Ramage said. "But the numbers of students caught using vapor devices has increased way more than the tobacco use has decreased."

E-cigarettes, also known as "vapes," are handheld electronic devices that stimulate the feeling of smoking tobacco. They work by heating liquid, contained in disposable pods, into an aerosol that can be inhaled.

These products don't contain tobacco, but the liquid pods contain nicotine, and therefore the CDC refers to them as tobacco products. Due to the presence of nicotine, users are at risk of developing a dependency on the highly addictive substance.

The liquid pods typically contain artificial flavors such as apple juice or cotton candy - which is particularly appealing to young users, as they are reminiscent of the taste of candy.

E-cigarettes were originally marketed as a safer alternative for adult smokers. However, the unintended consequence has been the mass adoption of e-cigarette use by minors, who might not have picked up smoking otherwise.

It is unclear if e-cigarettes are more or less dangerous than regular cigarettes or smokeless tobacco, but research from the National Institute on Drug Abuse has shown that teens using e-cigarettes are more likely to use cigarettes in the future.

Ramage said it's harder to catch students using e-cigarettes than traditional cigarettes because they don't release the same distinct smell as tobacco.

"If a kid were to walk into a bathroom and light a cigarette, people are going to know about it within a minute," Ramage said. "But when kids are vaping, there are so many cover scents, and so all it smells like is somebody putting body spray on in the bathroom."

The FDA announced a series of enforcement actions against e-cigarette companies on April 24. According to a statement from FDA Commissioner Scott Gottlieb, these steps are the first the agency is taking toward reducing teen e-cigarette usage.

The FDA also announced forthcoming actions against e-cigarette retailers that are using advertising to mislead kids. It announced a campaign targeting retailers selling e-cigarette devices to minors, and took several actions against the e-cigarette company JUUL, a device particularly popular among young people.

The sale of e-cigarettes is banned to people under 18, but Ramage said teens are often able to purchase the devices from adults and then further distribute them with an upcharge.

Nikki Hankison, Hocking County Health Department nurse, said one of the reasons why teenagers are choosing to use e-cigarettes is because they aren't aware of the health risks.

"[Kids] don't think they are addictive or as bad as cigarettes," Hankison said. "The short term effects we know about are that it does change the teenage brain and we see effects on the lungs."

Nicotine is one of the most addictive substances in the world, and studies have shown that developing brains are more susceptible to its effects.

Additionally, a Harvard found that many e-cigarette flavors contain the chemical diacetyl, which is added to foods like popcorn and caramel for its buttery flavor. When large quantities of the chemical are inhaled, it can cause a condition called popcorn lung - a scaring of the air sacs in lungs that narrows airways.

Ramage said when a student is caught with an e-cigarette, the device is taken away and the infraction is the same as any other tobacco violation, and the student receives three days of out-of-school alternative placement.

Most of the e-cigarette users caught on school grounds are freshmen and sophomores, Ramage said. He doesn't necessarily believe this reflects the majority of underage e-cigarette users, but that older students are more mature and understand the consequences of using tobacco products on school grounds and likely decide not to use them there.

Unlike cigarettes or tobacco, which are discarded when confiscated on school grounds, Ramage said parents get the option to pick up the device.

"Eight times out of ten it's a situation with the parent says 'Throw it away, I didn't approve it, I don't want them having it, and you can toss it,' " Ramage said, "If we started confiscating them and tossing them without contacting the parents, it just creates ill will."

Cigarettes contain toxic chemicals such as tar and nicotine, and research has proven the health dangers of long-term cigarette use. However, Hankison said it is unclear at this point how e-cigarette use affects health in the long run.

"Long-term effects with e-cigarettes and vaping are still unknown due to how relatively new they are. We don't really have any studies yet that can help us know that info," she said.

A recent study completed by the National Academies of Sciences, Engineering and Medicine found that in addition to nicotine, most e-cigarettes emit and produce a host of toxic substances. Whether or not the levels of those substances will result in detrimental health effects in the long-term is unclear.

The same study also showed that e-cigarettes can help adult smokers quit smoking cigarettes, which is what many e-cigarette devices where intended for in the first place.

Ramage said that even thought the school has taken steps to educate students about the dangers of e-cigarettes and other tobacco products, it will always be difficult to keep kids from doing something that seems cool.

"Trying to explain to a kid how dangerous something like that is kind of falls on deaf ears because they feel like, quite honestly, that's the principal trying to tell me not to do something that's really cool and fun and they don't want us to have any fun," he said.