By Ingrid Howard
The use of e-cigarettes, or “vapes,” in high school-aged youth has become so socially acceptable that the students who aren’t doing it are probably on the outside.
That’s what Lindy Walker, Help the Hills Coalition chairwoman, told parents at the Vaping Workshop held Oct. 9 at Vestavia Hills High School.
What teens might not realize is that they are getting as much or more nicotine in e-cigarettes as in traditional cigarettes and ingesting many of the same potentially dangerous chemicals.
Susan Walley – a professor at UAB and hospitalist at Children’s of Alabama – passed around products by JUUL, a company that claimed 72 percent of the U.S. e-cigarette market share in the third quarter of 2018. The JUUL resembles a flash drive, making it easy for teens to conceal. Each pod used in the device has 59 milligrams of nicotine per milliliter of liquid – two to three times as much nicotine as other e-cigarettes.
“Just to compare, in a traditional cigarette … the average amount of nicotine that someone is going to get is about one to two milligrams,” she said. “And we know from anecdotal evidence that youth are using one to two of these pods a day.”
This dramatically increases the likelihood of nicotine addiction. Youth also are more likely to become addicted because their brains are still in the developmental stage, she said.
“We’re seeing kids that use it, even for a couple of weeks, and they already have that physiological addiction,” she said.
Walley said teens may not realize e-cigarettes contain nicotine because the products, labeling and marketing are not fully regulated by the FDA.
“You might have a product that says that they have no nicotine, and when scientists do quantitative studies, they actually do contain nicotine,” she said. “For the youth, that’s thinking, ‘I’m just going to do this for the doughnut flavor,’ and they buy something that they’re told has zero nicotine, and then what happens is it could have nicotine.”
When asked about the risk of certain tobacco products, surveyed students were less likely to say an e-cigarette is risky than they were to say a traditional cigarette is risky.
“Kids are like, ‘Oh tobacco’s bad, cigarettes are bad, but e-cigarettes, those are safer,’” Walley said. “That’s the perception.”
That may at least in part be because e-cigarettes have become so ubiquitous in society, Walley said. She showed a photo of an Over the Mountain convenience store with a large, bright yellow ad for e-cigarette products on its brick exterior.
“When you go to a gas station and there is a flagrant sign that makes it seem totally normal to buy tobacco products, even though all of us are like, ‘We’re too smart to fall for that,’ that is social norming,” she said. “The next time you see it, it’s not that big of a deal.”
Sales of tobacco products, including JUUL, are banned to people under 19. But teens manage to buy them, anyway. Most teens are getting their e-cigarettes from convenience stores rather than vaping shops.
The Real Risks
Because of low regulation from the FDA, what’s advertised in e-cigarette products may not be what’s actually in them. What’s more, e-cigarettes contain some of the same substances that are considered dangerous when inhaled in traditional cigarettes.
Research also has found that e-cigarettes contain ultrafine particles that can get deep into the lungs and cause damage, along with metallic nanoparticles from the degradation of the heating mechanism, Walley said.
She said it could take a while to gather enough data on e-cigarettes to accurately assess their risks. It took more than 50 years to prove to the public that traditional cigarettes cause cancer, Walley said.
“We know that e-cigarettes have many of the exact same components as cigarettes, but we don’t have 50 years of data to say that e-cigarettes cause cancer or e-cigarettes cause heart attacks,” she said. “But as a parent and as a pediatrician, knowing how much damage cigarette use and tobacco use has done, I don’t want to wait 50 years and then say, ‘Oh, we were wrong.’”
What to Do?
The workshop had many parents asking what they could do to make sure their children weren’t vaping.
Although e-cigarettes don’t have the same tobacco smell as traditional cigarettes, Vestavia Hills High School Principal Tyler Burgess said a smell still can be detected.
“A lot of the fruity smells, literally Fruity Pebbles, remember the cereal? Trix? That artificial fruity flavor smell? We will get that hint in bathrooms. We’ll get that hint on their clothing if they really are smoking a lot,” he said.
Possessing e-cigarettes at VHHS is a class 2 offense, Burgess said. First-time offenders have to attend Saturday school. A second offense would mean in-school suspension, and a third offense would mean alternative school or suspension. But he said few students are caught more than once.
“I do think that it’s happening quite a bit,” he said. “It’s just a matter of kids getting better at hiding it.”
When asked how often students are using e-cigarettes at school, Burgess said daily.
“We might not have a student get in trouble for it daily, but we could, probably, if we devoted our lives and our time to it,” he said.
One of the issues is the identification of e-cigarettes, said VHHS Assistant Principal Jennifer Brown. She said the school had a workshop to show teachers the products.
“They were like, ‘I’ve seen one of these in my class before!’” she said. “We’re trying to educate everyone.”
But a foolproof way to stop vaping among youth hasn’t been found.
Burgess said the school has health-related assemblies and would like to have more, but it also has to balance assembly time with instructional time.
“Yes, I agree that the burden is on the school,” Walker said. “But the burden is on us as parents. … We have got to educate ourselves and have these intentional conversations. And that’s what tonight is all about.”
The event was arranged by Help the Hills, a coalition dedicated to reducing use and abuse of harmful substances in Vestavia Hills youth. For more information, email info@leadershipvestaviahills.com.
