Thanks to e-cigs, gains in reducing teens' nicotine use going up in smoke

More

Thanks to e-cigs, gains in reducing teens' nicotine use going up in smoke

Monticello High School Principal Adam Clapp first became aware of students vaping at school last spring.

Since then, he's confiscated seven electronic cigarettes from them, while middle school Principal Jeanne Handley has confiscated at least three at the grades 6-8 school.

Clapp said the older students have been caught with them in restrooms and locker rooms — and posting pictures of themselves vaping in the school building on social media.

"Although we haven't had any students vaping in class, we are not naive to the fact that it's very possible this could be happening. Vaping is so easily concealable and hard to detect," said Clapp, who sent letters about the burgeoning health problem and what the products look like to parents and put up information in the school for students to increase awareness.

Champaign County Deputy Kevin Franzen estimates his collection of vaping devices taken from Unity high school and junior high students over the past four years is 50-plus.

"I have about every shape, size and flavor they've got," said Franzen, the school resource officer.

While some of the earlier models are large and bulky, the newer, preferred ones not only are small enough to be hidden in the palm of your hand but also resemble common school supplies such as a stylus and a long flash drive.

"You can actually charge a Juul by plugging it into the USB port on your laptop or computer," Franzen said, incredulously, referring to the most popular brand of e-cigarette among youth today.

Clapp and Franzen are among the area school leaders, health officials and students who are sounding the alarm about youth vaping — which Food and Drug Administration Commissioner Dr. Scott Gottlieb said in September has reached "epidemic" levels — and calling for tighter restrictions on the e-cigarette industry and in their communities regarding where vaping can occur.

According to an FDA, Centers for Disease Control and Prevention and National Cancer Institute report released Thursday, cigarette smoking in the U.S. fell to 14 percent in 2017, the lowest level since records have been kept.

At the same time, vaping among youth — including nonsmokers — has risen dramatically. Preliminary data showed it was up 75 percent over last year.

The same upward trend can be seen among young people in the state. According to the 2018 Illinois Youth Survey, e-cigarette use has increased 65 percent among high school sophomores and 45 percent among seniors in the past two years.

The survey found: About 18 percent of 10th-graders reported smoking them during the past 30 days, up from slightly more than 11 percent in 2016; and about 27 percent of 12th-graders, up from slightly more than 18 percent two years ago.

E-cigarette use in the past 30 days among eighth-graders was 7.4 percent, up from 6.4 percent in 2016.

"Our survey rarely registers increases of this magnitude among any of our measures of illicit youth substance abuse," said Scott Hays, a senior research scientist at the University of Illinois Center for Prevention Research and Development. Part of the School of Social Work, the CPRD has conducted the biennial survey since 1993.

"This increased use of e-cigarettes among Illinois teens reverses great strides that were made in reducing tobacco use among youths over many years."

E-cigarettes are battery-powered devices that heat a liquid into an aerosol, which the user inhales. It provides a similar sensation to inhaling tobacco smoke but without the smoke.

While the earliest version was patented in 1963, local public health officials said the modern e-cigarette was introduced to the U.S. market in 2006.

"They are really a relatively new product. That's part of the reason why there are still lots of questions," said Talia Shaw, a health educator for the Champaign-Urbana Public Health District. "They haven't been around long enough for there to have been any long-term studies on their effects or what's in them. That varies widely from company to company, and their ingredients and how they're manufactured are still not regulated by the FDA."

Today, vaping instruments come in different shapes and sizes and go by a variety of names — e-hookahs, vape pens, mods and epods.

"The most profitable one right now is the Juul" manufactured by Juul Labs Inc., Shaw said. "It's so popular, it's become a verb. When you use is, it's called 'juuling.' That's problematic, because a lot of young people don't see Juuls as being e-cigarettes. They don't equate juuling to vaping when it's the same thing."

While e-cigarettes are marketed as aids to help reduce or quit smoking and not meant for anyone under 18, health advocates point out the vaporized liquids, or "vape juices," come in many different flavors that are sweet and appealing to kids.

"They have flavors like cotton candy, tutti fruity ... pina colada," Shaw said, adding e-cigarettes have never been approved as a cessation device like nicotine patches and gum or certain medication.

On Friday, the FDA announced that starting this week, it plans to ban convenience stores and gas stations from selling sweet flavors — only allowing tobacco, mint and menthol — in an effort to curb teen vaping. It also plans to put in place stricter age-verification requirements for online sales.

Shaw and Summer Phillips, with the Douglas County Health Department, also want federal regulations on manufacturers when it comes to the ingredients in the e-liquids. Right now, there's not a lot of research due to lack of oversight.

"You may have research on one brand or flavor and have totally different results with another brand or flavor," Shaw said. "One thing we do know: The majority of e-liquids contain nicotine, and a lot of times, there's a lot of it."

Phillips said one Juul pod has the equivalent of a pack of cigarettes. In Douglas County, where she works as an outreach coordinator and health educator in the high schools, it's common for regular vapers to go through 1 to 1 pods a day.

"Kids see an older sibling or their friends doing it, and they think it's harmless," said Phillips, who estimates one out of four high school students in her county have tried vaping and one out of 10 vape daily.

"They will pop their heads into their lockers between classes or go into a bathroom stall or in the classroom if the teacher leaves the room," Phillips said, adding she and her colleagues are working with the UI School of Social Work on a cessation program. "They love the creme brulee, mango and other fruity flavors. They don't realize there's nicotine in the vapor, and the milligram content is so much higher, so they get addicted faster. Before they know it, they need it, and they don't know how to cope without it."

"We know nicotine, other than being very addictive, is also harmful to youth brain development," Shaw added. In addition, "some of the different flavorants have chemicals in them that are linked to lung disease. They've also found evidence of heavy metals such as nickel, tin and lead."

Franzen said some devices can be opened to allow the user to add ingredients. The liquid has been found to contain THC (tetrahydrocannabinol), the active ingredient in marijuana that gives it its narcotic and psychoactive effects.

"The liquid smells nothing like your run-of-the-mill cannabis," the deputy said, adding he's only encountered one such device. "It has no odor, so it's extremely hard to detect."

Until this week, the only regulations regarding e-cigarettes were that they couldn't be sold to anyone under 18 or in vending machines. Health officials would like to see the age raised to 21.

But "they know who to go to and when," Franzen said, adding "I'm not saying every vape shop is selling to minors, but some of them are not following the law."

According to the Illinois Youth Survey, most respondents reported getting vaping materials from an older sibling or friend, while others purchased them from a gas station, store or online. A smaller percentage reported getting them from a parent or taking them from them without their knowledge.

While school and health officials and students are glad the federal government is cracking down on online sales to minors, they also want to see more happening at the local level to keep vaping products out of kids' reach and also limit where vaping by anyone can occur.

In October, Monticello schools Superintendent Vic Zimmerman addressed the problem at the school board and city council meetings, asking the council to consider tighter restrictions, even a ban on e-cigarettes.

"It's kind of scary," said Zimmerman, who became concerned when he noticed an increase in suspensions for vaping last semester and early this semester. "We don't know what's in this vape juice ... or what the long-term effects are."

Monticello City Administrator Terry Summers said there were also a few incidents at the aquatic center last summer. At Mayor Larry Stoner's request, he reached out to city attorneys to look at strengthening their ordinances.

"I think we're definitely going to entertain (prohibiting vaping) in any public space," Summers said.

While smoking and tobacco use are prohibited in most buildings and vehicles used by the general public under the Smoke Free Illinois Act, which took affect in 2008, Shaw said that e-cigarettes weren't included.

"They weren't really on anyone's radar at that time," she said.

Some municipalities have added them to their ordinance, she said. She said the C-U public health district also is working with local businesses on adding vaping to their no-smoking policies.

And last semester, Shaw said, the health department also worked on an e-cigarette prevention project with Bill Behrends' government and civics class at Centennial High School. While the program's goal is to show young people how they have a voice and can advocate for change, she said it also created more awareness about vaping dangers in the community.

While they'd heard of vaping in the news, Franzen and others said students actually made them aware it was happening locally. They added they're proud to see young people taking the lead to raise awareness about the dangers among their peers and work to find solutions much like they've done with drugs, alcohol, suicide and other problems teens face.

Behrends said that initially, some in his class were "lukewarm" about taking on the topic "mainly because they didn't like the idea of more restrictions, in general. But what was interesting was after researching it, how very quickly they came to realize this was a problem among their peers ... and we needed to talk about it and address it.

"Their personal stories of what was going on here at school, a lot of (staff) didn't even realize was going on. The students talked about how they were charging their Juuls on their Chromebooks while they were in school. Some said they've seen students vape in the back of classrooms. And they were telling us (their peers) don't understand how harmful or potentially harmful it is. They see people do it, and they try it. They don't necessarily see it as harmful. It's just a flavor."

At the May 15 Champaign City Council meeting, several then-seniors proposed a city ordinance prohibiting e-cigarettes, including Juuls, in the same places cigarettes and other tobacco are banned. Kayla Campbell said that's something Lafayette, Ind., 23 cities in the state and the UI have done.

"You don't know what you're putting into your body, and when you're doing it in public, you don't know what you're exposing other people to," Madeline Martin said.

Valena Green said the proposal stemmed, in part, from the class' survey on vaping. Of the 443 respondents — mainly students, but also some staff and community members — 72 percent said they knew teens who vaped.

"A lot of students leave their classrooms at the same time to go meet up in the bathroom to Juul or vape," Emily Nwokobia said. "They're also seen in their cars juuling. ... They say after they use, they feel as though they don't want to do work, so that creates unmotivated, unproductive students in the classrooms."

In Champaign, students receive a warning and their device is confiscated for their first offense, they receive a Saturday detention for the second and a three-day suspension for their third. (In other districts such as Salt Fork, suspensions come on the first offense along with having to sit out a third of the season for student-athletes.)

The survey also showed 79.2 percent said vaping shouldn't be allowed in public spaces, and 71.4 percent supported the class' proposal.

Jeff Hamilton, Champaign's communications manager, said the legal department has been researching the topic and plans to present its findings at a study session "possibly before the end of the year."

Back at Monticello High, the Student Advisory Group also tackled vaping at its meeting last month, said members Nick Wolter and Kaleena Davis.

Wolter said he first noticed kids vaping in the school restrooms last March. Davis said she saw photos and videos of it on kids' "Finsta," a second, private Instagram account for friends and peers that's far less filtered than their public account.

"A big part of it is their friends. They feel pressure to fit in," Wolter said. "They didn't see it as a health threat at first. Mr. Clapp has done a good job of putting the information out there — and letting us know that if you're caught, you'll get a suspension."

"It still exists," Davis said, but added "It's less prevalent now. ... A lot of it has to do with integrity. If not for yourself, don't do it for other people."

Clapp said Monticello will continue to educate students and parents and monitor students closely at school. But he and other school and health officials urged parents to educate themselves about vaping and talk to their kids.

"Schools cannot do this alone," Clapp said. "In order to do what is best for students, this will take a collaborative approach from students, parents, the community and the school."

County by county
E-cigarette use in area counties and statewide in the past 30 days, according to the 2018 Illinois Youth Survey:

 Grade  8th  10th  12th
 State  7%  18%  27%
 Champaign  4%  n/a  n/a
 Douglas  3%  13%  16%
 Ford  12%  23%  19%
 Piatt  5%  11%  29%
 Vermilion  14%  19%  21%



Note: Not every school participated in the youth survey.

More

-