Education about cigarette and tobacco use has been prevalent in public schools for years. But those who educate America’s young people are adjusting their tactics to account for a new issue: vaping.
That includes Chatham County, where, according to the 2017 Youth Risk Behavior Survey, 46 percent of high schoolers and 13 percent of middle schoolers have used an electronic vapor product, which includes vape pipes, vape pens and e-cigarettes.
“The use of cigarettes has gone down,” said Tracy Fowler, Chatham County Schools’ executive director of student support services. “The vaping has become the thing to do.”
Rob Schooley, the district’s school health, physical education and wellness instructional program facilitator, added, “It happened quite quickly. We watch these sort of things. E-cigarettes have been around for a long time, but it wasn’t until the past five years that it became popular.”
Priority for education
As organizations that work with young people wrestle with this rise in popularity, tackling the relationship between vaping and youth has become a priority for health departments across the country, including Chatham County’s Public Health Department. Anna Stormzand, the department’s health promotion coordinator, has been taking the lead on educating the school system and raising awareness.
“We are concerned about the potential that electronic vapor products like Juuls have to addict another generation to nicotine and tobacco products,” Stormzand said. “E-cigarette products contain nicotine and many other harmful substances. Nicotine is highly addictive chemical and can affect a young person’s brain development which can lead to lasting consequences.”
The idea of electronic cigarettes goes back to 1930, according to the Consumer Advocates for Smoke Free Alternatives Association, or CASAA. But that first product was not commercialized, with electronic cigarettes first introduced into the United States in 2006. Perhaps the most popular type of e-cigarette, the Juul, was first put into market in 2015, produced by San Francisco-based PAX Labs. Juul became its own company in 2017 and, according to Wired, is now worth $38 billion.
Stormzand said vapor products like Juuls are problematic for a few reasons, primarily the negative health effects. She said that e-cigarettes emit an aerosol that “is not clean air and exposes both the user and non-users to harmful substances.” The vapor may also contain “heavy metals, such as nickel or lead, ultrafine particles that can be inhaled deep into the lungs, cancer-causing chemicals, flavoring such as diacetyl which has been linked to serious lung disease, and volatile organic chemicals.”
Additionally, like tobacco products, e-cigarettes and the like can deposit nicotine through the placenta into a fetus during pregnancy and affect lung, heart and brain development.
A company under examination
Despite its popularity, Juul now finds itself the target of North Carolina’s government. Attorney General Josh Stein filed a lawsuit against the manufacturer on May 15, saying Juul was “designing, marketing and selling its e-cigarettes to attract young people” and “misrepresenting the potency and danger of nicotine in its products in violation of North Carolina’s Unfair and Deceptive Trade Practices Act,” according to a press release.
“Juul targeted young people as customers. As a result, vaping has become an epidemic among minors,” Stein said. “Juul’s business practices are not only reckless, they’re illegal. And I intend to put a stop to them. We cannot allow another generation of young people to become addicted to nicotine.”
The press release said that, in 2017, almost 17 percent of all North Carolina high school students reported using an e-cigarette in the last 30 days. According to the Chatham County Community Assesment, that number reached 22.4 percent among Chatham high schoolers.
The youth population is of particular concern, Stormzand said, because of products like Juul and their ability to create more addiction.
“It is estimated that one Juul pod contains the same amount of nicotine as a pack of 20 cigarettes,” she said. “Young people unfortunately are often not fully aware of the health risks posed by these products and can easily get addicted just like they would with any other tobacco product. We are also very concerned about this renormalization of smoking that we are seeing among our middle and high school students.”
Juul has posted several items on its website about combating youth usage, saying the company has taken down some social media pages and restricted the sale of certain flavors. In a February post on its website, Juul said, “We do not want youth using our product. It is antithetical to our mission.”
Figuring out next steps
The rise not just in Chatham but across the country — the latest N.C. Youth Tobacco Survey indicated that e-cigarette use among high school students rose 894 percent across the state from 2011 to 2017 — has made vaping a key topic of Chatham County Schools’ health education.
“I can’t think of a staff development that we haven’t had with the healthful living staff,” said Schooley, “that doesn’t include some vaping information.”
Fowler said the school district added vaping and e-cigarettes as prohibited behaviors and items on school campuses to the Code of Conduct a couple years ago, and educational posters and placards have been hung in hallways and cafeterias as “conversation starters.” E-cigarette information has also been added to the health curriculum.
Enforcement is a little tougher with vapor products than normal cigarettes, district officials say, because e-cigarettes do not leave an odor and are easily disguised. Some Juul products look just like USB flash drives and can be plugged into computers — all Chatham County Schools high school students have use of a laptop — to charge.
Efforts to fight back against this spread are ongoing, Fowler said, including introducing specific information about quitting to students caught with tobacco products.
“It’s really kind of amazing how quickly this became such a thing to do,” she said. “It’s something we continue to keep an eye on. I think all the principals would say it’s something that they battle with. The biggest reason would be because there’s no odor to it.”
Stormzand said parents and adults can be positive role models for these young people by not using tobacco products themselves and having conversations with youth “about the importance of seeking help to quit if they have already started to use these products.”
Fowler and Schooley said they feel most students understand the dangers of cigarettes, but they haven’t gotten that same message across on vaping.
“We’ve spent many, many years telling kids cigarettes will kill you,” Schooley said. “But the perception of harm (for vaping) is less.”
Reach Zachary Horner at zhorner@chathamnr.com and on Twitter at @ZachHornerCNR.