Vaping didn't start out as a big issue in Crook County High School or Crook County Middle School.
As Jason Ritter, the high school's student service coordinator remembers it, vaping was "a very minor problem, an almost exotic form of getting nicotine."
Not anymore. It has instead become the primary means by which middle and high school students are getting nicotine. In the words of Ritter, educators have seen "an absolute explosion" in e-cigarette use since last school year. And Crook County is not alone, he added. The problem is nationwide.
At Crook County High School, roughly two months into the new school year, about two students per week are getting caught with vaping devices, and Ritter is convinced those numbers are only scratching the surface."When we speak to those students who are willing to talk to us about the situation, they believe that easily half of their friends are regular users of vaping devices," he said.
It has become the primary discipline issue at the school.
Crook County Middle School leaders are not seeing the same level of vaping — at least not on school grounds.
"To a large degree, the middle school environment is a largely supervised type of environment," said Principal Kurt Sloper, "so it's more difficult to bring something to school that you are not supposed to have and keep that a secret." Sloper is aware of just a handful of incidents this school year where students have been caught with vaping pens or flavored oils.
But off school grounds might be a different story. Sloper suspects that more of the middle school-age vaping happens off campus. He noted that word of mouth from students as well as information gleaned from the school's anonymous tip line, which is available to all students, suggests use is growing away from school.
People vape by breathing through electronic cigarettes or vape pens that heat liquid to create a vapor. That liquid can contain nicotine, THC and other ingredients such as flavorings. The industry has been criticized for promoting sweet-flavored products that appeal to children, such as bubble gum and creme brule flavors.
What is driving the explosion of vaping in local schools is not fully known, but Ritter believes that the marketing campaigns behind e-cigarettes and vaping devices may have given students the impression that it was a safer alternative than traditional tobacco use.
Recent events suggest otherwise. The Oregon Health Authority reported two deaths associated with vaping-related illnesses, and many other illnesses have emerged throughout the country. So concerning was the problem that Gov. Kate Brown tried to impose a six-month ban on the sale of flavored vaping products.
"My first priority is to safeguard the health of all Oregonians," Brown wrote in early October. "By keeping potentially unsafe products off of store shelves and out of the hands of Oregon's children and youth, we prevent exposing more people to potentially dangerous chemical compounds and help lessen the chance of further tragedy for any other Oregon family."
Brown added that the "safest option" for people right now is to stop vaping altogether, in line with what State Health Officer Dean Sidelinger advised in late September. "Until we know more about what is causing this illness, please, do not vape," Brown said. "Encourage your friends and family members to stop vaping immediately. Talk to your children about the dangers of vaping. The risks are far too high."
The Oregon Court of Appeals ultimately blocked the ban, so at this point flavored vaping products are still available for purchase.
With no bans in place, school and public health leaders are searching for ways to keep vaping products out of the hands of teens. Community health leaders are leading that charge locally as staff from the Crook County Health Department have employed teen surveys and other focus groups to determine the depth of the issue.
During focus groups held this past spring, teens revealed that vaping has become the main source of substance use among peers. "All we see is vaping," they said.
Now health leaders are trying to gather some numbers to back those verbal accounts.
"From a public health standpoint, we are really trying to wrap our heads around the scope of the issue locally, more than just anecdotally," said Katie Plumb, the health department's prevention and health promotion supervisor. "That anecdotal information is really important, but we need multiple data sources to fully understand the scope of the problem."
She went on to say that the school district has partnered with the health department in the past six months to a year to help with a survey that will provide some new data.
Once health officials determine the scope of the issue, their next step will likely involve determining where the teens are getting access to vaping products.
The schools, meanwhile, are adjusting their enforcement and education efforts to keep up with a what is an ever-evolving issue.
"We have initiated regular bathroom checks," Ritter said of the high school. "The one place that we don't have cameras in the school is in the bathrooms, and bathrooms have become the place that students congregate to vape."
Getting caught, at the high school or the middle school, typically warrants a few days of in-school suspension, the vaping materials are confiscated, and parents are contacted.
However, Ritter is quick to stress that enforcement is only a small part of how the school is addressing the problem. He feels that a better response is to educate students, parents, teachers and the community.
To that end, school staff members have engaged in professional development to learn about the most common vaping oil flavors, as well as the devices used to vape so that they know what the activity looks and smells like.
In addition, students are being taught the physical impacts of vaping and what types of health risks it might pose. At the middle school, the health curriculum has been expanded to include the health impacts of vaping.
Complicating those efforts is the fact that the impacts of vaping on human health are not entirely known.
"It's difficult right now. There is different information out there," Sloper said.
"We are talking about a beast that is changing very rapidly," Ritter added.
Consequently, the health risks were a tough sell, and it wasn't until the vaping-related deaths occurred that some students began to really listen to the warnings and re-evaluate the safety of vaping.
But this is not true of all students who are vaping. Ritter said that some teens have discounted the deaths as a consequence of buying black market vape oil.
"Many students believe if you buy vaping oil from a store, you will be fine," he said.
And there are other students who are addicted to nicotine and unlikely to change their behavior regardless of any education efforts. These teens, Ritter says, need help kicking the addiction — and resources are somewhat limited.
The high school, as part of its enforcement effort, offers parents opportunities for addiction counseling, but it is not mandated, and parents don't often accept the offer.
"I think a lot of people are naturally resistant to the idea that their teenage child has an addiction issue." Ritter said.
Plumb agrees, noting that cessation services are traditionally more oriented toward adults than teens.
"I think we have to be realistic in saying, 'Yes, students have started using these products and potentially do need cessation services,'" she said.
To help bolster cessation options, the high school is looking at ways to partner with Rimrock Trails and other community health organizations in order to help students if they choose to quit.
Beyond the health department and schools, community leaders have also gotten involved in the battle against youth vaping. Crook County Empowered, a coalition of leaders in multiple community sectors, is targeting the issue, looking for specific ways to slow it down. Within that coalition, an e-cigarette task force has been formed with goal of limiting youth access to vaping products.
"We have excellent buy-in from key stakeholders," Plumb said. "It is a really collaborative approach because that's what it takes. It takes a whole community to address an issue this complex."
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