Teen Vaping: Head in the clouds
Braden Smith, Wilsonville High School Class of 2019, used his electronic cigarette like a cellphone. It became a habit.
Smith started using a Juul — a brand that manufactures a popular and discrete line of e-cigarettes — his sophomore year.
While Smith no longer uses it, he said there are plenty of students who Juul (teens use the brand as a verb for vaping, using vapor-based tobacco products like the Juul brand) at school, though technically it's banned on Oregon's school grounds.
But recent data shows tobacco use on campus has been on the rise.
Amid a federal investigation into e-cigarette companies who appear to be marketing toward youth, schools are battling a growing trend of teens vaping on campuses.
According to the U.S. Food and Drug Administration, an estimated one in five high school students use smokeless tobacco products (smokeless products include chewing tobacco) such as e-cigarettes. The products are used by inhaling a sweet-tasting tobacco vapor that contains nicotine, the highly addictive substance found in cigarettes.
Vaping has become so commonplace among teens, Oregon students and teachers say it even happens on campuses — sometimes right in the classroom.
"We have kids charging their e-cigarettes on their Chromebooks in class," said Connie Jolley, a health teacher and drug prevention club leader with the Tigard-Tualatin School District. "We have kids taking hits in class."
Jolley says vaping became so pervasive, the drug prevention club at Tigard High School made it the focus of an awareness campaign.
"I have a son in the school and he talks about how often he sees it in class," Jolley said. "What I do know is (that) at any given time you could walk into a bathroom and see it. Two years ago that wasn't the case."
The issue of teen's vaping isn't isolated to the Tigard-Tualatin School District or larger districts like Portland Public Schools. It appears to be common in West Linn-Wilsonville.
Students report seeing their peers Juul in school bathrooms, at football games, dances, in the car during lunch, on field trips, in the hallway and even in class.
"Kids don't care," Smith said, adding that Juuls and other vaping devices don't smell like cigarettes so it's easier to conceal.
Another recent graduate from West Linn High School, who spoke on the condition of anonymity, said he vaped on a field trip this past school year. While on the school bus, he even noticed other students passing their Juul back and forth, breathing the vapor into their shirts so no one noticed.
"It's funny. People like the danger of doing it when you're not supposed to," he said.
In 2017, Oregon tried to curb youth smoking by raising the minimum purchasing age for tobacco products to 21. The Oregon Health Authority calls the move "an evidence-based strategy that will help reduce youth initiation of tobacco."
WL-WV students said raising the age to 21 didn't deter them from purchasing vape products. Seniors would purchase the products for younger students before the age was raised to 21, and if students were lucky, the occasional convenience store or smoke shop would turn their backs on IDs of underage kids.
Since Oregon no longer sells tobacco to anyone younger than 21 and Washington state's law raising the smoking age from 18 to 21 doesn't go into effect until 2020, some students decided to take quick trips to Washington to buy e-cigarettes and vape products.
Smith said he knows someone who would bring back products and charge teens extra for vaping devices and refills.
Lawmakers say the prevalence of smokeless devices like e-cigarettes and vapor pens has increased teen tobacco use and students say it's easier than ever to sneak tobacco products on campus.
That's due largely to vaporized tobacco devices that have been manufactured to be so discreet, they don't resemble cigarettes and instead look like USB data storage devices, which are widely used in academic and professional settings. The devices often are marketed as a less harmful alternative to cigarettes, but the products still contain nicotine. What's more, the products deliver flavored, often sweet-tasting vapor, making them far more palatable than traditional cigarettes to minors.
Juul is best known for its device that resembles a USB drive.
Smith was never attracted to the flavors, but rather the device's sleek look. He said they are also reliable and easy to charge.
An 18-year-old female from West Linn, who also spoke on the condition of anonymity, said she likes Juuls because the look is more appealing than other brands and it can be carried anywhere.
"It's lowkey; it's hidden," she said.
The male WLHS graduate and his friend said the fruity flavors of Juul vapor and similar devices contribute to teen use. The two teens had vaped before Juul was introduced to the market from vapes that looked like "those phones from the '80s," the recent grad said.
His friend added that when the flavored pods came out, he tried cucumber and thought "Whoa, this is life-changing."
The cucumber flavor and other fruity flavors have since been banned from store shelves, though all flavors are still available online on Juul's website through age-verification technology that aims to block people under the age of 21 from purchasing products. But the verification technology is easy to bypass. After clicking a button claiming a person is 21 and older, people have full access.
"I think the flavors definitely had a big thing to do with it," he said, adding that he and his friends also like the head rush from the nicotine, but the flavors provide an extra bonus — which is why he thinks teens get hooked on the product. But both WLHS students don't think that eliminating flavors would deter teens from vaping. They think, by now, many teens are addicted and just want their "nicotine fix."
E-cigarettes, which are meant to reduce cigarette smoking, have actually contributed to a rise in underage tobacco use, according to the FDA. The Centers for Disease Control and Prevention lists e-cigarettes as the "most commonly used tobacco product among U.S. middle and high school students."
In Clackamas County, 9.8% of high school juniors reported using cigarettes in 2016, while 17.6% reported using vaping products. In 2018, the number of juniors using vaping products increased to 25%, while those who used cigarettes dropped to 6.5% — both slightly higher rates than recorded among juniors in the state of Oregon, according to the Oregon Health Authority's Student Wellness Survey.
According to Yale Medicine, youth are particularly susceptible to addiction from vaping due to their still-forming brains, which are more sensitive to the "reward system" — or mesolimbic dopamine — hit provided by the nicotine.
"I would tell parents to educate themselves about how dangerous vaping can be and talk to their kids about those dangers," said WLHS Student Resource Officer (SRO) Jeff Halverson. "The biggest issue with vaping is how addictive it is and how quickly people, young and old, get dependent on it. It's not simply a matter of telling people to 'Stop' because their bodies won't let them. Once addicted to vaping, they will need some assistance in being able to quit."
Some say companies like Juul are complicit in teen tobacco use and target young people with their ads.
A research letter published by JAMA Pediatrics in May noted that more than 80 percent of Juul's Twitter followers in April 2018 were under 21.
Some WL-WV students say they picked up Juuling because they saw celebrities posting pictures of Juuling on social media and thought it was "cool." Others said it was a social fad appearing in "cool" and "funny" videos from a popular Snapchat account. The two male graduates from WLHS said their own posts were shown on the account before it was shut down. They were at a restaurant doing homework on TI84 calculators and wrote "Di4j," representing "Do it for Juul," with the calculator and put their Juuls next to it to make it appear like they were in class.
"That's what I think boosted it to get popular," one of the male teens said. "It was literally just videos of 16-year-olds vaping."
In April, Oregon Sens. Ron Wyden and Jeff Merkley, along with Massachusetts senator and Democratic presidential hopeful Elizabeth Warren, were among nine senators who wrote to Juul Labs Inc., questioning the company's partnership with "big tobacco" and requesting data about the company's advertising purchases, which they say are targeted toward teens.
Wyden and Merkley say they suspect Juul purposefully marketed its products to teens. Other practices, like introducing new flavors with new nicotine levels, may have violated FDA regulations.
"The ever-increasing popularity of Juul is clearly evident from your sales data — with Juul sales increasing 641 percent between 2016 and 2017, from 2.2 million devices sold to 16.2 million devices sold," the senators' letter to Juul CEO Kevin Burns states. "While you and your investors may be perfectly content with hooking an entire new generation of children on your tobacco products in order to increase your profit margins, we will not rest until your dangerous products are out of the hands of our nation's children."
In 2018, in response to federal pressure to curb e-cigarette use among youth, Juul committed to de-activating its social media accounts and stop selling its sweet-flavored products to vape shops and retailers.
Still, state and federal efforts to curb teen smoking and vaping may not be working.
Halverson confirmed vaping is an issue in schools.
"I agree with the fact that they're targeting youth. No adult wants cotton candy flavored cigarettes," he said. "If you've ever tried a cigarette, that first cigarette is never like, 'Oh, it's great,' but if you inhale this cool vapor that tastes like cinnamon bears (and think) 'Hey, that's great. This is awesome. And now I need that nicotine fix.'"
He said along with the flavors, technology and easy access is what appeals to youth. He said devices can be ordered online and it's easy to hide.
"I'm older, but when we were kids the whole thing with cigarettes was you stunk like cigarettes, whereas with a vape, they just put it down in a spot they know we won't check them," Halverson said. "If you get a large group of teenage girls, they're going to have some perfumes and body sprays anyway. It's easy to hide."
If Halverson catches an underage person vaping, he said he would issue them with a Minor in Possession, but the schools handle it differently.
According to the West Linn-Wilsonville School District, administration confiscates the devices, notifies parents and depending on the situation, the district could notify the School Resource Officer.
"In order to support the health (of) all of our students, our district believes, first, in an educational approach so that we can find the best short-term and long-term outcomes for students. That being said, school discipline may be part of a response depending on the context of the situation," said Andrew Kilstrom, WL-WV School District's communication director. "While we do not track student discipline specific to e-cigarettes or tobacco use, we have seen an increase in e-cigarette-related situations in the last year or two."
Halverson agrees, and said it's been pretty steady as far as an increase over the last two years.
"I think it's just in the schools. We don't see them congregating around a bus stop doing it. They're trying to be quick and sneaky about it. They can blow the vape and be done with it. They hit the vape pen one time (and) the whole thing takes less than 30 seconds," Halverson said, adding that some students will inform SROs that students are in the bathroom vaping and when Halverson gets to the scene, he can smell it, but the student is already gone, so it's hard to prove.
Halverson hasn't received any calls from local businesses complaining about underage people purchasing vapes or tobacco products.
"If I was a betting man, I'd say 95% of these things are getting purchased over the internet," he said.
Vaping: A healthy alternative?
While some students claim to vape because it's "healthy," there are dangerous health risks that can impact the forming adolescent brain.
Jaime Zentner, program planner for the Clackamas County Public Health Division, said nicotine is one of the strongest, most addictive drugs.
"It is compared to heroin as far as the addictive nature of it," she said, adding that nicotine is considered a gateway drug to heroin, or marijuana — which can also be vaped. "It basically is priming the brain to more serious addictions."
Since one Juul pod contains about the same amount of nicotine as about 20 cigarettes — some students in West Linn-Wilsonville have gone through as many as two or three pods per week — it makes it even easier to form an addiction.
"While there is some suggestion that vaping products are less dangerous than cigarettes, this is because we do not have the clear link between use and lung disease including lung cancer that we have with tobacco products. The harms of oil vapor on the lungs is not fully known," said Sarah Present, health officer for Clackamas County Public Health. "There may be benefits for adults who are attempting to quit cigarettes to switch to vaping as a potential harm reduction technique, but even this is controversial. The main concern at this time for youth for whom vaping popularity is sky-rocketing is the clear connection to increased risk of lifelong addiction."
Not only is nicotine addictive, it's known to increase people's blood pressure and pulse rate, which could affect blood flow in the brain, added Present.
Aside from nicotine, many e-cigarette aerosols contain chemicals that are known to have harmful cancer-causing effects — though these are less harmful toxins than those in cigarettes.
"What is not known is how much of these chemicals actually get into peoples' bloodstream and/or directly cause these problems," Present said. "There is variability in e-cig products, thus we can't make an overarching statement about the effects other than there are very concerning risks of the known chemical exposure, and the science on the actual effects is still emerging."
How to tell if your child is vaping
Often it can be difficult to detect when a person is vaping, so Zentner encourages parents to look for changes in their child's behavior like increased mood swings, irritability or anxiety, as those may be indicators of withdrawal from nicotine addiction.
Also being up-to-date on what the devices look like — and knowing what to look for like unfamiliar chargers, coils, batteries or vape pods — can help parents detect if their child is vaping.
"Decision makers, parents, school people, nobody knows what these products are or what they look like," Zentner said. "Anytime we've made a presentation we bring this Juul product and they're fascinated by it."
Zentner also recommends that a trusted adult talk with kids about the risk factors of vaping. The Clackamas County Public Health Division have also compiled a list of resources for schools that help explain what vaping is, what the devices look like, the risks, how to talk to your child and more.
"We have reached out to all of the school districts in Clackamas County. What we are wanting to do is ask them their experiences, how many students have they disciplined over the past year, who have been caught with vaping products," Zentner said, adding that she's heard from about half of the school districts and have shared the materials with their administration. "Schools don't have everything. They have traditional health curriculum, which talks about traditional cigarettes and the impacts of that. Just because these vaping products are so new and emerging products come out every day, these resources are just more relevant."