Advocates fighting the rise of e-cigarette use among youth
FRANKLIN, Ind. (AP) - For students at Franklin Community Middle School, e-cigarettes seem to be everywhere.
Students use them after school when they're hanging out. Some even bring them to school, hiding them in their shirt sleeves to vape during class, or stopping in the bathroom to use the devices.
The hottest trend is Juul, small devices that look like flash drives, don't produce any smoke or vapor and are easy to conceal.
"Kids just started doing it to be cool, but then that leads to addiction, because there is nicotine in there," said Cora Bechert, an eighth-grader at the school.
Health officials are concerned that vaping has become a crisis among young people across the country, and Johnson County is no different. The use of e-cigarettes such as vapes, Juul and other similar items nearly doubled among high school students in the past year. Even middle school students reported an almost 50 percent increase in usage.
The drastic increase has become a primary focus of health officials, school administrators and parents. While strides have been made in reducing the number of teens smoking traditional cigarettes, vaping has emerged suddenly as a serious threat to public health.
"We don't want to risk losing another generation to tobacco-related diseases, and see them actually pick up smoking in the future," said Nick Torres, director of advocacy for the American Lung Association in Indiana.
The health unit for seventh-graders at Indian Creek Middle School has always included lessons on the dangers of alcohol, drugs and tobacco. Typically, that has focused more on traditional cigarettes and smokeless products such as chewing tobacco.
But in recent years, health classes have included information about e-cigarettes and vaping.
"We learned that it's not a safe resort for smoking cigarettes, that it's just as bad," said Jalen Sauer, an Indian Creek seventh grader. "People think that it will help them get off cigarettes, but then they get hooked on that."
Even among middle school students, e-cigarettes are something that they're more conscious of.
"I don't want to be one of those people who does this stuff," seventh-grader Landon Craig said.
In early December, U.S. Surgeon General Dr. Jerome Adams released a statement confirming what health officials had known for the past few years. Adams called e-cigarette use among youth an epidemic.
"The recent surge in e-cigarette use among youth, which has been fueled by new types of e-cigarettes that have recently entered the market, is a cause for great concern. We must take action now to protect the health of our nation's young people," Adams said in the statement.
The statistics on e-cigarette use is staggering. The devices, which deliver nicotine, flavorings and other additives to users through inhaled aerosols, entered the U.S. marketplace about 2007.
By 2014, the devices became the most used tobacco product among U.S. youth.
According to the National Youth Tobacco Survey, more than 3.6 million high school and middle school students used some form of e-cigarette last year. The survey reported 11.7 percent of high school students used e-cigarettes in 2017. That number had risen to 20.8 percent of high schoolers in 2018.
"It's definitely a noticeable problem. We're probably like most schools in the area in that we see a lot of it," said Steve Ahaus, principal at Franklin Community High School. "We want to inform the kids more around the building. I think a lot of them think it's not a big deal, and it's more of a harm to them a lot of them realize."
Indiana just finished collecting data from a statewide tobacco survey, and is in the process of sorting through those surveys, said Miranda Spitznagle, director of Indiana Tobacco Prevention and Cessation.
"We do know from the survey we did two years ago that e-cigarette use is the most common form of tobacco use among our young people," she said. "We had been seeing that trend emerge, and it's obviously something we're paying attention to."
E-cigarettes have been touted by some as a healthier alternative to regular cigarettes, as well as a way to help people quit smoking. But the Food and Drug Administration has not found any e-cigarette to be a safe and effective in helping smokers quit.
"One thing we try to say is that comparing the safety of e-cigarettes and regular cigarettes is the wrong comparison," Torres said. "The cigarette is the deadliest consumer product on the market. Saying something is less dangerous than a cigarette is a low bar."
Most of the aerosol from the devices contains nicotine, which can harm the developing brain, according to report by the U.S. Department of Health and Human Services.
The aerosol from e-cigarettes also contain chemicals such as propylene glycol and vegetable glycerin, which a study from the University of North Carolina found to be toxic to cells. The devices also produce chemicals including acetaldehyde, acrolein and formaldehyde, which have been found to cause lung and heart disease.
"We've been trying to push the FDA to take some meaningful action against the marketing practices of the manufacturers, to do a review of what is in the product," Torres said.
Health officials don't have a solid answer as to why so many young people are using e-cigarettes. But they point to the way that these products are marketed with unique flavors that might appeal to first-time tobacco users.
People can pick up vape liquid that tastes like cotton candy, bubble gum and pink lemonade.
"It's really being pushed towards youth. It's remarkable to see the marketing tactics and the strategies they're using," said Michelle McMahon, community coordinator for public health organization Empower Johnson County. "We've seen some that look just like popular candy or soda brands. You're not targeting an adult when you put things like that out there."
With the rise in youth e-cigarette use, advocates have had to scramble and work quickly to try and counteract the marketing already in place for these products.
The state health commissioner issued a letter last year to school administrators to make them aware of the problem, give them resources to educate their staff about what to look for and providing materials for outreach organizations at the local level.
In 2015, local leaders formed Empower Johnson County, a community group designed to reduce and prevent youth substance abuse through advocacy, education and enforcement. One of their primary goals was to educate people about and prevent the use of e-cigarettes.
The organization does tobacco retail audits throughout the year. Volunteers for the organization go into any store within Johnson County that sells tobacco products.
"We go in and try to find out what kinds of products are available in our community. How are they being marketed? How are they being labeled? Where is the access - is it on the counter, where it's easy for anyone to take?" McMahon said. "We want to know what's in our community and what it looks like."
According to surveys conducted by the Truth Initiative, a nonprofit public health organization, 74 percent of teens who used Juul products got them from a physical retail store, as opposed to online or through a friend.
The Indiana Alcohol & Tobacco Commission excise police make routine checks of tobacco retailers throughout the year, taking teens in undercover to see if they can purchase products. They recorded 14 violations of selling to minors in Johnson County in 2018.
The organization has worked with schools and parents to spread information about the dangers of e-cigarettes.
Youth councils, such as those at Franklin Community Middle School and Center Grove Middle School Central, were formed to be student-led advocates addressing issues such as drug and alcohol use, tobacco use and suicide.
"We're all in the same age group, and other students can realize that kids that they're in classes with go through stuff to. We can relate to them," said eighth-grader Maddie Cottrill.
Vaping has become an increasingly important topic for the council for Franklin students. During Red Ribbon Week, an annual drug awareness campaign, students made e-cigarettes a priority, getting classmates to sign pledges not to vape and passing out information.
"It's a little thing, but it's blown up a lot in the community. We want to address it and show the danger of it and how harmful it can be," said eighth-grader Emma Ulerick.
Similar awareness campaigns through the other schools, with illustrations and pictures letting parents know what to look for have also been effective, McMahon said.
"We're really to educate parents because they don't know what a Juul is or what these things look like," she said.
Health officials say that the foundation of their efforts will all start at home, which is why educating parents is so important.
"Just have the conversation," McMahon said. "Find information to educate yourself about the dangers of them. Research shows that with kids who don't use tobacco or nicotine-related product or even alcohol, in more than 80 percent of the cases, it's because their parents had a conversation with them about it. The parents are the first line of defense."
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AT A GLANCE:
In January 2018, the National Academies of Science, Engineering and Medicine released a consensus study report that reviewed more than 800 different studies.
That report made clear: using e-cigarettes causes health risks. It concluded that e-cigarettes both contain and emit a number of potentially toxic substances. The report also states there is moderate evidence that youth who use e-cigarettes are at increased risk for cough and wheezing and an increase in asthma exacerbations.
A study from the University of North Carolina found that the two primary ingredients found in e-cigarettes - propylene glycol and vegetable glycerin - are toxic to cells and that the more ingredients in an e-liquid, the greater the toxicity.
E-cigarettes produce a number of dangerous chemicals including acetaldehyde, acrolein and formaldehyde. These aldehydes can cause lung disease, as well as cardiovascular disease.
E-cigarettes also contain acrolein, a herbicide primarily used to kill weeds. It can cause acute lung injury and chronic obstructive pulmonary disease and may cause asthma and lung cancer.
Both the U.S. Surgeon General and the National Academies of Science, Engineering and Medicine have warned about the risks of inhaling secondhand e-cigarette emissions, which are created when an e-cigarette user exhales the chemical cocktail created by e-cigarettes.
In 2016, the Surgeon General concluded that secondhand emissions contain, "nicotine; ultrafine particles; flavorings such as diacetyl, a chemical linked to serious lung disease; volatile organic compounds such as benzene, which is found in car exhaust; and heavy metals, such as nickel, tin, and lead."
The Food and Drug Administration has not found any e-cigarette to be safe and effective in helping smokers quit.
- Information from the American Lung Association
IF YOU GO:
"What's in that Vape?"
What: A series of community conversations in which representatives from Empower Johnson County, Tobacco Free Johnson County and Upstream Prevention will give updates on e-cigarette use. A panel of local school administrators, students, police, fire or health care professionals will give their perspectives of vaping.
When:
7 p.m. Jan. 29, John R. Drybread Community Center, 100 E. Main Cross St., Edinburgh
7 p.m. Feb. 26, Beeson Hall, 396 Branigin Blvd., Franklin
6 p.m. March 12, Trafalgar Library, 424 S. Tower Dr., Trafalgar
Information: Facebook.com/Empowerjohnsoncounty
Source: Daily Journal
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Information from: Daily Journal, http://www.dailyjournal.net