Why teen vaping is an epidemic that needs urgent attention, experts warn

E-cigarette use among teenagers is a growing epidemic that's quickly outpacing other substances, such as alcohol, marijuana, prescription drugs and opioids, health experts warn.

The rapid increase in teen vaping has caught many suburban school officials, law enforcement and health care workers by surprise. And everyone is moving quickly to stem its proliferation.

"It truly exploded," said Margaret Polovchak, manager of prevention services for OMNI Youth Services, addressing e-cigarette use among high school students at Northwest Suburban High School District 214 and at seven middle schools within Wheeling Township.

"We saw the beginning of it, certainly, a couple of years back. But when we got the latest data that showed the huge growth, even the schools said we have to take action on this right now. It is a top priority."

Last week, Lake County State's Attorney Mike Nerheim jump started the drive when he announced a lawsuit against Juul Labs, the leading manufacturer of vaping products.

But suburban schools are girding for the battle as well. Some are bringing in experts to talk to students, parents and teachers about the dangers of vaping. A few have installed monitors in bathrooms and locker rooms where students commonly vape.

"A lot of school districts have chosen to respond in a punitive way. We've taken the educational response," said Tony Venetico, principal of Huntley Community Unit District 158's Marlowe Middle School in Lake in the Hills.

District officials hosted a special Parent University session on vaping last school year, including 12 presentations by local experts for more than 1,300 students. The message about the practice's dangers will be reinforced this school year in health education classes.

"We're trying to be proactive," Venetico said. "Because of the education, we are seeing a larger increase of other students reporting people who are using or who have a device, out of concern."

Detecting vaping devices in schools presents a challenge as e-cigarette vapors don't linger and some devices resemble pens or USB flash drives that are concealed easily.

"With all the additives they are putting in - you can have cotton candy or bubble gum (flavor) - it makes it very difficult to detect. Are they chewing gum or are they vaping?" said Lake in the Hills Police Sgt. Adam Carson, a certified drug recognition expert. "Right now, it's education for the staff and the teachers."

Rising health concerns

Health officials are sounding the alarm in the wake of dozens of cases of teens and young adults nationwide being hospitalized with severe respiratory problems after vaping either nicotine or marijuana. State and federal health authorities are investigating 94 suspected cases of severe lung illnesses linked to vaping and e-cigarette since late June. Vaping symptoms include cough, shortness of breath, fatigue, fever, vomiting and diarrhea.

The Centers for Disease Control and Prevention is working with health departments in California, Indiana, Illinois, Minnesota and Wisconsin on clusters of pulmonary illnesses linked to vaping, primarily among adolescents and young adults, though CDC officials caution that "more information is needed to determine what is causing the illnesses."

The CDC and U.S. Food and Drug Administration have launched independent studies about vaping's effects. While those efforts are proceeding, local officials urge individuals and families to recognize the potential for harm.

"While the short- and long-term effects of vaping are still being researched, these recent hospitalizations heighten the need for parents to talk with their teens about vaping and for both to understand the consequences and potential dangers of vaping," Illinois Department of Public Health Director Ngozi Ezike said.

The American Association of Poison Control Centers reports that, as of July 31, poison control centers had managed 2,439 exposure cases related to e-cigarette devices and liquid nicotine in 2019.

Safer than cigarettes?

Alluring marketing, appealing flavors, a coolness factor and easy online access are among the reasons why vaping has exploded among youths, experts say. They warn that teens have been lulled into a false sense of security because vaping often is marketed on their social platforms as being safer than cigarettes.

"I just feel like kids my age, they don't understand the health risks associated with it," said Allison O'Connor, 16, a junior at Benet Academy in Lisle who serves on the Du­Page County Health Department's Reality Illinois teen advisory panel. "People my age were told that they are not as bad for you as cigarettes."

The panel has been advocating for smoke-free parks, under-21 tobacco laws and preventing underage alcohol and marijuana use. Vaping now is a focus because of how widespread it has become.

Nationwide, the number of middle and high school students using e-cigarettes rose from 2.1 million in 2017 to 3.6 million in 2018. Also, 10.7 million youths between 12 and 17 years old reportedly either have used e-cigarettes or are open to trying them, yet nearly 80% of middle and high school students don't understand that regular use could pose a great risk, the FDA says.

"Kids have a perception that (vaping products) don't have nicotine, but a majority of them do," Polovchak said. "The part that is frustrating to me is this is just Big Tobacco once again duping our kids. It's another generation of kids that we're going to have to combat the barrage of messages they receive."

In Illinois, vaping has outpaced cigarette smoking among high schoolers - 42% reported having used an electronic vapor product compared to 28% who tried cigarette smoking, according to the latest Illinois Youth Survey.

"What parents may not know is, in 2018, one in five high school students reported using e-cigarettes in the past month, according to the surgeon general," said Melaney Arnold, Illinois Department of Public Health spokeswoman. "E-cigarettes put youth at risk for addiction and possibly worse asthma outcomes, yet almost 40% of 10th- and 12th-grade students believe there is low or no risk of negative health effects."

Creating awareness

The biggest concerns with vaping are nicotine addiction - a vape pod could contain zero nicotine or up to the equivalent of five packs of cigarettes - and not knowing how other vaping substances affect the body over time.

"Anything that creates addiction pathways in the brain is probably preprogramming certain people for adult addiction," said Judy Pasternack, a nurse and professional development specialist for behavioral health and substance use for Northwestern Medicine.

It takes four to six weeks to develop an addictive brain pathway with vaping compared to six months to a year with cigarettes, experts say.

Vaping "e-liquids" may contain unknown chemicals, varying compositions of flavorings, propylene glycol, vegetable glycerin and other ingredients that are aerosolized when heated. Inhaling droplets with harmful chemicals could cause long-term damage to peoples' lungs, Arnold said.

Teens also are vaping any substance they can get their hands on, including illegal drugs or adulterated liquids laced with THC, the ingredient that produces marijuana's high, cannabis or cannabidiol oil. As a result, they could suffer seizures, hallucinations or have dilated pupils affecting their ability to walk, ride a bicycle or drive - endangering themselves and others.

Health officials are targeting teens with anti-vaping messaging on social media platforms to counter e-cigarette advertisements, as well as in school health classes.

"(Schools) have never experienced this kind of immediacy of something coming into their system and disrupting it," said Laura Crain, drug free program coordinator for the McHenry County Substance Abuse Coalition. "We are working with our health departments to integrate vaping more (into) tobacco cessation programs. A lot of our schools have asked for those resources now."

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Teen smoking/vaping by the numbers

Bottles of various flavors of vapor solution, known as "juice," for use in e-cigarettes. Health officials warn of dramatic increases in teen vaping in Illinois and dozens of cases of hospitalizations nationwide related to vaping. Associated Press File Photo, 2015
Twice as many high school students used nicotine-tinged electronic cigarettes in 2018 compared with the previous year, an unprecedented jump in a large annual survey of teen smoking, drinking and drug use. It's causing school and health officials to step up efforts to educate students and parents about the dangers of vaping. Associated Press File Photo, 2018

Vaping facts

E-cigarettes and vaping devices are unsafe for kids, teens and young adults. They typically contain nicotine, which is highly addictive and can harm adolescent brain development. Here's what you need to know:

• Purchasing, smoking or vaping any tobacco/vaping products is illegal for anyone under 21 years old, per Illinois law.

• Besides nicotine, vaping devices or e-cigarettes can contain harmful ingredients, including ultrafine particles that can be inhaled deep into the lungs; flavorants such as diacetyl, a chemical linked to serious lung disease; volatile organic compounds; and heavy metals, such as nickel, tin and lead.

• Among Illinois high school youth, past 30-day e-cigarette use is rising significantly, while cigarette smoking is declining.

• In 2017, Illinois high school student data show: almost 28% reported having tried cigarette smoking; 8% reported currently smoking cigarettes (at least once during the last 30 days); 42% reported having used an electronic vapor product (including e-cigarettes, e-cigars, e-pipes, vape pipes, vaping pens, e-hookahs and hookah pens); 13% reported currently using an electronic vapor product.

• Since 2008, cigarette smoking among high school seniors has decreased from 21% to 5% in 2018.

• Between 2016 and 2018, e-cigarette use in Illinois increased from 18.4% to 26.7% among high school seniors - a 45% increase. The increase was 15% among eighth-graders and 65% among 10th-graders.

Sources: Illinois Department of Public Health, Illinois Youth Survey, Youth Risk Behavior Survey

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