Vaping is on the rise nationwide and especially so with youth. Local officials are working hard not only to inform and educate students, but the community at large.
Chris Kempker, the tobacco prevention and youth development coordinator at the Iowa State Extension Office in Henry County brings eight years of expertise to a game that started about 12 years ago with e-cigarettes. She said they were initially introduced to the world as a way to quit smoking.
“Although they are not an FDA (Food and Drug Administration) approved device, that’s how they were marketed: as a new way of smoking and also to help you quit smoking. The first companies were not really marketing to youth so much but as to adult smokers who were looking for an alternative or a way to quit,” she said.
Danielle Pettit-Majewski, director of Washington County Public Health, said there are many FDA approved devices for anyone with an addiction to use such as gums, patches and medications. However, e-cigarette and vaping devices will soon have to be FDA approved to be sold.
According to a news release from the Truth Initiative, a nonprofit public health organization, manufacturers for e-cigarettes must submit their products to the FDA by May 12, 2020 in order to keep them on the market. If the companies fail to do so, the products will be removed.
Pettit-Majewski said this is a big win for public health because it will help reduce the number of products on the market. In the mean time, the epidemic still is in full force.
Kempker said studies have shown adults who use the devices are traditionally duel users, meaning they use both traditional cigarettes and e-cigarette devices. She said this has transitioned into tobacco companies catching onto the popularity and now other products like juuls are available. A juul is a small device people can use to vape. It is much smaller than an e-cigarette, making it easier to conceal.
According to the National Institute on Drug Abuse, an e-cigarette is a battery-operated system that people use to inhale flavored aerosol, which usually contains nicotine, and other chemicals. A cartridge holds the liquid and is heated through an atomizer by a battery within the device. The user then inhales the vapor, resulting in vaping.
Kempker said between 2017 and 2018 there was a 78 percent increase in vaping nationwide. She said many people attribute this jump to the juul because of its wide variety of appealing flavors and unique marketing tactics for youth.
“They have been using social media influencers like YouTubers to promote the product and make it look interesting with all the smoke rings they blow,” she said.
Sarah Smith, a substance abuse prevention specialist at Prelude Behavioral Services in Washington reiterated this, saying the events and celebrities used to promote the products are what get kids interested in starting to vape. Kempker said this leads to part two of the issue, how easily concealable they are.
Because they are so small, they are simple for kids to hide and virtually unrecognizable to a parent. She said they come in many shapes, sizes and colors with some resembling a pen and some juuls as small as USB flash drives. The other problem is the amount of nicotine in the product.
While e-cigarettes take cartridges, juuls take pods. She said one pod has the same amount of nicotine as one pack of cigarettes. Pettit-Majewski said this is especially dangerous in youth because their brains are not fully developed yet and are more prone to addiction.
“The unfortunate thing is when you have adolescents, your prefrontal cortex, what allows you to make good decisions, is not fully formed until you’re 25,” she said, explaining the brain strengthens specific pathways that are used frequently and the ones not used disappear. “If you are constantly strengthening the pathway for addiction, that’s how your brain is going to be wired.”
According to the Iowa Youth Survey published by The Iowa Department of Public Health in 2019, the percentage of 11th-graders who in 2016 reported smoking cigarettes in the last 30 days in Washington County was up from the state average by 1.1 percent and youth who used an e-cigarette or similar product in the last 30 days was 1.5 percent lower than the state average. In Jefferson County, the number of youth who reported having smoked a cigarette in the last 30 days was just below the state average but the number of students who reported having used an e-cigarette in the last 30 days was 18.4 percent, more than double the state average of 9.1 percent. In Henry County, 5 percent of youth reported smoking a cigarette when the state average is 7.1 percent and only 5.6 percent reported using an e-cigarette.
While the survey only polled 11th-graders, Kempker said there have been big problems with vaping products at the middle school level. She said although students must be 18 years of age to legally purchase them, they are finding alternative ways.
“Just like anything else they can’t have, they get someone else to buy it for them,” Smith agreed.
Smith said the most common way students are getting a hold of the devices is by purchasing from other teenagers. She said in most cases, the retailers have not been the culprit and regularly check IDs as required by law. Kempker said youth have found a way around that by ordering them online. She said all they have to do is click a box that says they are over 18 and they have full access.
However, Smith said requesting ID for the purchase of an e-cigarette, vaping product or any accessory to go with them is a relatively new law. According to We Card, a nonprofit that works with retailers who sell products that required ID, the FDA released regulations on Aug. 8, 2016, requiring all retails to ask for the ID of any customer under the age of 27.
Restricting not only the purchase of the devices but where they can be used is a rising issue. Pettit-Majewski said her department is actively trying to find a solution for cleaner air.
In January 2019, she approached the Washington County Board of Supervisors about the prospect of banning vape and e-cigarette usage in all county parks. Smoking cigarettes is already banned under the Iowa Smokefree Air Act (ISAA) that was created in 2008. However, because vaping products were not invented yet, they were not included.
She said the goal with bringing the issue to the county level was to try and raise awareness and spur the state to include the devices in the ISAA. The motion failed, but Pettit-Majewski took it to the city level instead.
The Washington City Council passed a resolution that does not allow for e-cigarette or vaping usage in any of the city parks within 30-feet of where children are playing. She said she has spoken to members of the Kalona City Council about the issue but nothing has been passed yet. No other communities in Washington County have reached out or considered the option, she said. Pettit-Majewski said the goal with the 30-foot ban is that it will encourage the community to police each other by holding each other accountable.
“We want to make sure kids are being kept away from the potential emissions. We don’t know what is all in them. They’re still doing research on that and ultimately it’s hard to know what the long term effects are on a product this new, but we have already seen some of the short term consequences,” she said. Pettit-Majewski said as of Nov. 5, there were 44 total cases of lung injuries in Iowa directly related to vaping.
At the school level, Kempker visits each of the districts in Henry County to give presentations. She said students have been taught for years that smoking is bad and for the most part have caught on. Teaching students that vaping is bad is more challenging, she said.
Because the products are so new, there are few studies done that prove what specific chemicals are in the devices but Pettit-Majewski said the Center for Disease Control (CDC) has recently announced vitamin E acetate is one chemical causing lung injuries.
“It’s an additive in the production of vaping products. Vitamin is in cereals, medication, milk, it’s in a lot of things. It’s fine if you’re taking it as a vitamin or putting it on your skin, but if you are inhaling it that can interfere with normal lung functioning,” she said.
Smith said getting this message of about the dangers of e-cigarettes and vaping across to students is vital. She said for most, it can start at home.
“The most important thing parents can do is have a loving, strong, bond with their child that will protect against many risky behaviors. That happens very young, that doesn’t just happen in eighth grade,” she said. “That happens young and talking with children about healthy behaviors from a very young age as well.”
She said the more casual the conversation can be, the better. Smith suggests using signs or advertisements seen at the store to start the conversation with the child. She said this way it feels like a more natural setting for the student to open up instead of feeling cornered.
“Having that attitude of patience and understand with your child is so important,” she said.
For anyone seeking help quitting an addiction, Kempker recommends mylifemyquit.com where users can find resources to communicate with a counselor. Smith said this is an especially great resource for students because there is an option to chat online with a counselor instead of having to talk on the phone.