A handful of studies suggest that adolescent e-cigarette use dropped substantially during the pandemic.
That’s good news for educators who were struggling to fight back a rise in vaping among middle and high schoolers. But how can K-12 educators maintain that momentum and head off another upswing?
Prior to 2020, the number of teens vaping had been on an alarming rise—doubling between 2017 and 2019, according to a survey by Monitoring the Future, which is funded by the federal government and administered by the University of Michigan. In that survey, 16 percent of 8th graders, 30 percent of 10th graders, and 35 percent of 12th graders reported vaping 2019.
Another annual survey of teens, the federal National Youth Tobacco Survey, also found in 2019 that more than a quarter of teens vaped in the 30 days prior to taking the survey.
Even for teens who didn’t use e-cigarettes, vaping was still a part of their daily lives as they watched peers do it or were inundated with images of vaping on social media, a 2019 survey from Common Sense Media found.
This year, however, 11 percent of high school students and 2.8 percent of middle school students reported currently using e-cigarettes in the National Youth Tobacco Survey. That marks a significant drop from peak use in 2019 and from 2020 when the survey found that nearly 20 percent of high schoolers and 5 percent of middle schoolers were vaping. The survey was conducted fully online this year for the first time in order to include students learning from home. Because of that change, the Centers for Disease Control and Prevention cautioned that this year’s results shouldn’t be used as a one-to-one comparison with previous years.
That said, some outside experts still see promise in these findings. Dr. Nance Rigotti of Harvard University, who was not involved in the CDC’s research, told the Associated Press: “They found a dramatic drop from last year, and it’s hard to imagine that doesn’t represent a real decrease in use among high school and middle school students.”
While the 2021 data show an encouraging decline, said Ashley Merianos, an associate professor at the University of Cincinnati who specializes in adolescent substance use prevention, education, and counseling, there are still reasons for concern.
“The frequency of e-cigarette use patterns are less encouraging,” she said.
Among high schoolers who said they currently use e-cigarettes, 43 percent said they vaped as many as 20 out of the past 30 days and 1 in 4 reported vaping daily, which Merianos said are similar to 2020 trends.
“Therefore, e-cigarette cessation efforts are critically needed to decrease high frequency use patterns among youth e-cigarette users,” she said.
Other studies have also found declines in e-cigarette use among adolescents. A national survey of 13- to 24-year-olds found that over half of them changed their vaping habits in 2020—35 percent reduced their nicotine use and 32 percent reported quitting altogether. E-cigarette use among adolescents in Northern California participating in a study by researchers from the University of California, San Francisco and Stanford University also dropped significantly in the latter part of 2019 and in early 2020.
So, why the decline?
Stay at home orders and remote learning may have made it harder for students to obtain e-cigarettes and vape undetected. Another possibility is that messaging around the potential dangers of vaping are getting through to adolescents. The 2020 Monitoring the Future survey of 8th, 10th, and 12th graders found that adolescents’ views of the dangers of vaping had increased significantly in 2020, as did their disapproval of vaping nicotine. That same year the survey saw a leveling off of e-cigarette use.
These are all good signs, but still more than 2 million middle and high school students reported vaping in 2021, according to the National Youth Tobacco Survey. That behavior can have serious consequences for their health. There are toxic chemicals and metals in many e-cigarettes, and nicotine is far more concentrated in e-cigarettes than in traditional ones, which health experts worry will have long-term negative effects of on students’ developing brains. Researchers from Stanford have found that teens who used e-cigarettes were at greater risk of getting sick from the coronavirus, likely because vaping damaged their lungs. Other research has found that e-cigarette use can lead to smoking traditional cigarettes.
What can schools do to prevent students from vaping?
“One crucial way schools can keep up the momentum of these declining trends is to continue to educate youth, their parents and families, and school personnel on the harmful health effects these products can have on youth development,” said Merianos.
Here are tips that experts and school leaders have shared with Education Week on how to educate school communities on the harms of e-cigarettes, prevent students from vaping, and intervene for students who already do.
Don’t rely on scare tactics or discipline. Over-the-top scare tactics and strict disciplinary measures without an education component don’t work. Instead of being scared straight, students are more likely to stop taking educators seriously. Some districts have found that even suspending students over vaping on campus didn’t seem to effect students’ behavior—and there is the risk that students may vape even more when they are out of school and unsupervised.
Take an educational approach. Education programs for students shouldn’t just focus on the dangers of vaping, but also on how students can spot slick marketing campaigns aimed at them. Some schools even recruit students to help convey these messages. School nurses are good resources for tailoring grade-level appropriate messages and materials for elementary, middle, and high school students.
Educate the adults, too. Educational efforts should also focus on parents and caregivers, as well as school-based personnel such as teachers, counselors, and nurses. For parents, informational letters explaining the prevalence of vaping are a good start, as parents may not be aware of the full scope of the issue. Educators should also encourage families to talk with children about the issue regularly, instead of just a one-off lecture. Teachers, school nurses, and school counselors can all benefit from professional development that addresses current vaping trends, the health effects of vaping, and guidelines for referring students for treatment.
Have clear policies and plans. Schools must have clear policies about e-cigarette use on campus and the consequences for violating those policies. Policies should be shared with students and families. Schools should also outline a plan for screening and addressing students who are already addicted to e-cigarettes. This may mean developing their own programs or referring students to external programs or treatment centers.
Create a community-wide approach. In Colorado, at the peak of national teen e-cigarette use, the Boulder Valley School District developed a coordinated response to its student vaping problem. It included education programs for students; informational parent nights with local medical experts and law enforcement; encouraging family doctors to ask screening questions during regular check-up appointments; and backing a series of citywide policies aimed at cutting back on e-cigarette use.
“There are freely available resources that schools can use,” said Merianos, such as free prevention materials—like posters and messages to share on social media—from the U.S. Food and Drug Administration. She also recommends lessons and activities for grades 6 through 12 developed by the FDA and Scholastic.
Schools and communities have become increasingly creative in how they approach this problem, including installing devices in bathrooms that detect vaping and, in the case of the city of Salem, Mass., even instituting an e-cigarette buy-back program. Through a program launched in early 2020, students who turned in their e-cigarettes to the Teen Center based at Salem High School and participated in a four-part smoking cessation program got a $50 gift card.
Finally, several school districts, from Boulder, Colo., to Los Angeles, to Peoria, Ill., have opted to raise the legal stakes over the vaping crisis by filing lawsuits against the companies that make, and the stores that carry, e-cigarettes.
Denisa R. Superville, Assistant Editor contributed to this article.