Despite federal efforts to decrease tobacco and e-cigarette use among teens, the issue remains prevalent in schools across the state.
According to a May 2019 Crow Wing Energized survey of 596 Brainerd High School and Brainerd Learning Center students, 37% of students surveyed admitted to trying cigarettes or e-cigarettes, while 8% said they had smoked cigarettes in the past 30 days before the survey, and 20% — or 1 in 5 students — said they smoked e-cigarettes in the same timeframe.
The most popular places for students to use cigarettes/e-cigarettes, the survey found, are home, parks, vehicles and school bathrooms.
Crow Wing Energized, a Crow Wing County and Essentia Health partnership aimed at improving health and wellness in the community, is working to combat the issue of vaping and tobacco use among middle and high school students after realizing the issue is on the rise.
The 2019 Minnesota Department of Health Student Survey showed a jump in students who use vaping products between 2016 and 2019. The percentage of eighth graders who reported to have vaped in the past 30 days jumped from 5.7% in 2016 to 11.1% in 2019 — a 95% increase. For ninth graders, the increase was from 9.3% to 16.3%, and juniors in high school who vaped jumped from 17.1% up to 26.4%, or more than a quarter of 11th graders.
Karen Johnson, Crow Wing Energized program director, and Jessica Williams, community health educator, discussed vaping during a Brainerd High School staff meeting Wednesday, Jan. 22, hoping to help staff members become more aware of what the vaping devices look like and why they’re so dangerous.
Originally marketed as harmless tools to help adults quit smoking, e-cigarettes — also known as e-cigs, e-hookahs, mods, vape pens, vapes, tank systems and electronic nicotine delivery systems — are battery-powered devices that deliver an aerosol by heating liquid that usually contains nicotine, flavorings and other chemicals, like THC (an intoxicating chemical found in marijuana). They can contain lead, volatile organic compounds and cancer-causing agents, according to the Centers for Disease Control and Prevention.
Users inhale the aerosol into their lungs.
Vaping liquids are available in many different flavors — like sweet or fruity flavors — to further appeal to teens and young people. More than 15,000 e-cigarette flavors are on the market in the U.S., Williams said. Federal legislation passed earlier this month banned certain flavors of cartridge-based nicotine devices — like Juul pods — in an effort to discourage kids from using them. The ban includes mint-, fruit- and dessert-flavored cartridges but does not apply to menthol or tobacco flavors. It also excludes open vaping systems, like vape pens, which require users to manually fill e-cigarettes with liquid.
Johnson said the ban helps but still doesn’t get rid of the problem.
E-cigarettes and vaping devices can be made to look like regular cigarettes or cigars, or they can look like USB drives, pens, candy tins and other everyday items, making them easy for students to conceal. Users can even buy clothing, like hooded sweatshirts with strings to vape through, to make e-cigarette use even easier to hide.
“It really was marketed as harmless, and I don’t think parents were aware,” Johnson said after Wednesday’s meeting. “I don’t think anybody was aware of what’s happening.”
Different vaping devices can carry varying concentrations of nicotine. The popular brand Juul, for example, sells its products in pods, which Williams said each contains as much nicotine as a pack of cigarettes. One pod, she said, typically lasts about 200 puffs.
The Food and Drug Administration has not approved e-cigarettes as aids to quit smoking and regulates them the same as tobacco products.That means adults must be 21 to buy the products, after President Donald Trump signed legislation in December raising the federal minimum age to buy tobacco from 18 to 21. Surveys, however, show many students are getting the products from peers and not buying them for themselves anyway.
Many big tobacco brands have started buying into e-cigarette brands as well. Altria, which owns Marlboro cigarettes, is one of the owners of Juul. Blu, a United Kingdom-based e-cigarette company, is owned by Imperial Brands, which also owns several varieties of cigarettes.
“What that means on a larger scale is that … a lot of companies that have e-cigarettes also have access to tobacco lobbyists,” Williams said.
BHS teacher Jessica Wales has been working with Crow Wing Energized and Students Against Dangerous Decisions to further help spread awareness on the dangers of vaping throughout the school. For Wednesday’s meeting, she brought dozens of vaping devices confiscated from students by School Resource Officer Troy Schreifels so staff members could see what exactly they should be looking for.
“So if you see it around, you know what you’re looking at,” Wales said of the devices after the meeting. “And I think everybody knows that it’s dangerous and not good for you, but I don’t know if they know how much it’s going on.”
BHS students caught with vaping paraphernalia are issued a citation. First-time offenders, however, can choose to go through a program called In Depth with district nurse Aimee Jambor instead of getting the citation. Jambor discusses the harmful health effects of vaping with those students. She also learns from those students about vaping habits in the school, like the prime time for vaping during the day is between classes and often takes place in the bathrooms.
Wales said she wants to continue with more educational efforts so both students and staff members understand the dangers of vaping. She said she thought about writing a Crow Wing Energized grant for vape sensors in the school that would pick up the vapors, but decided she wanted to focus on education instead of punishment.
Tobacco, e-cigarette enforcement
Tuesday, Jan. 22, Johnson and Williams, along with Essentia Health physician Dr. Jennifer Mahling-Stadum, addressed Brainerd City Council members to ask for their help to combat tobacco and e-cigarette use in the community.
Though the minimum age to buy tobacco is now 21, the law is a federal one and can only be enforced by the FDA, meaning local law enforcement agents have no way of enforcing it in local establishments. The law also covers e-cigarettes.
To combat that issue, the trio at Tuesday’s meeting asked the council to consider amending its city ordinances to reflect the federal law.
Mahling-Stadum said she hopes the state will do its part to make local enforcement easier in the future, but until then, it is essentially up to city governments.
“I would love it if we could actually enforce our federal law, but since we can’t, I feel like we can do something locally to protect our children now because I would prefer not to see anymore of it,” she said.
As a doctor, Mahling-Stadum said she has seen the negative effects of vaping on middle and high school students. She noted the human brain is not fully developed until about ages 25-26, meaning students aren’t necessarily capable of making an informed decision when it comes to vaping, which can create a nicotine addiction.
“It creates addiction pathways in the brain. And once you’ve made addiction pathways in the brain those are there and they’re permanent,” she said. “Their brain is plastic until the age of 25 or 26, like I said. So you’ve created a child with an addiction.”
That nicotine addiction — even if overcome — can lead to other substance addictions later in life, Mahling-Stadum said.
“Let’s protect our children,” she told council members.
The council unanimously voted — with council member Kevin Stunek absent — to direct city staff to review ordinances and work to update them to be in line with federal law.
Tobacco use in adults
Every three years, Essentia Health completes a community needs assessment to look at health trends in the community. Johnson provided the city council with the most recent survey findings, which show an increase between 2014 and 2017 of adults in Crow Wing County smoking and a decrease in adults trying to quit.
The survey showed the amount of adults who use tobacco jumped from 17.6% in 2014 to 23.3% in 2017. Cigarette smokers who stopped smoking for one or more days in the past year declined from 70.8% in 2014 to 44.1% in 2017.
For the full 2017 survey results, visit http://crowwingenergized.org/community-healthy-survey/.