Aidan Brennan never questioned what his classmates were doing when he found them huddled in a circle in their school bathroom his freshman year. They weren’t very good at hiding it.
But he did wonder if there was a way to help.
“A lot of them say, ‘I’m not addicted. I can stop vaping at any time; I just don’t have a reason,’ ” said Brennan, who is now 16. “There’s this huge negative impact, and a lot of kids becoming addicted, because of how popular they are and a misconception that they’re safe.”
Today’s teens were once on track for some of the lowest tobacco-use rates ever, but decades of progress appear to have been derailed by the recent surge in popularity of e-cigarettes, experts say.
That doesn’t mean they blame the kids, though.
Critics say youth are the intentional targets of the sleek, high-tech devices, made in ways that are easy to conceal from adults and glamorized in advertisements featuring young people blanketed across social media. The aerosol that’s inhaled comes in tasty flavors modeled after fruit, candy and desserts, with quirky names like “fairy dust,” “bubbly burst” and “unicorn vomit” that can appeal to kids.
Many kids don’t realize they’re even using tobacco, experts say.
Some teens, such as Brennan, now an Upper Arlington High School junior, are fighting back. This year, he’s the vice president of the youth-led branch of The Stand Project, a community group aiming to curb youth substance abuse and support students and families in Upper Arlington dealing with its effects.
The group speaks at middle schools annually about the dangers of vaping and hosts after-school events throughout the district to offer students a fun, safe, substance-free environment, such as a recent movie night on the high school football field after a game, he said.
“We’ve gotten a lot of good feedback,” Brennan said. “I think it’s more impactful to hear it from us, not just teachers and other adults.”
Between 2017 and 2018, use of e-cigarettes among middle school students nationwide increased 48% and among high schoolers increased by 78%, according to the 2018 National Youth Tobacco Survey from the federal Food and Drug Administration and Centers for Disease Control and Prevention.
In 2018, 1 in 5 high schoolers and 1 in 20 middle schoolers in the United States vaped.
The release of Juul devices in 2015 corresponded with a large increase in youths using electronic cigarettes, said Marielle Brinkman, a research scientist at Ohio State University’s College of Public Health. Brinkman is also affiliated with the University of Maryland Tobacco Center of Regulatory Science, and her research informs the FDA in regulating tobacco products.
Previously, e-cigarettes were bulky or resembled traditional cigarettes. Those weren’t particularly appealing to a generation raised to think of smoking as a dangerous, disgusting habit.
But the small, flash drive-looking Juul devices are different from many other e-cigarettes because they use nicotine salt and contain much higher concentrations of nicotine, which are masked by the flavors, Brinkman said.
“These devices are designed to look like the iPhone of cigarettes,” she said. “There’s a certain status symbol to it.”
Sometimes vaping among adolescents starts as something that’s simply driven by curiosity, Brinkman said.
But from there, it can become a coping mechanism, and then, a crutch.
Because their brains are still developing, teens are more likely to get hooked quickly and not realize it, especially if they don’t know they’re inhaling nicotine, said Dr. Judith Groner, a Nationwide Children’s Hospital physician and a former chair of the American Academy of Pediatrics section on tobacco control.
One vape pod can be the equivalent of a pack of cigarettes, she said.
Vaping puts teens at risk for cardiovascular and respiratory issues, headaches, seizures and other serious consequences, as exemplified by recent nationwide cases of lung disease and deaths that appear to be linked to vaping, Groner said.
Research suggests vaping can also lead teens to seek out other substances to satisfy their addictions, including cigarettes.
“What you’re inhaling isn’t just harmless water vapor, as the term misleadingly applies,” said Linda Richter, director of policy research and analysis at the Center on Addiction, based in New York. “It’s actually a mix of toxic chemicals that’s quite harmful.”
Many young people aren’t just vaping tobacco pods, but are mixing their own liquids using ingredients such as THC, the psychoactive ingredient in marijuana, and other contaminants, Richter said.
Dr. Rob Crane, a professor of family medicine at Ohio State and president and founder of Preventing Tobacco Addiction Foundation and its Tobacco 21 campaign, said he hopes to see more health professionals, parents and legislators push for stricter regulation of the products, including banning flavors and advertising targeting youth, mirroring cigarette restrictions.
A law that took effect Oct. 1 in Ohio that made it illegal to sell to people under 21, which will, in theory, make it more difficult for teens to access them. But Crane said Ohio’s law is flawed because it delegates enforcement to police, not health agencies, and punishes young buyers, not the businesses selling the products — something tobacco industry lobbyists argued for, Crane said.
Columbus Public Health, for example, enforces tobacco laws for the city and has one of the strongest systems in the country, he said.
Though Ohio’s weak law doesn’t preempt local legislation, Crane fears it will discourage municipalities from enacting stricter regulations of their own.
“It’s a step backward,” he said. “We rolled the dice with these kids’ lives.”
That’s why Brennan says preventative education is so important.
“I’ve definitely seen people around me get trapped in addiction,” he said. “Everyone knows someone who does it, so it’s really easy to get exposed. That’s why I want to make sure kids are informed and aren’t pressured into making poor decisions.”