Teen vaping on the rise in Nome
At the beginning of this past school year, the administration of Nome-Beltz Middle/High School installed sensors in a set of its bathrooms to detect vaping among students. Principal Teriscovkya Smith said she quickly found herself playing a game of cat and mouse. The sensors were regularly going off between five and 20 times a day, she said.
“We ignore most of the alerts because we just don’t have the time to address every single one,” Smith told the Nugget. “And that’s only the vaping that’s going on in those bathrooms. We know that vaping is going on in our other bathrooms around our campus as well.”
Nome isn’t alone in dealing with a rise in vaping among teens. While cigarette use has declined among youth across the country, the use of vapes has been sharply increasing, a trend that public health experts say is concerning.
Risks of vaping
Smith said she often encounters a perception among her students—and even parents—that vaping isn’t so dangerous.
“They’ll tell me, ‘Well, I tried a cigarette and that tastes disgusting, and I can see how it’s bad for you. My vape tastes good. I don’t feel any symptoms,’” she said.
While vapes might not contain as many toxins as cigarettes, they don’t come without risks. Most of them contain some level of nicotine. How much depends on the product. And Christy Knight, the program manager for the Alaska Department of Health Tobacco Prevention and Control Program, said parents should be aware of the risks that nicotine poses for developing brains.
“We know that nicotine is an addictive substance,” said Knight. “And when used by somebody under the age of 21, it’s particularly concerning for a few different reasons. Primarily, their brain is developing at that age, and nicotine can impair their learning, memory, attention and mood. It can also create pathways which make them more prone to addiction to other substances.”
Nine out of 10 current smokers tried smoking before 18 and progressed from occasional to daily smoking in their young adulthood, Knight said.
“That’s exactly what the industry wants—they want children to become addicted as soon as possible so that way, they can be lifelong buyers,” said Kathy Holly of the Chronic Care Active Management and Prevention, or CAMP, Department at Norton Sound Health Corporation.
Vapes additionally contain cancer-causing chemicals and toxic metals like nickel, tin and lead, Knight said. Since these products are so new, health experts still don’t know the full extent of their effects.
“With cigarettes, we have over 50 years of research of long-term health effects,” Knight said. “E-cigarettes entered the U.S. market around 2007. We don’t have nearly that amount of research on e-cigarettes yet. What we do know is concerning enough when it comes to addiction and the impact on the developing brain. There’s a lot that we don’t know. But we do know these products contain chemicals that are known to cause cancer. Unfortunately, it’s going to take time to see the long-term effects of those chemicals with these particular products.”
Just as research on vaping is still in its infancy, so is the messaging around the dangers of vaping. Smith was a high schooler in the 1980s, and she remembers being surrounded by anti-smoking messaging in posters and commercials.
“If you were going to smoke a cigarette, you knew it could cause cancer, and you chose to do it even though you knew that the research said every inhalation was bad for you and it was and it was a risk,” Smith said. She said she gets the sense there isn’t a similar attitude yet around vaping.
Knight said that public health officials have made advances over the last few decades in countering misleading information about tobacco products and implementing policies that helped change cultural norms. For example, tobacco-free school policies and smoke-free policies at state fairs and other family events all helped create a new norm that kids should be in smoke-free environments, Knight said. Price increases for tobacco products over the years in Alaska also had an impact on smoking rates.
In 1995, 37 percent of Alaska high schoolers smoked cigarettes. That number dropped to 16 percent in 2009 and eight percent in 2019.
“There’s been tremendous progress, especially with the youth population in addressing tobacco use, and that’s what makes us so concerned about electronic cigarettes,” Knight said.
In 2015, 18 percent of Alaska high schoolers used vapes. That number jumped to 26 percent in 2019, the most recent year that Alaska Department of Health has data for. This data is collected as part of the Alaska Youth Risk Behavior Survey. Knight said that 2023 is a data collection year, and a more current estimate for vaping prevalence should be available in the spring of 2024.
There is a lot of evidence to show what messaging works to turn teens away from cigarettes, Knight said. The most effective strategies often involve showing teens how marketing is tailored to attract them to these products.
“We find that youth are actually very vulnerable to tobacco industry ads and marketing in general,” Knight said. When it comes to e-cigarettes, many are in brightly colored packaging or have sweet flavors added to make them more appealing to youth. That innocent packaging can fool parents, too. Smith described showing one parent who admitted thinking that their kid’s vaping device was a set of AirPods.
Holly, with NSHC’s CAMP Department, has been giving presentations about vaping in schools and setting up informational tables at community events like basketball games. She said her goal in talking to kids about vaping is not to make them feel guilty about doing it. “We just want them to have the information so that way, hopefully, they can make the right choices for their bodies and themselves,” Holly said.
She said that she’s working with Nome-Beltz on strategies to deal with the high number of kids who get caught vaping. Holly envisioned an in-school suspension in which the students would have to participate in a mandatory class on the long-term effects of vaping.
When it’s time to quit
Principal Smith recognized the futility in sending kids home for a vaping-related suspension, when it means they might have even more unrestricted access to a vape. She also recognized that it’s tough to expect kids to quit vaping cold turkey when they might be consuming the equivalent of a pack of cigarettes a day in nicotine. Smith described seeing middle schoolers going through nicotine withdrawals.
“It’s pretty similar to when people are withdrawing from commercial cigarettes or chewing tobacco,” Holly said. “People are fidgety, they’re irritable, and they have really strong cravings.”
Teens trying to quit nicotine are encouraged to keep themselves busy with other activities when they feel fidgety. Counseling to help people quit is also available at NSHC. But research shows that many teens will need help to quit nicotine, either through nicotine replacement and/or medications. NSHC offers nicotine replacement products, such as gum or patches, to adolescents. While adults can get these products over the counter, adolescents will need a prescription.
“Multiple medications are helpful with nicotine addiction, and those can be prescribed by a primary care provider, including our advance practice providers in the village communities,” said NSHC spokesperson Reba Lean.
Knight said that one challenge in getting adolescents to quit has been that nicotine replacement therapy is not approved by the FDA for people under the age of 18.
“The reason being that youth are still developing, and it requires a clinician judgment to determine whether or not it’s safe for that youth to use nicotine replacement therapy,” Knight said. “We need more research, and in the interim we really encourage parents to talk with their pediatricians, because their pediatricians know where the child is in their development and can assess their level of addiction.”
Reducing vaping rates might also be an issue for the wider community to tackle, and not just the school administration or hospital, Smith said. She said that the students who talk to her about vaping say they are getting these devices from adults.
“I think that it warrants a community conversation,” Smith said. “I feel that the school can’t do it in a vacuum, the hospital can’t do it in a vacuum, there has to be some kind of community conversation about this to educate people.”
State legislators are getting involved in measures that might help cut vaping among teens, too. Just last week, the Alaska House passed a bill that would put a 25 percent statewide tax on retail vaping products and raise the minimum legal age for the purchase of e-cigarettes from 19 to 21.