About three years ago, Troy, now a 17-year-old Las Vegas high school student, took a few hits from a friend’s vape pen.
“My friends were always (vaping) in front of me and, of course, I was interested and there’s a lot of peer pressure,” said Troy, who didn’t want his last name used in this story. “I hit (the pen), and then from there I eventually got one and started doing it more and more.” He now goes through about three tanks of nicotine-infused vape liquid per week, he said.
“I see those anti-vaping ads all over the place and it makes me kind of regret it,” Troy said. “Now that I’m addicted to it, it’s a constant challenge every day. But I keep doing it. I get itchy in a way if I don’t do it, kind of restless. The more I do it the more I regret it… It’s just so bad now. I wish I never started.”
Youth vaping on the rise
Kelli Goatley, president of The Nevada Tobacco Prevention Coalition, said that in the 1990s about 30% of Nevada’s teenagers smoked cigarettes, but after a concentrated anti-smoking campaign and other measures, that rate dropped to 3.6 percent in 2019. But over the last several years, vaping among teens has become widespread. In 2019, 24% of Nevada high school students said they had used a vaping product in the past month, a 9% increase from two years before.
According to the 2019 Nevada Youth Risk Behavior Survey, alcohol is the most commonly used substance among teens, followed by vaping, cannabis, prescription painkillers, and cigarettes.
“This is remarkable because alcohol has been around for quite some time but vaping wasn’t even on our radar from a public health perspective ten years ago,” said Jennifer Pearson, a University of Reno, Nevada associate professor at the School of Community Health Sciences. “It went from zero to second place both nationally and in Nevada.”
Federal measures effective?
Federal and state officials have been trying to curb the increase in vaping among young people. Federal legislation in 2020, called the T-21 law, raised the legal tobacco/E-cigarette purchase age to 21, an action that is pending in Nevada. Nevada and other states have levied hefty taxes on vaping products, and the Food and Drug Administration took some flavored e-cigarette refill cartridges off the market.
Other research suggest that youth vaping may have decreased during the pandemic, perhaps because kids are isolated from their peers and some are spending more time closely monitored by their parents. “We won’t know for sure until more data come in, and if any decrease is real, vaping may rebound when teens go back to in-person school,” Pearson said.
She said she is not aware of any rigorous studies that show a change in teen vaping due to the new T21 law, but she anticipates that we will see changes in the future. “There hasn’t been enough time to do the research yet,” she said, “especially since the pandemic is making research more difficult than usual.”
Website offers advice
Goatley, Pearson and others spoke during a webinar sponsored by the Nevada Tobacco Prevention Coalition on Jan. 26. The panel members explained the dangers of vaping among young people, the extent of use by adolescents and teens and the coalition’s efforts to combat the problem.
The coalition has a website where parents can learn about the signs of vaping and vape addiction in teens as well as information on how to talk to adolescents and teens about the health dangers of the habit.
Chemicals in vapor
Vaping pens and disposable e-cigarettes have tiny tanks filled with liquids that contain nicotine, among other chemicals. The liquid is heated, producing a vapor, which is then inhaled. Health officials cited research that the chemicals in the e-juice can harm the development of young brains. Getting addicted to nicotine through vaping, they said, also increases the chances that a person will fall prey to other addictions in the future.
Pearson said the Youth Risk Behavior Survey, jointly administered by the CDC and the Nevada Division of Public and Behavioral Health, revealed that high school students think it’s easy to get vapes and about one-in-three bought e-cigs themselves in 2019. In addition, rural students, LGBT students, students with depressive symptoms, and students who were recent users of cigarettes and cannabis are at greatest risk of becoming addicted to vaping, she said.
Where students live makes a big difference in whether or not they take up E-cigs. In the 2019 survey, about 39% of Nevada rural high school students reported vaping in the past 30 days, compared to about 21% of urban students. High school students with depressive symptoms also are at greater risk of use. About 32% of those with depressive symptoms said they had vaped in the past 30 days, compared to 15% of students who did not report depressive symptoms.
Starting young
The survey also showed that in 2019, 3.6 percent of Nevada middle school students used an e-cigarette before age 11 and 7.5 percent of Nevada high school students reported using an E-cig before age 13. Pearson said those percentages, though small, are alarming because early use translates into worse consequences down the road.
“They are at greater risk of becoming addicted to that substance, they are at greater risk of negative health outcomes, and at greater risk of having negative social outcomes such as problems at school,” Pearson said.
Troy, who started vaping when he was 14, said he is feeling the negative consequences of vaping, although most of his friends shrug off the dangers of the habit.
Easy to get E-cigs
“Mostly everybody does it around me,” he said. “They are very lackadaisical about it. They are the ones who got me on it so they aren’t saying anything negative about it; if anything they are encouraging it. They have heard about the health (concerns), they don’t seem to care about it, not like I do.”
Troy said he’s tried to quit, but “it’s hard to give it up, especially because I can get (vape pens) so easily; it’s incredibly easy.” He sometimes has a hard time remembering things, he said, and thinks vaping may have something to do with that.
“Sports-wise, I try but can barely run one lap around the track. After 100 yards I’m breathing heavy, I can’t catch my breath. It might not be as bad (on lungs) as cigarettes, but I think it still damages me exponentially.”
Vaping is common at his high school, Troy said, in the bathrooms during breaks and even in classrooms in the midst of lessons. “In school, you would honestly be surprised how much people smoke and vape,” he said. “You go into the bathroom and it’s just clouds in there. If a teacher was to come in, we’d most definitely get caught. I’m surprised that teachers don’t seem to have caught on.”
The spy craft of vaping
In classrooms, vaping is made easier by cleverly-designed camouflage. Vape pens can be hidden in Sharpies, highlighters, USB drives, small tissue dispensers and other common objects. The e-liquid tanks have even been concealed inside hoodies, with hollow drawstrings at the neck used like the hoses of a hookah.
“Anything you can get your hands on can be turned into a cover for a vape pen. My friends taught me how to make them. I shouldn’t say this, but think it’s cool. I make them and hide them in my binder. I can bend over in class and hit it. If you hold (the vapor) in, most of the vapor will disappear. If you were the teacher you’d miss it. We can blow the vapor in our backpacks, close the bags, and you wouldn’t even know we just smoked in your class.” – Troy, 17, a Las Vegas high school student.
Troy said his parents don’t know he vapes. “Oh my, if they did I’d be in serious trouble,” he said. He said his pens usually are concealed as Sharpies or USB drives, but he still takes precautions to hide them at home.
Prevention and mitigation
Malcolm Ahlo, the tobacco control program coordinator at the Southern Nevada Health District, said parents and guardians are the first line of defense against vaping by young people. “Parents need to have that conversation with kids as early as possible,” he said. “And it should be a conversation, not preaching. The fastest way to get kids to do something is tell them they can’t do it. Avoid scare tactics, be open and listen to them.”
“We don’t encourage parents to snoop or be accusatory. The most important thing is to have those conversations about vaping early, before they start, and, ideally, before they start getting that peer pressure.” — Malcolm Ahlo, tobacco control program coordinator, Southern Nevada Health District.
Other coalition members said that a bill to increase the age of legal purchase for tobacco products, including e-cigs, from 18 to 21 to get Nevada in line with federal law, will again be before lawmakers this coming legislative session. In addition, the coalition is continuing its campaign to educate parents and kids, including a peer-to-peer prevention/cessation program in Southern Nevada called Breakdown.
Peer-to-peer effort
Alan, 18, of Las Vegas, is an ambassador of the Breakdown campaign. Last year, he and other students identified as “influencers” brought the message to Clark County middle and high schools. That effort, paid for by the coalition, includes free merchandise branded with the anti-vaping effort’s logo.
“Before the pandemic, we’d go to different schools and set up a booth with our Breakdown merchandise. That gets their attention. The lunch break draws a lot of kids. We have shirts, hoodies and other branded items and that puts our name out there in all the schools.” — Alan, 18, a Las Vegas high school student.
When lots of students are wearing the clothing that promotes the Breakdown message, others want to follow suit. “Kids want to be like each other,” he said. “Now we’re (reaching students) on social media, but it’s better to do it in person; there’s a better vibe and energy in person.” Still, he said, the message is the same, that vaping is “just not healthy, not cool.”
Alan said that in Las Vegas, “pretty much everywhere you go you see kids passing (vape devices) around. The peer pressure is kind of crazy. (Those who do it) think it makes them cooler.” He said he hasn’t given in to the peer pressure because “I believe in myself; I’m not a follower.”
Wanting to quit
Troy said he gets the message that vaping is unhealthy and really wants to quit. “I see these ads and the people trying to talk me out of it,” he said. “People tell me I’m not doing well in school anymore, or that I need to calm down (the habit) or that I reek of the smell or whatever.”
He started vaping cannabis extracts last year, he said, but that’s an occasional thing. “If my friends have it, I’ll hit on it, but I don’t sell it or even buy it.” Vapes, meanwhile, are easy to get either from friends or online, he said.
Troy enjoys math and would like to teach the subject some day. He worries about the health effects of his habit and the toll he thinks it is taking on his grades, but doesn’t think he’ll be quitting anytime soon.
“My girlfriend tells me to stop and says she doesn’t even want to be around me anymore,” he said. “But I’m so addicted, it’s like ‘what do you expect me to do?’”