Smoke And Mirrors

Billowing clouds of fragrant, nearly invisible smoke are wafting over schools nationwide, exhaled illicitly by teenage students catching a quick, forbidden nicotine buzz. They even do it in classrooms - while class is in session.

"It's a problem across the entire country," says June Eassa, director of the School District of Palm Beach County's Department of Safe Schools. "Students are utilizing e-cigarettes, and many of them are getting caught at school. They have charged Juul [e-cigarette devices] in classroom computers."

The use of vaping devices, known as e-cigarettes or "vape pens," is a rapidly growing, fashionable and heavily addictive trend among Florida youth; meanwhile, more and more young people are turning away from smoking tobacco.

However, vaping, promoted by manufacturers as a safe, healthy alternative to smoking, has its own dangers and threatens to draw teenagers back into a lung-damaging dependency on nicotine even as anti-smoking activists are winning the war against tobacco.

Vaping devices usually consist of a heating element or coil, often rechargeable, and "vape juice," an oily concoction containing nicotine and flavoring chemicals that the devices heat into a virtually odorless and hard-to-detect vapor for inhaling.

The new fad comes at a time when the Florida Department of Health states that the number of teens who have tried cigarettes has declined by 41.2 percent between 2012 and 2017.

But vaping is up - way up. A recent Florida Department of Health Youth Tobacco Survey stated that youth use of e-cigarettes has outpaced tobacco, with 10.9 percent of Florida youth using e-cigarettes and 3.8 percent using tobacco. The survey also found that, between 2012 and 2017, the number of kids who had tried vaping went up by 292.2 percent and the number of regular users of vape devices went up by 370.9 percent. In 2016, 12.4 percent of Palm Beach County youths between the ages of 11 and 17 reported using e-cigarettes, along with 10.7 percent in Miami-Dade and 9.1 percent in Broward.

In the big-money world of e-cigarettes, things are looking rosy indeed for manufacturers and sellers. PR Newswire reports that the market for e-cigarette and other vapor products amounted to $11.43 billion in 2016 and is expected to reach $36;86.43 billion by 2025.

Tobacco Free Florida calls e-cigarettes "a new way for the industry to try to get a generation of 'replacement smokers' addicted and replace the millions who have died from the harmful health effects of nicotine."

It's working. Teenagers are becoming hooked in droves.

"Over the last three years, the use of e-cigarettes has grown 300 percent in our schools," says Brian Dawson, specialist manager in charge of the tobacco prevention training program for educators at the Palm Beach County Department of Safe Schools. "It is on the increase, and we are doing everything we can to stem the tide."

The School District of Palm Beach County is so alarmed that, in January, it sent a letter to parents stating: "Scientific research indicates that the use of e-cigarettes, vapes and similar devices may have adverse health consequences for users."

The letter contains photos of the most popular devices and warns parents that they may contain "nicotine, marijuana or other drugs, as well as varying compositions of flavorings." And it notes that possession or use of such devices on school campuses is "strictly prohibited."

"Obviously, the high school children are most apt to do it, but we are seeing more and more in the

middle school ages," Dawson says. "It is the latest epidemic in schools."

One device, Juul, is especially frustrating educators' efforts. Thin and high tech in appearance, it looks like a USB drive. Even though it's illegal to sell tobacco products to those under 18, teens are finding it fairly easy to pick up a Juul starter kit, with the device and four flavor pods, for under $50 online, simply by checking the "yes" box when asked if they are over 21 years of age.

Once kids have it, it's easy to hide, emits scant visible smoke and no scent, and can be used in classrooms or school bathrooms with little fear of being caught. The "pods," or juice packs, contain roughly the same amount of nicotine as a pack of cigarettes and come in kid-tempting flavors like creme brulee, mango, mint and cucumber. A Juul pod contains more addictive nicotine than the amount found in other e-cigarettes.

"Many kids are doing three pods a day," Dawson says. "We believe flavors are being put in there to attract teenagers. Why do they look like candy? Why do they smell like candy?"

Juul has 54.6 percent of the U.S. e-cigarette market - which is quite amazing for a product that went on the market for the first time in 2015. In 2017, Juul's revenue was up 700 percent - to $224.6 million.

"Juul sales have grown so much that they make up more than half the cigarette market in convenience stores now," says Heather Youmans, senior government relations director for the American Cancer Society Cancer Action Network.

Vape producers argue, advertise and make kids believe that e-cigarettes are less harmful than smoking regular tobacco and can help those addicted to cigarettes kick the habit. In fact, studies are largely finding the opposite.

A report from the National Academies of Sciences states that, while e-cigarette smoking is less harmful than smoking cigarettes, it is "gateway" behavior that likely could lead young vapers to smoking cigarettes in time.

The report also notes "most e-cigarettes contain and emit numerous potentially toxic substances." California health authorities found that "e-cigarettes emit at least 10 chemicals that are found on California's Proposition 65 list of chemicals known to cause cancer, birth defects or other reproductive harm."

The California Department of Public Health states: "E-cigarette users are no more likely to quit than regular smokers, with one study finding 89 percent of e-cigarette users still using them one year later. Another study found that e-cigarette users are a third less likely to quit cigarettes."

A 2018 study from Dartmouth College revealed that, while 2,070 adult smokers would quit smoking in 2015 while using e-cigarettes and remain nonsmokers, an estimated 168,000 adolescents and young adults would begin smoking cigarettes because of the use of e-cigarettes. This, the study notes, eventually would result in 1,510,000 years of life lost.

The content of e-cigarettes is also suspect, as they may contain much more nicotine than stated on packages and "e-juice" marketed as nicotine-free may actually contain nicotine, says Samir Soneji, assistant professor in The Dartmouth Institute for Health Policy and Clinical Practice at the Dartmouth Geisel School of Medicine. The Johns Hopkins Bloomberg School of Public Health found that dangerous metals such as lead, manganese, chromium and nickel are found to leak from the heating elements of many tested e-cigarettes, and Tobacco Free Florida notes that probable cancer-causing chemicals, such as formaldehyde and acetaldehyde, are measurable in some e-cigarette vapor.

"We do not know how safe vaping is," says James Hall, senior epidemiologist with the Center for Applied Research on Substance Use and Health Disparities at Nova Southeastern University. "The chemicals in the vapor are as dangerous as those found in regular cigarettes."

Parents who are concerned that their children may be vaping should look out for behaviors symptomatic of nicotine addiction, such as coughing, agitation or jitteriness. Educate yourself as to what e-cigarettes and Juuls look like and the effects of their use. Our experts also recommend keeping a close eye on credit card accounts and money, because the costs of vaping Juuls (pods cost $15 to $16 for four) quickly add up - another factor that can lead nicotine-addicted kids to cigarettes.

If your kids already are hooked, get them involved in a smoking cessation program, Eassa suggests, and speak openly about the issue.

"We always encourage parents to talk to their kids about what these products really are and that they are addictive," says Youmans.

Dawson agrees that frank talk and education are key: "We are trying to do everything we can so kids can make their decision based on the facts - not just, 'This is a safe or harmless way of smoking.' It's definitely not harmless." O