While smoking is down among teenagers, this generation of high school students has not been spared from nicotine addiction.

Today's high school and junior high school students are increasingly turning to a habit that leaves no lasting odor and involves the use of paraphernalia that is hard for parents and teachers to spot. It's called vaping.

Camden Hills Regional High School Principal Shawn Carlson said vaping, or the use of e-cigarettes, has become the most common means of substance use by students in schools.

Belfast Area High School and Searsport District High School have seen a similar rise in the use of e-cigarettes in the past three to four years. Searsport Principal Marianne DeRaps calls the problem “pretty widespread.” Belfast Principal Jeff Lovejoy noted it’s not just high school students, but middle-schoolers as well.

School administrators across the Midcoast and throughout the nation are dealing with students vaping in bathrooms, on buses, in locker rooms and even in classrooms. However, Mount View school officials say vaping has not emerged as a major problem.

Mount View High School Principal Zachary Freeman suggested reaching out to a school that has an issue like Cony High School in Augusta, which recently developed specific policies around vaping. Mount View Middle School Principal Quinton Donahue said, to his knowledge, there has not been a “single case of vaping at the middle school.”

The numbers seem to indicate that Mount View schools are an outlier. Use of e-cigarettes among high school students rose 78 percent from 2017 to 2018, and it increased 48 percent among middle school students, according to the 2018 National Youth Tobacco Survey.

In 2017, one out of every three Maine high school students (33 percent) reported ever using an electronic vapor product, according to information provided by MaineHealth. The situation has prompted a crackdown on the industry from the FDA.

E-cigarettes were developed to provide a safer alternative to cigarettes for adults trying to wean themselves off nicotine.

The most popular form of e-cigarette with teenagers, the JUUL, looks like a thumbdrive for a computer or a wide, flat pen. It even plugs into a computer USB port to recharge, and teens have been known to make a sport of asking teachers to use classroom computers to charge them.

A pod of liquid that the kids often refer to as "juice" is plugged into the apparatus. This liquid, which contains numerous chemicals and a very high dose of nicotine, is heated and the teens inhale the vapor produced. The nicotine dose is 5 percent in most of the flavored pods offered for these devices.

In Waldo County schools, officials are still developing policies and plans to educate students — and their parents — about the dangers of e-cigarettes.

“Our polices haven’t caught up,” DeRaps said. “We are trying to revise and update staff so they can be more aware and take a more proactive stance. We have brought in people to talk to students and they talk about it in part of their one semester of health."

Searsport School Resource Officer Chris McCrillis said he worked with the school nurse and presented a class on the dangers and concerns around vaping. In Belfast, Lovejoy said, health classes talk about the misconception that vaping is a much healthier option. But, he said, there’s no active campaign in place targeting vaping.

"It got marketed so quickly in ways that are aimed right at kids," Carlson noted. "The flavors are aimed at kids. There aren't adults buying bubblegum-flavored vape products."

The flavors have caused widespread criticism of the industry, and the sudden surge in use by teens has prompted action from government regulators, with the promise of stronger measures if the industry does not take steps to regulate itself.

FDA Commissioner Scott Gottlieb issued a lengthy statement Nov. 15 calling for stronger enforcement to prevent sales to minors and voluntary action from the industry.

JUUL CEO Kevin Burns issued a statement Nov. 13 saying the company would no longer accept orders for mango, fruit, creme and cucumber JUUL pods to more than 90,000 retail stores, including convenience stores. He also vowed to increase security for online sales of the products.

School officials say teens have been able to gain access to the products. Sale to teens by adults, including older siblings, is suspected, and officials say some have found places to buy the products online.

One local high school student said students need only to see the "dealer" at their school to buy an e-cigarette for $10 to $20.

Not all of the flavors that appeal to young people come in the form of official JUUL products. Other companies selling unregulated pods containing unknown chemicals have marketed flavors directed at young people, including "Pink Frosted Yellow Cakes," "Berry Lemonade" and "Strawberry Milk." Other bootleg flavors have included "Gummy Bear" and "Cotton Candy."

JUUL has announced it is taking action in court to prevent these other entities from selling these products aimed at young people.

Carlson questioned why e-cigarettes are sold in convenience stores to begin with, arguing you do not typically buy nicotine gum or patches and other products aimed at quitting there.

One of the questions raised has been why these products appeal to young people. Several reasons have emerged. The chemicals provide a high, or "buzz," and e-cigarettes are popular because teens see celebrities using them.

Teens also enjoy doing tricks with the "smoke" from these devices. Videos on YouTube and other social media feature young people blowing elaborate smoke rings and showing off their vaping skills.

McCrillis interprets student vaping as being seen as “cool” by peers. Searsport Dean Joshua Toothaker noted some students use vaping as a coping mechanism, an assessment with which DeRaps agrees.

“They are self-medicating,” she said. “I see kids in the morning coming to school with Dunkin' Donuts coffee; it’s like they need something to speed them up. There is no stereotype of kids doing this, as in years past there would be ‘the smokers’ and it would be like a social club. Now, it’s the athlete or high achiever. There is no way to stereotype; it’s just prevalent.”

Health consequences

Dr. William Stephenson, a Rockport pediatrician, said that while these products are probably better than smoking cigarettes, they are by no means known to be safe. He said the use of nicotine in these high doses increases blood pressure and heart rate and makes it hard to sleep. The liquid heated in the products contains chemicals, some known to be toxic when heated, he said.

Studies show young people who vape tend to suffer more coughs and cold symptoms.

The nicotine dosage alone could endanger the life of any small children who try the e-cigarettes, he added.

Dr. Kendra Emery of Pen Bay Family Medicine in Rockport said nicotine in any form is harmful for a developing brain (younger than 25). Nicotine can cause addiction more easily in a young person than in an adult; it can lead to changes in the brain that increase the likelihood of mood disorders; and it can impair impulse control. Teens who are addicted to nicotine face greater chances of depression, anxiety and loss of concentration.

The chemicals in the pods and the heating of heavy metals in the products also raise concerns, according to doctors. And they agree that the long-term health effects of these products will not be known for some years to come, when the consequences are seen in those who chronically use these relatively new devices.

In addition, students who become addicted to vaping are more likely to smoke cigarettes in the future. As authorities crack down on underage vaping, teens may turn to cigarettes as an alternative.

Vaping on school grounds is illegal, as it is for minors in general. Disciplinary actions vary from school to school, but often include in-school suspension and time spent in a restorative process that involves the student's taking responsibility, becoming educated about the dangers of vaping and possible further intervention.

School officials agree the best action parents can take is to increase awareness and talk to their children every day about this and everything else.

Carlson is optimistic that parents can provide a strong positive influence for young people.

"Kids are still going to experiment," he said. "They're still going to make mistakes, they're still going to try these things, but if they're hearing all the time what parents' values are, then I think they are far less likely to end up with a significant issue."

DeRaps and Lovejoy both suggest good communication between parents and students is vital.

“Parents need to balance helping their kids be more independent with being a good parent,” DeRaps said.

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Republican Journal staff members Fran Gonzalez and Stephanie Grinnell contributed to this report.