The American Heart Association held a webinar on Zoom May 5 to discuss the topic of combating vaping and other tobacco uses in schools. The webinar was watched by 46 registered viewers from various school districts in Iowa. The guest panel presenters were Jeff Willett, Ph.D., vice president of Integrated E-Cigarette Strategy, American Heart Association, Amy Kimball, DO, FAAP, an Iowa Chapter of the AAP Pediatrician, Nathan Wear, Associate Superintendent of Linn Mar Community Schools, and Matt Meendering, Principal of Dowling Catholic High School.

According to Willet, the use of e-cigarettes and other related products has caused a resurgence in youth cigarette smoking in the United States, which previously was declining. In 1997, one in four high school students smoked, while in 2020, only one in twenty students smoked cigarettes. However, the popularization of e-cigarettes has provided an attractive, yet equally harmful, alternative to traditional cigarettes, with one in five high school students in the United States using them. A primary reason for this attraction is the marketing and appeal of flavored e-liquids. Willet said removing these flavored products from the market is critical to public health.

“The vast majority of youth who are using e-cigarettes would have never started using a traditional cigarette or other tobacco product. We believe e-cigarettes do pose significant health threats for young people.”

Some reduction in the use of these products occurred in 2019 with the outbreak of EVALI, a serious lung injury related to vaping, and the prohibition of some flavored e-cigarettes by the FDA. However, FDA regulation didn’t apply to e-liquids used in open-tank, disposable e-cigarettes, or menthol e-cigarettes.

“The fight against Big Tobacco is constantly changing,” said Willet. “We have to be vigilant with new products the industry is introducing, and we need to address loopholes Big Tobacco successfully exploits to continue selling their products and addicting new generations.”

While e-cigarettes, vaping, and other related products are often sold as healthy alternatives to smoking, or even ways to help people stop smoking, Kimball said these products contain increasingly more nicotine, with one “pod” being equal to a pack of twenty cigarettes.

“Many youth are going through multiple pods a day as they are getting more addicted to them. Their nicotine concentrations are just astronomical at this time. Not only do we worry about their use of combustible cigarettes, but also other drug use. It becomes a gateway product for them.”

According to Kimball, Iowa statistics show a higher percentage of use than the national average with 20.1% of high schoolers using e-cigarettes. This poses health risks to the brain, lungs and blood vessels leading to long-term cardiovascular disease. In addition to the high levels of nicotine, the chemicals used to create flavors are toxic to human cells. The most severe flavor threats are cinnamon and cherry. Smokers of e-cigarettes are five times more likely to have severe effects from COVID-19 and seven times more likely to suffer complications if they are using both e-cigarettes and traditional cigarettes.

To combat the use of these harmful substances in schools, Meendering and Wear proposed updating school policies to ensure these substances are addressed, as well as increasing a focus on students’ mental health. Proper education is paramount to combat the idea of e-cigarettes being safe. Kimball and Wear asserted the key to preventing the spread of new addicts is empowering them to hold themselves and each other responsible and eliminate the social drive which encourages kids to try the products.

“Peer support instead of pressure can be powerful,” said Kimball. “Some students won’t be worried about the addiction consequence, but they might be concerned about how much it will cost them over two month’s time for example. I try to find their “currency” that makes it important to them.”

“In my experience, I think kids need to hear from other kids,” added Wear, referencing videos of teenage testimonies regarding their negative experience with vaping. “They listen to peers. That is why those videos are so powerful because they are students speaking about their experiences.”