By Paul W. Bennett (AIMS Education Fellow)
A New Brunswick principal, Brad Sturgeon of Fredericton’s Leo Hayes High School, has broken the silence and rung the alarm bell over the rapid spread of vaping among students – before, after and even (surreptitiously) during class. Today’s high schoolers, right across Canada, can now be spotted, almost anywhere, puffing on e-cigarettes easily concealed in their pockets.
The prevalence and use of electronic cigarettes has increased rapidly over the past decade, particularly among youth. The extraordinary growth of e-cigarettes has also raised significant public health concerns about the emergence of a new generation of teens with nicotine dependency.
Changes in the design and marketing of vaporizers with the introduction in 2015 of more stylish, sleekly-designed, discreet high-tech devices, known as JUUL, have proven irresistible to teens and become the latest ‘nightmare’ for today’s high school principals and teachers.Public concern has reached a panic stage with the spread of fear over a recent spate of lung-disease cases involving teen users of e-cigarettes, and claiming the lives of more than a dozen American students.
School authorities in Canada as well as the United States are coming rather late to the challenge of combating vaping and its associated health risks. Advance promotion of e-cigarettes as a smoking cessation device may have contributed to the initial ambivalent, almost helter-skelter, response. A May 2019 Ontario Tobacco Research Unit report confirms that schools were caught off-guard by the surge of vaping among never-smokers and responded with interventions once used to combat smoking or imported from the United States, where the craze is far more advanced among youth.
Vaping devices and products containing nicotine are now flooding the Canadian market and readily available in local convenience stores and gas stations. Since September 1918, JUUL, the San Francisco-based company that controls over 50 per cent of the market, has been selling its sleek devices that look like a computer flash drive and are re-chargable at a USB port. They have proven more popular that the Imperial Tobacco brand Vype, released Canada in the Spring of 2018, and Japan Tobacco‘s Logic brand released in early 2019.
First introduced by Juul Labs in mid-2015 as a smoking-cessation device, JUUL became the so-called “iPhone of e-cigarettes.” The extraordinary sales growth of the product was driven by a variety of effective, wide-ranging and engaging campaigns reaching youth through social media, particularly on You Tube, Twitter, and Instagram. Five million Canadians, mostly aged 15 to 34, had tried e-cigarettes by 2017 and 300,000 reported using it every day. One more recent study, published in the British Medical Journal, reported that the proportion of Canadian teens (aged 16 to 19) vaping rose from 8.4 per cent in 2017 to 14.8 per cent in 2018, a 74 per cent increase.
The Ontario Tobacco Research Unit conducted an environmental scan of current harm reduction programs and quickly recognized that there were, as of the Spring of 2019, no studies of the effectiveness of such interventions. Most intervention programs were public education and school-based efforts, typically aimed at teaching children and youth about the dangers of vaping in the hope of reducing or eliminating the practice. Three of the programs reviewed were E-Cigarettes: What You Need to Know (Grades 6 -12, Scholastic), CATCH My Breath (Ages 11-18, CATCH), and School E-Cigarette Toolkit (Grades 6-12, Minnesota Department of Health).
The report also examined interventions outside of schools, including community-based initiatives, public health efforts, health-care programs, and public policy strategies such as advertising and promotion restrictions, age restrictions, labelling and health warnings, flavouring restrictions, and safety requirements.
Most of the actual school-based interventions were embedded in existing tobacco control programs and sought to counter the marketing messages of companies claiming it is a safe, smoking cessation activity. The Ontario Tobacco Research Unit recognized the scattered approach being taken and recommended considering interventions that proved successful at reducing rates of regular cigarette smoking among youth. They also identified the need for a more coordinated and planned anti-vaping strategy.
Vaping has overtaken smoking as the favoured health-risk behaviour of high school students. Some 15.8 per cent of Ontario Grade 9 students vaped in 2017, and only 6.2 per cent smoked cigarettes. As many as one out of every three high schoolers may now be regular users of vaporizers with nicotine-laced fluids. The recent health scares may have jolted users and curbed the growth in usage, but it remains the biggest, mostly unaddressed health issue in our high schools.
Vaping cessation interventions are becoming a more urgent necessity and simply mimicking anti-tobacco interventions may not work, given the paltry state of research on health impacts. The time is now for schools to collaborate with health practitioners to develop more comprehensive, less ad hoc, e-cigarette harm reduction programs.
Paul W. Bennett, Ed.D., Director, Schoolhouse Institute and the author of eleven education policy research studies for the Atlantic Institute for Market Studies (AIMS), and most recently Missing in Action: School Storm Days, Student Absenteeism, and the Workplace, The Atlantic Institute for Market Studies (AIMS), June 2019.
