With hundreds of breathing illnesses and multiple deaths related to vaping reported across the nation, President Trump has proposed a ban on flavored e-cigarette liquid to help quell the swell of underage vaping.

But is underage vaping really prevalent among teens?

According to The New England Journal of Medicine in an article published Wednesday, “In 2019, the prevalence of use during the previous 30 days was more than one in four students in the 12th grade, more than one in five in the 10th grade, and more than one in 11 in the eighth grade.

“Students who had vaped nicotine during the previous 12 months and those who had ever vaped nicotine also significantly increased in each grade from 2018 to 2019.”

Howard Community Regional Health Behavior Health Therapist Megan Williams attributes the allure of vaping to teens in part to the adolescent years being a time of experimentation.

However, many teens are not aware of the risks or damage related to vaping.

“Exposure to nicotine during youth can lead to addiction and cause long-term harm to brain development,” according to the National Institutes of Health. “The vapor can also contain toxins [including ones that cause cancer] and tiny particles that are harmful when breathed in.”

Registered respiratory therapist at Community Howard Regional Health Carrie Stone said the popularity among young people is a great concern.

“It is becoming an epidemic, especially with the younger age groups because it’s easy to hide and easy to get,” she said. “The flavors and products are geared to the kids, like cotton candy, bubble gum and those kinds of things.

“It’s hard to combat this because these kids think that it’s no big deal, it’s not smoking, it’s not going to hurt them. ... It becomes a problem then because a lot of those kids are more predisposed to turn to tobacco products when they get older.”

Stone said chemicals like diacetyl, which are found in some of the flavorings, are linked with health problems such as bronchiolitis obliterans, better known as popcorn lung.

“Some of the flavorings contain formaldehyde, which is used in embalming and making treated lumber,” Stone continued. “Diacetyl is a buttery flavoring like what you might put on your microwave popcorn. That first started to show up as a problem in those manufacturing facilities that use those chemicals and those chemicals can cause lung diseases and lung irritation.”

Stone noted there can also be a sense of false security or assumptions of safety when people who vape make juices for their devices.

“They might make their own juices to put in there and think that since they know what they are using it’s safer. But any time you’re breathing in chemicals or substances that you’re not meant to be breathing in, it’s bad for your lungs,” she said.

Life and death

Eight people have died in the last several weeks due to a vaping-related lung illnesses, and as many as 530 people in 38 states have a vaping-related illness, according to the U.S. Food and Drug Administration, which has opened up an investigation into what chemicals are causing the deaths and illnesses.

Due to the outbreak of deaths and illnesses, the CDC activated its Emergency Operations Center Monday.

“Based on initial data from certain states we know that most patients have reported a history of using e-cigarette products containing THC,” according to the CDC. “Many patients have reported using THC and nicotine. Some have reported the use of e-cigarette products containing only nicotine.”

“The CDC has made it a priority to find out what is causing the outbreak of e-cigarette or vaping-related injuries and deaths,” CDC Director Robert Redfield said in a release. “An activation of the CDC’s Emergency Operations Center allows us to enhance operations and provide additional support to CDC staff working to protect our nation from this serious health threat.”

Impact on business

Howard County businesses stand to face a decline in sales or even closures if a ban on flavored liquid is imposed.

Chad Meyers owns Fog Foundry, a vape shop in Kokomo with other locations in Lafayette and Frankfort. Meyers noted his stores were one of the first in the state to raise their age requirement to 19 to combat teen vaping.

“We try to be as vigilant as possible,” he said. “We understand that more than likely these teens are getting their products from 18-year-olds that are still in high school.”

Since the recent health scare began, Meyers has already seen decline in sales of 20% and feels the ban would devastate his and many others’ businesses.

“If a flavor ban is enacted federally or within the state of Indiana, it will close our doors,” he said. “... You’re going to see the people that are nicotine-dependent are going to go back to [smoking cigarettes]. We all know those do have a health risk.

“Our agenda when we opened the shop was to make sure that people were vaping as safely as possible and people were vaping most effectively to get enjoyment out of it,” Meyers said. “Part of our goal is to keep that up and to teach the public that it isn’t the plague that everyone thinks it is.”

Education is key

Howard County Tobacco Free Coordinator Shirley Dubois has been working with both young people and adults to share education on the hazards of tobacco. Dubois, an advocate of the flavor ban, gives presentations on various tobacco products, how to identify problems and how to get help.

“Education is key,” she said. “Generally I give them the resource materials like brochures or flyers on talking with your teens about e-cigarettes. I direct them to our vape-free Indiana webpage that has all the facts and resources on how to quit. You can download and print how to talk to your kids, how to recognize if your child is using the product.”

Dubois also shared methods of noticing if kids are hiding these products such as checking what seems like an empty Starbucks cup for devices. Even everyday items could be concealing a device. Dubois recently purchased an e-cigarette designed to look like an Apple Watch.

“The vaping thing is so new that the problems are just starting to come around because the symptoms are not going to happen immediately and so they’re not going to start looking at those things immediately,” respiratory therapist Stone said.

“It takes a little time but now that the research is coming back, the symptoms are coming back and we’re seeing deaths from it … now when it’s being looked at a whole lot more we can really start telling people about the dangers.”

To get more information on how to recognize if your child is vaping and how to handle it, visit kokomoymca.org/health-wellness/tobacco-free-howard-county or vapefreeindiana.isdh.in.gov.

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