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Getting teens out of nicotine

Michael Smith
USA TODAY

Throughout the first two decades of the 21st century, efforts to reduce youth smoking have been pretty successful. According to the Centers for Disease Control and Prevention last year, teen use of tobacco products steadily dropped between 2011 and 2019. But as electronic cigarettes, or vapes, gain popularity as a way for adult smokers to secede from cigarettes, they are also giving more teenagers a stealthy gateway into nicotine addiction.

While tobacco use among teens has dropped, the latest CDC data shows 27% of American high school students say they have used an e-cigarette within the last 30 days, a rising number which has school and health officials scrambling to address the issue. Despite e-cigarettes being regulated like tobacco, teens can obtain products that resemble USB jump drives or pens and use nicotine products virtually undetected.

Last week, the Tobacco Settlement Endowment Trust Board of Directors discussed new programs to educate Oklahoma students about health issues facing their generation, including tobacco and e-cigarette use. The same week also saw Dickson High School notify parents about new punitive actions for students who violate state tobacco laws, which include e-cigarettes.

Principal Matt Krimmer said the new disciplinary measure is meant to send a strong message to students that may not be received otherwise. “Students that are found to be vaping on campus, the traditional punishment was to assign them in-school detention, but in addition to that we also will be issuing a citation through the ABLE Commission,” Krimmer said by phone on Thursday.

The Oklahoma Alcohol and Beverage Laws Enforcement is also responsible for enforcing tobacco laws. Dickson schools will now be able to notify ABLE if a student is in violation of state law regarding youth access to tobacco or nicotine products, said Krimmer. According to documents from the ABLE website, the first violation can result in a $100 fine and a second violation can result in a $200 fine.

If fines are left unpaid, violators may see the suspension or non issuance of their driver’s license. An appeals process appears to be available to someone cited for violating a youth tobacco law, but a message left for the commission about that process was unanswered on Friday.

Krimmer said he has not received any criticism of the policy. “There were positive things on social media last night, I even had a parent thank us for taking these initiatives,” he said. “I think most parents understand and many parents are dealing with this,” adding that he wants to prevent students from using or illegally acquiring nicotine while on campus.

Krimmer won’t be relying on this punishment alone to prevent nicotine use by his students. “Obviously we don’t want to be overly punitive,” he said. Dickson High School often has anti-smoking literature and the topic is regularly discussed in health classes, and members of the Madill Police Department will soon be traveling to visit the Comets and talk about the dangers of tobacco and nicotine.

The amount of educational support available to Krimmer and other Oklahoma schools may be boosted this year. TSET last week announced a proposed timeline to fund and launch a series of programs to boost health education for teens.

According to a Tuesday statement, TSET board members discussed investing $12.5 million over five years in an educational campaign that would begin as soon as this September. That campaign would launch youth programs that incorporate tobacco prevention, nutrition and physical activity, and would later evolve into youth advocacy programs.

“The vaping epidemic is reversing two decades of declines in teen tobacco use,” said TSET executive director Julie Bisbee. “Increases in childhood obesity mean that our youngest generation will be the first generation to see a decrease in life expectancy. That’s unacceptable,” Bisbee said.

The TSET plan would still have to be approved by the board at its March meeting.

If implemented as proposed, that plan could also have an impact on recent grades given to Oklahoma by the American Lung Association. As part of its annual State of Tobacco Control report, the association also issues grades in five areas of efforts to reduce or eliminate tobacco use. While only four states--Alaska, California, Maine, and North Dakota--received higher grades for Tobacco Prevention and Cessation Funding, Oklahoma still received a “D” grade in that area.

“The youth vaping epidemic showed no signs of abating in 2019 with high school e-cigarette use increasing by a staggering 135% over the past two years,” said the report released on Wednesday. “Important steps forward were taken to address this public health challenge in 2019 such as increasing the tobacco sales age to 21 – first in many states and then nationwide – but overall the country failed to do what was necessary to avert the crisis.”

The federal government has taken some measures to curb e-cigarette use among teens. For example, the Food and Drug Administration last month announced a new enforcement policy for how flavored e-cigarette products can be marketed. “FDA is also concerned about the extraordinary popularity of flavored ENDS (electronic nicotine delivery systems) products with youth,” says an FDA statement. “Evidence continues to accumulate, further confirming that youth are particularly attracted to flavored ENDS products.”

The American Vaping Association, a Connecticut-based nonprofit that advocates for the e-cigarette industry, acknowledges research and data from both the FDA and CDC but does not consider e-cigarette use among teens a severe problem. In response to last month’s FDA policy, association president Gregory Conley said targeting flavored e-cigarettes will only drive those who use nicotine back to traditional tobacco products.

“While the ideal is for no youth to vape or smoke, the unintended consequences of policies like these could be more young people smoking cigarettes,” Conley said in a statement.

As e-cigarette technology evolves, a new generation of parents, teachers, health officials and industry leaders will consider many issues similar to what were posed by the tobacco industry of the past. When asked if he remembered education about the dangers of tobacco during his high school days in the late 1990s, Krimmer went silent. After a few moments of thinking, he came up empty.

“I don’t remember school going out of the way to do anything. I was definitely a D.A.R.E. kid, and I remember them talking about drugs and things like that,” he said, referring to the nationwide Drug Abuse Resistance Education program launched in the 1980s.

Unlike 20 years ago, school officials like Krimmer now have to use multiple tools to reduce and eliminate the multiple ways nicotine can be used by teens. He worries that tobacco and e-cigarette use among students could set up years of addiction and wants to steer them away from that decision.

“The fact that they’re marketed and targeted toward students, this is our cigarette crisis.”