The Youth Vaping Epidemic

June 5, 2019, Feature, by Vitisia Paynich

2019 June Feature The Youth Vaping Epidemic 410

How park and recreation agencies are helping to fight e-cigarette use among America’s teens

“Vaping is considered cool in my group of friends,” says one female teen, who was just 13 years old the first time she began vaping. “It might just be the fact that you’re doing the things you know you shouldn’t be doing.” This high school student represents a mere handful of real California youth who shared their real-life experiences using e-cigarettes and other vaping products for a public service video produced by Tobacco Free California, in an effort to discourage others from following in their footsteps. However, this problem among today’s youth is not exclusive to the Golden State or the West Coast. It’s a frightening scenario playing out in towns all across America.

Smoking remains the leading cause of preventable illness, attributing to more than 480,000 deaths in the United States each year. Research data from the “2018 National Youth Survey” conducted by the Centers for Disease Control and Prevention (CDC) reveal that e-cigarette use among high school youth rose by an astounding 78 percent from 2017 to 2018, while more than 1 million additional teens began using e-cigarettes in the past year. Acknowledging these startling figures, the U.S. Surgeon General declared vaping a youth epidemic.

This nationwide crisis has prompted park agencies across the country to partner with their public health agencies to sound the alarm about youth vaping by educating parents, preteens and teens about the negative health outcomes associated with e-cigarette use, as well as the added risk of second-hand smoke exposure. They are also working with their city officials to establish smoke- and tobacco-free park policies.


What Are Electronic Cigarettes?

Electronic cigarettes, or e-cigarettes, are battery-operated devices that release doses of vaporized nicotine, or non-nicotine solutions, that users inhale. Although companies market these products to adults as aids to reduce or quit smoking, recent studies suggest a single vape pod contains as much nicotine as a full pack of cigarettes. The term “vaping” refers to the use of e-cigarettes or vaporizers.

E-cigarettes are a $2.5 billion industry with more than 460 different e-cigarette brands, according to the National Institute on Drug Abuse. Common nicknames for these products include e-cigs, e-hookahs, hookah pens, vapes, vape pens and mods, which are more powerful, customizable vaporizers. The most popular among these brands is JUUL, which sells an e-cigarette device that resembles a USB flash drive.

E-cigarettes and other tobacco products pose many health risks to youth. They contain harmful and potentially harmful ingredients, including formaldehyde and acrolein, which can cause irreversible lung damage. They also contain nicotine, which has addictive properties. Other studies show these products can affect brain development in youth.


Health Advocates vs. the FDA

Three years ago, the U.S. Food and Drug Administration (FDA) began regulating sales, marketing and production of these products, especially as they relate to youth. By 2018, the agency proposed strict rules that would ban retailers from selling menthol cigarettes and flavored vaping products. What’s more, the FDA commissioner at the time, Scott Gottlieb, called for additional measures for prohibiting companies from marketing e-cigarettes directly to youth via the internet. However, health advocates contend the agency hasn’t done enough.

In the American Lung Association’s State of Tobacco Control 2019 report, the nonprofit gives the FDA an “F” grade. “The FDA regulation grade has a few components,” notes Thomas Carr, national director of policy, the American Lung Association. He says the FDA hasn’t moved forward with the prohibition of menthol-flavored tobacco products, which is one reason for the failing grade. “The fact that the FDA hasn’t regulated tobacco products in an adequate way is another reason why,” Carr continues. “But overall, it’s just been a lack of action in general.”

He also notes that the slow pace at which the FDA seems to be moving on tobacco control isn’t solely reflective of Trump Administration policies. “I think the FDA under the Obama Administration dragged its feet as well on this,” he says. “Back in 2011, [the FDA] said it was going to regulate e-cigarette tobacco products, and then it took the agency until 2016 to get a final rule in place that would allow the FDA to actually do that. I think just that delay alone hurt our ability to respond to the youth e-cigarette epidemic we’re seeing now.”

Despite the Lung Association’s admonishment of the federal government, Carr says “The Real Cost” Youth E-cigarette Prevention campaign is “the one bright spot for the FDA.” This newly launched marketing campaign includes a partnership between the FDA and school districts nationwide to spread the word about the harmful effects of e-cigarettes to teens using various marketing tools, including posters. Some movement also has been occurring in Congress. On May 20, 2019, Senate Majority Leader Mitch McConnell (R-Ky.) introduced a bipartisan bill co-written with Sen. Tim Kaine (D-Va.), raising the national legal age to buy tobacco products to 21.


Spreading the Word

When tackling the youth vaping epidemic head on, most park agencies recognize the complexities of this important issue and acknowledge they can’t do it alone — the same could be said for public health departments in cities across the country. Kelsey Fife, health promotions specialist at Mesa County Public Health in Colorado, knows this all too well, especially when examining the numbers.

According to a survey conducted on high school-aged youth in Mesa County, about 50 percent of high school youth admit they’ve tried vaping and approximately 30 percent said they’ve used an e-cigarette or other electronic vaping product in the past 30 days. “That’s a lot higher than what we see with other tobacco products,” says Fife, “and the second-most tried and used substance of all of them after alcohol.” Even more startling, only 45 percent of those Mesa County high school students believe vape products are harmful, while 60 percent said, if they wanted to, they could obtain these products easily or very easily.

She adds that those findings made this a community-wide issue and “was a key reason I was interested in doing education in our community.” Thus, Mesa County Public Health — with the assistance of a state-funded grant program called Communities That Care — collaborated with a number of local agencies to address this growing problem and to discuss how to educate parents and youth about the harmful effects of vaping and smoking. One of those agencies included the city of Fruita (Colorado) Parks & Recreation.

“[Mesa County Public Health] approached us and we agreed to be a partner with them, and we’ve been working through the Communities That Care process,” says Ture Nycum, parks and recreation director, city of Fruita. Communities That Care is a program, funded by marijuana tax dollars, that brings together community members to thwart problem behaviors and adverse health outcomes, such as substance misuse, among youth grades six through 12.

Nycum notes that his agency’s partnership with the Communities That Care program led to the Fruita Youth Initiative in the city. “Part of that is to really look at our environment and look at some of our ordinances and the laws we have on the books, as well as just looking at what’s happening in our community regarding substance use around youth,” he explains. “When we were looking at that, we noticed we didn’t really have anything that addressed smoking as well as vaping use within our park system. So, that’s when we looked at updating our smoking ordinance [through] the Fruita Youth Initiative.”

In December 2018, The Daily Sentinel reported the Fruita City Council voted 5–1 to ban smoking of any substance — which includes using vaporizers or electronic cigarettes — in any city-owned park, recreational facility or open space.

Nycum admits that his agency hasn’t witnessed a high rate of vaping among youth in his parks, however, he contends: “We figure if we can address it community-wide, that’ll definitely help reduce it within the park system and in public spaces.”

And since Fruita was updating its park policy around smoking and vaping, Fife says: “We wanted to provide some information to the community members on the ‘why,’ particularly…because…vaping is so new to people and very much a hot topic now. So, we wanted to back up their policy with some education.”


Presenting the Facts

On January 30, 2019, Mesa County Public Health, Fruita Parks & Recreation and other partners, including local law enforcement and school district personnel, hosted a Teen Vaping Prevention event for the community. The event drew about 75 people that included parents and some older youth.

During the evening, Fife made a presentation encompassing four elements: (1) introduce the numbers, (2) set the scene for how we got here, (3) address the marketing tactics and (4) discuss the local and state policies surrounding vaping/e-cigarette products.

She also discussed the basic components of the e-cigarette and vaping culture, including the different types of products on the market and the language that people might be using to talk about it, “because people who haven’t done it may not understand it,” notes Fife.

Some community members in attendance spoke about how e-cigarettes and vaping directly impacted their own families. Nycum says, “I talked to a few parents who said that they’ve found their kids’ vape pens…and some of them were definitely trying to figure out how to address it with their kids.”

Bringing awareness about the marketing tactics of these e-cigarette brands was another component of Fruita’s Teen Vaping Prevention presentation on January 30. “We know that 90 percent of people start smoking before the age of 18, before the legal age,” says Fife, “and 99 percent start before the age of 25. So, all those people are starting before their brains stop developing and that’s also when you’re more likely to become addicted to that substance.”

Fife says some of the questions they fielded from those in attendance included:

  • How are young kids getting a hold of vape products?
  • Why start vaping?
  • What is the data around connection to vaping and increased use of other illegal drugs?

The event proved to be quite informative and helpful to those in attendance. “I could see us doing it again…maybe, in the next school year,” says Nycum.


Vaping in Parks

Fruita, Colorado, represents merely one of many cities throughout the United States that have adopted smoke- and tobacco-free policies. In many cases, these changes begin with the community members themselves. On August 10, 2018, Nevada’s Reno City Council passed an ordinance banning smoking and vaping in its parks. Those in violation could face misdemeanor charges.

“It was actually a grassroots citizen-led initiative,” explains Andy Bass, director of parks, recreation and community services, city of Reno. “It started when we had a joint park commission meeting between the city of Reno, our neighboring city, Sparks, and our county, Washoe County.”

Bass adds that during that joint meeting, attendees listened to a presentation by a professor from the University of Nevada, Reno, and a representative from a health district that addressed the effects of smoking and vaping. The presentation led to the creation of three advisory committees and a larger discussion about banning smoking and vaping within city parks.

“It took about a year and a half, with…each of these three groups working together on what an ordinance would look like, drafting an ordinance and then presenting the ordinance to the different [governing] bodies and gaining their approval, and then taking that to the city councils and county commission for their approval,” Bass recalls.

Although the process took a long time, he says it was a well-thought-out one that ultimately became an ordinance. Bass adds: “We really should be leading the health discussions of our community as a park and recreation agency, and this [ordinance] was a way that we could impact the health of the community.”

Greater Huntington Park and Recreation District (GHPRD) in West Virginia was another agency that took a measured approach to finally passing its own tobacco-free park policy. The park district manages, operates and maintains 14 parks. “We built eight new playgrounds in the past six years. And each time we did, we created a tobacco-free zone around each playground; basically, to get people who were smoking and vaping away from the kids,” notes Kevin Brady, GHPRD’s executive director. He adds that his district did it by posting thoughtful, yet direct, signs — such as Young lungs at play. Please don’t smoke.

“Initially, we did only the playground areas, identified a 25-foot perimeter around them and declared that a smoke-free zone by putting up signs,” he says. “We primarily got a very positive response from parents.”

Brady says the next steps were establishing a special committee of the GHPRD Board of Park Commissioners and then working on a comprehensive study of the park district with Marshall University to gauge how community members perceive GHPRD and what improvements they would recommend. Their findings revealed that 87 percent of survey respondents would prefer going totally smoke-free and vape-free in their parks.

“Working with our board of directors, we established our policy,” Brady says. The park district consulted with its attorneys and collaborated with its county health department to develop a policy that would make all of GHPRD’s parks smoke-, vape- and tobacco-free, with the exception of the remote parking areas at the parks. The tobacco-free policy officially went into effect May 1, 2018.

Local municipalities aren’t the only ones taking a proactive approach to combating smoking and vaping. Additional progress has been made in this area at the state level. For example, in Maine, a state law was passed banning smoking of tobacco or any other substance in, on or within 20 feet of a beach, playground or restroom in a state park or state historic site.

On May 15, 2019, New Hampshire Governor Chris Sununu signed House Bill 139 into law, allowing the state’s Department of Natural and Cultural Resources to issue rules restricting smoking in state parks.


The Role of Park Agencies

What can park professionals do to educate the community about youth vaping? According to Ture Nycum: “I honestly believe partnering with your local public health department, police department and local schools is invaluable. It’s been invaluable here in Fruita to be able to talk to all those other agencies and come up with strategies on how to educate the community on what’s happening [with youth vaping] and then letting the community members make their own decisions.”

He adds that forging a partnership between your public health department and your park and recreation agency makes perfect sense, because public health departments have a lot of content and research they can provide, while park and recreation agencies have a lot more contact and outreach with the community. What’s more, it’s important to engage the community to get their input, especially about the pros and cons of instituting smoke- and vape-free policies in your parks.

When it comes to funding for tobacco cessation and education, Thomas Carr believes partnerships are critical. “I’d certainly encourage park and recreation departments to work with their local public health departments to talk about how they could work together to reduce tobacco use in parks. I think that would be a great partnership that could be explored in any state,” he says.

So, what role should park agencies play in confronting this serious epidemic? Perhaps Andy Bass sums it up the best: “Our role is to improve the health of our community members and if there are ways to mitigate the harmful effects of tobacco and e-cigarettes, then we should be willing to stand up and fight for it.”

Vitisia Paynich is a Southern California-based Freelance Writer for Parks & Recreation magazine.


Vaping Fast Facts

78%: The number of U.S. high school students who reported being current e-cigarette users increased 78.0 percent between 2017 and 2018 to 3.05 million (or 20.8 percent).
Source: “2018 National Youth Tobacco Survey,” Centers for Disease Control and Prevention (CDC)

48%: Numbers among middle school students rose 48.0 percent to 570,000 (or 4.9 percent).
Source: “2018 National Youth Tobacco Survey,” FDA and CDC

Four out of five kids who have used tobacco started with a flavored product.
Source: American Journal of Preventative Medicine

Youth report vaping as early as 12 years old.
Source: NBC News

Among middle school and high school students who reported ever using e-cigarettes in 2016, the most commonly selected reasons for use were:

  • use by “friend or family member” (39.0 percent)
  • availability of “flavors such as mint, candy, fruit or chocolate” (31.0 percent)
  • belief that “they are less harmful than other forms of tobacco, such as cigarettes” (17.1 percent)

Source: “Reasons for Electronic Cigarette Use Among Middle and High School Students” — National Youth Tobacco Survey, United States, 2016


Vaping Glossary of Terms

Following is a partial list of commonly used vaping terminology.

Analog: a slang word for an ordinary tobacco cigarette. This term implies that e-cigs, vape pens and vape mods are the digital/electronic option, while tobacco is the old physical or “analog” version.

Atomizer: this is another name for the heater coil that turns the e-juice into vapor. An atomizer must have plenty of liquid to operate properly; if it goes dry, it’s at risk of overheating and getting damaged.

Cartomizer: a disposable combination of an atomizer and a cartridge that includes both the heating coil and the liquid tank; many cartridges are technically cartomizers.

Cartridge: the disposable part of the electronic cigarette that attaches to the battery and holds the e-liquid. To create vapor, you inhale through the hole on the top of the cartridge.

Cigalike: a slang term for standard e-cigs that look like traditional cigarettes (as opposed to vaporizers, which don’t resemble cigarettes).

Clearomizer: a large, clear cartomizer that includes a clear tank and an atomizer base with a heating coil and wick.

Cloud Chasing: when vapers try to achieve the largest possible cloud of vapor, which can be dangerous.

E-cig: shorthand for “electronic cigarette.”

E-juice (E-liquid): the liquid used in vape pens and mods that turns into vapor. It is made of water, flavoring, nicotine and some combination of propylene glycol and vegetable glycerin.

Gurgling: a sound personal vaporizers make when too much e-juice has been added, or when the liquid has gotten into the central tube of the tank.

JUULing: a slang term for vaping using a JUUL e-cigarette device.

Leaking: this can happen when too much e-juice has been added to a personal vaporizer (PV), when it is carried or stored improperly, if it is damaged or if the pressure changes, like on an airplane.

Mod: short for “modification,” this refers to modified vaporizers or PVs that allow for modification.

Ohm: a measurement of electrical resistance. The lower the number, the faster the coil will heat and the more vapor it will produce.

Pod Mod: a new kind of personal vaporizer that uses self-contained “pods” filled with the vape juice.

PG and VG: propylene glycol (PG) and vegetable glycerin (VG) are two ingredients commonly found in e-liquid, as well as in various foods and medicines as a preservative.

PV: stands for personal vaporizer. These are larger than “cigalikes” and have refillable tanks for e-juice.

Tank: a PV tank is the cylindrical container that holds of the e-juice in a PV.

Wick: inside the tank cap, there is a wick that delivers e-juice to the heated coil.

Vape: the verb “to vape” means to use e-cigs or vaporizers, which produce vapor.

Vape Pen: this type of personal vaporizer is about the size and shape of a fountain pen.

Vaper: a person who vapes. Notice that the spelling is different from “vapor,” which is what all e-cigs and PVs produce.

Source: Mistic E-cigarettes; Pennsylvania State University