WATSONVILLE — For several decades, public health officials battled cigarette smoking by young people, and by many accounts, those efforts have been successful.
According to the Centers for Disease Control, cigarette use among both middle school and high school students has decreased since 2011.
But since the advent of electronic smoking a little more than a decade ago, the numbers of young people using nicotine products have taken a drastic turn.
According to Tara Leonard, a health educator with the Santa Cruz County Tobacco Education and Prevention Program, one in five high school students nationwide use e-cigarettes, which is a 78 percent increase between 2017–18.
At the same time, one in 20 middle school students reported vaping, Leonard said.
The Centers for Disease Control and Prevention has reported a more than 800 percent increase in electronic cigarette use among middle school and high school students between 2011 and 2015.
The problem has even made its way to elementary schools, with one report of a third-grader caught with vaping products, Leonard said.
“We’re seeing a rise at an incredible rate,” she said.
Leonard said she expects those numbers to be even higher when the annual California Healthy Kids Survey is released in the summer.
The survey asks students in grades five, seven, nine and 11 a host of questions about heath risks and behaviors.
U.S. Surgeon General Dr. Jerome Adams weighed in on the issue during a Dec. 18 press conference.
“I am officially declaring e-cigarette use among youth an epidemic in the United States,” he said.
WHAT IS IT?
Also known as vaping, e-cigarettes work by heating a liquid into vapor inside a small electronic device, which the user then inhales. Many of the liquids contain nicotine, the addictive substance found in tobacco. Users can also ingest marijuana through vaping.
The products are marketed as a tool for adults who want to quit smoking, a claim that has not yet been proven.
But the flavored liquid offered by tobacco companies has caught on with legions of young people drawn to such flavors as “ gummy bears,” “sour patch” and “cotton candy,” which health officials believe were designed to attract a new generation of young customers by making it easier to start the habit.
“We see it as a predatory move by the tobacco industry,” said Martine Watkins, who is the senior community organizer for the Santa Cruz County Office of Education.
An e-cigarette, like a Juul, are marketed as a tool for adults who want to quit smoking, a claim that has not yet been proven. — Illustration by Tony Nunez/Register-Pajaronian
According to a study by the University of Michigan, vaping brings with it far fewer than the 7,000 harmful substances found in traditional smoke, and are therefore thought to be a safer alternative.
But with an industry in its relative infancy — e-cigarettes made their debut in 2007 — the long-term effects of vaping are far from clear, and researchers still don’t know all the compounds created by vaping.
Many of the vaping “pods” contain nicotine, some of them equivalent to two packs of cigarettes.
Nicotine is a highly addictive substance that raises blood pressure, and increases heart rate and the likelihood of having a heart attack, according to Johns Hopkins Medicine.
“People need to understand that e-cigarettes are potentially dangerous to your health,” said Dr. Michael Blaha, director of clinical research at the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease. “You’re exposing yourself to all kinds of chemicals that we don’t yet understand and that are probably not safe.”
According to the American Lung Association, the vaporized liquid among other things releases diacetyl, a chemical that can cause “popcorn lung,” which is the scarring of the air sacs in the lungs. The result is the thickening and narrowing of the airways, coughing, wheezing and shortness of breath.
Communities throughout the U.S. have several measures in place to keep tobacco products out of the hands of kids, but much of the heavy regulation that governs them have not yet found their way to vaping.
Police agencies conduct decoy operations to make sure retailers are not selling to young people, and most online retailers that sell vaping products require buyers to go through a third-party age verification system.
The Santa Cruz County Board of Supervisors on Tuesday approved an ordinance that bans the sale of flavored tobacco and vaping products in the unincorporated parts of the county beginning on Jan. 1, 2020.
A total of 36 California counties have passed similar measures, and the cities of Watsonville and Capitola will soon consider similar bans. The Santa Cruz City Council approved a ban in November.
Erika Trejo, Tobacco Use Prevention Education Coordinator for Pajaro Valley Prevention and Student Assistance, said many young people can easily purchase vaping products on the internet, while others are getting them from their homes.
Educators are responding with education in the classroom and communities, but it has been difficult to convince young people that the seemingly innocuous products are dangerous, Trejo said.
“We are expecting to see a rise in kids using these products,” she said.
Still, many young people are easily getting their hands on the products, Leonard said.
“Retailers will swear that they don’t sell to minors,” she said. “Websites swear that they have age restrictions. But if you talk to high school principals, they will tell you they confiscate these things on a daily basis.”
Aptos High School Principal Peggy Pughe said the problem is a challenge for all schools as administrators look for the easily concealable e-cigarette devices, some of which are designed to resemble USB thumb drives.
“Kids are becoming more savvy,” she said. “The faculty is super well-connected to the students, so they pay attention. We have a faculty interested in knowing what to look for.”
Watsonville High School Principal Elaine Legorreta said students are caught a few times per month at the school, thanks to increased vigilance of school staff.
“We know it’s on the rise,” she said.
Pajaro Valley High School principal Matt Levy said the numbers there are similar to those of Watsonville High.
There have been no expulsions in the district stemming from vaping, but the numbers are difficult to track because the district lumps it with tobacco use and marijuana, spokeswoman Alicia Jimenez said.
A Juul Labs Inc. e-cigarette sits between an iPhone and a thumb drive. Because of their sleek design, an electronic cigarette can blend in with other electronics. — Illustration by Tony Nunez/Register-Pajaronian
Still, the problem has not yet reached the level some schools are reporting.
“In PVUSD we haven’t seen it as an epidemic,” Jimenez said.
According to PVUSD Director of Student Services Suzanne Smith, the problem is worse at the middle school level.
EASY HABIT TO PICK UP
With the harsh smoke associated with traditional cigarettes, becoming a smoker used to require withstanding the harsh fumes and bitter taste of the burned tobacco.
That’s not the case with vaping, which delivers a pleasant taste along with a burst of nicotine.
The ease of use and the colorful marketing often leads young people to believe vaping is healthier than smoking, Leonard said.
“The vaping industry has figured out a way to remove the negative experience,” she said. “It’s still deadly and addictive but that’s not as obvious anymore.”
The FDA in 2009 banned flavored cigarettes after Congress said they were aimed at hooking young people on tobacco.
STUDENTS WEIGH IN
While some students report that vaping is a problem at their school, others say that their administrators do a good job of keeping it off campus.
“The students know the consequences,” said 16-year-old Watsonville High School student A.C., who asked to only be identified by her initials.
Still, A.C. said it has been easy off-campus for her to get her hands on nicotine-based vaping liquid, which she said tasted “nasty,” and which made her feel like her head was spinning.
“I feel like it’s not for me,” she said.
A.C. now avoids vaping at parties, but said she isn’t bothered by seeing her friends do it.
“I’m sure they know what they’re doing,” she said.
A.E., 17, also disliked vaping nicotine liquid, but said she “vapes” marijuana about once a week, in part because she feels pressure from her friends.
She said she does this despite knowing the risks learned during a freshman health class about drug and alcohol abuse.
Watsonville High School junior Jesus Flores, 16, said he avoids vaping because he is a soccer player and wants to stay healthy.
“I know the risks,” he said.
Flores said he has seen many young people, some as young as 11, using vaping products outside of school hours.
“Nowadays you see small kids with marijuana or vapes, not knowing what they are doing, but just because they think it’s cool,” he said. “It bothers me because I can’t do anything about it.”
Flores said that it is easy for young people to get vaping products, despite laws preventing it.
“There are some stores that don’t even ask for IDs,” he said.
Moreover, many kids know that purchasing illicit products is as easy as a text message away, he said.
All of this could be combated with increased health education and activity-based after-school programs, Flores said.
“They should do more to prevent it,” he said. “We have to try to stop this. Little kids are going to be the future.”
TESTING THE SYSTEM
While researching for this story, Register-Pajaronian Managing Editor Tony Nuñez and I visited five websites to try to purchase vaping products.
Most offer a starter pack, which comes with a vaping device and nicotine-based liquid.
We were pleasantly surprised to discover that all of them use third-party age verification systems.
This included entering a name, birthdate and address. Two required the last four of our social security numbers, while the rest asked us to upload photos of our driver’s licenses. This information would then be used to check our names against public records.
Instead, this newspaper purchased a Juul and a four-pod pack for roughly $72 at 831 Smoke Shop off Freedom Boulevard.
The store, which an employee said has been around for four years, had massive signs throughout reminding customers they will need to show ID in order to purchase nicotine products. And, sure enough, an employee asked for ID, studied it for a few seconds and scanned it, too, as a precaution.
Editor's Note: Tony Nuñez contributed to this report.