TUPELO • As the public is focused on the emergence of vaping-related lung disease, public health officials and educators are equally worried about the rapid rise in vaping among high school students.

“Five million American teenagers are vaping right now,” said Robert McMillen, Mississippi State University researcher and professor who led the Mississippi Youth Tobacco Survey. “What is going to happen with that addiction is really alarming.”

Even though e-cigarettes are illegal for people under 18 to purchase, the Mississippi Youth Tobacco Survey found that vaping among high school students grew from 11.5 percent to 21.6 percent between 2017 and 2018. Based on the survey results, researchers estimate 28,189 Mississippi public high school students were using e-cigarettes last fall. By comparison, the survey estimated 9,000 Mississippi high school students smoke cigarettes, 6.9 percent.

Mississippi mirrored the trends in the national tobacco youth survey, which saw rates go from 11.7 percent of high school students currently using e-cigarettes in 2017 to 20.8 percent in 2018.

It will take a broad coalition of state agencies, educators, researchers, parents and community advocates coming together to address youth e-cigarette use in much the same way they did with tobacco in the 1990s, said Amy Winter, Mississippi State Department of Health tobacco control director.

“Youth do not need to use any kind of nicotine product of any kind,” Winter said. “Nicotine is a highly addictive substance … young brains are still developing into the mid 20s.”

Hide and seek

For school officials, combatting on-campus vaping is a game of hide and seek.

“It’s everywhere,” said Saltillo High School principal Casey Dye, whose staff has grabbed fewer than 10 vaping items this year. “This is a battle we are all fighting.”

The state youth tobacco survey found Mississippi teens who use e-cigarettes are much more likely to use pod-based e-cigarettes, like Juul and similar brands, McMillen said.

The Juul-style vapes are much smaller and easier to conceal than the vaping pens, roughly the difference between a thumb drive and a large dry-erase marker. They can quickly slip into a pocket without the telltale outline of a cigarette pack or smokeless tobacco can.

Saltillo High School has strengthened its policies against vape devices, Dye said. The staff watches the halls and the restrooms.

“I’m not going to say that we catch everybody,” Dye said, but the staff is working to aggressively enforce the policies. “We need the help of parents at home.”

Tupelo High School assistant principals haven’t found as many vaping devices and products so far this year.

“It comes in spurts,” said Assistant Principal Ryan Curry.

Curry is hopeful a combination of vigilant staff and the threat of three-day suspension are discouraging students from bringing vaping devices on campus. The school strengthened its policies to include not only tobacco products and vape devices, but things like lighters and Juul pods.

“It’s built into the same policies,” Curry said.

But as teachers and parents learn what to look for, the vape designs can shift. This school year, Saltillo High staff have seized a vape designed to look like a smart watch. The face pops off to become a vape device.

“You could push a button and tell the time,” Dye said.

There’s also vapewear on the market, like sweatshirts that have a pouch to conceal a vape, Winter said.

“It’s an evolving landscape,” Winter said.


Helping young vapers kick the habit is not simple. Because the Juul-style vape devices deliver higher concentrations of nicotine, youth are developing addictions more quickly.

“It’s a level of addiction to nicotine our pediatricians have never seen before,” McMillen said.

Youth under 18 can’t purchase over the counter smoking cessation aids, and the increase in vaping has been so rapid that there are no standard recommendations for physicians to follow.

“We don’t have best practices yet because there’s no research yet,” McMillen said.

Teens under 18 can get help through the state’s tobacco quit line – (800) 784-8669 – with the consent of an adult and receive counseling to assist them, Winter said.

In the big picture, McMillen anticipates there will be another substantial increase as they compile the results for this year’s surveys.

“We haven’t had any meaningful regulation that would change the usage patterns,” McMillen said.

While youth e-cigarette use and the vape-related lung disease are separate issues, the attention currently focused on e-cigarettes will hopefully lead to meaningful solutions.

“I think there’s an opportunity for strong regulation,” Winter said, although she was not advocating for any specific remedy. “It’s a complex problem, and it’s going to be a complex solution.”

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