H4, Health Dept. Warn Students Against Vaping

“Imagine if you got three weeks of stricts for buying coffee if you weren’t over 18,” upper Emerson* said. “Just like vaping, coffee makes tons of students become frustrated and get headaches, but in keeping with mainstream culture, the Academy decided it’s okay to drink coffee, but not okay to vape, even if both are addictive. Perhaps vaping has more consequences, but perhaps it doesn’t.”

As of Oct. 8, 2019, 1,299 lung injury cases associated with e-cigarette or vaping product usage have been reported to the Center of Disease Control and Prevention (CDC) from 49 states, the District of Columbia and one U.S. territory. Twenty-six deaths have been confirmed in 21 states, with a 17-year-old teenager identified last week as the youngest vaping casualty thus far.

In recognition of growing concern, the CDC recently gave vaping-related lung injuries a new name: EVALI, or e-cigarette or vaping product use-associated lung injury. “At this time, FDA and CDC have not identified the cause or causes of the lung injuries among EVALI cases, and the only commonality among all cases is that patients report the use of e-cigarette, or vaping, products. No single compound or ingredient has emerged as the cause of these injuries to date, and there might be more than one cause,” the CDC’s website states.

However, “more information is needed to know whether one or more e-cigarette or vaping products, substances, or brand is responsible for the outbreak.”

The relative novelty of vapes and pertinent studies presents a daunting challenge to users and health professionals. “To me, one death is too many,” Health Department Chair Michelle Soucy said. “The cause of these deaths is not fully understood yet, and that scares me.”In light of growing concern nationwide, student health group H4 has installed informative flyers in dormitory bathrooms about the health risks of e-cigarette usage and support systems in place for those seeking to quit, while Medical Director Katharina Lilly and Licensed Clinician Marco Thompson delivered this Tuesday’s assembly on marketing tactics utilized by e-cigarette advertisement agencies and the four levels of addiction: “like it, want it, need it and crave it.”

However, Exonians are not wholly convinced that the perils of vaping are substantial enough to warrant urgent help, nor that solutions to the issue of student vaping are within the Academy’s purview.

In his assembly presentation, Thompson introduced a confidential support group for students struggling with addiction every Thursday during department meeting block in the church basement. “It was my goal, along with my colleague Mr. Brandon Thomas, to create a safe and confidential space for students to speak openly about their substance use concerns,” Thompson said. “From an adult perspective, I place the utmost importance on students being able to seek the assistance they need. We would be unable to do that with this group if the space were not both safe and confidential.”

This group is not connected to the ASAP (Academy Student Assistance Program) or affiliated with the Deans. Unlike the ASAP program, there is no requirement to inform parents of a student’s participation in this group and Deans will not be notified of attendees.

To address escalating concerns, H4 designed four different styles of posters—“one from the approach of [portraying] vaping as an epidemic, one about the business side of how tobacco companies run the vaping companies, a few with quotes from current students who vape and the fourth about resources the Academy offers to students wanting help with their addiction,” upper and H4 member Ellie Griffin explained.

“We did not want the posters to feel derogatory in any way. We just wanted to spread awareness that vaping is dangerous and that the Academy is here to help with quitting,” Griffin said.

For students and faculty involved in efforts to combat student vaping, gauging the scale of the issue on the Exeter campus has been a significant challenge. Nationally, vaping appears to be “an epidemic among high school students,” Soucy noted. However, Academy survey results indicate that Exeter rates are lower than the national average.

In the Youth Health Risk Behavior Survey administered in 2017, less than 16 percent of Exonians reported vaping 30 days prior to taking the survey. “I am not sure what we will find when we administer the survey again, but my guess is that our students do not use at the rates of youth in other parts of the country,” Soucy said. “I think Exonians are smart and realize how the industry has manipulated a new generation to use a nicotine product that was on its way out.”

Emerson, on the other hand, believes these figures are inaccurate and conjectured that many students do not give honest responses in school surveys for fear of repercussion. “The State of the Academy survey projected the number of students who have vaped at 10 to 15 percent, which is just not true,” Emerson said. “In my experience, the number has to be more around 40 to 50 percent. I can just count off on my head at least 50 people who vape at the Academy, and that’s just the people I know.”

Upper and H4 member Anna Jacobowitz offered an estimate closer to 30 percent. “I definitely don’t think that [vaping] is just an Exeter phenomenon,” she said. “I think this is a prevailing part of our age group nationally, and Exeter is no exception.”

Griffin attributed the prevalence of on-campus vaping to misinformation and insufficient knowledge about the potential consequences of using vape products. “There are many students who vape on campus, and I think they take the lack of long-term research on the effects of vaping as justification for not seeking out help or acknowledging the problem,” she said.

Emerson claimed that many of the studies conducted on vaping thus far have been inconclusive. “I question whether [researchers] have isolated vaping products that one can buy in the store, or if they are referencing all the vaping products one can buy,” Emerson said. “If you buy pods from online, they are often contaminated with other chemicals or products. You should only really hit products that you can buy in a store, and it’s not clear whether the studies take this into account.”

Upper Randall* agreed with Emerson, comparing and contrasting vapes with other substances that are allegedly more dangerous. “The posters around campus are not going to affect my use, because [vaping] is still safer than most other substances and the kids who did die from it were excessive users,” Randall said. “As long as my use doesn’t get out of control, I’m not in danger of any illness.”

Students and faculty agree that vaping has become more prevalent among Exonians as of late. “Definitely between 2015 and 2018, there was a big jump in [vaping] because of the invention of Juuls and sleeker products that are easier to hide,” Randall said.

According to Director of Counseling and Psychological Services Szu-Hui Lee, this upward trend has been apparent to health center staff. “I would say that in the last two years, there’s been an increase of students talking about their usage,” Lee said. “While not everyone is struggling with this, it certainly is on the minds of a lot of students—about their own use, worries about a friend’s use, how to refuse offerings, etc.”

Upper Taehoon Lee, who believes that approximately 25 to 30 percent of the student body vapes, noted that a student is more likely to vape if they are around others who participate in the same activity. “It’s interesting because a lot of people are completely oblivious of the fact that people vape and think ‘oh, nobody vapes in my dorm,’ when in fact, more people vape than they think,” he said. “It definitely depends on who you’re around.”

Emerson, on the other hand, does not believe vaping is limited to specific social circles. ‘That’s the funny thing,” he said. “I don’t think it’s [only] prevalent in specific niches. Even though there are some people who you would assume [vape] more than others, it’s spread out, which contributes to why it’s so prevalent.”

Prep Barbara* says she began vaping in October 2017, before arriving at Exeter. “I was with my friends at a Halloween party and we left the party to go to a graveyard … One of my friend’s older brothers had gotten her [a vape], and they split the cost amongst the three of them. They were all really excited that they had one and they were all posting their tricks, blowing Os or whatever they could do, so then I tried it,” she recalled.

Others, like upper Clyde*, picked up the habit at Exeter. “At first I thought, ‘wow, this is lame. Then, I started to do it at parties, when it came up. I used to use my close friend’s who vaped with them, but I got my own Juul last spring. That spring, I used it way more than I should have, to the point where it made me pass out,” he said.

Clyde soon found himself addicted. “I wanted to stop, so I tried to sell [the vape] and failed. Over the summer, I started smoking cigarettes again, and when I got back here, I got some Juul pods because they were convenient. I struggle with alcoholism and it’s been really hard, so nicotine is something I can still hold on to and use in that way because it’s not as bad. Even though it’s way more addictive, it’s not as destructive to my lifestyle,” he said.

The Academy has taken several steps to combat vaping, Soucy noted. “I think our school is doing a good job at talking about this issue in health classes, at assemblies, in advisory groups, and we are making it clear that these devices and use of any nicotine is prohibited on our campus,” she said. “There has also been an effort to inform faculty about these devices and the kinds of products that are out there.”

“Additionally, the health center will help students who are users and/or addicted to nicotine. Whether that help comes from a health professional and/or in the form of coming to the new support group that Mr. Thompson and Mr. Thomas are running … the process is confidential,” Soucy continued. “We want students to be healthy. It is not our goal in the health center to get anyone in trouble.”

Some students worry that this issue may be beyond the Academy’s control. “There are people who will experiment with vape and other substances—it’s pretty common for teenagers,” Jacobowitz said. “I’m not sure what the administration can do.”

Bella Alvarez ’19 voiced that Exeter adults lack a sufficient understanding of how Exonians are introduced to vaping. “One thing that is humorous to me is the way that adults [depict] ‘peer pressure’ as a means of influencing students into vaping—I’ve never found myself locked in a room with someone holding a Juul in front of me demanding that I hit it,” Alvarez said. “The subtleties of peer pressure are much more nuanced and if the administration wants to stop vaping, they [need to] present scientific evidence that illustrates the harmful effects of ‘Juuling’ and allow for some sort of ‘amnesty’ program.”

Griffin hopes that spreading word of non-disciplinary response options will encourage more students to seek help. “I think the Academy should keep raising awareness of the dangers of vaping and emphasizing that asking for help will not land you in disciplinary trouble and that your parents do not necessarily have to be notified,” she said.

Upper and H4 member Haruka Masamura encouraged her peers to utilize the abundance of available resources and actively confront their addictions. “I’ve heard that ‘Juuling’ is almost like a cup of coffee everyday for working adults: some people need it just to get through the day,” Masamura said. “However, with other resources like counselors on campus, I hope that students can find the root problem that made them first go into vaping, and from there, be able to quit vaping entirely.”

*Asterisks denote name change to preserve anonymity