As teen vaping rates continue to rise, Minnesota educators are monitoring their classrooms and hallways for well-disguised vaping devices.

Some are shaped like USB flash drives that students can charge by plugging them in to their laptop. Others double as pens and highlighters. Some are even less conspicuous: shaped like a smart watch, an ID badge attachment and even a replacement hoodie string.

What started out as a fad marketed to youth as a safer, healthier alternative to smoking cigarettes has ballooned into a health epidemic that public health officials and politicians are scrambling to rein in. As of Nov. 20, the Centers for Disease Control and Prevention (CDC) says 2,290 injuries and 47 deaths have been reported as a result of using e-cigarette or vaping products. Teens and young adults make up the bulk of those vaping-related hospitalizations resulting from serious lung damage, says Diana Zuckerman, president of the National Center for Health Research.

“I just want to emphasize how serious this is,” she told education reporters during a recent webinar hosted by the Education Writers Association. “When we think about smoking, we know it’s dangerous 20, 30, 40 years down the road. The fact that we already have so many kids hospitalized from vaping is just an unprecedented kind of epidemic.”

Armed with this new health information, administrators and educators at many metro area schools are doubling down on their anti-vaping efforts. While the bulk of their focus remains on getting information to students and parents, many are expanding the scope of their educational outreach and shifting from a punitive disciplinary approach to one that takes a more holistic approach.

‘We’re trying to rewrite the script’

In the Forest Lake Area Schools district, J.P. Jacobson, a middle-school principal, says the anti-vaping push has continued to focus on arming students with “good information, so they can make a good choice when there’s not an adult right there.”

That means talking about the health implications with students during advisory periods, reaching students in health classes and putting up anti-vaping posters.

Given how pervasive vaping has become in most student bodies, many districts are taking this sort of blanket approach to their educational outreach efforts.

According to the results of the Minnesota Student Survey conducted in 2019, 26.4 percent of 11th graders reported to have vaped in the previous 30 days — up from 17.1 percent three years prior. Additionally, the survey found that 11.1 percent of eighth-graders and 16.3 percent of ninth-graders reported vaping at least once in the past month.

But putting information about the health risks associated with vaping out there isn’t enough. So Jacobson and his colleagues are focusing on strategies they hope will change how students perceive vaping, socially.

“Too often, kids will make a decision based on what is seemingly socially acceptable. We’re trying to rewrite the script,” he said, noting they’re already seeing some success.

For instance, some of his teachers created an anti-vaping music video earlier this school year that he says has been well received by students. And another teacher in his building has created a pledge wall in the hallway, where students can add their name to a growing list of their peers who have pledged to say “no” to vaping.

Equipping parents with information about vaping, he adds, remains a key strategy as well. That includes more traditional PowerPoint-based delivery methods. And it includes a more hands-on approach, offered through things like a mock bedroom set up in the auditorium that’s staged with inconspicuous vaping devices.

Ann Lindberg-Borgen, a clinical alcohol and drug counselor and the chemical health coordinator for the West St. Paul-Mendota Heights-Eagan Area Schools district, helped launch the Top Secret Project — the traveling bedroom exhibit that made its way to Forest Lake — three years ago, through the Hazelden Betty Ford Foundation.

In her 22 years with the district, she says she’s never dealt with a more pervasive substance. She’s seen vaping devices that are difficult to distinguish from key fobs and watches. And while she’s been tracking the negative health impacts of vaping — such as signs of addiction starting after just six months of use, withdrawal symptoms like headaches and coughing, and even projectile vomiting caused by a strong hit of nicotine — it wasn’t until this past school year that she really had hard facts on the health risks of vaping at her disposal.

In addition to hosting informational nights for parents to learn about vaping, and sending brochures out to every household (grades 5-12), she’s also added educational evening sessions for students to her task list. They’re a requirement of the in-school suspension option that students in her district have, when caught with a vaping device on school grounds.

They also have the option to take an out-of-school suspension, she says. But, to date, she’s had just one student go that route, compared to nearly 50 students who’ve chosen to attend.

“The biggest part of this whole epidemic is getting education out there,” she said, noting there’s no student demographic that’s more at risk than others of vaping. “I just think we’re gonna lose this generation if we don’t deal with it.”

Building out recovery resources

Working with students in the Wayzata Public Schools district, Ali Wobschall, director of Partners in Prevention, says the addictive qualities of vaping make it particularly concerning.

“I think that’s one of the most difficult aspects of this,” she says. “Because the vape is so highly concentrated with nicotine, addiction is happening faster than with other substances our coalition works to address.”

So while last year’s anti-vaping campaign focused on getting information to students, educators and parents at the secondary level, she says, the focus this year has been on getting students into recovery.

They’ve already conducted several staff trainings, run a poster campaign designed by students, put health warnings on billboards in the community and sent out informational brochures to every household. This year, those efforts are trickling down into the district’s three middle schools, with discussions currently under way about how to approach preventive messaging with elementary students and their families.

According to student survey data collected this school year, Wayzata students who vape are saying they started vaping because they thought it would help them manage their stress or anxiety. Wobschall says findings like this underscore the need for more services, like mental health supports.

When asked, the majority of students who were self-identified users indicated they’d either tried to quit or were interested in quitting and “want more support,” she adds. That aligns with what educators are hearing from students they advise.

A less punitive approach

Likewise, in the Rosemount-Apple Valley-Eagan district, health staff are looking at ways to build out a more holistic approach to dealing with vaping in schools — a less punitive approach that’s better fit to address any related mental health issues.

Deb Mehr, the district’s health services coordinator, says the district recently received a grant from the county that will be used to accomplish two key things: add vaping information to the curriculum and support diversion efforts that keeps kids in school and connect them with resources to make healthier decisions.

Addressing misperceptions about the health risks associated with vaping, she says, are paramount. And it’s hard to have engaging conversations with youth when they’re too fearful of disciplinary action to seek information or help.

Her sense of urgency around addressing vaping is spurred by two recent seizure episodes at two different school sites — once this year and once last year. In other instances, she’s found students who’ve been vaping experience very high blood pressure and pulse rates.

“I think part of the problem is kids don’t know what they’re vaping,” she said.

Health officials have linked recent vaping-related lung injuries to THC and vitamin E oil, mostly found in illegal vaping products. But even legal ingredients — like nicotine and formaldehyde — are “potential carcinogens and very toxic” says Zuckerman. And manufacturers aren’t required to list all of the ingredients, since they’re considered trade secrets.

Along these lines, teaching students to be more critical consumers is key to keeping them safe, says Leslie Stunkard, a licensed drug and alcohol counselor in the Minneapolis Public Schools district.

With more than 70 schools districtwide, she says the push from her team has really been to teach students, especially the older ones, to be “skeptical about the advertising they hear.” She likes to point out how these companies are trying to market themselves as a good thing — by offering scholarships and even selling vitamins.

Offering another example of how educators in her district are getting students to think more critically about vaping, she says a science teacher at Washburn High School has created a lesson on vaping that explains the how even the name “vaping” is deceiving.

“I think one of the things that slowed us down a bit is the staff are learning — just as we and the students are learning — just how dangerous it is,” she said.