For decades, schools have been on the front lines in a successful campaign to reduce teenage cigarette smoking. Now, some educators are developing policies to control students鈥� use of e-cigarettes, devices still unregulated at the federal level that many fear could revive the tobacco habit among adolescents.
Otherwise known as 鈥渧ape pens,鈥� 鈥渃loud pens,鈥� and by other names, e-cigarettes are undoubtedly catching the eye of teenagers, and of even younger children. The in 2013 that the percentage of students in grades 6-12 who had tried e-cigarettes more than doubled between 2011 and 2012, growing from 3.3 percent to 6.8 percent.
Thirty-eight states of the product to minors, but e-cigarettes and other Electronic Nicotine Delivery Systems (ends), aside from those marketed for therapeutic purposes, are unregulated by the U.S. Food and Drug Administration. A in April, if passed, would put such devices under the category of tobacco products, allowing them to be regulated as such. The comment period for the proposed rule ends Aug. 8.
Electronic cigarettes鈥� lure to a young market may be due to several factors. Aesthetically, the sleek battery-operated cigarette, which houses an atomizer that vaporizes a liquid form of nicotine and other chemicals, is a far cry from its tar-and-ash predecessor. The liquid comes in individual cartridges, often with a flavoring such as chocolate or pi帽a colada.
鈥淲e know from past experience with other tobacco products that flavoring can mask the harshness of these products and make them appealing and enticing,鈥� said Brian King, a senior advisor in the CDC鈥檚 . Such flavorings in regular tobacco products in 2009.
Ready Access
Though many 鈥渧ape shops鈥� will not sell electronic cigarettes to minors, these products are often accessible through sellers like eBay.
鈥淲e haven鈥檛 had many younger children come into the store,鈥� said Vic Vega, the owner of Vapor Villa in Catonsville, Md., which does not sell to minors. 鈥淲e are aware that many of them turn to independent sellers.鈥�
Also, because e-cigarettes are not yet considered tobacco products by federal authorities, their marketing is not restricted, as it is for traditional cigarettes. And educators and law enforcement officials have noted that e-cigarette advertisements are using some of the same tactics that once drew teenagers and young adults to conventional cigarettes.
鈥淚t鈥檚 kind of a wild, wild West in terms of regulations. Big companies can have a billboard with Santa Claus on it, or other child-friendly characters, promoting e-cigarettes,鈥� said Stacy Deeble-Reynolds, the prevention coordinator for the Orange County Department of Education, which provides support services for 27 districts and more than 500,000 students in southern California.
The federal government鈥檚 slow response is due in part to a lack of sufficient longitudinal data on e-cigarettes鈥� potential health effects. The product鈥檚 popularity began growing around 2009, making it difficult to garner long-term evidence of electronic cigarettes鈥� health implications. What is known is that nicotine, the addictive ingredient in tobacco products, is a major component of most e-cigarettes.
鈥淲e know that nicotine has adverse health effects on the adolescent brain,鈥� Mr. King said. 鈥淎 lot of these products are advertised as containing no nicotine, but laboratory testing has shown that they actually do.鈥�
Some products also contain 鈥減otentially hazardous chemicals like metals, low-level nitrosamines, [and] formaldehyde,鈥� said Mr. King.
Phil Daman, the president of the , in Washington, sees e-cigarettes鈥� health implications in a different light, noting their benefit for adults hooked on regular cigarettes.
鈥淎 lot of my family died from smoking traditional cigarettes,鈥� Mr. Daman said. At the same time, he added, 鈥渨e don鈥檛 think it鈥檚 appropriate to have minors using a product that is really for adults.鈥�
Though the SFATA supports federal regulation to prevent the sale of e-cigarettes to minors, Mr. Daman does not view vaporizers as simply tobacco products, but rather as a product category of their own.
School Regulations
As more adolescents start using electronic cigarettes鈥攐ften on school property鈥攄istricts and administrators scramble to adjust pre-existing tobacco-free policies to encompass the newer product.
Though most states prohibit e-cigarette sales to minors, districts are left to their own discretion in dealing with students who bring e-cigarettes on campus.
On school campuses in Orange County, Calif., for example, no e-cigarettes are allowed. If students are found with such a device, it is confiscated and further measures are taken. Most likely, the school will put the student, and frequently the parents, in informational classes that warn against the dangers of e-cigarettes. Students also get cessation services.
In February, Orange County鈥檚 education and sheriff鈥檚 departments hosted an event to raise awareness about the prevalence of e-cigarettes in schools and their known health effects.
Many other districts have adopted rules on e-cigarettes and ends, often after state regulations were passed. Some districts, such as Florida鈥檚 Miami-Dade County, did not wait for state guidance.
The 345,000-student Miami-Dade system added specific language to its tobacco-free rules in fall 2013 to adequately cover electronic cigarettes, according to Walter James Harvey, the school board attorney. Now, students caught with e-cigarettes are given an 鈥渁lternative to suspension鈥� or educational classes on the devices鈥� effects, he said. Parents and school administrators also worry about electronic cigarettes鈥� ability to function as drug paraphernalia. Anecdotal evidence from schools nationwide indicates that some students have used e-cigarettes to smoke cannabis, hash oil, and other illegal substances on school campuses.
Ongoing Research
Meanwhile, researchers are working to find more concrete evidence about the effects of e-cigarettes. The , an ongoing FDA and NIH longitudinal study, includes a section on e-cigarettes and is expected to be completed in 2016.
A in the Journal of the American Medical Association warns of 鈥渁 major risk that e-cigarettes will revive the popular smoking culture that has taken decades to dismantle鈥� and advises the FDA to move quickly on regulations to prevent their spread among adolescents.
Ms. Deeble-Reynolds concurs. 鈥淲e don鈥檛 want students to be a part of longitudinal studies and be continually smoking these devices,鈥� she said, 鈥渢hen 20 years down the road not be able to do things like play soccer with their kids because they can鈥檛 breathe.鈥�
