E-cigarettes are not new. But there are trends in the usage of e-cigarettes among teens that are new, and alarming.

The Centers for Disease Control and Prevention say that more than one in five high school students has vaped in the past 30 days, as well as five percent of middle schoolers. To put those numbers in perspective, fewer than three adults in a hundred were current e-cigarette users in 2018.

With those figures in mind, the Hopewell Valley Municipal Alliance will host a community forum on the trend of vaping, juuling and e-cigarettes among youth at 7 p.m. on March 28 in the Performing Arts Center at the high school. Smoking policy expert Kevin Schroth will give a presentation, which will be followed by a panel discussion featuring a physician from Princeton Nassau Pediatrics as well as administrators from the middle and high schools and at least one recent CHS alumnus.

The national numbers are reflective of the Hopewell Valley teen community. In the fall, students at the high school and Timberlane Middle School took Pride Surveys’ school climate survey. The survey was opt-in, and required parental approval.

One 7th grader out of 144 responding reported having used an e-cigarette in the past 30 days, and among ninth graders, just 5.5 percent had vaped in the past month. However, of the 100 11th graders who responded, 21 percent reported having used e-cigarettes in the past 30 days, on par with the national average.

Most adults report using e-cigarettes as a means to quit smoking tobacco cigarettes. Whether e-cigarettes have legitimate therapeutic uses is hotly debated in the public health community, but what is not debatable is this: teens are not using e-cigarettes to quit smoking. In Hopewell, even 11th graders have hardly ever touched one. It’s all about the nicotine buzz that e-cigarettes deliver, same as tobacco products.

“Because of the widespread use of e-cigarettes amongst adolescents and teens, it is necessary to give our parents the most up-to-date information on this growing trend,” says Heidi Kahme, coordinator of the Hopewell Valley Municipal Alliance. “Our hope is to prevent nicotine addiction and substance abuse amongst our youth.”

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Not that long ago, public health professionals coast to coast thought they had Big Tobacco on the run. Cigarette manufacturers have long been criticized for targeting youth with their marketing, the idea being that if they could hook ’em young, they would have lifelong customers in their hands. But decades of anti-smoking campaigns and crackdowns on stores selling goods to underaged smokers had gradually paid off.

The CDC reports that just 8 percent of high school students were tobacco cigarette smokers in 2018, down from nearly 16 percent in 2011. According to the Pride Surveys, the percentage at CHS is a mere 0.9 percent, although it’s worth noting that the results are based on a response rate of 45 percent for 9th grade and 35 percent for 11th.

“(Tobacco companies) know most millennials have never smoked cigarettes and never will,” says Devangi Patel, a health educator who had a table about e-cigarettes at Central High School’s Teen Wellness Day in early February. “They’re using the same marketing techniques they were using with cigarettes: targeting women and youth with e-cigarettes, using social media platforms, using social media influencers. They realize millennials don’t like being marketed to directly, so it’s being done subversively.”

Patel also had a vaping information table at Teen Wellness Day in 2018. But she says that in the space of a year, the concerns teens have about e-cigarettes have shifted.

“Last year it was more about how it’s not safe for you, how it’s not just water vapor (that you are inhaling),” Patel said. “Now it’s about nicotine addiction. Kids are realizing this is not good for them. And also realizing that these companies are targeting them. That was surprising to them. That’s making them realize that they need to be smarter, that they need to know better.”

Kevin Schroth spent eight years working as head of policy for New York City’s Bureau of Tobacco Control. The Trenton native and Lawrenceville School grad is now an associate professor at Rutgers University’s School of Public Health, where he works to address the threats posed by the diversifying market of tobacco and nicotine products, including electronic cigarettes.

Schroth says the tobacco-nicotine landscape has evolved before, but never like this. “This is the most significant change we’ve had, perhaps since the advent of the cigarette, in terms of the role of a mass-market nicotine product,” he says.

He acknowledges that some people see e-cigarettes as a potentially beneficial product for helping addicted smokers to quit.

“But the other way of looking at it is that they are a product that is drawing astounding numbers of teenagers into the world of nicotine addiction,” he says. “Also, when we look at the numbers, it’s very clear that many of the teenagers who are getting addicted to e-cigarettes are kids who would not have picked up smoking.”

One way that tobacco smokers say they use e-cigarettes to quit traditional cigarettes is to gradually lessen the amount of nicotine delivered by their e-cigarettes. Schroth is taking a wait-and-see approach on the potential benefits, noting that while it may work, it is not a scientifically proven cessation strategy.

“There’s new evidence that suggests electronic cigarettes might be reasonably effective in helping people to quit, but it’s emerging evidence. We have to wait and see to get a clearer picture of that,” he says.

Schroth advises people who want to get trustworthy information about vaping to turn to the CDC website, rather than relying on other sources like bloggers and social media. “There is a lot of good research out there, but there’s a lot of research that’s very questionable as well,” he says. “I feel like the CDC is always a very reliable source of information. Some people might assume, without looking at their website, that it’s going to be a biased, pro-health source that only counsels against using e-cigarettes. But if you look at their website, you’ll find that they try to provide a fair and balanced picture.”

He says it is clear that youth underestimate the chance of addiction. “Teenagers will be teenagers, and one of the characteristics of that is a sense of invulnerability and a lack of ability to foresee long-term consequences,” he says. “Now there’s a new product out there that has probably the same or comparable risk of being addictive (as cigarettes), but it appears in a package that does seem to be less harmful, which is exacerbating the issue.”

Also exacerbating the issue is that product selections continue to multiply. While tobacco cigarette smokers tended toward brand loyalty in their smoking choices, e-cigarette users are invited to experiment thanks to the industry’s proliferation of devices and flavors, each promising a different or better experience for the user. “We’ve been hoping the FDA would exert a little more authority in trying to freeze or control the market, and that hasn’t happened yet,” Schroth says.

Juul is a newer brand of e-cigarette that has made major inroads in the vape market. Schroth describes it as the iPhone of electronic cigarettes for the effect it has had in growing the market.

“Juul and similar products have become more efficient at delivering nicotine to the brain quickly, like tobacco cigarettes do,” he says. “Juul does everything a little better. It was the lightning in the bottle that caused what was already popular to go through the roof in terms of sales, particularly for high school students and young adults.”

At the forum on March 28, Schroth and the panelists will talk about the science, facts and clear risks associated with e-cigarettes. The event is open to the public and registration is not required. Schroth will also speak to 9th and 10th graders at CHS on March 29.