Vaping is Overwhelming High Schools & Middle Schools. How Can We Help Our Teens?

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Scary Stat: 66% of teens think that the only thing in their vape pen is harmless candy flavoring. 
(from National Institute on Drug Abuse data)

But they've been misled. E-cigs are loaded with cancer-causing chemicals, heavy metals, dangerous toxins, and far more nicotine than a cigarette.

​The Vengeance of Vape
It’s 11:47am at Thomas Jefferson High School. The bell rings. 457 high school students slowly gather their backpacks, glance briefly at their phones, and throw away leftover chip wrappers.


Tanya, a high school freshman, begins the trek to her first afternoon class, Algebra II. As she climbs the second floor stairs, she mentally walks through the standard mental checklist:  phone, wallet, keys, vape. She immediately realizes that she left her small, zipped pencil bag on the metal chair against the wall in the lunchroom. Her recently purchased grape flavored USB-shaped vape sits inside.


Turning around with a panicked sharpness, she faces a sea of high school humanity. She dodges and weaves through backpacks and odd stares, desperate for a visual of her recent purchase. As she rounds the curve down the stairs, her peripheral view catches sight of the zipped canvas bag. A momentary sigh of relief. Desperately, she ensures the vape’s presence within the bag. She exhales.


In nearly every middle school, high school, and college campus, scenes like Tanya’s are on repeat. Virtually every demographic is facing a crisis that resembles the tobacco usage peak of the 1960s [1]. At that time, over 40% of U.S. adults engaged in cigarette smoking [2]. Think about that! Nearly half of all American adults smoked cigarettes just a few decades ago. Even for non-smokers, the inhalation of smoke particles was nearly unavoidable.

​Smoking is…Familiar?
Oddly enough, many may hold the scent or image of smoking with a bit of nostalgia. Actors/Actresses often smoked as a sign of class. Teenagers, even young adolescents, used cigarettes to rebel from expectations. Many restaurants maintained a smoking and non-smoking section well in the 1990s. It was ingrained within American culture. Even as data of smoking-related health risks emerged, many Americans were reluctant to accept the statistical reality of their beloved tobacco.

Remember when doctors recommended cigarette brands?!

​Even throughout the 1970s, nearly 30% of American adults still denied that smoking was a cause of lung cancer [3].

Slow Yet Steady Decline
As societal norms and knowledge increased, so did Americans' acceptance of cigarette dangers. Multiple Gallup polls throughout the 1990s repeatedly showed that approximately 95% of Americans finally believed that smoking was harmful to health [4]. Between 1965 and 1991, there was a significant decline in cigarette usage, with a 39 percent decrease from the 1960’s peak. By 2005, 20.9 percent of the American population, approximately 45.1 million people, smoked regularly. The number had dropped by 50 percent [5]. By 2021, only 11.5% (nearly 12 of every 100 adults) reported regular engagement with cigarettes [6]. *If you are seeking a more thorough breakdown of smoking consumption by sex, age, race, education, household income, U.S. Census region, marital status, etc, this Center for Disease Control resource provides such data.

A Flip in the Opposite Direction
Outside of this promising data, however, lies an alarming trend that is quite contrary to the statistical decline of the last 60 years. In 2007, the smoking-prevention movement faced a mountain-sized curveball.

Enter, the e-cigarette.

The e-cigarette, commonly known as the vape, entered the U.S. market in 2007 and shortly after began to dominate the charts as the top tobacco product used by American teens today. Although teens have long engaged with tobacco in some capacity, the alarm today stems from the staggering increase within a short period of time.​

Between 2011-2015, there was a 900% climb in e-cigarette usage. Contributing to this massive spike was the misleading yet engaging marketing strategy of many e-cigarette companies, JUUL being one of the leading forces. Commercials were often filled with bright colors, fashion-forward young adults, and upbeat music. This JUUL commercial highlights these tactics. In retrospect, it is clear that the marketing strategy was, unfortunately, a complete success.


More recently, in the 2022 National Youth Tobacco Survey, an estimated 3.08 million middle and high school students reported using tobacco, with e-cigarettes being the most commonly used product[7]. In some schools, administrative leaders have even installed smoke detectors in the restrooms and intensified consequences as deterrence. For many educators and parents, this reality is not shocking, but rather a lived experience unfolding before their eyes.  
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What is Really Inside?
What is inside an e-cigarette? For many Americans, the pervasive misunderstanding is that vaping is significantly safer than a traditional cigarette. Besides, weren’t they created as a scaffold for nicotine-dependent cigarette smokers? Although it is true that some e-cigarettes do not contain nicotine, they all contain high-risk chemicals whose health implications have only partially been realized. Consider the following numbers from the National Library of Medicine [10].

• “In 54 samples of e-cigarette liquids, the average nicotine content was 11 mg/ml
• Major compounds of e-cigarette liquids include glycerol (average 37 g/100 g), propylene glycol (average 57 g/100 g) and ethylene glycol (average 10 g/100 g).
• The average exposure for daily users was estimated as 0.38 mg/kg bw/day for nicotine, 8.9 mg/kg bw/day for glycerol, 14.5 mg/kg bw/day for 1,2-propanediol, 2.1 mg/kg bw/day for ethylene glycol, and below 0.2 mg/kg bw/day for the other compounds.”

In another standout publication from the 2016 Surgeon General, there were further explanations of e-cigarette emissions. Secondhand emissions contain "nicotine, ultrafine particles, flavorings such as diacetyl, a chemical linked to serious lung disease, volatile organic compounds such as benzene, which is found in car exhaust, and heavy metals, such as nickel, tin, and lead” [11]. A subsequent publication in 2018 by the Surgeon General noted the immense nicotine that is present in JUUL e-cigarettes, a popular brand on the market.  “All JUUL e-cigarettes have a high level of nicotine.

​A typical JUUL cartridge, or “pod,” contains about as much nicotine as a pack of 20 regular cigarettes [12].

​Are These Really Harmful?
Many of these compounds are known to have significantly negative effects on the body, especially when experienced in high dosages. For example, both glycerol and propylene glycol are capable of altering the gene expression that controls the circadian rhythm of the lungs [13]. Beyond these primary ingredients, the additional compounds are often unknown, mislabeled, or unregulated.


One former vape user, Jay Jenkins, found himself in a coma after casually trying what he thought was a simple CBD-infused vape. Rather than the intended calming effects of CBD, Jay learned [two puffs in] that the vape oil was spiked with a dangerous street drug [14]. Inaccurately-labeled vape devices pose some of the greatest risk, as their components can be a complete mystery. Because federal regulators have been in contentious legal battles with e-cigarette companies since their inception, regulation for these products is ongoing and state-dependent.


Vaping does not only lead to poor organ function. It can cause hospitalization and death. As of February 2020, 2,807 hospitalized EVALI (E-Cigarette, Vaping Product, Use Associated Lung Injury) or death cases were reported within the United States and U.S. territories.

How Teachers & Parents Can Help

As a Parent, What Can I Do?
Having difficult conversations can be intimidating. Parents often feel pressured to say all the right words. Many are also afraid of the response. However, although vape use is a newer, dangerous trend, it has not been the only dangerous trend or habit teens have tried. Parents of teens in the 1960s can speak to this

In preparation, consider reading this resource from the U.S. Surgeon General. It provides potential questions and reasonable responses a parent can offer.

Most importantly, rather than put off the conversation, simply begin it. Beforehand, you can prepare yourself by maintaining calm body language and a steady voice. This will help open up conversation, rather than shut it down.  

If you are homeschooling, or you'd like printable materials to help support your conversation, check out the doodle notes set below in the teacher tips as well.

As a Teacher, What Can I Do?
Many of the same approaches relevant to a parent are relevant to a teacher, especially regarding calm body language. Keep in mind that there are added boundaries between teacher and student. Begin thinking of meaningful ways you can engage your students on this issue. Yes, even if this is not directly listed within your curriculum. It’s critical! I've created some doodle notes on the dangers of vaping to help your students to analyze the reality of this issue.

​It’s time to step aside and use just a bit of lesson time to address this. It’s worth taking a day to nip it in the bud and save some of our kids from these irreversible damages.

This set of materials is designed to help you approach the topic in your math class, homeroom, science course, or health class.

The goal is twofold: show students who are already vaping what the hidden dangers are, and at the same time prevent other students from trying their first e-cigarette in the future.

​Preparation for the Lesson

• Build up the activity ahead of time. To do this, you can use the bonus slides (which include some of the colored square infographics and stats you've been seeing this article) that come along with the printables to spark curiosity. These can be posted on the classroom door or displayed on a bulletin board.
• If possible, invite a former smoker or vape-user, perhaps a young person, who can speak to the impact vape or nicotine addiction has had on their life.      
• Consider posting one or more of the resources available on the Tobacco Education Resource Library to your class online platform (Canvas, Google Classroom, Blackboard, etc).
• Remind students that the resources are available on more than one occasion. You never know when a student may decide to utilize one of the resources.
• Choose which pages to print. You can use any combination of the pages that are included, depending on your content area and goals. For example, if you teach math and science, you can use Vaping by the Numbers and Vaping Ingredients: What’s Inside during your lesson, and then save the other two pages for if you have extra time or if you notice more student interest or a need for it.  If you teach health, try The Story of Vaping and The Effects of Vaping pages first.  If you are doing this in a homeroom class, or for all of your students because your school is having a problem with vaping, use all four pages across a 2-3 day lesson on vaping.

Different Kids Care About Different Things!  Consider this...
An important thing to remember is that different students will be struck by different aspects of this.  Some vague potential health "danger" may not seem important at all to a particular student, but he may be more taken aback by learning about the financial side of the issue instead.

Or, other teen students who have a hard time visualizing far-off lung problems in the future might not seem to be impacted by most of the health risks, but you might be surprised to realize they care about their teeth and the potential of burns or ulcerations in their mouths in the short term.

Other students will become indignant at the thought of being harmed for someone else’s profit, and motivated to quit or to avoid vaping in the future once they see the profits that are at play.  Other students may be more motivated by learning about the physical harms instead. Different teens have different motivating factors, and find different aspects to be more eye-opening, so certain pages will work best for specific students or groups. 

No matter what page or content seems to hit home for certain teens, these materials cover it all, so they are a ​great tool for helping them become aware.

​And Finally…
Remember that your connection and care are the most powerful tools you have! Your child-parent or student-teacher relationship opens the door to meaningful conversation and a teen feeling truly supported.


One way to empower yourself is to become a ready resource. Review and deeply digest some of the key research points in this article and others. Become confident with the names of available resources so you can share them on demand.


You have more power than you realize! Even one adult can be the difference between an addicted teen and a healthy, breathing, nicotine-free young adult. Be that one.

Details on What's Included in the Lesson Set:

The Vaping by the Numbers worksheet is a look at the stats on teen smoking use and vaping over the years. It’s great for math classes to use when practicing graphing and analyzing data while learning about an important topic that is relevant to teens’ lives. This page goes well alongside the Story of Vaping page so that students can see how the events in the comic-style timeline impacted the rates of youth smoking and why after cigarette use dropped, e-cigarettes came in and took over.

The Story of Vaping page gives insight into the marketing behind smoking, the profits and agendas at play, and how some doctors will even advertise and promote something dangerous if they are paid to do so. This page is great for helping students become aware that these entities do not always have their best interest at heart. Its fun comic format makes a heavy topic more approachable for students. This sheet is helpful for health classes, social studies classes, or homerooms to use and discuss together. Some students will become indignant at the thought of being harmed for someone else’s profit, and motivated to quit or to avoid vaping in the future, so this page can be a great tool for helping them become aware. Other students may be more motivated by learning about the physical harms instead. Different teens have different motivating factors, and find different aspects to be more eye-opening, so certain pages will work best for specific students or groups.

The Vaping Ingredients: What’s Inside? sheet looks at some of the chemicals that are present in e-cigarettes. It also includes a quick peek at the dangers of secondhand smoke. You can use this page in science classes or health classes, or use them with your homeroom group. Since most teens think that only flavoring is inside, this can be very eye opening!

The Effects of Vaping page is an important one to include for all groups of students if possible. It shows students the impact of e-cigarettes on their bodies. This will show them clearly that this is not a harmless form of smoking in any sense. This page will hit home for many students who were not aware of these dangers, or who have a hard time visualizing far-off lung problems in the future, but may care about their teeth and the potential of burns or ulcerations in their mouths in the short term. (Gotta protect those beautiful smiles!)

The PDF downloads are available here: Dangers of Vaping Doodle Notes for Teens

If you have had success in your own classroom (or home) with helping teens quit or avoid vaping, please share any tips in the comments!
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References:
​1
https://nap.nationalacademies.org/read/11795/chapter/4
2
https://nap.nationalacademies.org/read/11795/chapter/4
3
National Center for Chronic Disease Prevention and Health Promotion (US) Office on Smoking and Health. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta (GA): Centers for Disease Control and Prevention (US); 2014. 2, Fifty Years of Change 1964–2014. Available from: https://www.ncbi.nlm.nih.gov/books/NBK294310/
4
National Center for Chronic Disease Prevention and Health Promotion (US) Office on Smoking and Health. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta (GA): Centers for Disease Control and Prevention (US); 2014. 2, Fifty Years of Change 1964–2014. Available from: https://www.ncbi.nlm.nih.gov/books/NBK294310/
5
https://nap.nationalacademies.org/read/11795/chapter/4#45
6
https://www.cdc.gov/tobacco/data_statistics/fact_sheets/adult_data/cig_smoking/index.htm
7
https://www.cdc.gov/tobacco/basic_information/e-cigarettes/surgeon-general-advisory/index.html
8
https://www.cdc.gov/tobacco/data_statistics/fact_sheets/youth_data/tobacco_use/index.htm#:~:text=Tobacco%20product%20use%20is%20started%20and%20established%20primarily%20during%20adolescence.&text=Nearly%209%20out%20of%2010,try%20smoking%20by%20age%2026.&text=Each%20day%20in%20the%20U.S.,youth%20start%20smoking%20every%20day.
9
https://www.fda.gov/tobacco-products/youth-and-tobacco/results-annual-national-youth-tobacco-survey
10
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4304610/
11
https://www.lung.org/quit-smoking/e-cigarettes-vaping/impact-of-e-cigarettes-on-lung
12
https://www.cdc.gov/tobacco/basic_information/e-cigarettes/surgeon-general-advisory/index.html
13
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8787618/
14
https://www.cnbc.com/2019/09/16/investigation-finds-illegal-synthetic-marijuana-in-vape-and-edible-products-sold-as-cbd.html
15
https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html

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