Increased use of vaping devices among youth is not just a state and national phenomenon. Local school districts say they are battling the popularity of the devices, and it's presenting some unique challenges.
E-cigarettes, or vaping devices, allow smokers to inhale and exhale aerosol, flavors and other chemicals including nicotine, an addictive chemical derived from tobacco, through an electronic device, which is regulated as a tobacco product by the U.S. Food and Drug Administration.
The legal age to purchase, use, possess or transport tobacco or vaping devices in the state is 18. In Jefferson City, the legal age to purchase tobacco products was raised to 21 in 2017.
Statewide, there has been a significant increase in the use of e-cigarettes among students in the last two years, according to the Missouri Department of Health and Senior Services
"We now know that 90 percent of in-school suspensions now are for vaping," MDHSS Director Dr. Randall Williams said. "So it is our school systems that are sounding the alarm because it is overwhelming them from a regulatory framework."
The Missouri Department of Mental Health and the Department of Elementary and Secondary Education conduct a statewide survey on substance use and related behaviors for sixth- through 12th-graders in even-numbered years. Districts participating in the Missouri Student Survey are required to provide the survey to one middle school and one high school classroom per grade.
In 2018, the survey found more than 15 percent of Missouri students reported they had smoked e-cigarettes within the last 30 days. In 2016, more than 10 percent had said they had smoked e-cigarettes.
In the Jefferson City School District's survey for 2018, 17.9 percent of sixth- through 12th-graders said they had used e-cigarettes within a 30-day period.
Increased use among students
Officials at the two largest public high schools and two largest parochial schools in the Jefferson City area admit they have seen an increase in vaping and tobacco use among students in recent years.
In the Jefferson City School District, 405 tobacco incidents — which include cigarettes, chewing tobacco and vaping — were reported from the 2014-15 school year to the current school year. For most individual school years, 45-90 violations are noted.
From the 2014-15 school year to the current school year, 15 discipline reports in the Jefferson City School District specifically mentioned e-cigarettes or vaping at four buildings — Jefferson City High School, Jefferson City Academic Center, Lewis and Clark Middle School, and Thomas Jefferson Middle School.
During the 2018-19 school year, incidents of tobacco use in JC Schools spiked with nearly 150 violations reported.
Superintendent Larry Linthacum said of the increase: "Whether it's chewing tobacco or vaping or smoking a cigarette, it's one of our staff members being engaged and connected and saying something if they see students doing something that they shouldn't be doing.
"I think that's a positive. We want to see it go down to fewer kids doing this, but also making sure our staff is having the willingness to say something if they see or suspect students doing something they aren't supposed to be doing."
In the Blair Oaks R-2 School District in Wardsville, 13 vaping violations were reported at the high school from the 2014-15 to the current school year. More than half of the violations took place in the 2018-19 school year.
Thirty tobacco incidents were reported from the 2014-15 school year to the 2019-20 school year at Blair Oaks.
Officials at Calvary Lutheran High School, a private faith-based school, say two vaping incidents occurred between the 2014-15 school year and the current school year.
One incident occurred in the 2017-18 school year and the other in the 2018-19 school year. In both instances, the devices were not in use but were confiscated from students, CLHS Principal Erich Ahlers said.
"Students started talking about it the year before (2016-17)," Ahlers said. "I know that I was hearing that."
Officials at Helias Catholic High School, also a private faith-based school, said they have noticed an increase in vaping incidents, but declined to provide numbers of incidents to the News Tribune.
In a statement, Helias Principal Kenya Feummeler said: "We have noticed an increase in vaping in the past year. We are doing everything possible to be sure students are educated on the harmful effects of e-cigarettes and vaping."
Using discipline to address vaping
"We have a policy against these devices on our campus, and we take the job of helping to keep our students healthy very seriously; therefore, we strictly enforce the policy," Feummeler said of Helias' approach.
The school's policy states tobacco products including e-cigarettes are not permitted by students at any time on or around school grounds, said Sandra Hentges, Helias communications and admissions director. Possession of the products, including at school activities and events or in vehicles on school property is also prohibited.
The school reaches out to parents/guardians when students are found in violation of the policy.
Discipline actions from first to fourth offense include five detentions, one appropriate educational placement day, two AEP days and two days out-of-school suspension. Detentions take place either before or after school.
AEP is a "full day in an appropriate place in the school, supervised and working on school work, but not going to class," Hentges said. Students in AEP are not allowed to participate in sports or other activities during that time.
The school is looking into vape detectors for restrooms and locker rooms, she said.
In JC Schools, discipline for violations of tobacco and vaping policies are separated by possession and use. A first offense for possession is confiscation of the device and in-school suspension, detention or a conference with the principal.
The first offense action for students who use tobacco or vape products mirrors those who were in possession with an added one- to three-day out-of-school suspension option.
Any subsequent offenses include detention, ISS or one- to 10-day out-of-school suspension.
At Blair Oaks, a violation of the tobacco/vaping policy results in in-school suspension.
But monitoring and detecting vaping is more difficult than it is for cigarettes, Blair Oaks High School Principal Melinda Aholt said.
"The smell of vape is fruity or more flowery maybe. It has a different scent than heavy cigarette smoke. It's not as noticeable. Everybody knows what a cigarette smells like; we don't all know what vape smells like. That smoke is a lot lighter."
E-cigarettes are also easy to conceal because they come in a variety of sizes, Aholt said. Some even look like USB drives, she noted.
Using education to fight tobacco use
Area educators say they are using education to combat the increase of youth vaping. Preventive programs from state and national organizations are also aimed at teaching about the risk of nicotine.
During student group meetings, Helias is educating students through presentations, Hentges said. Posters are placed in restrooms and locker rooms. Conversations about the topic are initiated by coaches, counselors, school nurses and other administrators at the school, she said.
Linthacum said the Jefferson City district is encouraging students to make good choices and learn from their mistakes.
"We want to make sure our students are making good choices and help educate them on the risks that go along with choices and vaping," Linthacum said.
At Blair Oaks High School, Aholt is looking for speakers to give classroom presentations on vaping. The smaller group sizes allow clarity of the message, and students may be more likely to ask questions, she said.
"I think its always important to educate your kids," Aholt said. "Whether the kids are getting caught or not is not why we want to educate. We want to educate because our kids need to know more information on this."
A statewide approach
Gov. Mike Parson signed an executive order Oct. 15 calling for a coalition of state government departments to create and launch a campaign aimed at reducing youth vaping.
DHSS' Williams said: "Young people have mistakenly gotten the message that vaping is OK because they perceive it better than cigarettes, and we think that's absolutely not true."
The department is working with other state departments including DESE on the campaign called "Clear the Air."
Health officials are concerned, in addition to nicotine addiction, unknown damages from vaping have yet to be discovered.
DHSS reported 32 people in the state have a confirmed or probable case of electronic vaping associated lung injury. Eighteen of those cases involved youth ages 15-24. The Centers for Disease Control and Prevention has not confirmed the exact cause of the vaping-related illness.
The CDC has confirmed 1,604 probable cases of EVALI in 49 states, the District of Columbia and one U.S. territory, as of Tuesday. Thirty-four related deaths have been confirmed, including one Missouri man.
More research is necessary to confirm the exact dangers of vaping, but experts believe smoking e-cigarettes could leave solid particles in the lungs, Williams said.
And the concern, he added, is youth who vape have a higher chance of moving on to smoking cigarettes.