The lives of Tuscola County’s teens lie between two marketing strategies.
On one side are e-cigarette companies, with devices that resemble pens and flash drives and vapor flavors that are fruity, candy-like and packaged in colorful wrappers. On the other side is Amy Cuthrell and “We are not fish.”
What’s at stake is the addiction of local teens through vaping – the act of inhaling and exhaling the aerosol, often referred to as vapor, produced by an e-cigarette or similar vaping device.
“I think there is this thinking that it (vaping) is just a fad, but it actually is the creation of a generation of addicts,” said Cuthrell, a risk prevention specialist with List Psychological Services in Caro. “It was a genius marketing tool that R.J. Reynolds and our tobacco companies did. Nicotine is the most addictive substance on the planet. And we are hitting that at 12 years old. That’s the scary part of it.
“This was incredibly brilliant, as far as a money-maker, because once you start it is very hard to quit.”
So far, the e-cigarette companies are winning. According to a recent report from the Centers for Disease Control, nearly one out of every five high school students – 20.8 percent – used an e-cigarette in 2018, compared to just 1.5 percent in 2011. Another 4.9 percent of middle schoolers – one in 20 – did the same in 2018, up from 0.6 percent in 2011.
The National Institutes of Health’s Monitoring the Future Study, an annual survey tracking substance use among nearly 45,000 eighth, 10th and 12th graders, shows a dramatic increase in American teens’ use of vaping devices in just a single year – with 37.3 percent of 12th graders reporting “any vaping” in the past 12 months, compared to just 27.8 percent in 2017.
“These data are a sobering reminder of the rampant rise of youth e-cigarette use. I fear this trend will continue in 2019, forcing us to make some tough decisions about the regulatory status of e-cigarettes,” said federal Food and Drug Administration Commissioner Scott Gottlieb, M.D. “No child should be using any tobacco or nicotine-containing product and we’re committed to reversing this epidemic. We’ll continue to take a series of escalating regulatory actions to try to address the root causes of this spike in youth e-cigarette use, in particular by ensuring these products are sold in ways that make them less accessible and appealing to youth.”
While those are national numbers, the local outlook isn’t any better. According to the Michigan Department of Education’s Michigan Profile for Healthy Youth (MiPHY), 15.8 percent of Tuscola County middle school students and 32.1 percent of high schoolers used an electronic vapor product in the past 30 days.
And Cuthrell thinks those numbers are conservative.
“I think it is worse than that now,” she said.
All of this came at a time when cigarette use among teens was dropping, from 15.8 percent to 8.1 percent for high schoolers and from 4.3 percent to 1.8 percent for middle school students. But that, too, may change.
“Vaping is a gateway to cigarettes, or whatever is next,” said Cuthrell. “And that is the sad part about it.”
That’s because what teens are inhaling, for the most part, contains nicotine. E-cigarettes were sold, initially, as a way for people addicted to cigarettes to get nicotine without the harmful effects of a burning cigarette. That’s because an e-cigarette heats the liquid until it becomes a vapor to be inhaled, while a cigarette is heated to combustion, releasing smoke and other toxins into the lungs.
At some point, however, the firms making the vapor pouches, also known as pods, began creating sweet, fruity and candy-like products that appealed to young people. But that’s not all sweetness and light. Cuthrell said the vapors contain carcinogens, heavy metals and that one pod is equal to 55 cigarettes.
“We have some students who get (e-cigarettes) from China, over the internet,” Cuthrell said. “That really scares me because they are buying the pods as well. We have no idea what they are vaping in that. And we know there are heavy metals, there is copper, we are able to verify that within the components in these pods are some heavy metals.”
Because what is in most vaping products is not federally governed or approved, Cuthrell said, there’s no way of knowing what teens are inhaling. Even though some pods claim to contain no nicotine, she believes they do, simply based on what she sees happening to the young users.
“Because there is a reason that you still desire it,” she said. “There is a reason why you still want to do this. Just because they are not regulated doesn’t mean there is no nicotine in them.”
“They don’t see it,” said Chad Daniels, principal of Cass City Junior/Senior High School. “They’ll say there’s nothing in it, it doesn’t have nicotine, it doesn’t have this, it is just a fruit water. Here’s the thing: If it is just a fruit water, then why do you have to do it all of the time? If it just a fruit water, I can go to the vending machine and splash some of it in my face and get the same thing and not have to buy the vapor.”
But even if it is “just fruit water,” Cuthrell said, inhaling that simply isn’t natural. And that is where “We are not fish” comes in. The slogan refers to the fact humans do not get their oxygen through water like a fish does, so the inhalation of just water vapor alone is not good for the lungs and the body.
“What happens when you get water in your lungs? You cough,” said Cuthrell. “And what happens when you get too much water in your lungs? You drown.
“It doesn’t make sense to the adult population, but the kids get it.”
Besides, Cuthrell added, that may smell like watermelon, but it is not from a watermelon but rather from some synthetics. Some research indicates the chemicals used in the flavoring may be toxic, Dr. Richard Feldman, director of medical education at Franciscan Health Indianapolis and a former Indiana state health commissioner said in an interview with the Indianapolis Star. Scientists know vaping releases other substances such as formaldehyde that can endanger the user’s health. And there’s some evidence vaping may damage lung and throat tissue.
“No one squeezed watermelon juice into these vape pockets,” Cuthrell said. “Why do you think it tastes like watermelon? Because what they love is the flavors. Do you think someone seriously squeezed a watermelon into those cartridges? And no one squeezed a mango and made it taste like a Skittle.”
Another selling point to vaping is more simple: Teens see it as cool. And the proof lies in its overall appeal.
“You know who is doing it?” said Brian Galsterer, Reese High School principal. “Everybody. High schools are cliques – the nerds, the jocks, the geeks, the burnouts, the stoners, whatever. They can all agree that that (vaping) is cool. It is back to that marketing. They did a helluva job. It is not discriminating.
“The straight-A student who is a good decision-maker, he or she is vaping as well. They’ve done a helluva job of being able to market to all demographics.”
And while pure economics should limit vaping to the more well-heeled students – an e-cigarette device costs about $50 and four flavored pods cost about $16 – the law limits the purchase of such devices and products to those 18 and older. So teens have found other ways to vape.
What is happening, Cuthrell said, is someone 18 is buying several devices and pods and then reselling them, for a profit, to underage teens. The teens then pass the devices around, she added, because “not everybody can afford a $50 device.
“It is all fun and sneaky and they share it because it is quite expensive.”
Which leaves people like Cuthrell with another fish-type dilemma: Trying to get students to swim against the peer-pressure tide.
While nearly all high and middle schools have been running campaigns to stem that tide by informing both teens and parents of the dangers of vaping, Cuthrell takes that fight to a new level. She’s planning on putting Fatheads and information up in schools, preferably near the bathrooms, outlining the dangers of vaping. She wants to turn them into no-vape zones.
“They are doing it in the bathrooms,” she said. “They are doing it in the classrooms. They are doing it in the locker rooms.”
She’s trying to get outstanding students in schools to lead the effort to halt vaping. She’s also working with peer mentoring groups to aid the effort. She wants the kids to be the ones who explain to peers the issues with vaping. And she’s trying to arm teens with ways to say “no,” and to cope with their peers when being asked to vape.
“You have to have leaders,” she said. “Especially with youth, you have to have someone who is in charge or who has that leadership ability who can say, ‘Listen. I am done. So don’t ask me anymore.’ That’s what we need to do.”
But Cuthrell admits she’s swimming against a pretty strong current at this point. On the horizon, much to her chagrin, is the addition of pods containing THC and CBD, products derived from marijuana. Once those become more readily available, they could make vaping even more attractive to impressionable young minds.
“I just don’t think kids know what they are doing,” Cuthrell said. “I don’t think they know how dangerous it is. I am angry that people think it is okay to make youth into addicts. I am frazzled about that.”
Mark Haney is a staff writer for The Advertiser and can be reached at firstname.lastname@example.org.