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Teen Vapers Who Want To Quit Look For Help Via Text

Oct 23, 2019
Originally published on October 23, 2019 11:10 am

It all started at the mall when a friend offered her a puff from a JUUL e-cigarette.

"It was kind of peer pressure," says Beth, a Denver-area 15-year-old who started vaping in middle school. "Then I started inhaling it," she says. "I suddenly was, like, wow, I really think that I need this — even though I don't."

Soon, Beth — who asked that her last name not be used because she hasn't told her parents about her vaping — had a JUUL of her own. She was vaping half a pod of e-liquid a day, the nicotine equivalent of half a pack of conventional cigarettes. She used other brands, too — a Suorin, a Novo and a modified device, which gives users custom vaping options.

Beth tried to quit on her own, so her mom wouldn't find out. But it was hard and her school didn't have enough resources to help her, she says.

"When you wake up in the morning, you're just like, 'Oh, I need to hit my thing. Where is it?' You can't really get it off your mind unless you distract yourself," Beth says.

In a 2018 report from the Centers for Disease Control and Prevention, Colorado had the highest rate of teen vaping of 37 states surveyed. A quarter of those students said they currently used an electronic vapor product — double the national average. Beth guesses half her classmates vape regularly. Her school does offer some tobacco education, but she says teens could use a lot more support to help them to quit.

Beth managed to stop vaping a few weeks back, motivated by the news stories of young people falling ill. Plus, she says, her own friend got sick, and that was a turning point.

Before, she says, "I didn't really take it super seriously, because I was like, oh, what are the chances that that's going to happen to me? And then my friend actually almost had his lung collapse, and he was coughing blood and mucus. And I just couldn't do it anymore. It's not worth it."

As of Oct. 17, the CDC reported it was investigating 1,479 lung injury cases nationally associated with using e-cigarettes, including 33 deaths. Colorado, so far, has recorded nine cases and seven hospitalizations.

A federal survey shows more than a quarter of U.S. high school students have used an e-cigarette in the past 30 days. But public health advocates say that funding for anti-tobacco efforts is inadequate. Although states receive annual payments from tobacco companies as part of a 1998 lawsuit settlement, they're not following CDC guidance on setting aside large chunks of that money to help smokers quit or to prevent new smokers from starting. States can spend that money on whatever they want, and most do.

Another traditional funding source for antismoking programs has been cigarette taxes. But with fewer people smoking cigarettes, that revenue source has been less reliable. In Colorado, cigarette sales have declined by 41 percent since 1990, according to Colorado's health department. And in more than half of the states, including Colorado, vapes aren't taxed — at least not yet.

"It is daunting," says Alison Reidmohr, tobacco communications specialist for Colorado's Department of Health and Public Environment. "We've got more problems than we've seen before and fewer resources with which to deal with them."

Don Daniels, a Chatfield High teacher in Littleton, Colo., runs the school's tobacco education program, and keeps these vaping devices (confiscated from students) on hand to show students and parents what they look like.
John Daley/CPR

An estimated 27,000 Colorado high schoolers report vaping more than 10 days a month, Reidmohr says. "More people are using more nicotine products. Our young people are facing an epidemic of vaping. We're not funded to deal with vaping products."

Colorado spends nearly $24 million a year on tobacco prevention, but according to a recent report from the Campaign for Tobacco Free Kids, that's less than half of what the CDC recommends, and a fifth of what the tobacco industry spends on marketing in the state.

"Really, we have almost nothing in terms of treatment for these kids," says Dr. Christian Thurstone, who runs substance abuse programs for teens in Denver. He says teens have gotten addicted to nicotine so fast, it's uncharted territory.

Though there are websites, hotlines, therapists and coaches to help kids manage nicotine cravings, those efforts were all designed around traditional cigarettes, Thurstone says. He's turned up no studies about adolescents quitting e-cigarettes.

"We need some research, fast," says Thurstone.

A spokesman for the popular JUUL brand says no young person or non-nicotine user should ever try JUUL. But he doesn't say how minors who've started to use the product might quit.

Most teens just need to decide they're not going to use any more, says Gregory Conley of the American Vaping Association. "It's only a small sliver that may actually need some assistance to get off the products," Conley says.

Colorado's health department disputes that; it estimates 10% of the state's highschoolers are vaping nicotine more than 10 days a month.

In July, National Jewish Health in Denver launched a cessation program tailored to teens' needs. In a large open office, coaches answer calls. "Thank you for calling 'My Life My Quit' one says. "Congratulations on making the decision to quit." The program — which uses a traditional helpline, chats and live coaching — has seen a sharp surge in sign-ups in the last month.

Thomas Ylijoa, a clinic director with National Jewish Health in Denver., chats with Nichole Lopez, a tobacco cessation coach for a program there. In July, the hospital launched "My Life, My Quit" a vaping cessation program aimed at teens. The program has a traditional phone helpline, but also offers coaching by text and chat.
John Daley/CPR

My Life My Quit serves Colorado, and is available in 11 other states, as well — Iowa, Massachusetts, Michigan, Montana, Nevada, North Dakota, New Hampshire, Ohio, Pennsylvania, Utah and Wyoming. Clinic director Thomas Ylijoa says data show 12% of high school seniors in the U.S. are using e-cigarettes every day.

Teens are "telling us they can feel their lungs burning when they're using these products," Ylijoa says. "They're telling us that they can't exercise the same way they used to before. They're telling us that they can't give up these products just on their own, that they need help."

The program even added coaching by text, he says, because that's how many teens like to communicate.

In his office, Ylioja reads from a printout of text conversations between teens and coaches. " 'I'm 16 years old. I'm super addicted to vaping. I can't seem to quit when I don't have it, that's all I think about,' " one student writes.

" 'My family is worried and all the stories about people getting sick,' " says another text. " 'I don't know if it's really bad to vape, but because of these stories, they could be rare occasions, but I'm worried about it.' "

"Here's another one," Ylioja says, then reads out loud: " 'So my friends are the ones who got me into vaping and they think I should not stop. But I want to, because I don't want to hurt my family if I get sick.' "

Nichole Lopez, one of the program's coaches, says most teens say they've heard about the vaping sicknesses.

"It's freaking them out," she says. "They're scared. They don't want to die. I had somebody say, 'I just don't want to die, so I need to quit.' "

Lopez says teens often think they're invincible, but news of young people getting sick is suddenly making the dangers seem real.

The Truth Initiative, a nonprofit public health group aimed at helping young smokers quit tobacco use, has also expanded its resources to include a program focused on e-cigarettes. It's a free text messaging program "tailored by age group" to give teens and young adults appropriate recommendations about quitting. It also provides resources for parents looking to help children who are vaping and may want to quit.

Don Daniels, the director of the tobacco education program at Chatfield High in Littleton, Colo., says he senses what he thinks could be a sea change in teen attitudes.

The reports of people being "truly sick and dying from these devices is enough for young people to make a decision that's going to benefit their health," Daniels says. "They're savvy. This is a smart generation and they're thoughtful and they have the ability to make good choices."

Chatfield senior Mia Norrid, a swimmer, doesn't vape. But her mom posted a story about the vaping-linked illnesses on Facebook and tagged her daughter as a nudge to speak up.

"I think she tagged me so I could let my friends know about it, because a lot of my friends do it," she says.

Over lunch, a group of Chatfield ninth-graders showed off what they've seen on social media. In an app called TikTok, a search for "quitting JUUL" or "#stopjuuling" brought up videos of people "breaking their devices and, like, throwing them away and trying to get other people to quit, too," says one freshman.

In one of the videos, someone lit an e-cigarette device on fire; in another, a pair of devices are flushed down a toilet. A third shows someone whacking a JUUL with an ax on concrete.

Social media is often blamed for helping popularize e-cigarettes among teens. Now it may be playing a role in quitting, another Chatfield freshman points out. But do the students think it will make a difference?

"I do, yeah. For a lot of people, actually," the freshman says. "I've known kids who have stopped vaping because of it."

The state intends to survey Colorado high school students in the fall about how much they vape. Results are expected to be released in 2020.

This story comes to us through NPR's partnership with Colorado Public Radio and Kaiser Health News.

Copyright 2019 CPR News. To see more, visit CPR News.

DAVID GREENE, HOST:

American teenagers have been taking up e-cigarettes at a rapid rate, and this has worried their parents, teachers, also public health officials. But the recent news of vaping-related lung illnesses and deaths seems to be registering with many young people and scaring them. And yet, kicking the habit is extremely hard. As John Daley of Colorado Public Radio discovered, there's very little research and few resources out there to help teens quit.

JOHN DALEY, BYLINE: Beth is 15 and goes to a Denver-area high school. She started vaping in middle school. She asked us not to use her last name because she doesn't want her parents to know. Beth says it all started at a mall with a friend offering a puff from a Juul e-cigarette.

BETH: It was kind of peer pressure. Then I started, like, inhaling it. And then I suddenly was like, wow. I really think that I need this even though I don't.

DALEY: Soon, she had shelled out money to buy a Juul device of her own. Eventually she was hooked, vaping half a pot of nicotine liquid a day. And she used other brands - a Suorin, a Novo a mod. She was afraid her mom would find out, so Beth tried to quit, but it was hard.

BETH: When you wake up in the morning, you were just like, oh, I need to, like, hit my thing. Where is it? Like, you can't really get it off your mind unless you distract yourself.

DALEY: Beth guesses half her classmates vape regularly. Her school does offer some tobacco education. But, she says, teens could use a lot more help to quit. Beth stopped vaping a few weeks back, motivated by the news stories of young people falling ill, plus her own friend got sick.

BETH: It was a turning point for me because I didn't really take it super seriously because I was like, oh, what are the chances that that's going to happen to me? And then my friend actually, like, almost had his lung collapse. And he was coughing blood and mucus. And I just couldn't do it anymore. It's not worth it.

DALEY: A federal survey shows more than a quarter of U.S. high school students have used an e-cigarette in the past 30 days. But the money available to help teens quit is shrinking. One reason is fewer people are smoking cigarettes. Taxes on cigarettes helped pay for anti-smoking programs, but there's less of that money coming in. And in more than half of the states, vapes aren't taxed - at least not yet. Alison Reidmohr works on Colorado's tobacco control efforts.

ALISON REIDMOHR: It is daunting. We've got more problems than we've seen before and fewer resources with which to deal with them.

DALEY: Colorado spends nearly $24 million a year on tobacco prevention. But it's less than half of what the CDC recommends and a fifth of what industry spends marketing in the state. Dr. Christian Thurstone runs substance abuse programs for teens in Denver. He says teens have gotten addicted to nicotine so fast, it's uncharted territory.

CHRISTIAN THURSTONE: And really, we have almost nothing in terms of treatment for these kids.

DALEY: Thurstone says there are websites, hotlines, therapists and coaches to help kids manage nicotine cravings, but those were all designed around traditional cigarettes. Thurstone says he could find no - zero - studies about adolescents quitting e-cigarettes.

THURSTONE: We need some research, fast.

DALEY: A spokesman for the popular Juul brand says no young person or non-nicotine user should ever try Juul. But he didn't say how minors who started might quit. In July, a hospital in Denver launched a quit program tailored for teens.

UNIDENTIFIED PERSON: Thank you for calling My Life My Quit. OK. So you're feeling like quitting is a good step for you at this point. Congratulations on making the decision to quit.

DALEY: National Jewish Health runs the program. It serves Colorado but is also available in 11 other states. Clinical Director Thomas Ylioja says 12% of high school seniors in the U.S. are using e-cigarettes every day. He's seen a sharp surge in sign-ups in the last month.

THOMAS YLIOJA: They're telling us that they can feel their lungs burning when they're using these products. They're telling us that they can't exercise the same way they used to before. They're telling us that they can't give up these products just on their own, that they need help.

DALEY: They even added coaching by text because that's how many teens like to communicate. Ylioja reads from a printout of text conversations between teens and coaches.

YLIOJA: (Reading) I'm 16 years old. I'm super addicted to vaping. I can't seem to quit. When I don't have it, that's all I think about. My family is worried - and all the stories about people getting sick. I don't know if it's really bad to vape, but because these stories, there could be rare occasions. But I'm worried about it. My friends are the ones who got me into vaping. And they think I should not stop, but I want to because I don't want to hurt my family if I get sick.

DALEY: Nichole Lopez, one of the coaches, says most teens say they've heard about the vaping sicknesses.

NICHOLE LOPEZ: It's freaking them out. They're scared. They don't want to die. I had somebody who said, I just don't want to die, so I need to quit.

DALEY: Lopez says teens often think they're invincible. But news of young people getting sick is making the dangers seem real.

For NPR News, I'm John Daley.

(SOUNDBITE OF WENZEL'S "DEPICTION")

GREENE: John's story comes to us from a reporting partnership with Colorado Public Radio and Kaiser Health News.

(SOUNDBITE OF WENZEL'S "DEPICTION") Transcript provided by NPR, Copyright NPR.

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