Schools consider treatment with discipline in response to Vaping.

A sighting of student athletes in peak physical condition vaping moments after competing in a football game prompted Stamford High School Principal Raymond Manka to rethink his approach to the epidemic.

For those caught with e-cigarettes, his school has traditionally prioritized discipline. With each offense, the penalties become more severe, progressing from in-school suspensions to out-of-school suspensions and, eventually, notification of law enforcement.

However, after seeing two players from another school vaping near their bus, Manka began to think of it as an addiction problem rather than a behavior problem. “It broke my heart,” Manka said, adding that her school is now looking into how to offer cessation programs to students who have been caught vaping or with vaping paraphernalia.

“We have to figure out how to help these kids wean away from bad habits that may harm their body or mind, or otherwise create behaviors that may create habits that will be harmful for the rest of their lives,” he said.

In response to the rising number of vaping students, schools across the country have been grappling with how to strike a balance between discipline and prevention and treatment.

According to the Centers for Disease Control and Prevention, the use of e-cigarettes, also known as vaping, has now surpassed the use of traditional cigarettes in popularity among students. According to a CDC survey, one in every five high school students in the United States vaped in the previous month last year.

E-cigarettes generate an aerosol by heating a liquid containing high levels of nicotine—the addictive drug found in regular cigarettes and other tobacco products—flavorings, and other chemicals. When users inhale this aerosol, it enters their lungs; when they exhale, bystanders frequently breathe it in as well.

In comparison to traditional cigarettes, research on the health effects of e-cigarettes is painfully thin. According to experts, while using e-cigarettes appears to be less harmful in the long run than smoking regular cigarettes, this does not mean they are safe—especially for youth, young adults, pregnant women, or adults who do not currently use tobacco products.

“Studies have shown that e-cigarette use among young people is potentially associated with an increased risk of progressing on to cigarette use and to vaping cannabis, which has become increasingly common in recent years,” said Dr. Renee Goodwin, a tobacco and cannabis researcher and professor of epidemiology at City University of New York and Columbia University.

E-cigarettes can contain harmful substances other than nicotine, such as heavy metals like lead and cancer-causing agents. Vaping liquid is frequently available in a variety of flavors that appeal to youth and is packaged in a way that appeals to children. And, as Goodwin pointed out, the long-term health consequences are unknown.

According to experts, the CDC classifies e-cigarettes as a tobacco product, and many schools treat vaping similarly to tobacco use when enforcing codes of conduct.

During the 2017-18 school year, administrators in Connecticut dealt with 2,160 incidents in which students were caught vaping or with vaping paraphernalia in violation of school policies, an increase from 349 the previous year. According to the state Education Department, the schools issued 1,465 in-school suspensions and 334 out-of-school suspensions.

Some schools across the country have removed bathroom stall doors or installed monitors outside of restrooms to check students in and out. Others have installed humidity detectors that alert them when vapor clouds are detected.

Legislators are beginning to express similar concerns. Oklahoma has passed legislation prohibiting vaping on school grounds, and a dozen states have passed legislation raising the smoking and vaping age to 21.

Nonetheless, some school districts have begun to take a more comprehensive approach, focusing on treatment and prevention.

The Conejo Valley Unified School District in southern California recently changed its policy of suspending students for first offenses to sending them to a four-hour Saturday class on the marketing and health risks of vaping. A second offense results in a one- or two-day suspension, as well as several weeks of a more intensive six-week counseling program involving parents.

“I think we’re seeing a lot of success,” said Luis Lichtl, the district’s assistant superintendent, citing a decrease in both the number of incidents reported on campus and the number of suspensions this year.

“The schools that appear to be the most effective are those that, of course, enforce their disciplinary code—they can’t do otherwise—but use that as the floor rather than the ceiling,” said Bob Farrace, a spokesman for the National Association of Secondary School Principals.

Linda Richter, an expert on vaping and adolescent substance use at the Center on Addiction in New York, suggests that schools provide information about the health consequences and how companies have manipulated students into using vaping products by making them appear fun and cool. She claimed that the two-pronged approach resulted in a successful reduction in the use of traditional cigarettes.

“It’s unrealistic to expect a 13-, 14-, or 15-year-old to break an addiction by yelling at them or suspending them,” she said. “They require assistance, treatment, counseling, support, education, and comprehension.”

Suspending teens for vaping may be counterproductive, according to Dr. J. Craig Allen, medical director of Rushford, a mental health treatment center in Meriden.

“What do you think these kids will be doing at home if your solution is to send them home?” he asked. “They’ll be taking rips off their Juul all day to pass the time.”

The principal of Atherton High School in Louisville, Kentucky, Thomas Aberli, said the school started an intensive anti-vaping education program this year with the help of the American Association of Pediatrics. Teaching teens about how vaping companies have courted them with flavored products appears to be working.

“You could tell how enraged they were with this sense of manipulation,” he said. “That was a real turning point for us in terms of knowing how to approach this problem.”

In teen vaping crackdowns, other schools have continued to emphasize discipline.

Principal Tim Eastman of the Mattawan Consolidated School District, located just outside of Kalamazoo, Michigan, recently informed parents that students found congregating in bathrooms or parking lots will be taken to the office and searched.

“Anyone found in possession of vaping equipment will face suspensions,” Eastman wrote. “While this may appear extreme, the health and safety of our students is far too important to overlook.”

Eastman stated that the school is not currently providing any additional education or medical intervention to those caught vaping, but is considering it.

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