VAPING: Taking Your Breath Away

January 13, 2020 | PBAT MAGAZINE

By Mohamed Adaylam, Rosely Almonte, Lisbeth Cheng, Mingxi Wang, Yingqi Xu

“I started a year ago and I started because I saw my friends doing it.” Those are the words from an 11th grade student at FIHS about why he started vaping. Teen vaping is a problem that has been rising for a long time, but recently it is having a big impact on a lot of high school students, including students at FIHS. According to the 2018 National Youth Tobacco Survey, current e-cigarette use or “vaping” among middle and high school students increased alarmingly during the year 2019, with over 3.6 million kids currently using e-cigarettes.

 

A lot of people vape without knowing how harmful the e-cigarettes are. The goal of this report is to investigate this issue by gathering the stories of people who vape, researching the health risks of vaping, analyzing what is being done to help solve the crisis by schools and governments to see if something can be done to stop this health epidemic among young people.

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Juul in the hallway at FIHS

 

 

The Creation of Juul

 

Vaping has a long history, since ancient Egypt, there were people using hot stones to vape herbs, gradually more techniques were invented.  But the vaping industry as it is known today truly started in 2015, when Adam Bowen and James Monsees created a company called Ploom, Inc. which eventually became Juul Labs. They were graduate students in product-design at Stanford University. 

The construction of Juuls come in two parts: There's the e-cigarette itself, which contains the battery, temperature regulator and sensors that read the charge level; Then there's the pod, which contains Juul's patented e-liquid formula. The e-liquid cartridges, or Juul pods, come in a variety of flavors like cool mint, crème brulee and fruit medley, and each pod contains about as much nicotine as one pack of cigarettes. Juul pods contain a mix of glycerol and propylene glycol, nicotine, benzoic acid, and flavorings.

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Juul pod street trash

Juul street trash

Originally, the e-cigatterest were made to help adults quit smoking cigarettes, but as time passed, people started being addicted to them as well, especially children and teens. According to the Cleveland Clinic, “While the health effects of inhaling these ingredients aren't well-known, one thing is certain: nicotine is a highly addictive substance and each hit of the juul packs quite the nicotine punch. The nicotine content is 0.7mL (or 59 mg/mL) per pod, which is approximately equivalent to a pack of cigarettes, or 200 puffs.” 

Furthermore, vaping can cause many health problems, such as throat problems, lung disease, heart disease and cancer risks, etc. It is especially dangerous for teens since teens’ lungs are still developing. 

Ironically,  as cigarette smoking has reached the lowest levels ever recorded among U.S. adults, the market for e-cigarettes just keeps making more. “The maker of Marlboro cigarettes, valued the e-cigarettes maker at $38 billion when it invested $12.8 billion late last year for a 35% stake. It controls about three-quarters of the market for non-traditional smoking products. While the product’s popularity has grown considerably in three years, the company manufacturing it has managed to maintain a relatively low profile.”

From Mr. Liang's ( the FIHS program manager) interview, he said: “For now I use E-cigarette more than normal cigarette in home or driving, because it doesn't have strong smell.” Based on this interview, we know the E-cigarette has less strong smell than cigarettes. Since it doesn't have such a strong smell as cigarettes.

Due to the growth of vaping, Juul Labs Inc. made $1.3 billion in 2018 and forecasts revenue of $3.4 billion for 2019.  Juul has made a lot of money by selling Juul devices and pods. Generally, the Juul device costs between $35 to $50 and a package of four juul pods costs $15.99. 

 

But worse than the data for adults, is the rise in teen vaping. Based on the 2019 National Youth Tobacco Survey of FDA (Food and Drug Admission) and CDC (Centers for Disease Control and Prevention), over 5 million youth are currently using e-cigarettes in 2019, but it was just around 3.6 million in 2018. Among all the e-cigarettes users, 27.5% of them are high school students and 10.5% of them are middle school students. Majority of the e-cigarettes users reported that JUUL as their usual brand. So when people talk about using e-cigarettes, they use the word “juuling”. 

 

Vaping Illness

Alarmingly, since September 2019, the Centers for Disease Control and Prevention warned the public to stop using e- cigarettes as it investigated a mysterious vaping-related lung illness. Recently, in November, reports became public saying that vaping has caused at least 42 people died across 24 states. Further, according to the Centers for Disease Control and Prevention said that there were a further 2,172 cases of severe respiratory illnesses among those who vaped either nicotine or cannabis products. Also, there is even a Michigan teen had vape-related lung illness had to do a double lung transplant.

“I read many news in the Social Media and that there are so many teenagers have lungs disease because they are doing a lot of vaping but I don't have a scientific background.” These were the words from Ms. Lu, a school counselor at Flushing International High School (FIHS). “Now that I have read so many news about people dying because of vaping now definitely not ever touching that”- those were the words from Rosemary, Assistant Principal of Flushing International High School.

However, U.S. doctors don’t know what the vaping illness is. According to CNBC, they say: “Health officials still don’t know exactly what’s making people sick. The Centers for Disease Control and Prevention has dispatched more than 100 physicians and investigators to pinpoint the cause of the deadly outbreak, which it initially said resembled a rare form of pneumonia.” Even though there are more than 2,000 people have since fallen ill and 39 have died so far, but the U.S. Doctors still don’t know what’s making victims sick. According to the American Lung Association, they say that the inhalation of harmful chemicals can cause irreversible lung damage and lung disease because e-cigarettes also contains acrolein, an herbicide primarily used to kill weeds. It can cause acute lung injury and COPD and may cause asthma and lung cancer.

From the interview with Peter Koo said that more teens are trying because of the flavors. “They are not thinking about smoking, they think, ‘oh I am eating some candies’”. Health officials are getting closer to figuring out the root cause of the vaping-related lung illness. Based on a report from the CDC (Centers for Disease Control), researchers found the results of an analysis of lung health data from 29 patients across 10 states. Their results showed that vitamin E acetate was present in all 29 sample e-cigarettes, leading officials to conclude that vitamin E acetate is likely a reason that causes the lung illness.

Personal Stories

We interviewed an 11th grade student from team Metamorphosis. He is only 17 years old, and he started to vape when he was 16. The reason he started to vape is because his friend encouraged him to do it. He got his first Juul when a friend from the same school gives it to him. When he lost it in the boys bathroom, he decided to get a new one because he started to get addicted to it. He decided to buy a new one from his friend who also attend the school for $20 or more. But it started to get out of control so decided to stop. 

“Sentí que era algo estúpido, porque me hacia daño y gastaba dinero en eso. Yo paré hace como dos meses.” (English: I felt it was something stupid because it was harmful for me and I wested money on it. I stopped like 2 months ago.) Another reason why he stopped is because someone saw him smoking outside on the street and that person who saw him went to tell his dad. His dad talked seriously with him to stop doing it since the father went through the same problem and it took him a year to quit and that it was no good. Also, he has a good friend who told him to please stop because his friend didn't like to see him like that.

Another student said, “Juul has affected me. It gave me a lot of headache.” Those were the words from an 11th grade student at FIHS who used to vape. This evidence shows that vaping is a serious illness and that it doesn't only affect your respiratory system but can also affect your brain and that is especially harmful for teens. According to Teens Health since vaping put a lot of nicotine into your body slow brain development in teens and affect memory, concentration, learning, self-control, attention, and mood.  

It’s not just students who have vaped. We interviewed Ms. Nataly a 12th grade teacher in her classroom. She stated that she has vaped before, that she started vaping 2 years ago. She started vaping because her friend was telling her to try it but she didn't like it, it made her cough, so she doesn’t smoke anymore. “I didn't know when I first tried it, I didn't even know what is vaping, I wasn't sure what it was so that is why it made me nervous but as I was learning about it and asking question and I realized it was harmful,” said Ms. Nataly. Significantly, the National Center for Health Research said “Juul delivers higher concentrations of nicotine than other e-cigarettes. Not only is nicotine highly addictive, but it is also toxic to fetuses and is known to impair brain and lung development if used during adolescence.”  

Mr. Chris is one of the gym class teachers is a former smoker. We interviewed him one day in the classroom. While talking, he frowned and his hands were folded. “Times were different growing up, I mean I remember everybody smokes, my grandparents smoke, my mom and dad smoke, I grew up in a house thats smokes, so this was something that, I guess kind of grow up to me said Mr. Chris. But today he also added that he tried smoking when he was a teenager but quit when he had children since he was found with lung problems. “Every two year or three years I have to get a CAT scan and x-rays to just to make sure that is not cancer, it's there so it doesn't get bigger.” 

People sometimes forget that vaping is just a different kind of smoking and young people today start vaping the same reason young people used to start smoking.“When I smoking, I feel like relaxing , I feel like I am very cool because my friends are smoking and I feel that smoking can be socialized, can help me make friends, like you know you smoke I smoke so we can smoke and talk so we can be friends” said Ms.Lu, school counselor.

Significantly, according to CDC, it says that smoking increases the risk of people developing lung cancer by 25 or 26 times that people who don't smoke. And Smoking causes about 90% of all lung cancer deaths.  Based on the CDC article, it says that cigarette smoking is the number one risk factor for lung cancer. In the United States, cigarette smoking is linked to about 80% to 90% of lung cancer deaths.

Additionally, a member of the school counselor, Ms. Juliana, shared  her personal experience on vaping. Where the interview took place at her office room 305. The discussion was about when She told us that she had vaped in the past but only for about a month. She was dealing with anxiety and she felt anxious at that time, she learned the benefits of vaping and she bought a CBD pen to release stress. She said: “At the beginning, I didn’t know it can be harmful, but after learning more, especially because I work with students that was like abusing it a lot, then I was like it is not good.” According to the Smokefree.gov, it states that if you feel stressed or anxious sometimes and you vape, you will feel more stressed or anxious if you quit vaping because quitting can feel overwhelming . “The silliest thing is to ever start, because you will become addicted to smoking” cautioned Mr. Chris.

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( Data of  teen vaping)

 

 

Scope of the Problem

“I have read in newspapers and you see on TV, where vaping is not good for your health so why try it? Why you wanna damage your own body?” asks New York Councilman Peter Koo.

 

Despite the risks and dangers many young people continue to vape 12th grade student. Qingfa was interviewed about why and when he started vaped. His said “When I was in China and I followed my friends.” Recent research has shown that a lot of teens have started vaping because of friends doing it and have become the most recent reason of why there are a lot of teen vaping. It has been proof that statistically according to Center For Disease Control and Prevention “Among students who reported ever using e-cigarettes in 2016, the most commonly selected reasons for use were 1) use by “friend or family member” (39.0%). 2) availability of “flavors such as mint, candy, fruit, or chocolate” (31.0%) and 3) the belief that “they are less harmful than other forms of tobacco such as cigarettes” (17.1%)”  The least commonly selected reasons were: 1) “they are easier to get than other tobacco products, such as cigarettes” (4.8%). 2) “they cost less than other tobacco products such as cigarettes” (3.2%) and 3) “famous people on TV or in movies use them” (1.5%).

Prevalence in High School

Since vaping has been a big problem around the country it has also a big problem at FIHS. teachers and staff members of the school are aware about the effects of vaping. At Flushing International High School, students are doing a survey about vaping  to all the students from different grades (9th, 10th, 11th and 12th). Through this survey they found out that there are about 14.4% of 9th and 10th grade students, 23.8% of 11th grade students and 32.1% of 12th grade students are currently vaping. These shows that vaping exist in the school and can increase. We can see that students who attend 12th grade have the highest amount of student vaping. This shows that the school data is similar to the United States data about high schools, college students who vape because 12th grade students have the bigger amount of students vaping.

Government Actions

In response to the rising cases of vaping illness and the teenage vaping rate governments, businesses and schools have proposed different ways to fight the problem. From the interview with Anthony J. Lemma, the District Director of Congresswoman Grace Meng, we knew that the congress is opposed to vaping officially, and Grace Meng is a founding member of the congressional caucus, they actually talked about that issue, she is also at the forefront of this issue. In December 2019, the congress even sent a letter to Donald Trump saying to end the youth vaping epidemic and e-cigarette flavor ban. “The meteoric rise in youth vaping is a public health crisis threatening the health and safety of American youth,” said Congressman Raja Krishnamoorthi, one of the leaders of this letter.

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Tweet from Michael Bloomberg, 2019

“The federal government will act to ban thousands of flavors used in e-cigarettes," President Donald Trump said, responding to a recent surge in underage vaping that has alarmed parents, politicians and health authorities nationwide (Washington AP, 2019). For now the government have started to discuss the situation of vaping and how have been alarming for teens so they want to plan how can we stop that. However, the only thing that have been done is that you have to be at least 21 in order to buy a Juul and that some states have prohibited the sale of Juuls.

“U.S. President Donald Trump has announced that his administration will ban flavoured e-cigarettes, after a spate of vaping-related deaths.” Since there have been a lot of death when it comes to vape in all 33 states, most of these deaths are young people with an average age of 19. According to Tor Hoerman Law, LLC “As of November 2019, the states of New York, California, and North Carolin have sued Juul Labs Inc. The lawsuits allege that juul, the United State's most popular e-cigarette manufacturer, directly targeted young people through marketing and sales efforts while not doing enough to verify the ages of customers.” There is a law that was passed recently for the state of New York. On July 16, 2019, Governor Cuomo signed legislation to raise the age to purchase tobacco and electronic cigarette products from 18 to 21, effective November 13, 2019. The Governor also signed legislation in October 2017 to ban the use of electronic cigarettes on all school grounds and everywhere that smoking products are prohibited. 

In a 2017 survey of 15 to 17 year old adolescents in New York State currently using electronic vapor products, 19% of the teenagers said that flavors were the reason that they first tried an e-cigarette and 27% said flavors were the reason for maintaining use. Studies also show nearly 78% of high school students and 75% of middle school students report being exposed to pro-tobacco marketing in 2016. However, the New York City Council member Peter Koo said that the law means that all flavor can not be sold at the store, only one regular flavor. Because a lot of kids try because of the special flavor, but once you get used to it, you get addicted, you do it more often. When you are a teenager, your lung is still expanding, you are still growing, you don’t want to abuse your body or damage them. 

Others states has also started to ban the sale of Juuls, such as, Canada bans the sale, advertising and import of electronic cigarettes. Health Canada advises Canadians not to purchase or use them, claiming they contain a “known irritant” (propylene glycol). The State of Oregon announced two settlements have been reached that prevent two national travel store chains, Pilot Travel Centers and TA Operating, from selling NJOY electronic cigarettes. In addition, the company must give the Attorney General advance notice that they intend to sell electronic cigarettes in Oregon, provide copies of all electronic cigarette advertising, and provide copies of the scientific studies they maintain substantiates their claims. NJOY voluntarily stops all sales in Oregon. California passes a bill to ban the sales of electronic cigarettes in the state. Governor Schwarzenegger vetoes the bill stating, “If adults want to purchase and consume these products with an understanding of the associated health risks, they should be able to do so unless and until federal law changes the legal status of these tobacco products. ̈

Even other parts of the world have been aware of these problems and started to ban e-cigarettes. For example, Venezuela’s government threatens to punish with fines up to $8,400 for those who distribute or promote electronic cigarettes banned in the country for not having permits or corresponding health records. Brazil bans the sale, importation and advertisement of electronic cigarettes Hong Kong Department of Health bans electronic cigarettes. The maximum penalty for possessing or selling e-cigarettes is a HK$100,000 fine and two years’ imprisonment. Since smoke-free tobacco is prohibited in Hong Kong, the ban on e-cigarettes continues to leave high-risk cigarettes as the only legal tobacco product available. But, Bonnie Halpern-Felsher (a professor and expert in teen vaping at Stanford University) saying that ban on flavored e-cigarettes won't help youth that are already addicted. Also According to the Health and Human Services Secretary, Alex Azar said that the youth started vaping because of flavors but they continue because of nicotine.

In addition, another recent news says that “Apple is removing all vaping apps from the App Store this morning after 42 deaths.” Since vaping have started to affect people's health, big companies like Apple have started to remove the apps that are promoting vaping.

Educational Actions. “The best way is to talk about it in school, because it has been on the news about the bad things that have happened to them, make sure you cut the news out and make sure they see it. You don’t want it to happen to you, so tell them the disadvantages. You are inhaling the nicotine, nicotine is a drug. So tell them all the side-effects. “Hey you are still young, your body is still growing, don’t abuse it,” said Peter Koo.

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Vaping Workshop at FIHS

Flushing International High School

Many schools like FIHS have started to take action. This December, the school started to have vaping workshop for all grades (9th, 10th,11th and 12th) helping students to know about about vaping and the dangers of vaping. “I learned from the workshop a lot of things that vaping have like all chemicals and things like that, I didn't know that I just know vaping is to smoke only, and right now I know the effect that can happen on the vaping when you vape too much stuff like that,” were the words from a 10th grade student after he attended the workshop. “I think the workshop was really helpful because it increase or knowledge about the drugs and those objects that are really harmful for our health,” said Angely Li, an 11th grade student and a PGC leader at FIHS. “I learn the difference between smoking vape and smoking cigarettes and how vaping can affect you,” said Jerbinson, who is also an 11th  grade student and a PGC member at FIHS.

The organization that conducted the workshops was Elmcor Youth & Adult Activities, Inc., a Queens, New York non-profit, multi-service organization of professionals providing a variety of comprehensive programs that serve all populations from preschool aged children to senior citizens. They help raise awareness about the Dangers of Menthol Cigarettes and Flavored E-cigarettes. They have done workshops for hundreds of schools and they aim to help people make informed decisions instead of telling them what to do. The representative of the organization said that besides letting people know through workshops, being active is also helpful because it can take people’s mind out of vaping. 

“You can do it as a friend,  remind your friends hey! you know listen, don't do it becuase is not good for your health” says Peter Koo. The Centers for Disease Control and Prevention (CDC) says that vaping is not suitable for young people for sure and vaping was started to help smokers quit vaping but as time passes, more and more people try vaping for fun or other reasons without any experience of smoking. Juuls should be banned. It is clear that Juul and the other vaping companies have marketed and sold the product to young people, and that millions of students today are addicted to nicotine. 

 

“My sister-in-law used to smoke and now she is fighting cancer and so that's something that's really important for me and my family and my husband's family to stay away from smoking cigarettes because she is right now still battling lung cancer.’’ Those were the words from Ms. Nataly. This shows that smoking cigarettes is related to vaping because it can affect your health either inhaling tobacco or nicotine since both are drugs and people tend to get addicted to it. 

 

Local Community

Bashir who owns a deli in Brooklyn where he sells things including e-cigarettes, says, “if something is not good for you then don’t do it.”

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Bashir's Deli

A frequent customer to the store who used to buy a lot of tobacco products, including vapes says that he quit smoking because he decided to try vape since he after had several heart operations. “If you smoke, your heart and lungs don’t work as well as they should. You may have breathing problems during or after surgery, and you are at greater risk of developing pneumonia. You are also much more likely to need a ventilator, a machine that breathes for you after surgery.” It has been proven that vaping is taking people’s breath away.