Colorado teens haven’t cut back on vaping, but experts see encouraging signs

Colorado teens are vaping at about the same rate they have been since 2015, but there are some signs that could change.

The Healthy Kids Colorado survey, given every two years, asks middle and high school students about their behaviors and feelings related to drugs, sex, nutrition and other topics. The survey first included questions about vaping in 2015.

In the most recent data, collected during the 2019 school year, 26% of those surveyed said they had vaped within the previous 30 days, and 46% said they had tried it at some point. That’s not statistically different from the results in 2015 and 2017.

The percentage of students who said they’d vaped in the last month was down in 10 regions, up in eight and the same in one. Two regions didn’t have data from 2017 to make a comparison. Regions are made up of one large county or several more-populous ones.

Vaping rates among high school students haven’t changed much overall, but it’s a victory that use of e-cigarettes hasn’t increased, said Tara Dunn, tobacco communications specialist at the Colorado Department of Public Health and Environment.

The percentage of teens who said vaping is risky did increase from about half to almost three-quarters in two years, and more than half of those who use e-cigarettes said they’re trying to quit, Dunn said.

The 2019 survey coincided with an outbreak of vaping-related lung illnesses, which likely increased the perception of risk, she said. The illnesses were caused by an additive that was more common in vaping products with THC, according to the Centers for Disease Control and Prevention.

The percentage of people using an addictive substance typically doesn’t change quickly, so seeing progress on contributing factors is “promising,” Dunn said.

“We know behavior change takes a long time,” she said.

E-cigarettes can deliver twice the nicotine that cigarettes do, which makes them particularly addictive, said Dr. Judd Dawson, a family physician based in Longmont. It takes smokers an average of 30 attempts before they can quit for good, and it wouldn’t be surprising if vapers need to try at least that many times, he said.

Since the first attempt may not be successful, parents and others need to support teens to keep trying, Dawson said. Punitive measures, like suspending students caught vaping at school, could actually be counterproductive, because stress makes nicotine cravings stronger, he said.

“These kids are going to need more grace than that, because they’re going to give up on themselves” without support, he said. “Treat it like a goal you need to conquer in the long run, not to get through in a week.”

Long-term nicotine use is linked to heart disease, Dawson said, and using a device that encourages people to gather and blow out plumes of chemicals is risky during a respiratory pandemic. It’s difficult to quantify the other risks of e-cigarettes, because they’re relatively new and contain a broad range of chemicals.

Raising the price of vaping materials and cracking down on sellers who don’t card their customers reduces access to e-cigarettes, and banning flavors makes them less enticing, Dunn said. Some counties that made those changes have succeeded in reducing youth vaping rates, she said.

It’s difficult to establish cause and effect in some cases, because Boulder County students reported they were vaping less before a ban on flavored nicotine liquid and sales to people under 21 took effect — though it’s possible that publicity about the ban could have influenced behavior.

Anti-smoking campaigns succeeded not only by educating teens about the health risks, but by emphasizing the smell and yellow teeth cigarettes cause to make it seem like a gross habit rather than a cool one, Dunn said. E-cigarettes don’t cause those problems, so the messages will need to be different, she said.

About 46% of teens who vaped said their main reason for doing so was because friends or family members did.

“A lot of that norm-shifting work that went into cigarettes needs to happen with vaping,” she said.

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