As the use of e-cigarettes, or vaping, grows in popularity among teenagers across the country, Wadena County area educators are fighting back by raising awareness of the harmful and addictive nature of the products. Dan Huebsch, a youth worker with the Community Concern For Youth program of Wadena and Todd counties, and Laure Laughlin, Community Health Promotion Specialist with Wadena County Public Health, are hoping to stop the upward trend in youth vaping by sharing educational resources and information.

What is an e-cigarette?

An e-cigarette, or electronic cigarette, is a battery-operated product that uses heat to generate an aerosol from a liquid mix of flavorings, nicotine, cannabis and other chemicals. The aerosol is often called a vapor. The devices come in different sizes and look like traditional cigarettes, pens, USB drives or even iPods. JUUL pods are the most common e-cigarette used, according to Huebsch.

The flavor "juice" is usually propylene glycol or a vegetable glycerin-based liquid that contains nicotine, chemicals and metals, according to Laughlin. There is no tobacco in the juice.

Almost all e-cigarettes contain nicotine, Huebsch said. One JUUL pod contains the same amount of nicotine as approximately 41 cigarettes. He said youth typically use one JUUL pod in a day, either alone or with friends.

Newsletter signup for email alerts

“There is such a variation in the amount of nicotine, and oftentimes people don’t know what they’re getting,” Laughlin said. Companies that sell vaping products do not have to list the full ingredients, and the products can change rapidly, according to Huebsch.

The vaping products also allow THC oil or wax to be inserted in an odorless fashion. THC is the most active compound of marijuana. The pods can include up to 95% THC.

“There’s nothing medically necessary about having that amount of THC,” Laughlin said.

In 2017, about 35% of Minnesota high school students reported using marijuana while vaping.

The amount of nicotine in vape pods is variable, such as one JUUL pod with the same amount of nicotine as approximately 41 cigarettes.
Photo courtesy Minnesota Department of Health
The amount of nicotine in vape pods is variable, such as one JUUL pod with the same amount of nicotine as approximately 41 cigarettes. Photo courtesy Minnesota Department of Health

Health impacts

Within the aerosol, there are cancer-causing chemicals, heavy metals and ultrafine particles that harm the body, causing symptoms such as breathing difficulties, a lowered immune response in the lungs and cardiovascular issues like stroke, heart attack and diseased arteries, according to Laughlin. People can have "nic sick" symptoms like nausea and vomiting, an abnormal heart rate, sweatiness, anxiety, extreme fatigue and dizziness when over-exposed to nicotine.

“Even though…the number of harmful chemicals that are in an e-cigarette are less than a regular cigarette, it’s important to remember that…safer does not mean safe,” Laughlin said.

People can also be affected by second- and third-hand vape from the aerosol. Huebsch compared the aerosol released from an e-cigarette to the aerosol that comes from spray paint and hairspray, with the particles getting breathed in by other people nearby and also sticking to nearby objects.

People who vape are considered to be at a higher risk of serious complications related to COVID-19, due to factors like their lungs’ lessened immune response.

The health impacts of vaping continue to be researched.

How vaping started

The first e-cigarettes, released in the early 2000s in China and available on the U.S. market in the mid-2000s, were marketed as alternative cigarette products that could help people stop smoking traditional cigarettes. But the products were never approved as cessation devices by the Food and Drug Administration, Laughlin said.

“They (smokers) were getting off of the conventional cigarettes, with the tobacco, and changing to something else,” he said.

E-cigarettes started as single sticks that offered a specified amount of nicotine. Now, pods allow people to keep puffing with additional juice, as Huebsch explained: “The amount of nicotine that I think initially was started wasn’t nearly as high as it is today, and so it’s more addictive today than...a decade or so ago, when that was first marketed."

Huebsch said those higher amounts of nicotine create a more addictive product.

“What we’re seeing often is that young people have started with an e-cigarette thinking that’s all they’re going to do, but they actually end up going to a conventional cigarette as well, so it hasn’t worked well,” Laughlin said.

Vaping marketing

The tobacco industry is working to replace lost revenues from the downward sales of conventional cigarettes with revenues made from e-cigarettes, and is also trying to draw in a new, younger generation of users with colorful marketing tools, Huebsch said. E-cigarettes' affordable prices, eye-catching containers and variety of candy-like flavors are a draw for youth. The most popular flavors are fruity, menthol and candy. The containers often look like popular candy brands.

“What gets a lot of young people hooked on vaping is the flavors, the colors, the marketing -- you know, eye-level in your grocery stores or gas stations, in your vape shops,” Huebsch said. “You can’t tell me that you’re not marketing to young people when you have brands that look like this.”

In Minnesota, the tobacco industry spent $110 million on marketing in 2019. The use of social media, including posts, photos and videos promoting vaping, adds to the draw.

How much are e-cigs used?

In 2011, 1.5% of U.S. youth surveyed admitted to using e-cigarettes in the past 30 days; by 2019, that number had jumped to 27.5%, according to the National Youth Tobacco Survey. The same survey showed that conventional cigarette usage decreased within that same time frame, with 15.8% of youth using a traditional cigarette in the past 30 days in 2011, down to 5.8% in 2019.

In 2017, the Minnesota Department of Health reported that less than 10% of Minnesota high school students said they smoked traditional cigarettes.

The downward trend in cigarette smoking came after years of educating and advocating against the harmful practice, and followed the passage of the federal Tobacco 21 law, which says people under 21 years old cannot purchase tobacco products.

In 2019 in Wadena County, the following percentages of eighth, ninth and 11th graders surveyed said they had used an e-cigarette in the last 30 days:

  • 14.7% collectively

  • 5% 8th graders

  • 20% 9th graders

  • 23.1% 11th graders

Huebsch said the newer pod versions of e-cigarettes allow teenagers to more easily hide the products, including in clothing. Youth are also interested in vaping due to stress, coping with mental illness, and peer pressure, as Minnesota students shared in Tobacco Free Alliance focus groups in 2019.

Resources available

It is never too late to quit. Huebsch and Laughlin encourage people to talk to their families or other trusted individuals, such as school counselors or teachers, or medical providers. The MDH has a program for 13-to-17-year-olds called, My Life, My Quit. Visit mn.mylifemyquit.org for more information, or call or text “Start my quit” to 855-891-9989. For adults, Quit Partner is also available.

“At the end of the day, what we really want you to do is talk with the young people in your life about this, because it’s something that they don’t necessarily know a lot about .... They just know some people at school are doing this, some people on my club or sports team or bus or whatever might be doing it,” Huebsch said.

Additional resources include: