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Transcript of JoCo on the Go podcast 10/21/19

Theresa Freed: [00:00] On this week's episode, you'll hear from Johnson County experts about the dangers associated with vaping. According to the surgeon general in 2018 more than 3.6 million U.S. Youth, including one in five high school and one in 20 middle school students were using e-cigarettes. We'll tell parents what to watch for and how to get help. Also hear from a Johnson County teen about what she's seeing in the schools and what students are doing to educate each other about the risks of vaping.

Announcer: [00:28] Whether you live in or just love Johnson County, Kansas, JoCo on the Go has everything Johnson County. Here's what's happening and what's coming up in the community you call home.

Theresa Freed: [00:42] Thanks for joining us for JoCo on the go. I'm your host, Theresa Freed, Johnson County resident and employee of Johnson County government. If you've been paying attention to the news, you know vaping is a growing issue, especially among younger residents here in Johnson County and the rest of the country. To get us started on the conversation about vaping and its effects on youth, I am joined by Mike Krueger. She's with the Johnson County Department of Health and Environment. And we also have with us Jamie Katz, a prevention coordinator with Johnson County Mental Health and Hannah Silverstein, a student at Shawnee Mission West. Thank you all for being here today.

Mike Krueger: [01:15] Thanks so much for having us.

Theresa Freed: [01:17] Well first off, everyone is probably familiar with the harmful impacts of smoking in the various forms of tobacco, but vaping is something that's kind of the latest thing. Can you all tell us just what that is?

Mike Krueger: [01:29] So vaping is just simply the act of inhaling and exhaling the aerosol, otherwise known as vapor that is produced by an e-cigarette or any other device.

Theresa Freed: [01:38] Okay. And so what's the difference between e-cigarettes and Juul?

Mike Krueger: [01:42] So e-cigarettes are just the generic name for many vaping devices. There are also mods which are typically larger and can be modified to hold more e-liquid and produce more vape clouds. Currently the most popular e-cigarette on the market is Juul and Juul, I think an interesting fact about them is that in 2016 they had a 2% market share and now in 2019 they have close to 75% of all of the e-cigarettes sold in the United States. It's very small. It's what we call a covert device. It can be easily hidden. Young people have no problem getting a hold of it. They typically get it from friends. They can get it online, they can get it locally, but a lot of times they just get it from their older siblings or other people at school.

Jamie Katz: [02:27] And to add to that kind of looks like a USB. And so a lot of times adults and parents might really not know what to look for. And it's typically charged kinda similar to a cell phone with the, with the charging cable and you can even plug it into a laptop. And a lot of times it looks like a, like a flash drive.

Theresa Freed: [02:52] So it's, it's easy to conceal and so I imagine that's a problem probably at the schools. And then for parents obviously can't see that very easily. So why is, why is this something that we're hearing about now

Hannah Silverstein: [03:05] From a student's perspective, being not only a student at my high school but also a member of the Johnson County Teen Task Force. If you are looking at these companies such as Juul, they're really targeting their audience towards the youth with the ability to conceal their products, like the actual Juul looking like a flash drive I've seen students charge it in class and then also the flavors that can be really enticing to students. So like the mint or the mango, it just makes it more appealing to young people.

Theresa Freed: [03:36] Okay. So it doesn't have that same kind of smell and odor or anything like that. So it could smell like almost like a fragrance. Right?

Jamie Katz: [03:44] Yeah. And and a lot of times it has actually kind of a fruity flavor. Kind of sickeningly sweet kind of flavor, but fruity. It doesn't smell like, like tobacco smoke and it has its own kind of unique flavor. And right now there are actually over 8,000 flavors available on the market at this time. Eight of those flavors are Juul, but there are, there are approximately 8,000 flavors available. So they really appeal to, to a whole wide variety of, of young people. And a lot of those flavors are flavors that remind them of their childhood. A lot of kind of different candy flavors and, and you know, not really the flavors that maybe adults would really prefer. It's a lot of it is, is more flavors are geared towards youth.

Theresa Freed: [04:31] So you mentioned that people can get them from, you know, other students or adults or you know, things like that. So is there an age limitation on these or how does that work exactly?Ma

Mike Krueger: [04:42] It is only legal for people over the age of 21 but as we know and, and what we've been hearing lately, is that even in situations like on school bus rides, which is how it's getting into the hands of way, younger people, typically kids of all ages ride a school bus. So it may be a senior in high school who might have access to middle-schoolers or even younger depending on what school you're in.

Theresa Freed: [05:02] Okay. So that's just an extra layer of problem here. Right?

Jamie Katz: [05:06] And we know that municipalities that have passed tobacco 21, so increasing the age of sale from 18 to 21, you know, we, we have seen a bit of a decrease. And, and I think that's because it's probably unlikely that a 21 year old is hanging out with a 14 year old compared to an 18 year old that might be hanging out with a 14 year old.

Theresa Freed: [05:30] So some people assume since you're not inhaling tobacco, vaping is a safe alternative. So why isn't that true? And can you talk about nicotine and how that affects those using the product?

Mike Krueger: [05:40] Mostly vape is just not considered safe because we do not have any long-term research on its use. And the earliest studies that are coming out right now are just showing a myriad of negative health outcomes related to vape. What's alarming now that you're hearing in all of the newspapers and on TV, all of the serious health implications and hospitalizations and even the deaths that we're seeing. The most recent numbers that we have are, there have been 1299 reported cases of lung injuries due to vaping as of October 8th in the United States. And that includes every state but Alaska. And there have been 26 deaths reported in 21 states. The age of the death range is from the ages of 17 to 75. But typically what we are seeing is that it is young adult males under the age of 35. A lot of young people now are talking to us about the fact of THC being used and that they don't have to worry about that because they're not using THC in their vape. But actually these statistics still are not very confirming of that evidence because though people that were using THC in their vape device also, were using traditional vape, which includes nicotine. So it's hard to tell at this point what is what, but we do know a lot about nicotine and what we know about nicotine, especially in young people is that it affects the frontal part of their brain, which has everything to do with impulse control and mood management, which is difficult in young people anyway. So this makes them irritable, frustrated, all of these things that we are hearing from actual school counselors, people coming in, they're very addicted to the nicotine. And when caught, we have had reports of administrators saying that the young person will say, can I just have one more hit off my vape before my parents come and pick me up because I know I won't have it. So people are getting addicted much faster than you would with a traditional cigarette.

Mike Krueger: [07:36] Because if you think about a traditional cigarette, there is a time process. You have to take it out of your pocket, you have to go somewhere where you can smoke it. And this is an electronic nicotine delivery system, ENDS and that is very telling just the name. So it has a battery and it will run until that battery goes or the juice in that pod is gone. So kids can really vape all day long and we have reports that they do. And when Hannah was talking about it being easy to hide, there are clothing manufacturers now that are specifically making clothing for young vape users, which is shocking to me. So there are hoodies being made with strings that now have perfect openings that will fit their Juul device. So in the classrooms they can vape right in front of a teacher. They, there are YouTube videos that show them going up behind a teacher and vaping and the teacher has no idea. And of course the whole classroom is breaking up laughing and they're not even aware because that vape smell dissipates fast. Even people who use THC say they prefer to vape the THC because their parents won't know that either because a traditionally using marijuana you can smell it, but in a vape device, the way that it is, the processes, it goes into the air and it's in little droplets and it's gone fast.

Theresa Freed: [08:56] I know a lot of people who have started smoking when they started smoking, they talk about how disgusting that first cigarette was, but they went back for more. So you don't have that same issue with vaping, so, but why do people still choose to do it?

Mike Krueger: [09:09] So the difference with Juuls specifically is that they use nicotine salts and nicotine salts make the delicious flavoring that already exists go down even smoother. So everyone remembers if you ever tried a cigarette for the first time, that burning sensation, well, not only does it not have that, but it's really a pleasurable sensation because it has a stronger hit at the beginning and it tastes good. And all of the research says that teens, young people, start because of the flavors, but they continue with the use of Juul because of the nicotine and the addiction.

Jamie Katz: [09:41] And then to add to that, you know, they also, in addition to just the flavoring, the cost, it's relatively inexpensive. And also just the availability of it and the, and the fact that it's easily concealable. I mean all of those things make it very appealing to young people. A perfect teen product,

Theresa Freed: [10:05] Vaping is a widespread problem. Here's the U S surgeon General's latest public service announcement on that issue.

PSA: [10:12] Did you know the nicotine in e-cigarettes can harm brain development? It's a fact. Brain development continues through the mid twenties and using nicotine during adolescence can impact attention learning and memory. Did you know the nicotine in e-cigarettes can prime the brain for addiction, especially while it's still growing. It's a fact. This is US Surgeon General Jerome Adams. For more facts about the risk of e-cigarettes and how to protect our youth, visit e-cigarettes.surgeongeneral.gov.

Theresa Freed: [10:43] All right, and back to Hannah on that. So you know, not, you know, telling us exactly who's doing what or anything like that, but can you share with us a little bit about, you know, what they're talking about, what are you seeing?

Hannah Silverstein: [10:55] So I definitely see it a lot in the bathrooms at my school. I think there's one point last year where they had to close the bathrooms during lunch because people would just be vaping in there. I've seen people charging their Juuls during class and the teachers won't realize it because it does look like a flash drive or I'll see people in class actually vaping and you know, they can just wave away the puff of vapor so that no one smells it. So it's definitely very prevalent I would say. And it's kind of easy to conceal because some of the adults still don't know about it.

Theresa Freed: [11:28] All right. And can you tell me a little bit about this group that you're involved in and what's the role of that?

Hannah Silverstein: [11:33] Yeah, so I'm a part of the Teen Task Force of Johnson County. It's comprised of teens all across the Johnson County area from different schools, different school districts. And we focus on a couple of initiatives that including mental health, suicide awareness, and then also preventing drug and alcohol abuse in teens and so we've done some projects in the past that specifically deals with raising awareness about underage use of vape products. So we made a project called a Photovoice that depicted what vaping looks like in Johnson County and how so many teens are using it. We made a PSA video warning teens about using a vape and e-cigarette products. So it's definitely been a main focus of our group recently as the epidemic just continues to spread.

Theresa Freed: [12:23] Alright. And I know that younger people tend to sometimes feel like they're invincible and nothing can get them. Do you feel like that's what you're seeing or is this just a lack of awareness about what's happening and the potential risks?

Hannah Silverstein: [12:37] So I think as more and more cases are popping up of these deaths and illnesses related to vaping, I think teens are becoming more aware. But because of that nicotine and the addiction, and of course being in their youth, I think they are starting to just not care as much. But I hope that with more information coming out, it'll turn people away from resorting to things like vaping and e-cigarettes.

Theresa Freed: [13:04] And I imagine there's some appeal hearing that message from peers instead of adults to some extent. Is that right?

Hannah Silverstein: [13:10] Yeah, definitely. There is. I've seen signs around the school which shows like the punishments of vaping. And I think that students probably just ignore that.

Theresa Freed: [13:20] All right. Some good information there. So it seems like really the, the key here is, is prevention. We want parents to, to have the information, we want kids to have the information. How, how do they access that from both from the department of health and environment and also mental health?

Mike Krueger: [13:36] We are doing a lot of things on both sides. Jamie and I have had the opportunity to work together and as a cooperative in trying to really figure out with the schools we have done in the past year and a half, so much as the schools have become so alarmed at what's happening. They have reached out to us. We get calls every day from parents. In the beginning, administrators, so much so that at one point we had to, we said we can't, we don't have the capacity to even handle this. And we did a train the trainers. So we invited people from the schools, counselors, administrators, psychologists, all of them to come. And we gave them a flash drive that included PowerPoints that they could use to take out into the community to educate parents. But I, I frankly get calls at least once a week from parents saying, I don't know what to do now. I have a kid who's addicted, I believe they're using, I'm not really sure. And we tried to give them some of the signs of that and point them in the right direction, whether it's with their school or with some of the prevention things that I think Jamie can speak about that we're working on currently.

Mike Krueger: [14:37] So the other things that we have done, so we did a social media campaign called End the Trend, End the Trend on Vaping and it's focused for middle school students as well as parents, but really more students. And the focus of this campaign is the idea of you can either be the GOAT, which is the Greatest of All Time or you can be a guinea pig, basically guinea pig to the vape industry. And you have that choice to make as a middle school or whether you're going to be the GOAT or whether you're going to be a guinea pig. And what we saw from this campaign, it actually started in 2017 ended in 2018 and we're actually hoping to start it again actually in the next couple of months is we had actually over 4 million views, thousands and thousands of engagement from Johnson County youth that, you know, they want to be the GOAT. They want to be the Greatest of All Time. They don't want to be a guinea pig. And a lot of the teens said they didn't realize they actually had this misperception that they thought because the research wasn't out yet, that it made it safe. And what, what we tried to explain to them through, through social media and gifs and memes and, and YouTube videos is that it's actually, it's, it's not safer than cigarettes. It's just as is harmful and, and why do the unknown? And so we, we found that actually be quite successful. And as I said, we're actually going to be starting it again in about the next couple of months with some updates. And then the other thing is that it actually has become such an issue that, and we've heard so much from schools you know, as Mike said, we, we did a train the trainer workshop. We did a vaping kind of one on one workshop and had over a hundred community members come and to hear about vaping in Johnson County and in our community. But the other thing is that we have gotten a lot of requests from schools themselves really wanting more information from their students as well as parents themselves. And so we actually made our, our last, our 2019 youth leadership summit. The focus, the focus of that summit was on vaping prevention. So we had 29 schools participate in our youth leadership summit this year. Middle schools and high schools in each middle school and high school came out with a plan of what they're going to do and their school community around vaping prevention as well as other drug use prevention as well as the mental health promotion.

Theresa Freed: [17:07] Now parents need the tools if they find out their child is vaping. And this is kind of a foreign concept, you know, to a lot of people, a lot of adults who have children. So when they, when they find this out, what should be their steps to help their child overcome this?

Mike Krueger: [17:24] Well, of course we say, don't be too alarmed. And don't be confrontational, but rather just open the discussion with your child. And I totally relate to everyone saying we don't know what to do because I reassure parents that this is unlike anything we've ever seen. And most parents have a familiarity with smoking, with drinking and perhaps with some drug use, at least they know it. And I've heard of it. But when vaping came, it was such a brand new thing. They don't have a base experience to even speak from to say, well, I vaped when I grew up and it was bad for me and you shouldn't either. So that has been very hard for parents, but we try to have them open the conversation talk to them about what they know are the risks, really educate their child. And what's difficult right now is what is or is not out there in terms of true cessation efforts for them.

Mike Krueger: [18:15] Because right now the nicotine replacement therapy that is out there is designed for traditional cigarettes and for adults. So there really isn't anything pediatric that's on the market right now. We know it is coming. But at the schools there are several web based programs. One is called Aspire that I think two to three of our schools here in the Johnson County area are now using. We totally support what Hannah is saying. You cannot punish addiction out of people. And once a parent realizes that this is an addiction, this isn't just bad behavior, they will treat it differently and so they will want to get help for their child. So there's cognitive behavioral therapy, there might be some group things that will be offered. All of this is, we are still in the, that formulating stage and Jamie and I in fact are planning a new round table discussion for November 21st to address those same people who came to us before and now really sit down at a table and say, what are you doing specifically at your school?

Mike Krueger: [19:12] How is this being handled? Get their policies, find out what their discipline policies are and try to kind of formulate something that we all do a little more consistently. And then the other thing that I am creating now on our side through dag is the nine one three vape free website. And we are trying to put this together to be a one stop shopping for parents, for kids, for administrators, anybody that, and I would think that the schools should like this so they can direct them to a place where they get local information, national information, but most importantly accurate information about what vaping is and how it's impacting their children.

Jamie Katz: [19:50] Great. And to kind of add to what Mike was saying, you know what we've heard from school districts and from parents and just community members is that okay we know now about vaping, now what, what do we do? And so as Mike said, we're going to have a round table discussion on November 21st to really talk about that. Okay, what do we do? Because I don't think any of us right now have the answers. I know like no single department has all of the answers for this, but maybe collectively as a whole, as a community, as a Johnson County community, we can come together and talk about what can we do about it as a community. Cause we know that it's a problem. We know as Hannah said, you know, it's an epidemic that's going on. I mean we are a little lucky because our numbers are actually starting to decrease a little bit in our community. I think it's because of the work that really we have done, but still it is quite prevalent. What do we do about it?

Theresa Freed: [20:40] Well Hannah, I know that the teen years can be difficult and a little straining on relationships between parents and teens, but what do you feel is, is a way that parents can be helpful in the conversation?

Hannah Silverstein: [20:52] So I think they should definitely go into it with an open mind because vaping is different from smoking. I, I agree with what Mike and Jamie were saying. It's definitely more addicting because of the nicotine and just the ease of using it. So I don't think they should necessarily punish their children. Maybe try to educate them first into making a better choice and just be more open about it with their children.

Theresa Freed: [21:17] Okay. So certainly not accepting of it but, but providing good information so that the teens can make a good choice.

Hannah Silverstein: [21:24] Yes. Cause you know, the reverse psychology, if someone tells me not to do it, then that makes you want to do it more.

Theresa Freed: [21:31] Got it.

Jamie Katz: [21:32] And I think what we've heard also from teens is that teens have said that parents are their number one influence in their lives. It might not seem like it during the teen years, but that's what teenagers at least have told us in our focus groups. But if parents don't know about it, it's really hard to talk to your kids about it. So it's really important for parents to also become educated about what vaping is about Juul and just to have an open, honest conversation with your child even as young as elementary school. And that's what we're actually hearing from, from schools talking to even, you know, fourth, fifth, definitely sixth, seventh, eighth graders. And beyond talking to your, to your kids about your expectations, about, you know, how you feel about vaping so that they know. Because as I said, that's what teens keep telling us is that parents are their reason for not doing it.

Theresa Freed: [22:27] Alright. And that's great information about how early to start. Shocking, but, but good information. What message do you have for, for other students who have been offered this and you know, what should they do?

Hannah Silverstein: [22:39] So I understand the peer pressure related to it, but I think in the end it's best for your mental health, for your physical health, just to turn it away. There's so many other ways to calm yourself down and you won't have to get addicted to it in such a negative way. I really think before you even try vaping, you should really consider the consequences to your health as we've been seeing more of these cases with lung injuries and deaths. So I would just say really think before you make your choice so that you don't go down a bad path.

Theresa Freed: [23:12] All right, some great advice there and thank you all for, for joining us today.

Jamie Katz: [23:15] Thank you so much for having us.

Theresa Freed: [23:18] All right, and we want to note both the Surgeon General and the Centers for Disease Control and Prevention have great information on their websites about vaping prevention and response. We'll have links to those resources for you on jocogov.org. Thanks for listening.

Announcer: [23:33] You just heard JoCo on the Go. Join us next time for more everything Johnson County. Have a topic you want to discuss? We want to hear from you. Follow us on Facebook and Twitter at JoCoGov. For more on this podcast, visit jocogov.org/podcast. Thanks for listening.