In the 2014-15 school year, Plano ISD reported 36 tobacco-related discipline referrals to the state. Last year, that number totaled 111.
The increased use comes at a time of heightened scrutiny across the country about the possible health effects of vaping after a spike in lung-related injuries, especially among young people. There are also questions about the safety of illegal vaping products containing THC, the psychoactive ingredient of cannabis.
Educating parents, staff and the community plays a large role in deterring student vape use, especially when paired with programs targeting students, said Staci Antelo, director for District Health Services at PISD.
“They need to know what the dangers of it are so that they can make better choices about it,” Antelo said. “It’s here—there’s no question that it’s here—and kids are using them.”
District officials said their data on incidents specifically involving student vaping is not comprehensive. Records showed two instances two years ago. That number grew to 21 last school year, according to district data.
But the district does acknowledge the problem is growing. In response, this year, the district added vaping to the health course curriculum taken by students in middle and high schools.
“A lot of the information that we’re sharing with them, of course, is not being shared from these companies that are producing the product,” Antelo said. “When [students] are finding out some of the side effects and some of the facts about it, students are very honest in saying, “We didn’t know that; we had no clue [those are] some of the side effects to it.”
The district recognizes vaping as a distraction and a health risk to students in the same way it recognizes other addictive substances, said Molly Pipak, K-12 physical education and health curriculum coordinator at PISD.
“There’s nicotine. There’s other things that they could put in the electronic nicotine delivery systems that form that habit,” Pipak said. “Them needing to plug it in and charge it is becoming something that they are constantly concerned with.”
The district’s drug prevention specialist also hosts public forums for parents and staff at each feeder system in the district, Pipak said. The district is currently working on making these forums available to all community members. The next scheduled forum, on Feb. 20, will focus on vaping terminology and how to identify vaping or e-cigarette devices.
A February 2019 Centers for Disease Control and Prevention study found roughly 27% of high school seniors nationwide reported vaping within the past 30 days. That number was nearly 11% for middle school students, the study showed.
These numbers are likely underreported, said Tony Su, a pulmonologist at Texas Health Arlington Memorial Hospital.
Earlier this year, Texas lawmakers increased the legal smoking age from 18 to 21, making it illegal for anyone underage to possess or use vapes. The Plano Police Department said officers have seen little change in underage smoking since the law went into effect Sept 1.
Over the summer, the CDC began tracking lung injuries related to vaping devices or e-cigarettes. There were roughly 2,400 documented cases in the U.S. as of Dec. 13. Texas is one of 26 states with at least one death. Health officials confirmed in October that a North Texas woman died in connection with a vaping-related lung injury.
Roughly 77% of those injuries involved people under 34 years old, the CDC found. Fifteen percent were younger than 18, while 38% were between 18 and 24 years old.
“Vaping is a young adult’s disease,” Su said. “You shouldn’t be that sick in your 20s.”
Texas Health has also seen a number of minor vaping injuries in the older population, according to Glenn Hardesty, an emergency medicine physician at Texas Health Presbyterian Hospital Plano. He attributes this to the fact that older people are more likely to seek treatment sooner. Young people are more inclined to seek help only when they need hospitalization, he said.
Hardesty said he believes the number of people injured from vaping is higher than what has been reported because the medical community only recently became aware of the lung injuries.
“We probably saw some mild cases or minor cases of this that we didn’t recognize at the time because it really hadn’t been identified,” Hardesty said. “You see kids coming in with what we thought might have been asthma exaggeration or bronchitis and very well could have been a mild form of this vaping-associated lung injury.”
Local doctors began recognizing cases in the spring, said Crescens Pellecchia, a pulmonary doctor at Medical City Plano.
“[It’s] basically a huge inflammatory response,” Pellecchia said. “That inflammation presents differently in different people—some people will have weeks and weeks of symptoms, some people only a few days. Almost all of them end up on oxygen; about a third will end up on life support on a breathing machine. So it’s quite severe.”
Every injury case diagnosed at Medical City Plano as of mid-November involved people using devices containing THC to get high, Pellecchia said.
Roughly 83% of patients with vaping- or e-cigarette-related injuries nationwide admitted to using products containing THC, while 35% reported exclusive use of THC-containing products, according to the CDC.
More study is needed to determine what is causing these injuries, but THC and vitamin E acetate, an additive in THC vapes, are two suspects, Hardesty said.
Vitamin E acetate is naturally found in foods and does not cause harm when consumed or applied to the skin, the CDC states on its website. Previous research suggests that inhaling the vitamin is what is damaging the lungs.
The CDC also states that it is too early to rule out other chemicals associated with vaping or e-cigarettes that may be causing injuries.
More study is also needed on the long-term effects of vaping and e-cigarette use, said Aubrey Merrill, coordinator for surgical oncology services at Medical City Plano.
“It’s such a new product. It’s only been around for a few years,” Merrill said. “The more immediate danger is that you might get one of the lung injuries that’s occurring right now.”
Omar Awad, a pulmonologist in the Baylor Scott & White Medical Center Plano and McKinney hospitals, said most doctors believe vaping and e-cigarette use is not safe. The CDC also advises people not to use vapes or e-cigarettes.
For those who began vaping in an effort to quit smoking cigarettes, Pellecchia said he recommends they use nicotine replacement therapies rather than go back to cigarettes.
“Some of the problems in the lungs do happen that soon, but it’s usually decades in the making,” Awad said. “I don’t think we’ve even scratched the surface in knowing the potential harmful effects in vaping or e-cigarettes yet.”
Elizabeth Uclés and Olivia Lueckemeyer contributed to this report.
