It’s 11 a.m. on a Saturday and students from Cherry Hill East and Triton High School gather for a football game. A clique of about 10 sophomores mingle in the stands making typical high school banter: who was seen holding hands at the mall Friday, whose mom can pick them up, and where they can get some more pods for their Juul.
One 15-year-old boy closed his eyes and inhaled deeply from the sleek black stick hidden in his palm. He held it up so the Juul’s pod, the flavored liquid capsule and nicotine source, reflected in the sun. The juice was halfway gone.
“I just started this one this morning and it’s almost gone,” said the sophomore, who started vaping when he was 12 and now smokes a pod a day. His friends nodded and then another casually changed the subject back to the homework due Monday.
Vaping has consumed the lives of teens across the country, students say, many to the point of addiction. Juuls in particular, the rectangular devices that look more like a USB drive than an e-cigarette, lurk in the background of nearly every aspect of many teens’ conversations, school day, and social lives. Schools are enforcing strict rules to curb their use, placing vape detectors around campus, assigning staff to monitor hallways and bathrooms, making kids sign contracts against vaping, and meeting with parents to try to deter what government and health officials are calling an epidemic.
Gloucester Township police now give 40-minute anti-vaping presentations to fourth graders to curb the curiosity of kids as young as 9 or 10. “I want them to never even look twice,” said Officer Randy Pearce.
To understand how vaping affects suburban youth, The Inquirer interviewed more than a dozen teens who spoke candidly about how pervasive vaping is in their schools and social circles, despite its well-documented health effects, including lung illnesses that have killed 12 people, and the fact that for teens, using it is illegal.
Most said they started vaping because a friend or older sibling had one and they thought it “looked cool.” A few said they use it to help with anxiety. All admit that the fad is out of control, and while some are worried about possible negative health effects, many say they are too addicted to stop.
It was a brisk fall evening as two boys no older than 12 walked through Veterans Memorial Park in Gloucester Township. “All I think about is my video games, my Juul, and girls,” said one boy. “Right?” his friend said with a laugh before the two exchanged a fist bump.
As they passed, a 16-year-old student from Timber Creek High School walked up with her dad. It was the 89th day since she stopped using a Juul, she said proudly. Like others interviewed for this story, the student asked not to be identified because it is illegal for minors to use tobacco products.
The teen hadn’t been hooked for long. She’d used her friends’ Juuls on and off after spending a week down the Shore this summer, but even after such a short time, she started having intense cravings. But then her friend’s mom caught her vaping and she had to confess to her parents. Now, they make her track her progress through a sobriety app.
“The more I was surrounded by one, the more I wanted one,” said the girl. “But now, I have no urge to ask to use people’s Juuls because of how scared I am to get sick.”
At least 805 cases of illness from using e-cigarettes with nicotine or THC, the psychoactive ingredient in marijuana, have been reported around the country. Twelve people have died. In New Jersey, nine vaping-associated illness cases have been confirmed and 34 more among people age 15 to 55 are under investigation by the state’s Department of Heath. Pennsylvania has eight confirmed and six suspected vaping-related illness cases, and is investigating 63 more, the Department of Health said. The average age is 25 and the majority are men, the department said.
Juul Labs announced Wednesday that its chief executive would step down and be replaced by an executive of the tobacco giant Altria, which owns a 35% stake in the company. Juul also said it would suspend all U.S. advertising.
Still, teens say, the lure endures.
“You can’t go into any bathroom without seeing someone smoking a Juul,” the Timber Creek student said. Students have nicknamed bathrooms “vape lounges” because they are so frequently filled with smoke.
“Not a class goes by that I don’t hear someone asking, ‘Oh, do you have a Juul?' Or, `Do you have some pods I can buy off of you?’ " she said, "and it’s been like that since freshman year.” Students who can’t find pods or use their friends’ may resort to stealing money, pods, and the e-cigarette itself from peers to feed their addiction, she said.
While the 16-year-old was able to stop, others are too addicted. The sophomore who’s been vaping since he was 12 said he gets intense migraines and can’t sleep without his Juul.
“I want to stop because I’m scared. But it’s hard because it’s everywhere,” he said.
More kids are vaping than ever
Millions more young people are using e-cigarettes than ever, and despite educational awareness initiatives and restrictions in schools, the numbers continue to rise.
Vaping has more than doubled since 2017 among eighth, 10th, and 12th graders, according to a study released earlier this month by the National Institute on Drug Abuse. More than 3.6 million youth used e-cigarettes in 2018, according to the National Youth Tobacco Survey, a 78% increase from the previous year among high school students and a 48% increase in use among middle schoolers.
The health hazards of vaping have prompted some state and local governments, including Michigan, New York, and Massachusetts, to ban flavored e-cigarettes, and the Trump administration has proposed a federal ban. Walmart announced last week it would stop selling all e-cigarettes. Two weeks ago, Gov. Phil Murphy assigned a task force to build recommendations on ways New Jersey legislators can protect residents from vaping dangers. Pennsylvania lawmakers have not announced any legislative action.
While the minimum age to purchase tobacco products in New Jersey is 21 and in Pennsylvania 18, teens say they often get older siblings or friends of legal age to purchase products for them. Many also say they know which local convenience stores don’t ask for ID or they purchase them online. Some said students will buy pods in bulk and up-charge younger kids nearly double the price.
State law prohibits the use of electronic cigarettes or tobacco products on school grounds. In Gloucester Township, students caught vaping are immediately drug-tested, fined a minimum of $25, and the police are notified, according to school policy. Students who fail the drug test are suspended for a minimum of four days.
Students in the Black Horse Pike Regional School District in Gloucester Township were required to sign a contract at the beginning of the year confirming they understood the policy. Police have given presentations, the district sent letters home to parents, and messages about the “dangers of vaping” have been pushed out to each student’s school laptop, said Black Horse Pike Superintendent Brian Repici. Anti-vaping posters are displayed in hallways and two counselors who specialize in helping students with addiction, including vaping, have been assigned to each school, said Repici.
The district’s high schools have limited the number of bathrooms that students are permitted to use and assigned staff to monitor students going in and out of restrooms, he said. All school staff have been trained to recognize how vapes work and how to detect if students are under the influence.
In Pennsylvania, the Phoenixville Area School District purchased vape detectors for its one middle school and one high school. The detectors are in bathrooms and other areas around campus and look like smoke detectors. They sense vapors in the air, then silently notify the principal the location.
“We believe it has helped to reduce the amount of vaping,” said District Superintendent Alan Fegley. Still, he said, school officials catch a couple of students each week vaping on campus. Those students must take a six-hour course affiliated with Phoenixville Hospital on the dangers of vaping, he said. After the first offense, students may be suspended, fined, and required to do community service. Information on vaping is in the health curriculum and the district hosts educational nights for parents.
Cherry Hill East, which has about 2,100 students, has assigned pairs of teachers to monitor hallways and restrooms, said district spokesperson Barbara Wilson. Students are required to log into an internal system each time they leave class, and teachers monitor it to spot students who frequently leave class. “If a pattern doesn’t look normal, they’ll have the student come in and talk to make sure they’re OK,” said Wilson.
But teens still get away with it. One Timber Creek sophomore said he can’t get through class without his Juul. To hide it from teachers, he exhales the vapor from his Juul into his hoodie or hides behind a piece of paper, he said.
‘Juul’s marketing created a viral peer-to-peer fad’
E-cigarettes are not FDA-approved and doctors don’t know how grave the long-term health implications will be on teens’ bodies, said Brian Jenssen, a practicing pediatrician at Children’s Hospital of Philadelphia.
“Nicotine is one of the most addictive drugs,” said Jenssen, who conducts research on tobacco. “And nicotine on the developing brain is really harmful. It leads to addiction [and] increased impulsivity.”
He said that pediatricians primarily see youth vaping in the suburbs, which he said could be linked to socioeconomic status and kids’ ability to pay for pods, which cost about $16 for a four-pack. “I’m getting calls every day from colleagues and parents worried about their patient or child vaping.”
Juul is not the only e-cigarette on the market, but it controls about 75% of it, and is largely blamed for igniting the vaping explosion among teens. Juul Labs spun off of Pax Labs in 2017 and expects to see $3 billion in revenue this year, tripling what it made in 2018, according to Bloomberg. Altria Group Inc., one of the world’s largest tobacco producers and manufacturer of Marlboro cigarettes, owns 35% of the company.
Juul strategically targeted teens, researchers say, and its first six months of advertising was “patently youth oriented,” said Robert Jeckler, a surgeon and researcher at Stanford University who studied Juul’s first three years of marketing.
“Juul’s marketing created a viral peer-to-peer fad around Juul,” said Jeckler. The company strategically used social media and created hashtag campaigns. Ads featured models in their early to mid-20s wearing casual trendy clothes, jumping in the air or twirling their hair against a brightly colored background.
“Social media drove the Juul epidemic,” said Jeckler.
But addiction is what fuels it, students said.
“It’s like a cup of coffee,” said a Timber Creek junior. “People need it to start their day. And they don’t care about the risk.”
The junior sitting next to her nodded and said, “The addiction is real.”