Photo caption: Dr. Lorraine Smith (left) and nursing student Lindsey Boehm are working to educate young people and adults who interact with them about the dangers of vaping, especially during the COVID-10 pandemic.
The COVID-19 pandemic has elevated concerns about the significant number of teens and young adults who vape, with early reports showing that the coronavirus poses a greater danger to young people who use the products than to their non-vaping peers.
With that in mind, a University of Wisconsin-Eau Claire nursing faculty-student research team is leading an effort to educate young people and the adults who interact with them about the effects and dangers of devices like vapes and e-cigarettes.
“Preliminary reports are finding that young people who had used e-cigarettes are five times more likely to be diagnosed with COVID-19 than never-users,” says Lindsey Boehm, a senior nursing major from Eau Claire. “It’s critical for young people and others to understand the dangers associated with vaping.”
Boehm and Dr. Lorraine Smith, assistant professor of nursing, are leading a project titled “Implementing an Educational Initiative on Electronic Cigarettes and Vaping: A Nurse Led Intervention.”
Their work builds on an initiative that Dr. Diane Marcyjanik, a nursing professor who passed away in April 2020, and her students began two years ago, shortly after vaping was deemed a national public health epidemic among teens and young adults.
The original project focused on educating school staff about electronic nicotine delivery systems (ENDS) such as vape pens and electronic cigarettes. Before COVID-19, Marcyjanik and her students presented their research to more than 100 middle and high school staff members in Wisconsin.
Smith and Boehm are continuing their work, though adjusting their focus because of the pandemic.
They are coordinating with area youth clubs and centers to virtually share presentations with teens and adults that explain how prevalent vaping is, share examples of different devices and how they work, explain the nicotine content of vaping devices and discuss the health effects of vaping.
Getting accurate information about vaping to young people and the adults around them is critical, the researchers say.
As a nursing student, Boehm has studied the many short- and long-term health effects caused by cigarette smoking and the substantial improvements in public health as cigarette smoking decreased in recent decades.
"Now we're seeing the progress made on cigarette smoking being undermined by the increase in e-cigarette use the last few years," Boehm says. "People are making choices as teens or young adults that can affect their health for the rest of their lives."
Though the city of Eau Claire has banned the use of e-cigarettes any place where the use of traditional cigarettes are banned, she still sees many of her peers vaping, some daily and others doing it in social settings, Boehm says. Many of them seem unaware of the health dangers associated with it, she says.
"A lot of young people have the mindset that there aren't consequences from vaping because they think it's less dangerous than smoking," Boehm says. "They don't realize that there isn't a lot known about the long-term health effects because vaping products have only been around for less than 20 years. The long-term health effects of cigarettes weren't known at first either. It wasn't until the 1960s that cigarettes were definitely linked to lung cancer and chronic bronchitis. By then, nearly 40% of Americans already were smokers. So, we won't likely know the long-term health effects of e-cigarettes for decades."
Boehm and Smith say that they've found that many adults are aware of the prevalence of vaping use among youth.
“However, many of them lack knowledge about the different vaping devices out there, how much nicotine they contain, and the health effects associated with vaping and e-cigarette use in young people,” Boehm says.
So far, people who have participated in the virtual events seem most surprised to learn the nicotine content of different vaping products, Smith says.
“This made sense to us because we know that one study found that only one-third of JUUL users are aware that JUUL contains nicotine,” Smith says.
The nicotine content is critical information to have because research has shown there are several known adverse health effects of nicotine use in adolescents, like impaired brain development, enduring cognitive and behavioral impairments, and effects on memory and attention, Smith says.
It also has been determined that adolescents are more likely to become addicted to nicotine than adults, and that nicotine acts as a gateway to other substance use and addiction, she says.
In addition to the known health consequences associated with nicotine use in adolescents, another concern is the lack of knowledge about the long-term health effects of vaping, Boehm says.
“Vaping is at epidemic levels among youth in the United States and use of these products causes short-and long-term health effects,” Boehm says.
Already they have provided virtual presentations to area youth in Eau Claire, Chippewa, Dunn and Jackson counties by working with directors and staff at area agencies, Smith says.
While they prefer to give live presentations via a video stream, Smith and Boehm have developed a digital presentation that can be accessed and shared anytime. They also created printed handouts that they send to agencies serving youth.
“Teachers and other adults have responded very well to our educational presentation,” Boehm says. “Many of them see vaping and e-cigarette use among their students, and they are generally eager to learn more. Community partners also are very interested in our project and appreciate having materials they can share with their members and staff.”
The most recent data from 2020 shows that 19.6% of high school students and 4.6% of middle school students reported current e-cigarette use, Smith says. In Wisconsin, the Wisconsin Department of Public Instruction reported in 2019 that 45.4% of high schoolers said they had tried vaping and 20.6% reported use of ENDS in the past 30 days, she says.
It is too soon still to say whether the COVID-19 pandemic is having an impact on those numbers, Smith says.
“Data collection has been delayed during the pandemic, so we are not sure yet whether vaping is becoming a bigger or a lesser issue during COVID,” Smith says. “On one hand, students who lost their jobs due to the pandemic may no longer be able to afford vaping products and students who are quarantined or attending classes virtually may be cut off from their social suppliers of e-cigarette products.
“On the other hand, many people are experiencing increased stress and mental health issues during this pandemic, which may increase the use of nicotine as a coping mechanism.”
Smith says she plans to continue involving nursing students in the project in the coming semesters.
“Our next steps include, post-pandemic, returning to the original research to educate school staff and more actively engage school nurses to make this a nurse-led initiative in schools,” Smith says. “To disseminate findings on our study through scholarly journals is a priority, as well as continue to be an advocate for youth through educating the adults who work with them, continuing to directly educate them on the harmful effects of ENDS and to network with current youth advocacy leaders in our own community to impact the number of youth using ENDS.”
Boehm says being part of the research project has been rewarding and educational and will help her be more successful in her future career in health care.
“Participating in student-faculty research as an undergraduate student has been a wonderful opportunity that I am grateful for,” Boehm says. “Under the mentorship of Drs. Diane Marcyjanik and Lorraine Smith, I have developed my science research skills, such as critical literature analysis, study creation and execution, and data analysis. I have also developed my comfortability presenting to audiences virtually and in person about public health concerns.
“The skills and knowledge I have gained throughout this project will be helpful to me in my nursing career and in my future graduate-level pursuits.”