Oregon Vaping Death

A researcher holds vape pens in a lab at Portland State University in Portland, Ore., on April 16, 2019. Oregon's public health physician said on Wednesday, Sept. 4, 2019, that a person who contracted a severe respiratory illness and died after using an e-cigarette had purchased a vaping device containing marijuana oil at a state-legal dispensary. The death is the second linked by public health officials nationwide to vaping and the first linked to an e-cigarette purchased at a dispensary. File/Craig Mitchelldyer/AP

An outbreak of mysterious lung illnesses, some deadly, among e-cigarette users across the country has focused national attention on the potential dangers of vaping.

The prevalence of e-cigarettes among young people has prompted the federal government and some states to take action, but changes are also being made locally as South Carolina's school districts adapt to the trend by updating their tobacco-use policies and introducing more vaping education opportunities for middle and high school students. 

Many Lowcountry school districts have updated their tobacco use policies to include vaping-specific language.

The Dorchester School District Two board passed an amendment this summer to include all vaping paraphernalia.

The policy now prohibits all alternative nicotine products, including vape liquids or liquid containers, on school property or at school-sponsored events. First-time offenses will result in a three-day out of school suspension.

In Berkeley County School District, tobacco-vaping violations increased by 200 percent from the 2017-18 school year to 2018-19.

District spokesman Brian Troutman attributed part of the increase to a policy change that lumps tobacco and vaping violations together, in addition to school personnel who’ve been trained on how to better recognize the devices.

It’s a similar story in Charleston County School District and Dorchester School District Two. Both have seen increases in tobacco or alternative nicotine product violations on school campuses, and both have updated their tobacco policies to include vaping-related language. 

Their action comes in the wake of a growing national trend: The percentage of secondary students who have vaped nicotine in the past month has roughly doubled since 2017, according to preliminary data from a University of Michigan survey.

Anthony Alberg, a professor of epidemiology at the University of South Carolina, has studied vaping and e-cigarettes extensively.

He served on a National Academies of Sciences, Engineering and Medicine committee that produced a report on the public health consequences of e-cigarettes.

Through his research, Alberg found that there’s strong evidence to suggest that e-cigarette use among teenagers actually increases the likelihood that they will one day go on to use combustible tobacco cigarettes. 

The leading cause of premature death in the United States is smoking-related diseases including heart disease and 13 different types of cancer, he said.

“That's really what, in my mind, helps make very clear that there's big health risks associated with these products,” Alberg said.

Vaping in the boys room?

E-cigarettes are usually small devices that often use cartridges that contain nicotine, flavorings or cannabis products and other chemicals to create a water vapor that users inhale. 

Despite their prevalence, school administrators and teachers face specific hurdles to enforcing their e-cigarette policies, since the devices are often discreetly shaped and can produce virtually odorless smoke.

“Vaping is particularly difficult because there's not a strong scent,” said Preston Giet, Dorchester School District Two’s director of security. “And even the faint scent and the fumes that come from it go away so fast that sometimes you even see it out of the corner of your eye and you’re not sure if you really saw it, or if you did, who was doing it. So it's definitely hard to detect.”

In Charleston County, Laing Middle School Principal James Whitehair agreed.

“It does present unique challenges because it's often odorless,” he said. “But at the same time, students are concerned about their own safety, and they will often come to us and tell us that people have been vaping in the bathroom.”

Whitehair said school administrators use student testimony and footage from school cameras outside bathrooms and in hallways to track down those using e-cigarettes on campus.

“There's an investigative part of it that does take our time," he said. "We’re detectives in many ways.”

James Whitehair_02

Principal James Whitehair at Laing Middle School of Science and Technology stands in front of a decorated wall of vaping and electronic cigarette facts along a hallway near the front office on Friday, September 20, 2019, in Mount Pleasant. Andrew J. Whitaker/Staff

In Berkeley County, both student resource officers at Stratford High School attended a training that covered vaping, substance abuse and underage drinking earlier this year, said Goose Creek Police Department Lt. Tom Hill.

“They specifically told them what to look for when it came to small vape pens and that sort of thing and the different types of clothing that kids are wearing to conceal vaping products,” Hill said.

Compounding the problem is the easy access many students have to e-cigarettes. 

By law, people under the age of 18 (or 21 in some areas) should not be able to purchase any tobacco products, but that doesn’t stop them from getting into the hands of middle school and high school students.

Sometimes young students have access to vape paraphernalia via older siblings, said Linda Allen, Charleston County School District’s prevention and intervention coordinator.

“They find them, which is frightening, and use those, but it's mostly siblings,” Allen said. “And then you'll have an occasional older student that's going to sell them to them.”

‘The cool thing to do’

Whitehair said vaping-related incidents have been increasing at Laing over the past four or five years.

“It’s like the cool thing to do, unfortunately, for our youth,” Whitehair said. “And the most concerning part is they really, truly do not understand the damaging effects that it has on their bodies.”

He doesn’t remember the last time a student was caught with tobacco on campus.

“It seems like we've traded one addictive substance for another,” he said.

Troutman said the situation has changed in Berkeley County schools, too.

“I remember when I was in high school a long time ago, you know, we were always hearing ‘Oh, so and so got caught smoking in the boys’ room.’ I mean, there was even a song about it,” he said. "Now, you're not hearing about that. You're hearing more about, ‘So and so's got a vape pen in their backpack.’”

Cami Tidwell, the nursing services coordinator for Berkeley County schools, said the technology is changing so quickly it can be hard for parents and community members to keep up.

“The methods that they’re using are changing," she said. "There are more devices, there are different things that come out on the market so quickly.”

An emphasis on education

In Charleston County, if a student is caught with an e-cigarette at school, he or she will be referred to the Alcohol and Drug Alternative Program for Teens. 

Allen, the district's prevention and intervention coordinator, will meet with the student and perform an assessment to understand why he or she was using the e-cigarette in the first place.

Most of the students she sees at the district-level that have been caught with e-cigarettes don’t understand that the products are addictive.

“They have no clue," she said. "All they know is it smells good. It tastes good. And (their) friend did it.”

Allen may decide to refer the students she works with who've brought e-cigarettes, tobacco or alcohol on campus to outside services through organizations like the Charleston Center or the Medical University of South Carolina.

“It's not all punitive,” she said. “There's also the educational part that people need to realize,”

Whitehair, the principal at Laing, also stressed the importance of educating students and parents on the dangers of vaping.

The school hosts large-scale assemblies as well as small-group vaping education sessions. It’s is also addressed in students’ health curriculum.

Dorchester District Two hosted its first tobacco education night last month. During these sessions, Giet, the district’s director of security, informed parents and students on how to identify different types of e-cigarettes and the health risks associated with vaping.

Any student caught with vaping paraphernalia at school is required to attend one of the district’s informational sessions with their parents.

Giet said he will continue to host these sessions about once a month.

Berkeley County students are also educated on the dangers of vaping through a collaboration with the Kennedy Center.

The district has also increased educational awareness and training for student resource officers, teachers and other school staff.

A community affair

Educating students on the dangers of vaping needs to go beyond the school level, Tidwell said. 

Allen agreed.

"Just making the parents aware is huge … because they look like little cartridges, and the parents have no clue. They're like, ‘Oh, I've seen that in their room. I had no idea that's what that was.’ And so it's easy to hide. It's easy to smoke and get away with it," Allen said. 

Charleston County is working with outside agencies to create an additional comprehensive tobacco education program that will address vaping and e-cigarettes, Allen said.

Berkeley County hopes to expand its vaping information sessions for students and introduce educational nights for parents, too. 

Dorchester District Two will host its next vaping education night at 6 p.m. Oct. 15 at Ashley Ridge High School.

In Berkeley County, Daniel Island School will host a vaping education session for students on Oct. 8, at Cane Bay High School on Oct. 23 and at Timberland High School on Oct. 29.

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Contact Jenna Schiferl at 843-937-5764. Follow her on Twitter at @jennaschif. 

Jenna Schiferl is a Columbia native and a reporter at The Post and Courier. She has previously worked as an editor at Garnet & Black Magazine.