Designated vaping area signage, showing an electronic cigerette icon in green, with the text designated vaping area also in green bold type — Designated vaping area

How to deal with the vaping in schools – advice for teachers

Posted on August 18, 2023 By Colin, archived here in wiki form. (slight changes made for clarity in wiki page form, content unchanged. ed.)

VAPING BY STUDENTS at Australian schools is increasing and is understandably creating great concern for teachers and difficulties with enforcement.

While most Australian schools have clear guidelines on smoking, most do not have a policy on vaping or provide education programs for students or teachers. (here and here)

Schools do not have the resources to police vaping and the current punitive strategies of suspensions, vape detectors, locking toilet doors and toilet raids are not working. We need a fresh approach which acknowledges the reality that kids will vape, whether we approve or not.

This is my 7-point plan for teachers and school staff to deal with school vaping.

1. Keep it in perspective

The panic about youth vaping is grossly out of proportion to the harm it causes
— Dr Colin Mendelsohn

Other risky teenage behaviours are of much greater concern, such as smoking, binge drinking, illicit drug use and drink driving. There are high rates of bullying, mental illness, suicide attempts, sexual and other violence and car accidents that cause far more harm.

In 2019, 63 Australian teenagers (14-19) died from alcohol. No teen or adult has ever died from vaping nicotine.

Total deaths 2019 from vaping and alcohol, a graph showing zero deaths for vaping and (63) for alcohol — Total deaths 2019 from vaping and alcohol

A recent assessment of youth drug harms in New Zealand ranked vaping as just about the least harmful form of drug use among young people.

Adults should not over-react to youth vaping as it is likely to be another fad that may soon pass. Youth vaping peaked in the US in 2019 and fell 50% over the next 3 years.

2. Know the facts

There is widespread misinformation about vaping nicotine in the media and most people believe it is far more harmful than it actually is. Vaping is not risk-free but has only a small fraction of the risk of smoking. The risk of vaping is estimated to be around 5% of the risk of smoking or less by the UK Royal College of Physicians and the England government.

Most vaping by young people is short-term and experimental and the risk of harm is particularly low with this pattern of vaping
— Dr Colin Mendelsohn

Most teens who vape frequently are former or current smokers. For them, vaping may be beneficial and can help to prevent relapse to smoking.

New users who vape too much nicotine can get nausea, dizziness and feel faint. If this occurs, it is best to lie down and wait for it to pass. These symptoms settle quickly and are not serious.

Importantly, there is no evidence that vaping causes kids to take up smoking if they would not have already done so (the so called ‘gateway theory’). In fact, vaping is diverting kids away from smoking and reducing youth smoking rates overall.

Most young people who try vaping DO NOT get addicted to nicotine. Nicotine withdrawal is unpleasant, but not a serious health concern.

There is no evidence that nicotine harms the human adolescent brain. Studies have not found differences in in IQ, educational achievement or cognitive abilities in adults as a result of past smoking, so vaping is very unlikely to have these effects.

There is no evidence that vaping nicotine causes:

The misnamed serious lung disease “E-cigarette or Vaping Associated Lung Injury” (EVALI)
Seizures or
Spontaneous pneumothorax (lung collapse)

There is a rare risk of burns and injuries from lithium-battery explosions.

Harms from long-term vaping may emerge over time. Vaping may lead to respiratory or cardiovascular harm, but this is highly likely to be far less than smoking.

This 5-minute video summarises the health risks for teen vapers:

Further information

3. Provide accurate information

Schools should educate students and staff about vaping, providing honest, evidence-based information
— Dr Colin Mendelsohn

Exaggerating the risks of vaping or providing misinformation to discourage vaping leads to a loss of trust. Kids know when they are being lied to.

My advice on what to say to teens about vaping can be found here. Explain to kids:

Vaping is a quitting aid for adult smokers.
Vaping is not recommended for young people who do not smoke
Vaping is not harmless and there are small potential risks, particularly nicotine dependence (above). However, vaping is far less harmful than smoking
There may be additional risks from unregulated, black market products
There may be further risks from long-term use that we don’t yet know about
Ultimately, vaping is their choice

My short video can be used to educate students about vaping:

Peer pressure is a powerful driver of teen vaping. It can be helpful to teach kids how to refuse the offer of a vape, for example with role plays.

Discussion of the environmental impact of vaping may help. Explain that litter from disposable vapes ends up in landfill where it causes soil and water pollution. Lithium-ion batteries are a fire hazard if discarded into general waste. Vapes should be discarded in battery recycling bins.

4. Have realistic expectations

Even the best education programs have very limited success in changing youth behaviour
— Dr Colin Mendelsohn

Teenagers are programmed for “sensation-seeking”, and taking risks is an inherent part of this stage of life. Risky behaviours are driven by social (peer influence) and emotional factors, not cognitive factors or knowledge. This reflects the limits of the immature adolescent brain.

5. Avoid punitive and coercive measures

Coercive and harsh responses are counterproductive, like a red flag to a bull. Kids resent being lectured to about their behaviour and this can undermine their relationship with adults.

Punitive approaches such as suspensions are not effective and have potentially harmful consequences. such as academic failure, dropouts, violent and anti-social behaviour and smoking, especially for vulnerable students.

6. Advise on how to quit vaping

Quitting vaping is generally much easier than quitting smoking as vaping is less addictive. However, some students may need advice and support to quit.

Some vapers can stop abruptly. Others prefer to gradually reduce the nicotine content of the vape and try to use it less frequently. Increasing the time between vaping and setting rules for when and where you do and do not vape can help to gradually reduce use.

However, if there is any risk of relapse to smoking it is best to continue vaping
— Dr Colin Mendelsohn

Some people benefit from switching to nicotine replacement therapy (NRT), such as patches or gums, as a step towards quitting. After quitting, it is a good idea to keep a vape or faster-acting NRT (eg gum or lozenge) at hand for when a sudden trigger causes an urge to smoke.

Further information: Supporting clients who want to stop vaping. National Centre for Smoking Cessation and Training, UK. 2022

7. Develop a policy for vaping at school

Each school should have clear guidelines on vaping at school and how it should be managed.

Restrictions on vaping are needed, but a pragmatic, supportive and compassionate approach is more likely to be effective and acceptable
— Dr Colin Mendelsohn

Some students are addicted to nicotine and need to vape at regular intervals during the day. Schools should consider allowing addicted students to take short breaks to vape outside if needed during class hours. Nicotine withdrawal is unpleasant and can be disruptive.

Vaping in school toilets is unacceptable but policing it is almost impossible to enforce and is a strain on sparse school resources.

Although controversial, consideration could be given to allocating a designated outdoor area where students can vape. This should ideally be out of sight, for example behind the toilets. Vaping won't be as appealing to teens if they are allowed to do it.

The designated vaping area could be restricted to students who:

Are 'registered' as vapers
Are over a certain age (eg 16 and over), and
Have the written permission of a parent.

This proposal should not be seen as an endorsement of youth vaping, but as a pragmatic solution for the reality of nicotine dependence.

The sale of vapes at schools should be banned and vigorously enforced.

Resources

Dovetail. Queensland-based youth AOD training organisation

Dovetail is a Queensland-based training organisation which provides training across Queensland including in rural and remote locations. Dovetail has a specific focus on young people who use alcohol and other drugs.

Their advice is

Vaping is not for young people who are non-smokers
Evidence-informed prevention work is important
Poorly designed responses can increase harm
The best thing for health is to be smoke and vape free
Vaping is not harmless but current evidence suggests it is likely less harmful than smoking
Evidence suggests vaping can help some people quit smoking

Sheffield City Council