After watching father lose battle to nicotine addiction, SM East administrator raises concerns about spread of vaping

Jay Senter - January 17, 2018 9:03 am

Vaping

Susan Leonard is a well-known figure in northeast Johnson County, having served as the principal of Pembroke Hill Middle School for years before joining the SM East administration as an assistant principal in 2016. And as she’s watched students at the school and her own children — who are entering middle school — in recent years, she’s become increasingly concerned that young people today are getting a message that vaping is a danger-free alternative to smoking.

Susan Leonard. Photo by Bruce Mathews.
Susan Leonard. Photo by Bruce Mathews.

It’s a particularly personal issue to Leonard, who lost her father to lung cancer in 2005. His addiction to nicotine, she said, ultimately cost him his life.

“What a price he, and all of us who loved him so much, paid to that horrible addiction,” she said in a column penned this month and distributed to SM East families via social media.

Now, she’s asking for local parents to think through ways the community can help prevent young people from developing addictions that could compromise their health in later years.

“I am a realist and I know that ‘smoking in the boys room’ has been occurring since school has been around and I don’t believe I can compete against the well-funded marketers, or biology for that matter,” she wrote. “However, we can make a difference and do our best to prevent our children from developing addictions to substances we know can cause lifelong damage.”

Leonard’s full column is below:

What We All Need to Know About Vaping

By Susan Anderson Leonard, Ph.D.

On September 20, 2005 my recurring childhood nightmare came true. Lung cancer killed my father. I can’t explain how I somehow knew this addiction to nicotine was so powerful that it would beat my father, but I think I always knew it would happen. I knew it because I watched my father, a very strong and stubborn man, try and try and try to quit smoking. To me, it was nicotine I began to hate (and fear). Cigarettes were bad, of course, but it was the nicotine that he just couldn’t quit. What a price he, and all of us who loved him so much, paid to that horrible addiction.

I tell you this very personal part of my history to try to explain why it is so hard for me to see nicotine persist as an easily accessible and heavily used, but very dangerous, substance. I suppose it’s no different today than when my father’s generation began to smoke cigarettes. We’ve all seen those old advertisements for cigarettes including testimonials from physicians, right? Cigarettes are “refreshing” and so cosmopolitan. Today “vaping” is seen as a safe alternative to smoking. A lot of money is going in to creating that image and yet no regulation on the industry exists to protect consumers. As my own children enter middle school, a stage of development marked by a myriad of physical and neurological changes including a desire to try new and risky behaviors, I mean it when I say I am worried about our children.

First things first; we don’t even really know what our kids are vaporizing. Because the health risks associated with Electronic Nicotine Delivery Systems “ENDS” have not been adequately studied, the Forum for International Respiratory Societies (FIRS) concluded that “electronic nicotine delivery devices should be restricted or banned…” in their official position statement issued in July of 2014. Among the many concerns cited by this international collection of expert medical researchers, was that most delivery devices contain large concentrations of propylene glycol, which is a known irritant when inhaled, and very little is known about the effect of long term inhalation of this chemical. Additionally, because these devices are unregulated, the user really has no idea what other chemicals he or she may be inhaling, nor do any of us know what the short or long term effects of that exposure is. The whole idea that these devices are “safe” and somehow a better alternative to smoking has no basis in sound research. And, candidly, it is hard for me to believe that this industry is truly trying to do “good” by helping smokers wean themselves off harmful tobacco cigarettes when they market the devices with fruity flavors and pack their juices with more nicotine than a cigarette is allowed to contain (because cigarettes are regulated by the FDA). The bottom line is that nicotine is highly and quickly addicting and addiction creates a lucrative product. Addicting young users makes good business sense, but it absolutely does not make sense for our children.

What we do actually know is that these ENDS deliver varying amounts of nicotine to the user. Nicotine causes the release of adrenaline, which elevates the heart rate, increases blood pressure and constricts blood vessels. This can lead to long-term heart health problems. We also know that vaping is an efficient way to deliver nicotine. The effect is almost immediate, but it also wears off quickly and encourages the user to want to vape again and again. As with any addictive substance, your body will need more and more of it to feel the same effects.

This is particularly problematic for young people.

Adolescence is a time of rapid growth and development. The physical changes during this time are obvious, but the true hallmark of this period is a major reorganization of the forebrain circuitry. During this stage of adolescence the brain is sensitive to novel experiences. Unfortunately, just as young people want most to experiment with new and risky behaviors, science has proven that their immature brains have very different sensitivities to drugs and alcohol. Exposure to nicotine during this stage can lead to long-term changes in neurology and behavior. Chronic nicotine exposure during adolescence also alters subsequent response of the serotonin system. During this developmental phase of life, alterations to the brain are often permanent and it is important to note the difference between the effect of drug and alcohol use on a mature brain versus the brain of an immature, still developing brain.

We should also not ignore the ‘gateway’ effect nicotine has on its users. Study after study has shown that nicotine use is a gateway to the use of marijuana and cocaine. In 2012, among the U.S. adults 18-34 years of age who had ever used cocaine, nearly 90% of them smoked cigarettes (used nicotine) first. More alarming, behavioral experiments have proven that nicotine essentially “primes” the synaptic plasticity of the brain to enhance the effects of cocaine. So, it’s not just that one risky behavior leads to another, nicotine actually affects how the brain works making other drugs (most commonly marijuana and cocaine) a more pleasurable and desirable experience for the user. And it is relatively common knowledge that the younger a person begins using drugs and alcohol, the more likely it is that he or she will move on to other drugs and also more likely he or she will develop a serious addiction problem.

I was motivated to write about this topic as I encountered more and more use of ENDS in our school community. I am a realist and I know that “smoking in the boys room” has been occurring since school has been around and I don’t believe I can compete against the well-funded marketers, or biology for that matter. Young adolescents will always be thrill seeking and susceptible to making mistakes. It is a fundamental part of growing up and we should expect and allow this to happen as we lovingly guide our children to a healthy adulthood. However, we can make a difference and do our best to prevent our children from developing addictions to substances we know can cause lifelong damage. It definitely can feel like “everyone is doing it” with regard to the vaping trend, and I believe it will take “everyone” to make a positive change. Be informed about the risks, educate your children and support efforts to restrict and regulate these nicotine delivery devices. Specifically, you can support Tobacco21 laws. Different studies about the Tobacco21 law have yielded different results, but it is clear that they do make a difference. If we can do something that will reduce the rate of our high schoolers using tobacco (or ENDS) by 10 – 50%, why wouldn’t we? Currently Johnson County has been proactive in this area, but Fairway remains stubbornly opposed. We can change that! There are also more and more efforts to require that ENDS be subject to regulation through the FDA that would hold manufacturers of these products accountable to same standards of quality, safety and effectiveness as products that are already regulated and approved for smoking cessation such as the nicotine patch.

References:

  1. Forum of the International Respiratory Societies (FIRS): Electronic Cigarettes: A Position Statement (2014). Pulmonary Perspective. 190.6, p. 611-618.
  2. Kandel, Eric R., Kandel, Denise B. A Molecular Basis for Nicotine as a Gateway Drug (2014). The New England Journal of Medicine 371.10, p. 932-943.
  3. Morain, Stephanie R., Winickoff, Jonathan P., Mello, Michelle M., Have Tobacco 21 Laws Come of Age? (2016) The New England Journal of Medicine 374.17, p.1601-1604.
  4. Nelson, Mike. Pulmonologist, Shawnee Mission Medical Center. Phone interview January 4, 2018.
  5. United States Food and Drug Administration. Electronic cigarettes (e-cigarettes). Public Health Focus. [accessed 2018 Jan 9]. Available from: https://www.fda.gov/TobaccoProducts/Labeling/ProductsIngredientsComponents/ucm456610.htm
  6. Yuan, M., Cross, Sarah J., Loughlin, Sandra E., Leslie, Frances M. Nicotine and the adolescent brain (2015). The Journal of Physiology 536.16, p.3397-3412.

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