Tagged Marijuana

Camouflaged Vaping Devices Are Hoodwinking Parents And Schools

In yet another twist for worried parents: Meet the vaping hoodie. This high school fashion mainstay — defined by a hood with drawstrings — is now available as a vaping device, ready to deliver a puff of nicotine (or marijuana) anywhere, anytime. Including in the classroom.

It marks an addition to the fleet of discreet — some would say camouflaged — vaping devices that have teachers and parents struggling to monitor the usage of a product that has surged in popularity among high school-aged kids in the past two years, despite laws in most states that allow sales only to people 18 and up. (In California, it’s 21.)

A computer mouse. A phone case. Backpacks. USB jump drives. The vaping kit options colorfully advertised online are fashionable and many.

A growing number of camouflaged products – such as this hoodie, watch and flash drive – allow for “discreet” vaping. School officials say they are having a hard time keeping such devices out of schools. (Anna Maria Barry-Jester/KHN)

Juul, the San Francisco-based company that dominates the e-cigarette trade, and other manufacturers publicly tout their devices as tools for adults looking to get a nicotine fix without the toxins associated with burning tobacco. But the crowded market of devices and accessories that has sprung up around vaping is filled with products that seem tailored to teenagers who want to keep their use secret — and according to parents and teachers, are all but impossible to keep out of kids’ hands.

Preliminary federal data released this month show more than one-quarter of the nation’s high schoolers had reported vaping in the previous 30 days, up from 11.7 % in 2017. As the teen vaping scene has exploded, adults have had a hard time keeping up. In a 2018 survey, the Truth Initiative, an anti-tobacco advocacy group, surveyed middle and high school teachers on vaping and found that fewer than half recognized a photo of a Juul, the most commonly used device. A palm-size stick that charges via USB, it’s easily mistaken for a flash drive to the uninitiated.

Sven-Eric Jordt has seen the challenge in his kid’s school. By day, Jordt is an associate professor at Duke University, studying the health effects of inhaling various chemicals. By night, he educates his children on the potential risks of vaping. Recently, one of his daughters told him about the “Apple-like” watch manufactured by Uwell that is quickly becoming one of the more popular devices at her high school. With a touch of the finger, the face offers the time. But when removed from the wrist band, it is a vaping device.

“The teachers have learned to recognize Juul,” Jordt said, “but this just looks like a watch.”

The Centers for Disease Control and Prevention continues to investigate a spurt of vaping-related lung illnesses, mostly affecting young people. Authorities have reported 380 cases of suspected cases nationwide, including 70 in California. Seven of the cases — including two in California — have resulted in death.

It’s unclear whether a single device or agent is causing those illnesses. Most of the patients have reported vaping cannabis, according to the CDC, but some patients said they had vaped only nicotine or vaped both. In California and other states, at least some of the cases are linked to vaping unregulated cannabis products. The outbreak has focused new attention on what federal officials now characterize as an epidemic of youth vaping.

Two states — Michigan and New York — have moved to ban sales of most flavored e-cigarette products, which are popular among young people; and President Donald Trump this month said he would launch a similar effort at the federal level. In California, Gov. Gavin Newsom said this week that his administration would boost enforcement efforts against illicit and counterfeit vaping products and fund a $20 million public service campaign highlighting the dangers of vaping.

While research continues into the long-term prospects of e-cigarettes as a tool to help people quit smoking, experts say there is clear evidence that teens should not vape. Nicotine can cause changes in the developing brain that make lifelong addiction more likely. The liquids in vaping devices contain a range of chemicals that can harm the lungs.

Some schools have banned flash drives in an effort to keep vaping devices off campuses. But new stealth devices offer ways around these prohibitions.

The face of this “Apple-like” watch, when removed from its wrist band, becomes a vaping device. This product was purchased by KHN and is pictured on a model. (Anna Maria Barry-Jester/KHN)

Some of the devices likely aren’t legal. A decade ago, when vaping devices first hit the market, it wasn’t clear who had the authority to regulate them. Numerous court cases and regulatory shifts later, they fall under the Food and Drug Administration’s purview and are considered a tobacco product.

Depending on when they became available for sale, devices generally fit into one of three regulatory buckets. Anything marketed before Feb. 15, 2007, is exempt from regulation. Products sold after that but before Aug. 8, 2016, have until May 2020 to submit applications to the FDA for market authorization and can be sold in the interim. Anything that was not marketed by Aug. 8, 2016, needs FDA approval to be sold in the U.S.

For example, the vape watch, which appears to have become available this July, seemingly would require authorization from the FDA to be sold in the U.S. California Healthline was able to purchase it online for $34.95.

The FDA has sent warning letters to six companies about dozens of products being sold without the required approval, and less severe notices to a few others. All but a handful pertain to the liquids used in vaping devices. The FDA did not return a request for comment on how it determines which products are a priority for enforcement.

Representatives with Uwell, which manufactures the vaping watch, did not return a request for comment.

Enforcement of age restrictions varies, and the FDA has sent dozens of warning letters to companies for selling products to underage buyers. Websites take different approaches to age verification. California Healthline recently purchased several vaping devices, and the age verification process ranged from a single click where the buyer attests he or she is at least 21 to external software designed to check the name, address and age against other databases.

Until recently, Amazon sold the components of products that allowed people to build their own marijuana vapes. Some of these products have been linked to the current deadly outbreak. The online giant removed them after Minnesota Public Radio inquired about their sale.

In a statement, Tony Abboud, executive director of the Vapor Technology Association, one of the industry’s largest trade groups, blamed a few bad actors and illegal sales to ineligible customers, saying that the group “does not approve of youth use of any nicotine products, including these accessories.”

In absence of more aggressive federal efforts to keep these devices off the market, parents and teachers are left with the Sisyphean task of trying to keep them out of kids’ hands.

Ira Sachnoff has been a youth tobacco educator in the San Francisco Bay Area for decades. He says the skyrocketing popularity of the Juul-era pod systems has made this new generation of nicotine products tough to combat. “Schools are freaked out. They don’t know what to do because they are busting kids like crazy with these devices,” he said.

Some schools are installing vape detectors in bathrooms. Others are sending students caught vaping to counseling. The most important first step for parents and school staff, Sachnoff said, is to learn what the devices look like.

With a group at Stanford University, Sachnoff created the Tobacco Prevention Toolkit, a widely used collection of resources aimed at preventing middle and high school students from using nicotine products. One section includes links for parents and guardians to familiarize themselves with the devices and learn to talk with their kids about nicotine.

But with newer and smaller devices hitting the market, kids motivated to vape will have the upper hand. That’s why Sachnoff and other tobacco educators train peer counselors, fellow students who can talk about the risks. They hope they can convince kids that, like cigarettes, which have fallen out of favor in recent years, vaping isn’t cool and isn’t worth the gamble.

“I’ve been doing this for a long time,” Sachnoff said, “and I’ll be damned if after 25 years we’re gonna let this happen again.”


This KHN story first published on California Healthline, a service of the California Health Care Foundation.

KHN’s ‘What The Health?’: Despite Booming Economy, Uninsured Rate Ticks Up


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The annual report from the Census Bureau, released this week, found that 27.5 million Americans were without health insurance last year, an increase of nearly 2 million from 2017. The 0.5 percentage point increase in the uninsured rate — to 8.5% — was the first in a decade and came as unemployment and other economic indicators have been good.

Meanwhile, the Trump administration signaled that it is moving to ban flavored vaping liquid used in e-cigarettes. Companies making the products have been accused of marketing to underage users with flavors like mango and bubble gum.

And Congress is back from its summer break, with legislation to address rising prescription drug prices and surprise medical bills still on the agenda.

This week’s panelists are Julie Rovner of Kaiser Health News, Joanne Kenen of Politico, Tami Luhby of CNN and Rebecca Adams of CQ Roll Call.

Among the takeaways from this week’s podcast:

  • The Census Bureau’s report this week defied usual economic models. Normally, the more people employed, the more people insured.
  • Health advocates blame a variety of actions by the Trump administration for the lower rate of insured Americans. Those include policies intended to deter people from staying on or signing up for Medicaid; the elimination of the tax penalty for not having coverage; and the announcement that immigrants’ use of public benefits such as Medicaid could affect their ability to get a green card allowing them to live and work in the U.S.
  • The biggest surprise in the Census Bureau report was the increase in children without insurance. Coverage for kids has generally been a bipartisan goal on Capitol Hill. It’s not clear what caused that drop. It could just be a result of differences in how the survey was conducted, or it may be another sign of immigrants worried about whether using public insurance could lead to their deportation.
  • The administration’s announcement that it is moving forward on a ban of flavored vaping products comes as worries grow among parents and public health officials about an epidemic of lung problems around the country. Among those worried parents is first lady Melania Trump.
  • House Speaker Nancy Pelosi appears to be inching closer to releasing her plan to curb high drug prices. It’s not clear yet whether President Donald Trump will sign on to her effort. But Sen. Chuck Grassley (R-Iowa) is seeking support for his more modest plan instead, arguing to his Republican colleagues that if they don’t stand with him, they may be forced to accept Pelosi’s legislation if she manages to make a deal with the president.
  • Opponents of some of the legislation to curb surprise medical bills appear to have made progress over Congress’ August recess with a major advertising campaign saying the measures would hurt local hospitals and doctors. Advocates say the legislation is not dead, but the strong momentum it had is waning.

Plus, for extra credit, the panelists recommend their favorite health policy stories of the week they think you should read, too:

Julie Rovner: Vox.com’s “This life-threatening pregnancy complication is the next frontier in the abortion debate,” by Anna North

Joanne Kenen: The New York Times’ “Nursing Homes Are a Breeding Ground for a Fatal Fungus,” by Matt Richtel and Andrew Jacobs

Rebecca Adams: Kaiser Health News’ “‘UVA Has Ruined Us’: Health System Sues Thousands Of Patients, Seizing Paychecks And Claiming Homes,” by Jay Hancock and Elizabeth Lucas

Tami Luhby: The New York Times’ “Bernie Sanders Went to Canada, and a Dream of ‘Medicare for All’ Flourished,” by Sydney Ember

To hear all our podcasts, click here.

And subscribe to What the Health? on iTunesStitcherGoogle PlaySpotify, or Pocket Casts.

Listen: Health Officials Warn People To Stop Vaping

As the number of patients combating mysterious lung illnesses grows, state and federal public health officials are warning people to stay away from e-cigarettes and vape pens, especially those obtained off the streets.

As of Friday, public health officials were investigating more than 450 possible cases of severe pulmonary disease related to vaping, including five deaths, in 33 states, according to the Centers for Disease Control and Prevention. Investigators are looking into 60 possible cases in California, including one death.

Though the exact cause of the outbreak has not been determined, CDC officials said that the cases could be linked by some sort of chemical exposure, but that it is too early to single out one product or substance.

In the majority of the cases, patients reported recent use of THC, the psychoactive chemical in cannabis, officials said. A smaller group reported vaping only nicotine.

Public health experts recommend that people stop vaping while the investigation continues. If they develop symptoms, including cough, chest pain, shortness of breath and fevers, they should seek medical attention.

California Healthline reporter Ana Ibarra appeared Monday on “The Brian Lehrer Show” on WNYC to discuss what we know — and don’t know — about this growing number of vaping-related illnesses.

Talking With Teenagers About Marijuana

Photo

Credit Hilary Swift for The New York Times

Parents of teenagers face a confounding crosscurrent. While the legalization of marijuana in several American states now bolsters the common belief among adolescents that the drug is safe for recreational use, research documenting marijuana’s diffuse and possibly permanent harm to the teenage brain continues to pile up.

Normally developing teenagers question authority and are likely to be skeptical of adults bearing bad news about a widely used party drug. So how do we have successful conversations about the hazards of marijuana use? An open-ended exchange that credits the adolescent’s own observations may do more good than a single sit-down or lecture. Beyond that, we might consider how the facts are often received by adolescents.

With all the talk about cannabis legalization, parents may feel compelled to remind their teenagers that recreational marijuana is still banned for most American adults and for anyone under 21. Adolescents who use marijuana risk immediate legal consequences and, in districts with zero-tolerance policies, may be barred from organized school activities, suspended or expelled. They may also face long-term penalties affecting some jobs, internships, colleges and travel visas.

But the repercussions of being caught with marijuana don’t faze all teenagers. Most adolescents can name celebrities, famous athletes and classmates who use marijuana regularly, even flagrantly, without running into trouble. Teenagers tend to bristle at rules that seem arbitrary, such as the state-by-state regulations for marijuana and the fact that alcohol, which has a lot in common with pot, is legal. Further, adolescents can be understandably cynical about laws that aren’t applied evenly to everyone: While African-Americans and whites use the drug at similar rates, African-Americans are nearly four times as likely to be arrested for marijuana possession. However real and lasting the penalties for pot use may be, parents often run into resistance when trying to make this case to teenagers.

Taking another tack, adults sometimes point out that marijuana obtained through illegal channels may contain dangerous additives. This is one of the arguments for legalizing cannabis, and a great reason to abstain from sampling illegal drugs. We can note to our teenagers that, even if they trust the person offering them marijuana, somewhere down the line that drug was likely to have come from a dealer who doesn’t know or care about them.

While true, this claim often falls on doubtful adolescent ears. Most teenagers are aware of peers who smoke pot regularly, but few are aware of an incident where marijuana was indisputably laced with another substance. Adolescents know that frightened and well-meaning adults sometimes overstate dangers to make a point. Accordingly, teenagers weighing adult warnings against their own observations may conclude that mystery marijuana is more of an urban legend than a plausible risk.

Our most successful conversations might be the ones where we join our teenagers in questioning authority – that is, discussing what legalization does, and doesn’t, mean. Indeed, it’s easy to be on the right side of the law and the wrong side of science. Cigarettes and tanning beds serve as handy examples of legal ways to harm yourself. Savvy consumers are expected to look to the available evidence, not legislation, when making decisions about their own health and well-being. In terms of the science of marijuana, we know that adolescence marks a critical period of neurological development and that cannabis is harder on the developing teenage brain than on the comparatively static adult brain. Specifically, studies suggest that regular marijuana use during adolescence harms the parts of the brain responsible for learning, reasoning and paying attention.

Some teenagers will point out that research linking marijuana to neurological impairment often hinges on correlations. Teenagers may use pot because they have cognitive challenges, not the other way around. In a helpful clarification, a recent study in the journal Cerebral Cortex implicates the drug in brain impairment. The study found that, over time, the brain’s information processing centers flourished in the cannabis-free research participants and withered in the marijuana users. The same research also added to the body of evidence that regular pot use during adolescence lowers intelligence and slows mental functioning.

In talking with teenagers about emerging neurological findings, adults might say, “Whatever happens with the laws, I hope you’ll keep your eye on the science. You only get one brain for your whole life. I’m rooting for you to take great care of it.” Some parents underscore their safety-first approach by promising to spring their teenager, consequence-free, from bad situations involving drinking, drugs or any other dangers the parents may have asked their adolescent to avoid.

Adults can use the evolving marijuana regulations as a jumping-off point to talk with teenagers about how they’ll approach any number of dicey decisions. When discussing drugs, drinking, driving and other risky business, we can note that no authority – neither parents nor the government – can be trusted to supervise teenagers all of the time. Adolescence centers on the wish for independence. And independence centers on the willingness to look after oneself.

Lisa Damour is a psychologist in private practice in Shaker Heights, Ohio, a clinical instructor at Case Western Reserve University and the director of Laurel School’s Center for Research on Girls. She is the author of “Untangled: Guiding Teenage Girls Through the Seven Transitions Into Adulthood.” Follow her on Twitter: @LDamour.

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