With more than a third of Island students reporting they have used e-cigarettes and more than a dozen vaping-related suspensions already on the books for this school year, high school administrators on the Vineyard are joining educators across the country in voicing concern over what they’re calling an epidemic.

“Vaping has taken off in such a way that we can’t understand,” said school health department chairman Kathy Perrotta.

School administrators said evidence of the trend crops up in multiple places: suspensions from school, compulsive bathroom breaks, electronic cigarette canisters found on locker room floors.

The e-cigarette trend took hold among American teenagers soon after the Juul vaping device — a lightweight device that is smokeless, essentially odorless and looks like a USB flash drive — was released in 2015.

At the regional high school, student affairs administrator Dhakir Warren estimated that more than 14 students were suspended last semester for vaping. Vaping falls under possession of paraphernalia in the school’s code of conduct, triggering a three to five-day suspension for the first offense.

Massachusetts Interscholastic Athletic Association (MIAA) rules require athletes caught vaping to be suspended for 25 per cent of the athletic season for the first offense. High school athletic director Mark McCarthy confirmed that suspensions are affecting some sports teams, but declined to disclose how many athletes have been suspended, saying the issue affects all high school students.

Ms. Perrotta said she began hearing about Juuls among students in the spring of 2016.

In a 2018 youth risk behavior survey by the Martha’s Vineyard Youth Task Force, 36 per cent of Island high school students said they had recently vaped, up from nine per cent in 2016, according to youth task force program coordinator Jamie Vanderhoop.

Last month, Ms. Perrotta introduced a new health curriculum to grades nine through 12 called Catch My Breath specifically geared toward the risks of vaping. The curriculum was developed by the University of Texas school of public health in Austin and is presented in a series of four lessons. Some are facilitated by a trained peer leader.

“[The curriculum] addresses how we’re influenced, how we make decisions,” Ms. Perrotta said.

Juul devices are rechargeable via a USB port and deliver hits of highly concentrated vaporized nicotine from disposable pods. Company developers claim the devices are meant to be a more salubrious alternative for adult cigarette smokers, but with the help of social media, they quickly became trendy for younger users. And while e-cigarette companies have recently been the target of Food and Drug Administration scrutiny, little research has been done on the effects of vaping on teenagers.

According to the Centers for Disease Control and Prevention, the risks include the effect of nicotine on the developing brain, possible health impacts from inhaling the nicotine aerosol into the lungs, and nicotine addiction. Each Juul pod lasts for about 200 puffs and is said to have the same amount of nicotine as a regular pack of 20 cigarettes.

“Kids have told us that it looks more modern, it looks okay, it looks high-tech,” Ms. Perrotta said.

She said as part of the lessons in Catch My Breath, students are informally asked to estimate what portion of their peers have used a Juul in the past 30 days, a question slightly different from the Youth Task Force survey inquiry because it gets at culture rather than actual use.

“Our kids are guessing 80 to 90 per cent of people in the building,” Ms. Perrotta said.

Though the actual number is likely not so high, Ms. Perrotta said the response tells her there is a widely held perception among students that the devices are mainstream.

According to youth task force survey data, the majority of students do not think vaping is risky, with most responding that it is “not at all wrong,” or “a little bit wrong.”

Mr. Warren said he recognizes that some students are likely addicted to nicotine and may need help. When they are suspended, students are referred to services such as recovery coaching, and the school nurse is informed and connected with the student’s parents.

“We’ve got to understand that this is not always willful behavior,” Mr. Warren said of vaping. “We see kids waiting at the door at 2:05, and we know they’re just trying to get out of here because they have to hit their Juul.”

Martha’s Vineyard Public Charter School director Peter Steedman said he is also seeing a problem and hearing about the issue from school leaders across the Cape.

“When the issue has arisen at school, we have followed the disciplinary code as outlined in our handbook. Additionally, we have intentionally taught about the harm of vaping in our health classes,” he said in an email.

Mr. Warren said regional high school administrators plan to sit down with Island physicians this month to talk about an Islandwide approach.

“We have to collaborate between educators and parents and the medical community and all vested stakeholders responsible for youth,” he said. “We’ve got to make it a behavior that youth don’t want to engage in.”

The youth task force has invited tobacco control specialist Bob Collett to speak about the vaping issue to parents and educators on the Island periodically, including for a session with educators this month. A video of a presentation to parents from last year is available [here]. https://player.vimeo.com/video/245241992

Regional high school principal Sara Dingledy said going forward, it will be about changing the culture.

“There’s got to be a perception of risk,” she said. “We’ve got to educate so people understand risk to health and they understand the consequences.”

“What we really try to stress to students is you’re doing damage to your body while it’s still developing,” Mr. Warren said. “There are long-term implications to the short term decisions you’re making.”