If there’s one thing grown-ups know about Gen Z, it’s that the kids love to vape. This is reflected not only by current data (more than 37% of high school seniors use flavored e-cigarettes, according to data from the National Institute of Health), but also on TikTok, an app that’s hugely popular with the under-25 crowd. The hashtag #vapetricks has more than 175 million views, with teens regularly posting TikToks of themselves blowing vapor rings, usually with Absofacto’s “Dissolve” in the background.
As research emerges pointing to the negative health effects of vaping, however, and as the FDA and CDC continue to investigate hundreds of mysterious, vaping-related lung ailments across the country, at least one medical professional is using the app to try to discourage teens from using e-cigarettes.
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Dr. Rose Marie Leslie, 29, is a resident physician at the University of Minnesota North Memorial Hospital who specializes in family practice. She’s been on TikTok, where she goes by @DrLeslie, for about six months. “I didn’t know anyone on the platform, but I felt I had a lot of freedom to express myself and the chaotic life that is residency,” she tells Rolling Stone. “For some reason it just started clicking.” She now has more than 184,000 followers.
On her @DrLeslie account, Leslie is both warm and officious, just as you’d hope a real doctor to be; she often wears a lab coat and a stethoscope, pairing them with Warby Parker glasses. Though she occasionally uploads more standard TikTok fare like silly duets and memes (in one clip, she dresses up as the Purple Doctorfish from Spongebob to the tune of Billie Eilish’s “Bad Guy”), she primarily uses her account as a way to provide pragmatic medical advice to her (largely teenage) audience. “There seem to be a lot of people who want health information and they’re not getting it at school or at home, so I saw [TikTok] as an opportunity to provide that,” she says.
@DrLeslie has dispensed info on everything from how an IUD is inserted to why you shouldn’t use Q-tips to ranking the poop emoji according to the Bristol stool scale. But her most popular TikToks as of late focus on the current vaping epidemic, something that, she says, “is affecting a lot of the demographic that is on TikTok.” Usually, she’ll update her followers on the latest update from the CDC; in one TikTok with more than 189,000 likes, she compares an X-ray of the lungs of a person who has used e-cigarettes to a normal chest X-ray. “That’s a pretty gnarly chest X-ray, and I would not wanna have that disease,” she says at one point.
While the information she presents is clinical, her approach is breezy and straightforward: “I just try to give people information the same way I’d talk to my friends,” she says. And it’s paid off: over the past few weeks, since she started posting TikToks about vaping, her follower count has increased by about 90,000.
Leslie’s success on TikTok is surprising, for basically two reasons. Though it’s not unheard of for more serious content to go viral on TikTok, it is not, at its heart, a particularly great platform for disseminating serious information: for the most part, it’s just a silly lipsync app where people can make jokes about VSCO girls.
Further, TikTok is an app that’s primarily used by young people, a demographic that notoriously does not like being told what to do — and vaping is no exception. Since President Trump announced his intention to institute a ban on flavored e-cigarettes last Wednesday, there’s been tremendous backlash on social media, with many deeming the media coverage of the vaping-related illnesses overly hysterical and panic-stricken, and vaping influencers bemoaning a potential ban.
To that end, Leslie has received a slew of negative comments on her vaping TikToks, from teens who view her as a narc or killjoy of sorts; some will post duets (essentially, one user taking another user’s TikTok and adding to it) while they’re using e-cigarettes. Such reactions are “to be expected when you’re giving information that sheds negative light on something perceived to be cool,” she says. “[People] will comment and say, ‘I’ve been using e cigarettes for this amount of time and this hasn’t happened to me.’ These experiences exist and they are valid. I’m just trying to communicate what data we have, and also what the CDC says.”
Unfortunately, that data is fairly limited, and for the time being so is the information the CDC is willing to provide: while we do know that many of the cases of vaping-related lung ailments have been tied to black-market THC cartridges (specifically, thickening agents that contain vitamin E, which can be extremely dangerous if inhaled), not all of them have been tied to black-market cartridges or even THC cartridges in general. For the time being, the CDC is recommending that youth and pregnant women should not be using e-cigarettes, full stop, and as a physician, Leslie is hewing to those guidelines.
But even though some of her followers take a “you can pry my Juul from my cold dead hands” approach to her content, Leslie says that most of the feedback has been positive. “I get a lot of messages and posts telling me somebody has quit and they’re really glad they have, or a family member they know vapes and they’re now interested in talking to them about quitting,” she says. She’s also seen a general shift toward skepticism toward e-cigarettes on the platform, and has seen more TikToks tagged with #stopvaping. “Some teens are listening,” she says. “Not all, but some.”
And even though it wasn’t her original intention in joining TikTok, in many ways reaching an audience that is notoriously resistant to being reached is what Leslie’s profession is all about. “We spend a lot of time in the adolescent health field talking about how to talk to teens, and people come up with a lot of ideas, but I don’t see a lot of action,” she says. “And if you want to reach teens it’s important to make sure you’re engaging in communities and spaces where they exist.” And sometimes, that entails dressing up like a minor Spongebob villain and lipsynching to Billie Eilish.
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