Teens are vaping in high school bathrooms all across America, wreaking havoc on health and learning: 'Everyone does it'

It’s back-to-school season all across the country, bringing with it new outfits, fresh notebooks, some social anxiety and, for those in high school (and even some in middle school), bathrooms filled with the cherry-scented, chemical-laden vapor of e-cigarettes, or vaping. Just ask any teen, as Yahoo Life did recently...

“You walk into the bathroom and it smells like fruit and people are passing around a vape and asking people who look chill if they want a hit. Some sit on the floor, but most go into the stalls with their friends … Everyone does it.” — New Jersey sophomore, 15

“There have been times when it’s been uncomfortable to be in there with so many kids doing something that could possibly get you in trouble. They put security guards in the bathrooms that do something about THC, but the [nicotine] vaping is so bad they really stopped doing anything about it.” — Kentucky sophomore, 16

“Last year they installed vape detectors, but they don’t do anything cause people will just blow it at the ground.” — Vermont senior, 17

“It’s a running joke in the school that the [three single-stall] gender-neutral bathrooms are used more for hotboxing [vaping] and hookups than anything else … We haven’t had any assemblies on the situation or the dangers yadda, yadda, yadda. It’s covered as part of the wellness curriculum in ninth grade and then that’s pretty much it.” — Massachusetts junior, 16

“It’s a really big problem. I can’t go into any bathroom … at school because they are always filled with kids vaping. You get in trouble by just being near them. It’s just a cloud of fog in there.” — Texas senior, 17

To anyone but a teen (or the parent of one), the stories may seem shocking — but less so if you consider the statistics about who vapes: more than 2.55 million youth in the U.S., including at least 14.1% of high school students and 3.3% of those in middle school.

That’s according to the most recent statistics (2022) from the National Youth Tobacco Survey from the Food and Drug Administration and the Centers for Disease Control and Prevention, which also found that, of those youth who vape, 85% use flavored e-cigarettes (as opposed to unflavored options) and more than a quarter of users (27.5%) reported having a daily habit.

More recently, a joint survey by Harris Poll and Verkada (a company that makes vape detectors for schools) confirmed that the school bathroom is the No. 1 hot spot for teens who vape.

In response, administrators across the country have tried a range of approaches to battling the problem —vape detectors, bathroom monitors, locked bathrooms and even removing stall doors, as an Alabama high school infamously did several years ago.

Still, “You’re not going to punish your way out of this problem,” says Robin Koval, chief executive officer and president of the Truth Initiative, the country’s largest nonprofit public-health organization aiming to stop tobacco use and nicotine addiction. “Suspending kids from school, humiliating them by taking doors off bathroom stalls... These kinds of punitive approaches have never worked — and are unlikely to work to solve this crisis.”

As shown in a 2019 YouGov poll, more than half of Americans — 52% — supported a federal ban on flavored vaping products. And an effort to ban the sale of flavored vape pods has been underway for years, with the FDA announcing a 2020 order to stop most of them — it has been reviewing which products can go and which can stay, based on whether they offer more public health benefits (helping smokers quit) than harm (turning youth into nicotine addicts), and rejected the marketing of 6,500 flavored e-liquid and e-cigarette products as of May.

Meanwhile, brands have taken advantage of a loophole in the FDA order — which applies only to pods that go in refillable cartridge-based devices, and not to disposable all-in-one e-cigarettes, which are the product of choice for about 55.3% of youth who vape. So it tracks that so far, according to a recent study, the FDA enforcement efforts have made little to no difference when it comes to youth vaping rates.

What is vaping and why is it unhealthy?

E-cigarettes, according to the CDC, are battery-powered devices that come in a variety of shapes and sizes and work by heating a liquid that contains nicotine, flavorings and other chemicals (and sometimes marijuana and other drugs) to produce an aerosol. Users inhale the aerosol into their lungs — and bystanders breathe it in too, when the user exhales.

The firsthand aerosol is harmful for many reasons: Most e-cigarettes (99%) contain nicotine (though many do not disclose it), which can harm the developing adolescent brain (that keeps developing until about age 25), including the parts that control attention, learning, mood and impulse control. Nicotine also harms synapses — strong connections that form between brain cells each time a new skill is learned or a memory is created.

Nicotine is highly addictive, and quitting can cause withdrawal symptoms, which wane over time, including irritability and anxiety. With vapes — which are powerful, easy to access and easily hidden — “kids can pretty much use these almost 24/7, which means unbelievable high amounts of nicotine in very short periods of time,” says Koval. “So, they become addicted in very short periods of time.”

Use of nicotine has also been associated with mental health issues including depression and anxiety — even though “the most common reason youth give for continuing to use e-cigarettes is ‘I am feeling anxious, stressed or depressed,’” notes the CDC.

“We have a disturbingly high number of kids who are saying they are suffering from anxiety and depression, and we know that nicotine can amplify those feelings,” Koval notes, adding that, at the same time, teens “say they vape because they’re stressed and they’re trying to self-medicate — when, in fact, it’s doing the exact opposite.”

Beyond how it affects mental health, vaping THC — the psychoactive ingredient in cannabis — in particular has caused severe lung injuries linked to the vitamin E acetate found in such devices.

Finally, secondhand vape aerosol contains a potent blend of nicotine, ultrafine particles that can be inhaled deep into the lungs, flavoring including diacetyl (a chemical linked to serious lung disease), volatile organic compounds, cancer-causing chemicals and heavy metals like nickel, tin and lead, per the CDC.

The problem with in-school vaping

While vaping in or near schools is actually illegal in 10 states — and a federal law bans the sale of such products to anyone under 18 (with some states upping that to 21) — it’s clear that such technicalities are not having a huge impact on in-school vaping. And that’s a grave problem, say experts, from both a public and personal health perspective, as well as how it affects the learning environment.

Teachers, according to Truth Initiative research released in 2020, say youth vaping “is impacting their ability to educate students because of frequent class interruptions, decreased student focus and few resources to help them address the problem.” They report “constant disruptions” and decreases in students’ attention span, focus and self-control. One noted, “We now feel like we are almost like prison guards looking for contraband.”

Says Koval, “We don’t want kids sitting in classrooms who, all they’re thinking about is when they can get out of the room so they can go vape ... It’s hard enough to get a roomful of 15-year-olds to pay attention to you, and this makes the teacher’s job harder.”

School safety expert Michael Dorn — founder and executive director of a Safe Havens International, a Georgia-based K-12 school safety nonprofit — was a key expert witness in 1,500 federal civil actions filed by school districts against Juul/Altria, which recently settled for more than $2 billion. That had him overseeing detailed student vaping assessments at five of the districts heading to trial, he tells Yahoo Life, with findings that showed that in-school e-cigarette use has:

• created a “pervasive and highly negative impact on the safety, learning, and social environment,” with many school administrators saying they’ve spent “10, 20 and even 40 hours per week just on vaping incidents”

• led to “frequent evacuations of entire schools due to student e-cigarette use setting off fire alarm systems” and medical emergencies, with one Florida high school principal noting he had “summoned ambulances 15 times in one year” because of vaping

• been a contributing factor to active-shooter incidents because of locked bathrooms (as with Marjory Stoneman Douglas High School in Parkland, Fla.)

There is also the health issue of students’ strained bladders at schools that opt to lock bathrooms to prevent vaping, or where bathrooms feel unapproachable, says Dr. Belinda Li, a pediatric urologist and assistant professor of urology at Columbia University Vagelos College of Physicians and Surgeons.

“When delaying urination for hours at a time, it can stretch one’s bladder beyond normal capacity, which brings a risk of UTIs [urinary tract infections], episodes of urinary incontinence and, in the most extreme examples, which are rare, chronic bladder or kidney dysfunction,” Li tells Yahoo Life. “I would advise all adolescents to empty their bladders every two hours,” and to aim to find privacy and an “unrushed” environment — both admittedly hard to come by when bathrooms are locked and kids are clamoring to vape in the stalls.

What schools have tried — and what experts say works best

Punishment after the fact — and supervision (both human and technological) or education before — are the main ways schools and municipalities have gone at the problem.

Perhaps the most striking example of punishment, beyond standard suspensions, is a Texas law, House Bill 114, that went into effect on Sept. 1: It requires students caught with vapes at school to be placed in an alternative schooling environment, or Disciplinary Alternative Education Program, run by the district. Previously, punishments were at the discretion of a school district.

A growing number of schools are outfitting their bathrooms with vape detectors — particularly in districts that now have extra funds on their hands due to receiving settlement payouts from Juul. The devices look like smoke alarms but, rather than make a loud sound when vaping aerosol is detected, silently alert designated administrators.

Despite teens finding ways around the detectors, Dorn tells Yahoo Life, they “work extremely well as long as they are installed properly in indoor locations,” adding that “all three companies were very quick to point out they are not ‘the’ solution but should be viewed as a component” with other approaches, including educational programs, something else the settlement-receiving districts are investing in.

That’s a good thing, say experts in teen addiction, who call education and clear parent-teen communication a vital part of the equation.

In her widely used Tobacco Prevention Toolkit, Bonnie Halpern-Felsher, professor of pediatrics at the Stanford School of Medicine and youth risk-behavior expert, tries “to illuminate the role that marketing plays in getting kids to use nicotine products. We want young people to understand that they’re being manipulated by manufacturers,” she told the Stanford Medicine Newsletter. “We also talk about the chemicals in e-cigarettes and vapes and the associated health risks, as well as the addiction risk for the developing brain.”

She suggests parents talk to their kids with open-ended questions. “You can say: ‘I read an article about vaping products. I’m curious: What do you know about these?’ Then you can share your concerns: ‘If you’re using these products, I want to understand so I can get you some help. I’m not going to be mad,’” Halpern-Felsher said. “You can also talk with your kids about how to refuse, helping them plan responses so that they feel ready to say no.”

The Truth Initiative offers a school curriculum and free and anonymous peer-to-peer quitting program. “We have always believed that when young people are approached in a peer-to-peer manner, and when you give them the facts in a way that’s relatable, kids actually do make good decisions,” Koval says. “Our sense is you don’t use education as a punishment tool — you educate all the students.”