Taylor Webb just drove the two hours home from college without his trusty companion of the last couple years, a sidekick so tiny he could hide it in the palm of his hand.
He broke up with his vaping device in August because it had taken over his life.
He was coming home to Johnson County for an evening to try to stop other kids from making the same mistakes.
Webb, a senior at Kansas State University, was a school’s guest speaker as health professionals, educators and parents struggle to find an effective message to stop the runaway train of teen vaping. Some 3.6 million kids in middle school and high school vape, according to 2018 numbers from the Centers for Disease Control and Prevention.
Lately, it’s become a killer habit.
As of Oct. 1, the CDC had fielded 1,080 reports of lung injuries associated with e-cigarette use from 48 states. Eighteen deaths have been linked to vaping in 15 states, including two in Kansas and one in Missouri. And the death toll has grown in recent days.
What exactly made those patients sick, or killed them, is a mystery.
The trend has outrun the science that could sharpen the anti-vaping message aimed at teens. What exactly is it about vaping that injures lungs? Is the damage irreparable?
And if this generation of kids is becoming addicted to nicotine through e-cigarettes, how can adults help them kick the habit? There seem to be few answers.
The best hope is to prevent kids from ever starting.
Webb used to jones hard for his Juul vape pen. If his go-to gas station in Manhattan didn’t have his favorite vaping flavor — mint — he drove around looking for it, even if it took 45 minutes.
Over the summer he interned for a Leawood financial services firm. He thinks he would have done a better job if he hadn’t walked away from his desk every half-hour or so to vape, sometimes in a bathroom stall, sometimes while walking outside the building.
It got to the point where the former Gardner-Edgerton High School athlete couldn’t walk into the gym to lift weights without one … last … puff.
Then, he got sick.
“I was so naive when I started getting these symptoms,” Webb, 23, told The Star. “Shortness of breath. Rapid heart rate. A cough. I couldn’t catch my breath when I was just sitting down.
“Here I was a college kid, very active, lifted weights every day. Physically in shape. I didn’t eat junk food.”
Webb’s experience with vaping might have lived only as a cautionary tale among his friends if Ali Seeling, who has known him since he was 14, hadn’t recruited him for her personal crusade.
Seeling, a registered nurse and mother of four children in the Spring Hill school district, has been talking to students there about the health dangers of vaping. Recognizing that the message can sound “blah-blah-blah,” like a mom wagging her finger, she asked Webb to talk at a meeting for parents and their kids at Woodland Spring Middle School in Olathe last Monday.
Before Webb spoke, Seeling showed the 70 or so parents and kids in the audience a “Good Morning America” story about a teenager who wound up in the hospital with breathing problems that doctors suspected were caused by vaping. The boy lay in a hospital bed convulsing as if possessed by a demon, tethered to a breathing apparatus.
She and others like her have a target audience: Teenagers swapping pictures of themselves vaping on Snapchat and watching YouTube videos on how to blow smoke rings, savvy kids who know where to get illegal devices and know more about how to use an e-cigarette than their parents.
Promoted as a safer alternative to smoking cigarettes, e-cigarettes haven’t been thoroughly evaluated in scientific studies, says the National Institute on Drug Abuse.
“One thing that makes it hard to understand what is causing this rash of deaths and significant pulmonary diseases is we really have the wild, wild West,” Roy Jensen, the director of the University of Kansas Cancer Center, said during a recent Facebook Live presentation about vaping.
“It’s difficult to understand what are in these pods and what’s being added to these pods. And sorting that out is a huge issue.”
It’s only been since August 2016 that the FDA began regulating e-cigarettes. Ned Sharpless, the agency’s acting commissioner, spoke last month about a pending move to remove from the market flavored vaping products, which are particularly appealing to young people. He told a House subcommittee that the FDA “should have acted sooner” to regulate the devices and avoid what health professionals call an epidemic.
The latest young victim: A 17-year-old boy in the Bronx died Oct. 4 after he was admitted to the hospital in September with a respiratory illness. State health officials listed the death as vaping-related.
Seeling, a member of the Kansas state school board’s anti-vaping task force, doesn’t want that happening to her kids or their friends, which is why she asked Webb to come home and tell his story.
“I’m willing to jump in front of this train to save these kids,” she said.
Spitting up blood
Michelle Boucher’s high school son came home a couple of weeks ago with a scary story of his own. Boucher is a lung health coordinator at St. Joseph Medical Center who, like Seeling, goes into local schools to warn kids away from vaping.
She’s gathering intel on the trend from students in the classrooms. She’s found that some kids are going through four or five vape pods a week. Do you know how much one pod’s nicotine is equivalent to, she asks students.
“They say 20 cigarettes,” Boucher said. “They know and they don’t care.”
Depending what’s in those four or five vape pods, they could carry the equivalent of five packs of cigarettes.
Boucher found one high school boy who sells vape pods to middle schoolers, an increasingly common youth black market. She asked if he was concerned about “getting them hooked on something we don’t know anything about.” It’s an easy $20 to make in just a few minutes, the boy told her.
She found out a few days ago that one of her youngest son’s buddies, a boy who vapes, was spitting up blood. “This is a freshman in high school who is coughing up blood,” she said.
“I think what is so alarming about it, back in the ’50s and ’60s it took these patients 20, 30 years to see the effects” of cigarette smoking, she said. “Now it’s taking months. And that is what is concerning. And I think there needs to be alarms going off. Are these kids going to make it to their 20s, their 30s?”
Like other health professionals, Boucher used to recommend e-cigarettes to patients trying to quit smoking.
“We had no background,” Boucher said. “We had no research. It was recommended to patients as an alternative.”
Some adult vape fans swear that their e-cigarettes have, in fact, helped them stop smoking cigarettes. But Boucher tells kids, “Why do you want to introduce one more thing into your body that we don’t know about?”
The messaging was much clearer in the decades-long campaign to get America to quit cigarettes — known to cause cancer, emphysema, heart disease and other ills. And just when it looked as if American teenagers had turned their back on the habit, along came vaping.
People like Linda Richter with the nonprofit Center on Addiction in New York, who spend their waking hours preventing substance abuse, are watching decades of work come undone.
“It’s very, very frustrating and sad to see that this generation that was really on the cusp of rejecting cigarette smoking now being hooked on nicotine, to a staggering degree,” said Richter, the center’s director of policy research and analysis. “We’re talking about kids as young as 12, 13, maybe even 11. …
“But when vaping first emerged on the scene there were very mixed messages, and it wasn’t all nefarious.”
Because “smoking is such a harmful behavior and kills so many people every year, people were just hungry for anything that could reduce those rates,” Richter said. “And that includes health professionals, policy makers, people with really good intentions.”
The CDC’s current bottom line about e-cigarettes? While they “have the potential to benefit some people and harm others, scientists still have a lot to learn about whether e-cigarettes are effective for quitting smoking,” the agency’s website says.
They are not safe for “youth, young adults, pregnant women, or adults who do not currently use tobacco products. If you’ve never smoked or used other tobacco products or e-cigarettes, don’t start.”
“More scary than measles”
A Kansas teenager shared her vaping horror story during the KU Cancer Center’s Facebook presentation this month. Her face wasn’t shown because she didn’t want to be identified. She was 17.
In most states — including Kansas and Missouri — it is illegal for anyone younger than 18 to buy an e-cigarette. But a growing number of states and cities have cracked down and raised the age limit to 21.
Kids, though, reportedly don’t bother with the vape shops, many of which have signs on the front door warning that if you don’t have the right ID don’t even bother trying. Kids buy their vaping supplies illegally online — just click the little box and lie that you’re older than 21 — or they get them from older friends or siblings, and they know the places around town that will sell to underage customers.
Ask your kids. There’s a lot of buying and selling going on at school.
The girl in KU’s video began having trouble breathing after more than nine months of vaping e-juice infused with THC, the main psychoactive compound in marijuana — the stuff that gets you high.
“You can actually smell it if you do actual marijuana, and then with vaping it’s like so easy,” she said. “You can’t smell it, or your parents can’t smell it.”
Her mom took her to the emergency room when she got sick with headaches, fatigue and nausea. She spent 10 days in the University of Kansas Hospital, where doctors gave her steroids and breathing treatments. But a cloud hangs over her head. Is the damage to her lungs long-term?
“You hear about measles outbreaks,” said her doctor, Michael Lewis, the head of pediatric inpatient and intensive care units at the University of Kansas Health System. “This is more scary than measles at this point.”
Could THC be a culprit? Most of the more than 1,000 cases of lung injuries attributed to vaping so far involved people like this girl using products containing THC, the CDC reported. Those patients are 70 percent male and 80 percent younger than 35.
Mayo Clinic researchers found a similar common thread when they reviewed lung biopsies from 17 patients, — 13 men, median age 35 — who “were clinically suspected to have vaping-associated lung injury,” the New England Journal of Medicine reported. More than 70 percent of those patients had vaped with marijuana or cannabis oils.
Punish them or counsel them?
David Moore, a truck driver by trade, took his son and daughter, students in Spring Hill, to hear Taylor Webb talk about vaping, hoping that the presentation would scare them. He doesn’t know much about vaping himself. “This is new,” Moore said. “We just don’t know.”
One mom admitted much the same to Seeling, saying she secretly vapes with fellow moms who enjoy their e-cigarettes with wine because it “tastes good.” She wanted more information about the risks.
Seeling and others working to stop teenage vaping say moms and dads need information, too. Some parents told The Star they search their kids’ backpacks and bedrooms, and check their children’s cellphones for clues that they’re vaping.
Some parents just shrug it off.
“I still have parents say to me, ‘I’d much rather have my kids vape flavored water than do drugs,’” said Vicky Ward, manager of prevention and wellness services for Tri-County Mental Health Services in the Northland. “What I think is happening is the kids are telling their parents (it’s only water) so they can vape at home.”
Ward suspects that’s what some older kids tell their younger “customers,” too — an addicted customer is a repeat customer, she said.
“There is nothing to me that is sadder than a student who is by no means anywhere close to what we would consider a known drug user who started out vaping every once in a while because it was so trendy and so cool and they didn’t really believe it was harmful … and they get addicted very quickly,” Ward said.
Webb said his vaping began as something to do during a quiet, weeklong vacation at the lake two years ago. He said he felt he was hooked in that first week.
You cannot “punish people into sobriety,” Ward said, noting how some school districts suspend and send kids home if they’re caught vaping at school.
“And what do you suppose that kid is going to be doing for the next three days? Sit on the couch vaping because now they’re upset … and it’s become a coping mechanism,” said Ward.
Teens and younger children with still-developing brains can become addicted easily through repeated exposure to nicotine or THC, said Anjalee Carlson, a pediatric physician with Olathe Health Internal Medicine and Pediatrics.
“It might be a dependence at this point, so coming from a place of comfort and concern is much better received by an adolescent,” she said.
The science, however, is lacking on how best to help young, recovering vapers.
“We have not found out yet what works and what doesn’t,” Carlson said. “There are not a lot of studies out there. But some things that have proven effective in the past for any kind of addiction are support groups and cognitive behavioral therapy.”
They should see their doctor, she said — a cough or shortness of breath might give a clue that they’re vaping. She’s already witnessed tense moments, a “constant conflict” between parents who want their kids to quit and kids who say, “It’s no big deal. Everyone is doing it.”
Adults haven’t quite figured out how to make vaping look “uncool” to kids, a case that Taylor Webb hoped his story would make.
He said vapers would post on social media about going to the dentist with little black dots on the roofs of their mouths and being warned about cancer. He also saw other vapers mock those warnings with comments like, “reading this as I’m hitting my Juul.”
People his age are much more interested in sharing photos of their vaping adventures — see a vape, send a vape.
The first time he got sick he thought it was because of something he ate or drank. He suspected it was his pre-workout protein drink or supplements.
“I’d be laying in bed for 10 hours after I worked out and I couldn’t catch my breath. I think the fear factor started playing into it. I started feeling it in my heart. Then it became something I couldn’t ignore, it was always on my mind,” he said. “But I’d still vape.”
He talks about the stupid things he did because of that Juul like he’s lucky to still be alive. How many times did he drop it between the seats in his car and lean way over to fish it out, while he was driving, “because I had to find that thing right then. … It was crazy. I was late to work a couple of times because I couldn’t find my Juul.”
When he started getting sick he saw an urgent-care doctor who did a blood test and EKG, “and everything came back fine. But I was still experiencing these symptoms. Then I went to the ER. I was scared. I didn’t know what was going on. They said everything was fine as well.”
That’s when he decided he had to quit. And though he thinks it might not have been the wisest move, he went cold turkey with help from his mom and friends. He threw his vaping device into an apartment dumpster, the big one so he wouldn’t be tempted to jump in after it.
“I went through a very, very, very rough withdrawal period,” he told The Star. “I couldn’t sleep, eat. I lost 10 pounds. I didn’t want to work out anymore, didn’t want to go to school. I was feeling depressed to where it felt like I just wasn’t normal. I was lacking this thing that I wanted so bad.
“I never got suicidal. But there was a couple of days where I was like, ‘I don’t have a purpose anymore.’ I was just questioning everything.”
He wishes he could somehow make teens see that vaping isn’t as cool as they think. Some of his K-State friends have followed his lead and stopped vaping.
He stepped forward with his story to tell kid vapers that he was once in their shoes, and if they want to quit, “I will be their biggest hype man.”
As for him and his Juul, “I wish I never would have tried to do it that first time.”
How e-cigarettes work
The kids call them “nic sticks.” The Food and Drug Administration calls them “electronic nicotine delivery systems,” or ENDS.
E-cigarettes are handheld devices with four parts: a cartridge, or pod, that contains a liquid solution with “varying amounts of nicotine, flavorings and other chemicals,” says the National Institute on Drug Abuse; a heating element; a mouthpiece; and usually a battery as the power source.
“In many e-cigarettes, puffing activates the battery-powered heating device, which vaporizes the liquid in the cartridge. The person then inhales the resulting aerosol or vapor,” thus the name vaping.
To learn more
▪ Seminar: “Vaping: The New Look of Nicotine Addiction.” 5 to 6 p.m. Oct. 28, Alex George Auditorium, Community Center, Building D, St. Joseph Medical Center, 1000 Carondelet Drive. 816-942-4400.
▪ Centers for Disease Control and Prevention: cdc.gov/tobacco
▪ Center on Addiction: centeronaddiction.org
▪ Truth Initiative: truthinitiative.org