As a registered respiratory therapist at Yankton Medical Clinic, education has always been a part of Linda Reese’s job. But since becoming a Certified Asthma Educator last February, she has taken it to a whole new level.

“At about the same time that I got my certification, we started getting questions about vaping,” Reese told MED. “The high school was seeing a lot of it and we were getting questions.”

Vaping is the blanket term for smoking e-cigarettes, including the Juulpods, that have become so popular among teens and young adults. E-cigarettes heat nicotine, flavorings, and other chemicals to create a water vapor that can be inhaled. Though they were originally billed as a cessation aid for adults, an estimated 5.3 million middle and high schoolers have used them in the last 30 days.

Vaping is generally thought to be safer than smoking traditional cigarettes, but it is not without risk. As of November 2019, the CDC confirmed 47 deaths in patients with e-cigarette, or vaping, product use associated lung injury (EVALI).

When one of Yankton’s pulmonologists approached Reese for her insight on the problem, Reese committed to learning all she could about vaping. Last May, she presented her findings to Yankton 8th graders. It was to be the first of many presentations for area parents, students, and healthcare providers on the facts about e-cigarettes.

“These kids are being bombarded by marketing,” says Reese. “We aren’t wagging our fingers at them. We are just bringing them facts. E-cigarette companies are not giving them the facts and we just want them to be able to make good decisions for themselves.”

One fact that many kids, parents, and even healthcare providers may not know is that almost all e-cigarettes contain nicotine. And with vaping, it is possible to inhale significantly more nicotine than with traditional cigarettes thanks to extra strength cartridges and the ability to modify the e-cigarette’s voltage.

Additionally, the US does not regulate the nicotine content of e-cigarettes. A single Juulpod contains the same amount of nicotine as a pack of cigarettes.

“A lot of kids, and even parents, think it’s just flavored water,” says Reese. “What’s scary is that it is so much more addictive for adolescents because their brains are not fully developed.”

Beyond the risk of lung injury from e-cigarettes, their nicotine can affect behavior, decision making, impulse control and the ability to learn. It can also make kids more susceptible to depression and anxiety. Reese says healthcare providers need to know vaping terminology in order to ask the right questions of their young patients.

“If you ask a kid if they smoke and they vape, they’ll say no,” says Reese. “If they use Juulpods, they will say they don’t vape. You have to say something like ‘Have you been inhaling anything other than air?’”

Reese has now done multiple presentations on vaping for parents, teachers, and students at both public and private middle and high schools in her area. She has presented to her clinic’s physicians and staff and will soon speak to the respiratory department at Yankton’s Avera Sacred Heart Hospital.

“Parents and teachers tend to be shocked, but they are grateful for the information,” says Reese. “And I am grateful to the clinic for giving me the chance to share this. We are a pretty small community, so the people you are dealing with are your friends’ kids, your co-workers’ kids, etc. We have a lot of skin in this game.”