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How School Nurses Can Help Principals Combat Student Vaping

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Educators are grappling with widespread student vaping and use of e-cigarettes in schools, a problem my colleague Arianna Prothero and I wrote about this week.

While some schools are doubling down on a discipline-heavy, punitive approach to students found with vaping devices and e-cigarettes on campus, the National Association of School Nurses says principals and educators must be mindful of the addictive nature of nicotine in any response to the vaping "epidemic." Any policies used to address vaping should incorporate education, intervention, and efforts to help students quit, the association says.

"Our organization believes that when students become exposed to an addictive substance, that school districts consider, in this case, smoking cessation programs as a necessary intervention for those students, and that that should be embedded into any procedure that addresses tobacco use on campus," said Laurie G. Combe, the president of the National Association of School Nurses.

About one-third of U.S. high school and middle school students reported exposure to second-hand smoke from e-cigarettes in 2018, an increase from about a quarter between 2015 and 2017, according to a research letter posted on JAMA Open Network on Wednesday. About half of those students said they were exposed to second-hand tobacco smoke from traditional cigarettes, according to the letter.

Our story this week, included interviews with two registered nurses, Elizabeth Blackwell, a school nurse, and Stephanie Faren, the director of health services in Colorado's Boulder Valley school district, who are working with schools and the city on a comprehensive public health approach to an increase in vaping in the community.

Districts beyond Boulder Valley are also looking to school nurses to help shape how they respond to this rise in vaping—and they should, Combe said.

"I think school nurses can do early identification through screenings, they can provide prevention education, and then cessation intervention," Combe said.

Here are four ways school nurses can help principals with student vaping:

  • Education: School nurses can work with principals to develop education plans for teachers, counselors, parents, and students on the dangers of vaping, the effects of nicotine on the teenage brain, addiction, and treatment options. Nurses can coordinate professional development sessions with teachers, including health coordinators, to ensure the health curriculum is updated to address the harms of e-cigarette use and addiction. They can help tailor age-appropriate student-focused programs and provide access to online resources.
  • Screening: School nurses can ask simple screening questions about nicotine use and substance abuse when students visit the nurse's office. The questions have to be specific about e-cigarette use, Combe said. "When you ask kids if they smoke, they'll tell you no. But if you ask do you vape or use e-cigarettes, they will say 'yes, I do that,' " Combe said.  Specific questions like "Have you ever smoked cigarettes or e-cigarettes?" or "Do you use vape, mod, juul, e-cigs, hookah?" and how often they did so are more direct ways to garner accurate answers of teen nicotine use, according to Combe.
  • Early intervention and cessation: School nurses can evaluate whether students are ready to quit vaping and refer students to research-based cessation programs and providers in the community. They can also offer support to those students by arranging follow-ups on their progress. Combe recommends that nurses look to the latest evidence on what's most effective to help students quit.
  • Collaboration: Nurses can work with students who don't smoke and want to spread the message about the dangers of vaping to start a club or other student-led activities at schools. Because school nurses are likely to see this as a public health issue, they can be key allies in connecting those who work in schools with state and local officials—including state and local health departments, physicians, and chambers of commerce, and police departments—to establish joint programs and working relationships that tackle prevention, education, enforcement and treatment.

Caption: A researcher holds vape pens in a lab at Portland State University in in Portland, Ore., Tuesday, April 16, 2019. --Craig Mitchelldyer/AP


More on Teen Vaping

The Student Vaping Crisis: How Schools Are Fighting Back

'Juuling' in Class? Yes, It's Happening. Here's What You Need to Know

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