The advent of e-cigarettes and vaping among young people could be reversing decades of anti-tobacco campaigning, which has prompted federal, state and local organizations to redouble efforts to combat nicotine addiction.

At the local level, Brainerd School District faculty have seen a new wave of e-cigarette use among the student body in the last 18 months.

“It’s been a great challenge this year,” Brainerd High School Principal Andrea Rusk said during a phone interview Monday, Dec. 23. “We’ve seen a tremendous increase in students that have been caught. We share a great concern about the health hazards and the risks.”

Karen Johnson, the Essentia Health program director for community health at Crow Wing Energized, gave a bleak prognosis of vaping’s prevalence and how it looks to affect young people in central Minnesota.

“I think they didn’t realize, they didn’t associate any dangers with vaping,” Johnson said. “It’s not just water vapor. I think initially that might have been the message, especially for kids being marketed to by companies like JUUL. We’re creating addicts and we need to treat the kids who are addicted now.”

Perhaps the centerpiece of these efforts is the Tobacco 21 initiative — a statewide push for communities to establish a minimum age of 21 to purchase tobacco products, instead of the federally mandated 18 years old minimum. So far, more than 55 Minnesota communities and counties have agreed to be Tobacco 21 municipalities.

A nationwide Tobacco 21 law takes effect Sept. 1, 2020, but implementing these limitations now may help to curb what’s being described as an epidemic of e-cigarette use. The 2019 Minnesota Student Survey found 1 in 4 Minnesota 11th graders and 11% of eighth graders reported using an e-cigarette in the past month. Between 2016 and 2019, e-cigarette usage among Minnesota 8th graders doubled. In total, the recent surge marks the first increase in tobacco use among the general populace in 17 years.

In comments to Minnesota Public Radio, Senate Majority Leader Paul Gazelka, R-Nisswa, said the federal law that increases the minimum age from 18 to 21 appears to address the main thrust of what state legislators proposed to combat youth smoking and vaping in the past.

“Apparently it has solved that issue,” Gazelka said. “I was already very open to getting that done. So the fact that was done at a federal level is a good thing. So that was good news.”

According to Minnesotans for a Smoke-Free Generation, smoking remains the leading cause of preventable death and disease in Minnesota, costing the state 6,300 lives and $7 billion a year in lost productivity and health care costs. Nearly 95% of adult smokers started before they turned 21, and Johnson said raising the legal tobacco age decreases smoking initiation by 25% for 15- to 17-year-olds.

“Most kids are getting their e-cigarettes from friends, so they’re not getting them illegally,” Johnson said. “In the high school, there can certainly be kids who are 18 years of age. In the school setting, in the broader sense we’re looking at Tobacco 21 to help with that.”

She pointed to recent reports by the Centers for Disease Control and Prevention that indicate 2,409 confirmed cases of illnesses and lung injuries associated with vaping, while negative effects on physical and mental development, coupled with nicotine addiction, means repercussions can last a lifetime. At this point, there are 52 confirmed deaths associated with vaping, with five of those occurring in Minnesota.

It should be noted that, according to the Minnesota Department of Health, many cases of vape-related illnesses and fatalities can be linked to the presence of Vitamin E Acetate or illicit THC products or a combination of both in certain 2019 e-cigarette products.

Johnson said there’s a number of campaigns — most notably, “Don't Blow It,” an education and advocacy program launched by peers and students — which looks to counteract the false and sometimes misleading image of vaping as a safe alternative to traditional tobacco products like cigarettes, cigars, chew and others.

This was echoed by Rusk, who noted Brainerd High School students are introduced to education courses, as well as presentations and marketing to illustrate the harmful long-term effects of vaping. For students caught using e-cigarettes, the school’s approach has also changed, said Rusk, who described the change as a shift from a punitive model — where students were issued a citation and required to appear at court — to one that’s more education-based and informative in nature.

“This year, we are offering to students that, if they want to and it’s their choice, they can choose a different route,” Rusk said. “The student would take three courses after school that shows the dangers of vaping and smoking taught by our district nurse.”

Ultimately, Rusk said, it’s about the end goal of fostering mindful, responsible students who have all the information they need at their disposal.

“We really just want them to change behaviors — it’s just not punishing them,” Rusk added. “In the past, we’ve seen plenty of kids get multiple citations without any change in behavior, but they were never educated. I think even adults are ill-informed on the risks of vaping.”

Update: The current article has been revised to correct an error in a previous version that incorrectly stated the "Don't Blow It" program was created by "Pierz students." The Dispatch regrets this error.

GABRIEL LAGARDE may be reached at gabe.lagarde@brainerddispatch.com or 218-855-5859. Follow at www.twitter.com/glbrddispatch.