Medical students in Baystate’s Population-based Urban and Rural Community Health Track are working to address teen vaping in the rural Quaboag Hills community—a region whose teens have a higher e-cigarette (vaping) use than the national average.
Vaping-related lung injury is an emerging national public health crisis—the CDC reports 1,299 cases as of October 8, 2019, 36% of whom are 20 years old or younger.
That's in addition to the documented long-term negative effects of nicotine on the developing brains of teens.
The students will summarize data they gather about knowledge gaps, attitudes, and behaviors that increase the risk of vaping by teens, and make recommendations for helping them quit.
Trying to Understand the Risks for Vaping
Second year PURCH students Simone Thibault, Eleanor McClements and Emily Adler and pharmacy student Rachelle Kelley, are working with the Quaboag Hills Substance Use Alliance.
The students will go into schools and other community sites for one-on-one interviews and focus groups with teens, substance use counselors, teachers, school nurses, and public health professionals, and policy makers, according to their community preceptor, Gail Gramarossa, MPH, CHES, Program Director, Drug Free Communities Project.
They will also discuss teen vaping, nicotine use, and substance use seen in clinical practice at Quabbin Pediatrics/Quabbin Adult Medicine with their academic preceptor Dr. Scott Siege, who is medical director there and Chief, Department of Pediatrics at Baystate Wing Hospital.
Assessing the interwoven social and environmental factors influencing vaping behavior is part of the population health approach emphasized by Baystate Health.
Vaping Amplifies Dangers of Nicotine
Teens who vape are uniquely at risk for long-term, long-lasting effects of exposing their still-developing brains to nicotine, according to the CDC.
Nicotine disrupts the development of brain circuits that control attention and learning, leading to cognitive deficits. It also affects the brain’s reward system, increasing the risk of addiction to other drugs.
Inhaling e-cigarette aerosol has risks of its own. It contains flavoring agents, heavy metals such as nickel, lead, and tin, volatile organic compounds, and ultrafine particles that can be inhaled deeply into the lungs—all of which can be harmful to health.
A further concern is the crossover use of vaping devices for ingesting marijuana.
The region's teens identify marijuana addiction as their top reason for seeking treatment. Their reported marijuana use increases from 10% in 8th grade to 35% in 12th grade. Of those who reported marijuana use, 15-25% said they had vaped it.
Controversial Vaping Products Ban in Massachusetts
Massachusetts Governor Charlie Baker issued a 4 month ban on the sale of vaping products in September, citing an increase of reported cases. As of September 30, 83 suspected cases were reported to the Department of Public Health.
The Quaboag Substance Use Alliance hopes to expand the students' project to assess the effects of the ban on area students who vape.
They are interested in exploring whether students who are addicted to nicotine are having more issues with withdrawal, how they are accessing vape products, and if they are avoiding using marijuana or other THC products in vape devices.
Opportunity for Communities to Shape Future Physicians
Embedding students within local service organizations benefits the community as well as the students.
"Based on how common substance use and other behavioral health needs are, I think they will need to have a good understanding of drug use and addiction, no matter what type of practice or specialty they may pursue as doctors," added Gramarossa.
Other PURCH student population health clerkship projects underway this Fall focus on community-identified priorities with agencies serving Franklin, Hampden, Hampshire, and Worcester counties.