“You shouldn’t ever tell a smoker that smoking is bad for them because they know it. And they probably obsessively think about it,” explained Kate (not her real name), a junior. Kate started smoking cigarettes socially when she was 14. “People are destroying their bodies with it,” she said, “There isn’t any reason to make them feel really bad about it.”

Kate did not always consider the dangers of smoking. “I used to just not even think about it,” she remembered. “Then I started experiencing [side effects]. When I would be asleep I would suddenly wake up and just have shortness of breath, rapid heart beat, and I just couldn’t calm down. Cold sweat.”

She started wanting to quit. “I started noticing that a lot of smokers didn’t look that good,” she said. She started cutting down on cigarettes, and in the meantime picked up an electronic cigarette, or “e-cig.”

E-cigarettes are “nicotine delivery system[s],” according to Lori Carlson, the nurse practitioner at South’s school-based clinic. Instead of smoke, e-cigarettes produce vapor from a compound of nicotine and flavoring known as “juice.” Juice, expanded Kate, is offered in hundreds of flavors. “I actually [just] experienced this flavor: it tastes how flowers smell is the best way to describe it. That’s my favorite flavor I would say.”

Kate added that flavored juice makes e-cigarettes especially attractive to kids. “E-cigarettes might be even more appealing because they’re technological and kids these days are technological,” explained Carlson. “They’re kind of cyborg, they go with the time,” added Anne Gorton, South’s chemical specialist.

“Usually [e-cigs] are rechargeable,” said Kate. You plug in an e-cigarette to charge like you would a phone or an iPod. “Some are disposable, but I don’t think they’re as safe because there are weird additives… but there are additives in everything.” A lot of the danger surrounding e-cigarettes is unknown. This leads a lot of kids to believe they are safer than regular tobacco cigarettes.

According to the US Food and Drug Administration (FDA) website, “Only e-cigarettes that are marketed for therapeutic purposes are currently regulated by the FDA Center for Drug Evaluation and Research.” This means that consumers are in the dark when it comes to the risks of using e-cigarettes, even as directed. How much nicotine they are consuming, what and how much of any other additives they are ingesting, and if there are even benefits to using the product, remain unknown to consumers.

“They’re not very safe, I know that,” Kate explained. “I actually sometimes get a bit scared. I’ll be thinking and then I’ll just realize probably in like 5 or 10 years there’s gonna be a study that will come out and it will be like, ‘e-cigs worse than cigarettes!’”

She does know that some juices offer a much higher nicotine concentration than regular cigarettes. “I almost feel more addicted to the e-cig than I do to cigarettes,” said Kate.

Turning away from the risks of cigarette smoking does not eliminate her nicotine addiction. Nor does it necessarily mean that she will be healthier in the long run.

For now, though, it seems that e-cigarettes might be a good alternative to smoking tobacco. Kate described a friend who used e-cigarettes to successfully completely quit cigarettes. “He used to be like a pack a day and now he doesn’t smoke cigarettes ever. He looks so much better and so much healthier. He just uses his e-cig.”

“I think [e-cigarettes are] a good substitute for tobacco for whatever that’s worth,” Gorton explained. She added that they have potential to be beneficial and potential to be harmful. “We don’t know yet… What if they don’t have the same health effects tobacco does? That would be interesting,” she concluded.

But, Kate, added, if she wanted to quit nicotine altogether, “Probably cold turkey is the best way to do it.” Kate tried that method once. “It’s not a good thing,” was all she said. “That’s why I haven’t quit yet.” Some of the withdrawal symptoms Kate has experienced are hunger, headaches, and “Cravings, constant cravings, which sucks.”

“By the age of 27 I want to quit completely.” Kate is 17. 10 years seems like a long time to an outsider. But as a minor, cold turkey and e-cigarettes are her only options.

“The problem with tobacco addiction is that lots of kids’ parents don’t know they smoke,” Carlson said. “So if they want to quit they can’t really use the smoking cessation aids because they’re prescription only.”
Aids such as nicotine patches, nicotine gum, and nicotine reduction inhalers are typically safer and produce higher success rates than quitting cold turkey or turning to e-cigarettes.

Kate’s parents do not know she smokes. She explained that if they knew, “They would be very disappointed, ashamed, probably confused because I think a lot of parents think that not a lot of kids smoke nowadays.” Parents and students underestimate the problem of smoking.

Teenagers are especially susceptible to nicotine addictions.The American Lung Association reported that of adult smokers, 68% started smoking before they were 18. 85% started before they were 21. Smoking is not being stopped when it’s an issue. And for South’s student body, that’s right now.

According to tobaccofreekids.org, 18.1% of Minnesota high schoolers smoke tobacco. That is approximately 362 South students, almost one in five. Yet both Carlson and Gorton said that very, very few students seek help quitting. “It isn’t what brings them to my door, tobacco use or concerns related to tobacco use,” said Gorton. She estimated that about half of the students she sees for other chemical addictions also admit to using tobacco.

“Kids who smoke tobacco… they’re relatively unconcerned about tobacco.”

“Most kids are just into their tobacco use….They’re just starting,” Carlson explained. According to Gorton, kids who smoke respond to conversations about the dangers associated with the habit, “With some denial about the long term effects. They can always quit, they are only 15, they have lots of time.”

Kate explained that smoking is shamed more than it is supported. “There’s definitely a stigma about it and it’s probably good because it discourages people from smoking.” But, she added, smokers know the risks associated with tobacco use. Lecturing them or shaming them isn’t reaching out and it doesn’t help them stop.