Preventing vaping among teens in rural Florida

Teen vaping
Teen vaping. Photo by Daniel Ramos on Unsplash.

A team led by HOBI researcher Ramzi Salloum, Ph.D., will begin targeting tobacco prevention programs at youth in rural North Florida, who have some of the highest electronic vaping rates in the state.

“In rural communities throughout North Florida and the Florida Panhandle, 25 percent of youth ages 11-17 report using e-cigarettes or other tobacco products,” said Salloum, assistant professor in the University of Florida College of Medicine’s department of health outcomes and biomedical informatics (HOBI) and a member of the UF Institute for Child Health Policy (ICHP). Salloum and his team, which includes the UF Institute of Child Health Policy, the UF Institute for Food and Agricultural Sciences (IFAS) Cooperative Extension Service, and the OneFlorida Clinical Research Consortium’s clinical partners, received a one-year, $225,000 funding award from the Aetna Foundation to implement vaping and tobacco prevention programs aimed at these youth.

The tobacco prevention intervention comes at a time when use of e-cigarettes among youth in Florida has skyrocketed. According to the Florida Youth Tobacco Survey, conducted annually by the Florida Department of Health, in 2019 about 25.6% of Florida high school students reported current use of vaping – a 63% increase compared to 2017.

Because their brains are still developing, teens may be more sensitive to the highly addictive effects of nicotine and may become dependent on nicotine sooner than adults. Some studies suggest that e-cigarettes may serve as a gateway to the use of other tobacco products as well as alcohol and marijuana.

An even greater and more immediate health risk emerged in August and September 2019, when the U.S. Centers for Disease Control and Prevention (CDC) began receiving emergency-room reports of lung injuries and deaths associated with vaping products. The CDC says the condition, known as EVALI, or e-cigarette or vaping-associated lung injury, has been associated with 2,807 hospitalized lung injuries or deaths in the U.S. as of February 20, 2020.

Although the CDC has identified and addressed the likely causes of EVALI, and reports of new cases have declined significantly since September 2019, the CDC recommends that youths, young adults and women who are pregnant refrain from using e-cigarette, or vaping, products altogether.

“Given the higher prevalence of vaping and tobacco product use in rural North Florida and the health risks involved, implementing state-of-the-art vaping and tobacco control interventions in rural communities is urgently needed to stem this emerging public health crisis,” Salloum said.

The researchers will develop a toolkit that focuses on implementation and use of tested tobacco prevention programs in rural schools and youth community settings, including cooperative extension and 4-H youth development programs.

According to Salloum, rural youth face a different set of circumstances than suburban and urban youth.

“Parents often work multiple jobs, commute long distances, and there are little to no after-school programming options. However, 4-H youth programs are present in many rural areas and are recognized as a trusted source of programming for youth,” he said.

OneFlorida partners can play a valuable role in the project by promoting the school-based and county extension/4-H based programs in their pediatric and family practice clinic settings.

“Providing tailored and targeted messaging and information about educational programs from a variety of trusted sources – schools, youth programs, and physicians, for example—has been shown to be effective in encouraging youth participation,” Salloum said.

Because each state has a land grant university and cooperative extension, Salloum said that lessons learned in Florida may be applied in other states, as well.

Other members of the team include Michael S. Gutter, Ph.D., an associate professor and associate dean for extension and state program leader for 4-H Youth Development, Families and Communities at UF IFAS; Elizabeth Shenkman, Ph.D., professor and chair of HOBI and director of UF ICHP; Jaclyn Hall, Ph.D., an assistant research scientist in HOBI; and Ryan Theis, Ph.D., an assistant professor and medical anthropologist in HOBI who specializes in studies of the social determinants of health in vulnerable and marginalized populations.