A big reason Oregon approved a ban on flavored vaping products is to stop one particular group of people from getting hooked on nicotine: teenagers.
That ban is now suspended, after the Oregon Court of Appeals granted a temporary stay Thursday. But momentum against vaping is continuing, as one of the largest producers has vowed to pull most of its flavored vape products.
The average age of people sickened in the recent outbreak of vaping lung injuries is 20, with some patients as young as 15.
“In Oregon, almost one in four 11th graders report using a vaping product currently,” said state epidemiologist Dean Sidelinger, who hopes the ban will keep teens from vaping.
But whether you're talking to youth psychiatrists or teens themselves, the conclusion is the same: getting young people to give up unhealthy habits isn't easy.
What's on young users' minds
At lunchtime students stream across Southeast Powell Boulevard from Portland's Cleveland High School to Powell Park. They're eating, chatting and playing on the monkey bars.
In a far corner, a group of maybe a dozen kids are vaping and smoking. They’re willing to talk — but not give names.
One student, who said she vapes regularly, said a vaping ban would lead her to switch to cigarettes.
A teen boy acknowledged he vapes about four times a day. But he insisted he wasn't addicted.
Another teen who insisted she doesn't vape said the habit is pervasive at Cleveland High.
"All my friends vape on a daily basis," she said, saying teenagers think it's "cool."
She also blamed the widespread habit on the company JUUL, saying it "is getting kids addicted to vaping."
In September, the Food and Drug Administration warned JUUL against its marketing and outreach efforts. The co-founder Kevin Burns stepped down, and the company said it would suspend all product advertising in the U.S. This week the company also said it's suspending sale of most flavors, with the exception of tobacco and menthol.
But judging by the reactions from teenagers next to Cleveland, the advice from organizations like the FDA doesn’t get much traction.
And how to change them
“The data are pretty clear that information on its own is not going to work to change a kid’s mind,” said Dr. Sarah Feldstein Ewing, a professor of child psychiatry at Oregon Health and Sciences University.
Ewing said that’s because the adolescent brain doesn’t finish developing until age 25, particularly the area responsible impulse control and resisting temptation.
She says the best way to convince a teen not to vape is to have an open and honest conversation. Ewing advises adults to ask questions like, What do you think the risks of vaping are? and why do they think doctors are worried?
“So it might be the case that your child doesn’t immediately desist," Ewing said. "But that they do have a chance of knowing that you are a person they can talk to about it.”
She says the discussion should remain calm and be conducted at a time when the teen is receptive — like a car journey where there’s no eye contact.
At the same time, parents should set clear boundaries that will be enforced.
“For example, Johnny, if you come home with a vape pen, then you’re going to be grounded," Ewing suggested. "So if then the next time you do find something like that, there’s clear, reasonable and discussed consequences that you can then enforce.”
Health advocates in Oregon have been working on a permanent ban, but now will have to shift gears to defend the temporary ban in court. Those in the industry say they’ll fight it.
The federal government is investigating more than 1,400 cases of lung injury in every state except Alaska. Oregon’s seen 11 cases and two deaths.
Researchers have yet to pin down the exact causes of the vaping illness, which now goes by the name EVALI, which stands for "E-cigarette or Vaping product use Associated Lung Injury."