Across from two first-floor bathrooms at Swampscott High School hang posters warning students about the effects of vaping. One poster highlights the effects of vaping on the cardiovascular system, contrasting a gray “bad” heart with a more colorful “good” one. Next to an illustration of a vape sits a skull and crossbones.

Another poster outlines vaping’s effects on the brain, heart, mouth and lungs, listing effects like “popcorn lungs,” trouble breathing, plaque in arteries, impairment and tooth decay.

“Nothing eliminates the concern of student vaping,” said Superintendent Jason Calichman. “We have had speakers come in, and the topic has been taught in health classes, but we are always worried about the dangers of vaping.”

E-cigarettes, commonly known as vapes, are battery-operated devices that heat a liquid into an inhalable aerosol often containing nicotine, flavorings and other chemicals. Nicotine is highly addictive, according to the Centers for Disease Control and Prevention (CDC), and it can harm the parts of an adolescent’s brain responsible for attention, learning, mood and impulse control. E-cigarette marketing as well as the availability of products and social influences have affected youth to start or continue vaping.

“The brain’s not developed yet,” said Michelle Simons, a program support specialist for the Swampscott Health Department. “A teen without substances probably has poor impulse control…so take that and add a substance, you’re bound for some issues.”

While teen vaping has declined from its 2019 peak, it does still remain a significant public health concern, with 1.63 million, or 5.9%, middle and high school students in the country using e-cigarettes. The CDC says this includes 410,000 middle school students and 1.21 million high school students. Almost 88% of students currently using e-cigarettes are choosing flavored varieties. 

“It’s so sneaky and subtle,” Simons said. “Even people in recovery that have quit smoking cigarettes went to vaping instead.”

In 2019, Swampscott’s Board of Health hosted a public hearing with Joyce Redford, the director of North Shore Cape Ann Tobacco Policy Program, who shared that the use of “combustible tobacco or liquid nicotine has risen by 78% in the high schools and 48% in the middle schools” at the time.

“No tobacco products, including e-cigarettes, are safe, especially for children, teens and young adults,” the CDC notes.

According to the Substance Abuse and Mental Health Services Administration’s 2024 national survey on drug use and health, 9.6% of people aged 12 years or older vaped nicotine in the past month, which is defined as “current use.”

Within the same time frame, 71.5% of adolescents aged 12 to 17 and 50.3% of young adults aged 18 to 25 only vaped nicotine and did not use tobacco products. That percentage significantly dropped for those over 26-years-old, with 18% only vaping nicotine.

Calichman noted that the number of vaping incidents in Swampscott schools has dropped over the past few years. 

“Alothough there may be students who do vape, it certainly is not everyone,” said High School Principal Emily Zotto. “The majority of students make healthy decisions the majority of the time.”

Zotto said that the schools should at least in part be responding from an educational standpoint. All students are required to take health twice in their high school careers, and Swampscott health teachers bring in resources and explore partnerships so that students learn in classrooms with their peers.

For many years, the Swampscott High School has participated in the SBIRT, a verbal health screening tool, that asks students about their use and offers opportunities for students to connect with counselors and clinicians in school to learn more about the health impacts of vaping, Zotto said. 

“In partnership with the town health department, we are reinvigorating the iDECIDE program for students who are caught using substances in school / on school property,” Zotto said. “The educational program is facilitated by our own staff members, who have received additional training, to help provide education to students in a scheduled, consistent way.”

The Swampscott Health Department did not respond for comment.

iDECIDE – which stands for drug education curriculum intervention, diversion and empowerment – is a four-module after-school program that consists of structured activities, guided discussions, videos and at-home activities. The intervention program is for middle and high school students in Massachusetts. 

And the CDC did note that most middle and high school students who vape want to quit. In 2020, 63.9% of students who currently used e-cigarettes reported wanting to quit, and 67.4% of students who currently used e-cigarettes reported trying to quit in the last year.

“They don’t have the ability to say, ‘Oh my god.’ They might say that they’re doing this constantly, but there’s no brakes,” Simons said. “It’s like with social media. The brakes are not there…You don’t have the ability as a teen to look back and say, ‘Oh I suffered some negative consequences because of this, I’m not going to do it’ or ‘I’m going to try and refrain’ or ‘I’m going to try and cut back.’”

Simons did recommend some prevention work that can be done within the community as a whole.

“When kids walk home from school and they go by these corner stores, they’re like 60% more likely to start experimenting with tobacco products if they walk by stores that are selling them,” Simons said. “They go into the corner stores to buy a bag of chips or a drink or something, and the advertisements, they’re advertising to kids because they are shiny and flavored.”

Swampscott does not have any adult-only tobacco shops where no one under 21-years-old is admitted to the premises. However, Massachusetts law requires people must be over the age of 21 to buy vapes, with retailers required to check photo IDs. 

“I can’t imagine that the constant compulsion to vape – it’s going to be so difficult for people to stop,” Simons said. “I can’t imagine at some point the negative consequences, the cost, whatever the health effects are going to be from it that we aren’t fully aware of at this point.”