Teenage vaping has surged in Maine to become a top public health concern, while rates of youth cigarette smoking and drinking have continued to decline.

But a growing belief among high schoolers that marijuana use is safe has public health officials worried that more teens will start using cannabis products that have become far more potent. The average cannabis product has four times more THC – the chemical that produces the euphoric feeling – than it did in the 1990s, according to research.

And Maine’s teens turn to drugs more than their peers in most of the country. Maine is second-highest in the nation – behind only Vermont – in the prevalence of drug use among 12- to 17-year-olds, according to the National Center for Drug Abuse Statistics.

Teens who abuse substances are much more susceptible to health risks and addiction than adults because their brains have not yet fully developed. And the effects of substance use on a developing brain can last a lifetime, experts say.

Alex Swiercz, 22, started vaping as a sophomore in high school and had an addiction within a year. He quit in 2020 after he started coughing up blood. Courtesy of Alex Swiercz

Alex Swiercz, 22, of Winslow said he started vaping as a 16-year-old sophomore, attracted by flavors like blue raspberry, mint and mango. Within about a year, he had a full-blown addiction, vaping the equivalent to a pack of cigarettes a day.

“When you start you get a buzz from the nicotine,” said Swiercz, now a car salesman in Winslow who supports a proposed statewide ban on flavors in vaping products. “But the longer you use, the effects more turn into a feeling of anxiety until you get the next rip. I was an all-day, every-day user.”

Vaping reduced his lung capacity – he estimates he only had about 75% of his normal lung functioning. He started coughing frequently and was prone to lung infections. Vaping also hurt his performance as a member of the Winslow High School soccer and lacrosse teams, he said.

He quit vaping in 2020 – two years after he graduated from high school – after he started coughing up blood. Swiercz said he purchased a “stop vaping” app and it helped him stay motivated and avoid relapsing. The app tracks the health and financial benefits of quitting. He has stayed away from vaping since, and he said he still looks at the app to see how much money he’s saved – so far, about $2,100.

VAPING ERODES PROGRESS

Swiercz is one of thousands of teens to get hooked, and the addiction can last a lifetime.

The vaping industry is a $25 billion industry. Its products cannot legally be sold to anyone under 21 years old in Maine, but public health advocates argue that flavored products are luring young people into trying vaping. Usage is relatively easy for teens to hide. The vapors don’t smell like a cigarette or cigar and the vaping pens can be easily tucked away into backpacks or pockets.

The percentage of students who said they vaped within the previous 30 days increased from 16.8% of high school students in 2015 – the first year students were asked the question – to 30.2% in 2019, according to the Maine Integrated Youth Health Survey and the Youth Risk Behavior Surveillance Survey. The dramatic rise in vaping has eroded long-term progress in reducing teen smoking.

Cigarette use has been on a steady decline for more than a decade, dropping from about 16% in 2005 to 7% in 2019, the survey said. Alcohol use has steadily declined from 43% in 2005 to 28% in 2019.

“There is this heavy belief with students that cigarettes are yucky and gross but vaping is much healthier,” said Whitney Pierce, a substance use and mental health counselor who works with Biddeford adolescents. “There’s this constant misinformation you have to deal with.”

Mary Record, a health teacher at Scarborough High School, said it feels like all the gains public health has made in reducing cigarette use are quickly being lost.

“Our public health messages are getting buried by all the advertising of the vaping industry and the marijuana industry,” Record said.

Vaping usage declined to 17.4% in 2021, according to the state’s survey, but public health experts caution against reading too much into trends during the peak of the pandemic.

For the first six months of 2021 – a time when students were taking the survey – school was only in-person two days per week at most districts in Maine, and there were fewer opportunities for students to gather and socialize, possibly leading to a temporary decrease in access and usage, said Rita Furlow of the Maine Children’s Alliance. The survey is taken every two years, and students are slated to take it again this spring.

Whether the numbers are rising or declining, there’s no doubt that teen vaping is still common and a significant challenge. And there are increasing efforts to stem the tide.

The Flavors Hook Kids Maine grassroots campaign has successfully lobbied to ban flavored tobacco products in four Maine cities – Portland, South Portland, Brunswick and Bangor – and is now advocating for a statewide ban. State Rep. Jill Duson, D-Portland, is sponsoring a bill that would forbid the sale of flavored tobacco products statewide.

Joanne Grant, director of substance use treatment program operations for Maine Behavioral Healthcare, said public health messaging about the dangers of cigarettes and alcohol has been consistent and well-funded, while anti-vaping and other public health campaigns are much farther behind.

“We sent the message out loud and clear for years and years that cigarettes are bad for you,” Grant said. “We did a good job at that, and you won’t find a person who doesn’t understand that smoking is bad for you.”

The anti-smoking campaign was bolstered by a giant settlement with tobacco companies in 1998, resulting in more than $200 billion being pumped into public health campaigns against smoking.

Public health advocates are looking to this year’s survey to get a better picture of current trends. As with the reported decline in vaping in the 2021 survey, experts believe the pandemic may also have temporarily reduced the use of other substances that year. Marijuana use dropped to 17.9% of students, alcohol use dropped to 19% and cigarette smoking declined to 5.5%, according to the 2021 survey.

Opioid use – at crisis levels among adults and causing hundreds of fatal overdoses each year – represents a small percentage of teen drug use, with 4.1% of high school students having used an opioid in the previous 30 days, according to the survey.

CHANGING ATTITUDES ABOUT MARIJUANA

Maine is one of 21 states that have legalized marijuana for adults. And public health advocates worry that messages from the marijuana industry that downplay harms or make cannabis sound beneficial are outpacing warning about the risks.

While legal for adults, marijuana is illegal for anyone under age 21. Use among teens has remained relatively steady since 2005, with about 22% of Maine high school students reporting use within the previous 30 days in both 2005 and 2019 and similar percentages in the intervening years, according to the surveys.

But the science is clear that marijuana use is harmful to the developing brain, according to the National Institutes of Health.

The “drug may impair thinking, memory, and learning functions and affect how the brain builds connections between the areas necessary for these functions” according to the NIH. Some studies have shown possible lower IQs for regular cannabis users who started as teens, although more research is needed.

Any substance use during the time the brain is developing carries risks, said Dr. Noah Nesin, innovation adviser for Penobscot Community Health Care.

“The human brain grows and develops until about the age of 26, which is why youth and young adults are so susceptible to addiction,” Nesin said. “The rate of addiction to cannabis for this age group is nearly twice that of adults. Addiction often starts with the early use of tobacco, marijuana, or alcohol – all legal for adults and therefore more accessible to kids. This early use can create permanent changes in the developing brain and a greater risk for addiction to other substances in the years and even decades to come. Once those circuits are created in the developing brain, they are more readily triggered by the use of other substances in the future.”

Higher-potency marijuana may also lead to psychotic episodes in some users. The average potency of cannabis products has increased from 4% THC in 1995 to 16% in 2018, the latest available data, according to the University of Mississippi Potency Monitoring Project, which does work for the federal government.

But with legalization and changing attitudes among all age groups about marijuana use, more teens now believe that marijuana is not harmful to them.

The percentage of 12- to 17-year-olds who say using marijuana 1-2 times per week is dangerous declined from 55% in 2005 to 37.4% in 2020, according to the National Survey on Drug Use and Health.