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As soon as teachers turned their backs, students at Missoula Sentinel High School would reach into their pockets to grab Juul pens, take a hit and blow the smoke into their sleeves, said Mark Monaco, a school resource officer at Sentinel.

This “game” to use a flavored nicotine vape pen without teachers seeing became popular among students at Sentinel as well as other high schools across the country over the past year, Monaco said.

But the game, and the rising popularity of vaping among teens, hasn’t gone unnoticed by teachers and school administrators.

The use of e-cigarettes and vape pens has many parents, teachers and public health advocates worried. Years of anti-tobacco campaigns led many students to reject smoking, but new devices have ushered in a new era of nicotine users.

The number of high school students using e-cigarettes has increased 900 percent from 2011 to 2015, according to a 2016 study by the Surgeon General.

“There’s a lot of education around traditional cigarettes and tobacco and I think people have developed a profile of a typical smoker,” Sentinel High School principal Ted Fuller said. “But e-cigs seem to be used by all kids. They cross social groups and I think part of that is the marketing. People are convinced that they’re not as dangerous.”

Students see Juuls as the latest must-have tech gadget, Monaco said. They come in flavors like cucumber, mint, mango and fruit. And they're easy to obtain because they can be ordered online.

These reasons, among others, have led e-cigarettes to be the most used tobacco product by middle and high school students, with 2.1 million students reporting the use of them in the 2017 National Youth Tobacco Survey.

MCPS administrators took note of the trend and updated their policy that prohibits tobacco, alcohol and drugs to include the term “nicotine innovations.”

“Because of the advent of e-cigarettes and innovations like Juul, we had to come up with a more broad term so that we’re not always having to go back and change policy,” superintendent Mark Thane said.

Despite MCPS’s zero-tolerance policy against e-cigarettes, many students still try to sneak them into the classroom. And it’s not hard.

Juuls are small, portable and easy to mistake for a USB device. Students often conceal them in their sleeves and pockets, hitting them in restrooms or out on lunch breaks. Plus, the smoke is often odorless or carries the faint scent of air freshener.

But teachers are catching on and students can face serious consequences if they’re caught.

“The bottom line is that it’s illegal to use and possess,” Thane said. “We’ve had a number of students who have been cited as minors in possession with Juuls and other devices.”

Juuls and nicotine vape pens are legal for anyone over the age of 18 to own or use, but because they’re prohibited by school policy, any MCPS student in possession can face disciplinary actions for violating the student code of conduct.

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Student athletes face yet another layer of consequences.

In addition to disciplinary actions, students may have to take a class on a day they don’t have school to educate them on making healthier choices, said Kaylee Clugston, a project success coordinator with Western Montana Health and Addiction Services who works with students at Sentinel.

The classes are meant to provide support for students rather than act as a punitive consequence.

Clugston said that she thinks the best way to cut back on e-cigarette use among students is to provide more education. Many MCPS leaders agree and are taking steps to add lessons about the dangers of vaping to curriculum.

“There are units on substance use and abuse and specific to e-cigarettes and nicotine innovations,” Thane said. “We start in our sixth-grade health enhancement curriculum and up through high school.”

Clugston said it’s important for students to be aware that e-cigarettes pose the same health risks as any other tobacco product, including the potential for addiction. She wants more students to know that there are resources and people to help if they’re struggling and added that she’s always available for support.

Monaco said he also thinks it’s important for students to understand that vape pens contain other harmful chemicals because of the ingredients used to flavor them.

“It’s just a common thing that students have and they don’t even know what they’re ingesting,” Monaco said.

In addition to mandatory health classes, some schools are taking further steps to provide more education on the issue.

Jennifer Courtney, the principal of Missoula Big Sky High School, said their school is providing “push-in” lessons in which school psychiatrists, project success coordinators, social workers and counselors visit classrooms to give short lessons on a variety of health topics.

“We’re trying to reiterate that question of 'How do we take care of ourselves?' and sometimes the topic is around vaping, sometimes it’s around healthy relationships, sometimes it’s around communicating with our parents,” Courtney said.

In follow-up family engagement nights, parents are invited to learn more about each topic and invited to ask questions. In October, Big Sky will be hosting an event focused on vaping. Courtney said the event will provide parents with information about what they should look for and the impacts of vaping.

“It’s a real challenge for parents to be aware of the changing landscape and how these innovations may be impacting their kids," Thane said. "What is really challenging about the nicotine innovation products is that those kids may come from all spectrums of the student body. It’s not a particular clique or group."

In addition to understanding the dangers of the product, Thane emphasized it's important for students to be aware of deceptive marketing. Juul pens may seem harmless, especially when they come in fruity flavors and carry a sleek design but they're still a tobacco product.

"The bottom line is that they're not conducive to student health and well-being," Thane said.

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