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Hartford, Conn. – A glimpse of student athletes in peak physical condition vaping just moments after competing in a football game led Stamford High School Principal Raymond Manka to reconsider his approach to the epidemic.

His school traditionally has emphasized discipline for those caught with e-cigarettes. Punishments become increasingly severe with each offense, from in-school suspensions to out-of-school suspensions and, eventually, notification of law enforcement.

But Manka began thinking about it more as an addiction problem, and less of a behavior issue, after seeing the two players from another school vaping near their bus. “It broke my heart,” said Manka, whose school is now exploring how to offer cessation programs for students caught vaping or with vaping paraphernalia.

“We’ve got to figure out how we can help these kids wean away from bad habits that might hurt their body or their mind or otherwise create behaviors that can create habits that will be harmful for the remainder of their lives,” he said.

Schools elsewhere have been wrestling with how to balance discipline with prevention and treatment in their response to the soaring numbers of vaping students.

Using e-cigarettes, often called vaping, has now overtaken smoking traditional cigarettes in popularity among students, says the Centers for Disease Control and Prevention. Last year, one in five U.S. high school students reported vaping the previous month.

E-cigarettes produce an aerosol by heating a liquid that usually contains high levels of nicotine – the addictive drug in regular cigarettes and other tobacco products – flavorings and other chemicals. Users inhale this aerosol into their lungs; when they exhale, bystanders often breathe it in too.

Compared with regular cigarettes, the research on the health effects of e-cigarettes is painfully thin. Experts say that although using e-cigarettes appears less harmful over the long run than smoking regular cigarettes, that doesn’t mean they’re safe – particularly for youth, young adults, pregnant women or adults who do not currently use tobacco products.

“Studies have shown that e-cigarette use among young people is potentially associated with an increased risk of progressing on to cigarette use and to vaping cannabis, which has become increasingly common in recent years,” said Dr. Renee Goodwin, a researcher and professor of epidemiology at the City University of New York and Columbia University who studies tobacco and cannabis use.

Besides nicotine, e-cigarettes can include other harmful substances, including heavy metals like lead and cancer-causing agents. The vaping liquid is often offered in a variety of flavors that appeal to youth and is packaged in a way that makes them attractive to children.

Experts say the CDC classifies e-cigarettes as a tobacco product, and many schools lump vaping in with tobacco use in applying codes of conduct, treating offenses similarly.

In Connecticut alone, administrators dealt with 2,160 incidents in which students were caught vaping or with vaping paraphernalia in violation of school policies during the 2017-18 school year, up from 349 two years earlier. The schools issued 1,465 in-school suspensions and 334 out-of-school suspensions, according to the state Education Department.

Nationwide, some schools have removed bathroom stall doors or placed monitors outside of restrooms to check students in and out.

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