Significant progress has been made over the years to reduce smoking rates in Vermont. By 2015, the percentage of high school students who smoked tobacco was down to 11%. Then vapes entered the picture, and youth use skyrocketed. By 2017, 34% of students had vaped, and vaping has been declared a Pediatric Epidemic by the Surgeon General. As more and more youth use these products and become dependent upon them, learning and overall health are negatively affected. Some vapes can also be used with marijuana products, adding another layer of concern for the developing brain.

Schools and parents are scrambling to understand and deal with the vape phenomenon. Nicotine, which is found in most vape products — and all JUULs — is addictive whether it enters the body through combustion (smoking) or vaping. Quitting nicotine addiction is tough. The good news is there is a free and voluntary program specifically designed for teens ages 14 to 19 called Not On Tobacco (N-O-T). This is different from the adult program called 802-QUITS designed for 18 and older.

Let’s look at the problem. The first vaping product was created in 2004. With the development of the trendy JUUL in 2014 came a significant increase in youth use rates. These products are marketed to youth through appealing flavors of e-juice, colorful designs and sleek packaging, the discrete nature of the byproducts (teachers may not see or smell them when they are used in class), heavy marketing on social media, and advertising in stores. The flavored e-juice contains at least 10 to 15 known carcinogens and other toxic chemicals like formaldehyde (embalming fluid) and acetone (nail polish remover).

The flavorings were originally approved by the FDA to be food additives in items like candy and soda. When eaten, the flavors break down through the digestion process. These flavorings were never intended to be heated up, which changes the chemical composition, and then inhaled. The chemicals go straight into the blood, brain and lungs, bypassing any process to break them down. The vapor byproduct is actually not a vapor at all; it’s an aerosol that contains tiny, heavy metal particles like copper and lead. Once the aerosol hits the lungs it may lead to deep lung infections like bronchitis, wet lung and pneumonia.

Data from the Youth Risk Behavior Survey shows a negative association between tobacco use and academic achievement. In general, the more risk factors (easy access to substances, low perception of harm of substances, family distress, negative peer influence), the more likely youth are to engage in unhealthy behaviors. On the contrary, the more protective factors (positive self esteem, success at school, family support, community involvement and engagement), the less likely youth are to engage in unhealthy behaviors. Our goal as a community is to reduce risk factors and enhance protective factors. Quitting smoking and vaping does both.

A solution is the Implementation of a cessation program designed specifically for youth, that addresses both smoked, chewed and vaped tobacco products. The N-O-T program is based on Theories of Behavior Change and is a youth-centered approach that offers standardized training for facilitators and includes multiple learning strategies for the participants. N-O-T is the only cessation program to be named a Model Program by the Substance Abuse and Mental Health Services Administration and is the most researched, widely used and successful program in the United States. N-O-T is also recognized by the National Registry of Effective Programs. The program has significantly decreased smoking/vaping and increased smoking/vaping cessation among teenagers, and has been proven sustainable and useful in a variety of settings.

N-O-T consists of 10 50-minute group sessions, usually held in schools during school hours or in a community setting, and led by trained facilitators. The sessions are developmentally appropriate and conducted in small groups of no more than 10 to 12 teenagers. N-O-T takes a holistic approach to address behavior change and includes topics like motivation, stress management, the effects of smoking, preparing to quit, setting a quit date, relapse prevention, dealing with peer pressure, media awareness, support networks, and healthy lifestyles. Four additional booster sessions are offered after the program’s conclusion.

There are currently trained staff at U-32, Northfield Middle/High School, and Central Vermont New Directions Coalition.

While we are concerned about the youth tobacco/vaping use rate rising, we still need to recognize that most youth do not engage in these unhealthy behaviors. We must continue to provide opportunities for youth to be engaged in their community, participating in activities that spark joy and encourage healthy risk taking, and have trusting adults in their lives that they can go to in a time of need.

If you are concerned about yourself or a teenager and would like more information about the N-O-T program and the next session, contact Central Vermont New Directions Coalition at (802) 223-4949 or

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