In response to the country’s evolving vaping crisis, Pamela Messore ’77, a behavioral health social worker for 25 years in Providence and Woonsocket, is teaching mental health professionals and paraprofessionals how to approach their clients about vaping risks.
“The crisis has erupted very quickly,” said Messore, who is teaching an opioid use course at the Westerly Education Center through a grant co-funded by the Rhode Island College Institute for Education in Healthcare.
The recent outbreak of vaping-related illnesses has caused 39 deaths and more than 2,000 lung injuries reported in 48 U.S. states, according to the Centers for Disease Control and Prevention (CDC).
Messore has counseled adolescents about mental and substance abuse during the bulk of her career. In her course, she strives to educate about conditions such as “popcorn lung,” which damages the lungs’ smallest airways, sparking a shortage of breath. The CDC is studying whether diacetyl, a chemical that provides flavorings for vaping liquids, is contributing to popcorn lung injuries.
Statistics bear out that the most significant rise in vaping occurs among teens, with use among U.S. teens nearly doubling from 11 percent in 2014 to 20.9 percent in 2018, according to Monitoring the Future, a survey funded by the National Institute on Drug Abuse. In fact, one in four youths between the ages of 12 to 17 have tried vaping nicotine at least once, the 2019 National Youth Tobacco Survey estimates.
Rather than advising young people to quit vaping, Messore promotes a harm reduction approach, which calls for meeting teens where they are and accepting that everyone isn’t ready or capable of stopping their use.
“Just giving someone a pamphlet about the dangers of vaping doesn’t change anything,” Messore said. “We have been telling people not to smoke for more than 50 years, yet people still smoke.”
Harm reduction involves encouraging teens to purchase materials from legitimate licensed vendors.
“I wouldn’t buy anything online because, chemically speaking, you don’t know the origin of the vape’s contents,” Messore said. “I trust the licensed vendors in Rhode Island because they have a chain of custody about the origins of their products. With illicit sales, there is no chain of custody. You can hold a vendor accountable, but you can’t hold someone on the street or online accountable.”
“I believe that knowledge is power,” Messore said. “Once young people know more about vaping, perhaps they’ll vape less.”
In another education initiative, a group of Rhode Island College Doctor of Nursing Practice (DNP) students disseminated vaping information last month to seventh-graders at Nicholas Ferri Middle School in Johnston. The main point they aimed to get across is that e-cigarettes contain a concentrated amount of nicotine, a drug that can potentially slow brain development for anyone under 25 years old.
“My students stimulated great discussion with the kids about vaping risks, why kids vape and how advertising is targeting them,” said Professor of Nursing Joanne Costello, who teaches the DNP Population Health course.
The DNP students aren’t the only nursing students at the college spreading the word about vaping risks. B.S.N. major Evan Schmidt is also using the outbreak as a topic for his honors project. Through his research, he argues that in order for incoming nurses to be properly prepared to handle vaping-related illnesses, they should undertake exercises that simulate their role “on the frontline of medical crises.”
Karen Hetzel, Rhode Island College associate professor of nursing, BSN program director and Schmidt’s honors project advisor, said she anticipates that the vaping outbreak will spark the need for more education in middle and high schools about vaping risks.
“If education gets out about the health risks surrounding vaping, perhaps we can keep the deaths and injuries at bay,” Hetzel said. “Prevention is key everywhere, but in middle and high schools it’s very important. We’re not at an opioid crisis level yet but I think this is a problem that needs to be stopped before it gets any worse.”