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Session 1

Consequences of vaping

Agenda

True/False (5 min)
Quick Facts & Videos (10 min)
Ingredient Investigation (10 min)
Consequences (10 min)
Reflection (5 min)

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True/False: What do you already know?

Record your responses on your index card or paper.

Nearly all e-cigarettes contain nicotine
It’s easy to get addicted to nicotine
The vaping “clouds” are just water vapor
Vaping can cause problems like headaches, coughing, nosebleeds and diarrhea

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Harmless? Not really.

Nearly all e-cigarettes contain nicotine and other toxic chemicals that hurt the brain body in many ways

Using e-cigarettes while your brain is developing can cause lasting harmful changes in the brain

Scientists still don’t know all of the long-term effects of vaping because they’re still so new

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Dizziness

Headaches

Addiction

Nose Bleeds

Dry Mouth / Chapped Lips

Wheezing

Sore Throat

Coughing

Asthma Attacks get Worse

Phlegm

Nausea / Vomiting

Diarrhea

I still look cool, though. Right?

Ummm not really.

Short-Term Side Effects of Vaping

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Nearly ALL e-cigarettes contain nicotine--some pods contain as much as a whole pack of cigarettes
Nicotine gets you addicted to e-cigarettes quickly making it difficult to stop using them
Nicotine harms brain development

Nicotine can make you…

Moody
Confused
Nervous

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Addiction happens faster than you think.

Actually, 25% of teens who get addicted to nicotine are hooked within �a month.

Actually, while most teens said they wouldn’t be using nicotine for more than 5 years, 75% are still using it 8 years later.

In 2019. more than half of people who ever used an e-cigarette tried to quit.

60.2% of students who vape tried to quit in the last year.

88% of teens who try to quit find it too hard.

“I’m not going to get addicted from a couple of puffs.”

In the Beginning

1 Month Later

1 Year Later

“it’s not like I’m going to vape forever, it’s just a fun thing for now.”

“Quitting is so hard and these vapes are way too expensive.”

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Explain to students that many kids don’t realize how fast they can get addicted to nicotine. For example, a quarter of teens who get addicted, are hooked within a month. Most kids say they won’t be using tobacco products or nicotine for more than 5 years, but 75% of teen users are still puffing eight years later. In 2019, more than half of people who ever used an e-cigarette tried to quit. For the first two panels, ask students “What would you say to your friend if they said this?”

Since most of us haven’t been addicted to something before, we probably don’t know how hard it is to stop. 60.2% of MS and HS students who vape tried to quit in the last year. 88% of teens who try to quit nicotine can't do it without many attempts.

Teacher note: If students ask about cessation, please reference the cessation tools in the teacher resources section.

Key Talking Points:

A quarter of teens who get addicted to nicotine are hooked within a month.
While most teens said they wouldn’t be using nicotine in five years, 75% are still using it eight years later.
Of teens who try to quit nicotine, only 12% are successful on their first time.
Kids who use e-cigarettes are four times more likely to start using regular cigarettes.

Malarcher, A., Jones, S., Morris, E., Kann, L., Buckley, R. (2009). High school students who tried to quit smoking cigarettes: United States, 2007. Morbidity and Mortality Weekly Report, 58, 428-431.

https://www.cdc.gov/mmwr/volumes/71/ss/ss7105a1.htm

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8403058/

DiFranza JR, Savageau JA, Fletcher K, et al. (2007). Symptoms of Tobacco Dependence After Brief Intermittent Use: The Development and Assessment of Nicotine Dependence in Youth–2 Study. Arch Pediatr Adolesc Med. 2007;161(7):704–710. doi:10.1001/archpedi.161.7.704

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Nearly ALL flavored e-cigarette liquid contains nicotine
E-liquid is very harmful and can be deadly if swallowed
Since 2013, poison control centers have gotten 40,774 calls because of e-cigarettes

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Each group will read through your assigned chemical listed on the worksheet
In your groups:

Read the description of each chemical
Record group reactions to the information

All groups should complete the “Other Substances” section

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Instructor Notes:

Explain to students that they will be participating in an investigation of e-cigarette ingredients.�

Click to display the introduction. Remind students that e-cigarettes contain harmful chemicals and not water. Explain that each chemical has a “Material Safety Data Sheet” (MSDS) that gives information about it, like its short- and long-term side effects.

Divide students into groups of four and distribute one E-cigarette Ingredient Investigation handout to each group.�

Assign each group one of the substances from the handout. Read the directions as a group and instruct students to begin working. Remind students that all groups will complete the “Other Substances” section.

As students work, circulate through the classroom to provide help where needed. To help students think deeper, push them with questions like:

“How would you feel if this ingredient were in the school lunch and no one told you?”
“How would you react if a young family member (or pet) were about to eat your ingredient?”

Key Talking Points:

There are many chemicals in e-cigarettes that are toxic.

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Please summarize what you found out about:

Nicotine
Formaldehyde
Propylene glycol
8,000+ flavor chemicals

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Negative Consequences of Using E-cigarettes

On your index card or paper:

List negative consequences of using e-cigarettes

If you get stuck, check out these prompts:

How would your life be different if you had a nicotine addiction?

What could happen to your body if you started vaping, both now and in the future?
What would happen if your parents, teachers, a police officer or siblings saw you vaping?
Could vaping affect someone’s goals in school, sports, and/or life? How?

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Distribute one index card or square of paper to each student. Instruct students to think about what they learned and write down the negative consequences of using e-cigarettes.

Prompt students list the health and social consequences if their parents, friends, school or sports team knew they smoked e-cigarettes.

Prompt students to list the costs associated with using e-cigarettes.

Give the students three minutes to think and write. If they get stuck, prompt them to think about the extra questions listed on the screen.

Have peer facilitators collect the cards to read out loud to the group. As they do that, circulate around the room to discuss or provide help as needed. Encourage students to think deeper using these extension questions:

How would your life be different if you had a nicotine addiction?
What could happen to your body if you started vaping, both now and in the future?
What would happen if your parents, teachers, a police officer, or siblings saw you vaping?
Could vaping affect someone’s goals in school, sports, and/or life? How?
Note: if you need help answering legal questions about your state, you can visit 50 State Review.

https://publichealthlawcenter.org/resources/us-e-cigarette-regulations-50-state-review

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Negative Consequences of Using E-cigarettes

Potential consequences include:

Costs a lot of money
Can get addicted fast and lose control
Embarrassed because of wheezing, diarrhea, bloody nose, chapped lips
Trigger asthma attack
Bad influence on younger siblings/relatives
Get in trouble with your parents
Get suspended from school or activities
Could harm a baby or pet if they ate it
Get in legal trouble

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True or False?

Nearly all e-cigarettes contain nicotine
E-cigarette vapor is just water vapor
Nicotine is highly addictive, especially for kids
E-cigarettes are legal if you’re 18 or older

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Session 2

Making Our Own Choices

Agenda

Review (5 min)
Laws & Rules (5 min)
Guess the Percentage (10 min)
Refusal Skills (15 min)
Adult Interview & Recap (5 min)

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Nearly all e-cigarettes contain _______________, an addictive chemical.

What comes out of e-cigarettes is not a vapor; it is an ___________________.�
Some of the negative consequences of using e-cigarettes are…

If you get caught vaping, you can get in trouble with….

Let’s Refresh

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If you are under 21 years old, it’s illegal to buy e-cigarettes and other vaping products.

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Our School’s Rules

What is our school policy about e-cigarettes and other vaping products?

What consequences might happen if you use on school property?

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Guess the percentage of…

High school students who used e-cigarettes in the last 30 days.

Middle school students who used e-cigarettes in the last 30 days.

Most kids in middle school and high school choose NOT to use e-cigarettes.

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Refusal Skill:

A strategy that can help you say no to something you don’t want to do.

Exit Strategy:

A thoughtful way to get out �of an uncomfortable situation

Simply say ‘no’ in your own way.

Give a reason why you don’t want to use.

Add some humor.

Suggest something else to do.

Make an excuse to leave.

Avoid hanging out with smokers and vapers in the first place.

Make your OWN Choice

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What will you do?

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Refusal Skills
Say ‘no’ in your own way.	No, thanks. I’m good. That’s not really my thing.
Give a reason for not using.	My parents would kill me. I’m trying to stay in shape for soccer.
Add some humor.	Ugh, I can’t stand the smell of those things. Knowing my luck, that thing would explode in my face.
Exit Strategies
Suggest something else to do.	Let’s get in the lunch line before it gets too long. I told Lexi I’d find her after English. Wanna come?
Make up an excuse to leave.	Oh shoot! I forgot that my mom is picking me up at 4. I got stuck with lunch tutorials for math. See ya’ later.
Avoid hanging out with smokers/vapers in the first place.	I can’t tonight. Maybe some other time. Honestly, I think vaping is gross and don’t want to hang out if that’s what you wanna do.

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“We talked about �e-cigarettes today in school and I’d like to share with you what I learned.”

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How old do you have to be to buy vaping products like e-cigarettes?

Why do you think most young people choose not to use e-cigarettes?

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Session 3

Don’t Let Them Lie and Win

Agenda

Adult Interview (5 min)
Review (5 min)
Advertising (10 min)
Ad Analysis (10 min)
Warning Label (10 min)

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What facts did your adult know about e-cigarettes?

What were some examples your adult shared for resisting peer pressure?

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Instructor Notes:

Engage students by asking the following questions about their experience with the Adult Interview student handout:

What were some examples your adult shared for resisting peer pressure?
What facts did your adult know about e-cigarettes?

Be sure to thank the students for their hard work and emphasize positive key points that their parents made.

Remind students that, while e-cigarettes are new, peer pressure and advertising are not. Remind students that, while e-cigarettes are new, peer pressure and advertising are not. Some adults didn’t have to deal with e-cigarettes when they were your age, but they did have to deal with advertising and peer pressure to use regular cigarettes.

Because e-cigarettes are newer, however, many people don’t have all the available information. Now that we know more, we can share that information with them.

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Over 86% of teens stated that they had seen advertising for tobacco products and over 18 million teens were exposed to ads for e-cigarettes.

Studies show that kids who see e-cigarette advertising are more likely to pick up the habit.

Who do you think advertisers are trying to appeal to? What are they trying to say with this ad?

What information are they leaving out?

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Instructor Notes:

Explain to students that while peers can directly pressure them to try e-cigarettes by offering them one or may indirectly pressure them simply by vaping around them, some of the pressure and curiosity to try e-cigarettes has been purposely created by advertisements.

Facilitate a class discussion using the following questions:

Do you think e-cigarette packaging and design appeals to young people?
Do you think e-cigarette advertisements influence young people to use e-cigarettes?

Remind students that advertising is frequently designed to withhold information you need to make good decisions. It is designed to make you believe that there are lots of benefits while also hiding all the negative facts/consequences so that you’ll buy the product.

When it comes to e-cigarette companies, they market e-cigarettes to look delicious, cool, fun, and glamorous by using models, bright colors, and flavors. Advertisements by tobacco and e-cigarette companies usually do not tell you that e-cigarettes are filled with toxins, can harm your brain, and contain nicotine which can cause addiction. Over 75% of teens said they had seen ads for vaping products and studies show that kids who see the ads are more likely to pick up the habit.

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The tobacco and e-cigarette industry spends A LOT on advertising.

While advertising has worked to get some kids hooked, most kids choose NOT to use e-cigarettes.

$8.06 Billion / Year

$22 Million / Day

Almost $1 Million / Hour

Advertising $$

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Social Life

Celebrity

Freedom

Sports

Attractiveness

Beauty

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Instructor Notes:

Explain that tobacco and vaping companies use marketing and advertising to convince them to experiment with their product and become addicted so they can make more money.

Explain to students that companies use a technique called an appeal which helps to grab your attention and persuade you to buy or do something.

Click to display the common appeals used by the tobacco and e-cigarette industries*. The appeals can be alone or in combination with each other. A lot of times, companies will use more than one appeal in an ad to reach a larger audience in the hopes of selling more things.

Take time to explain each appeal strategy:

Social Life (“inclusion”): using the product will help you feel more included, respected, and accepted by your friends and other people you might want to be friends with
Celebrity (“popularity”): identifying with a celebrity and using the product to be more like them OR because a celebrity uses a product, you feel it is safe for you to use as well
Freedom (“liberation”): Open-minded people who want freedom, fulfilling work, and self-reliance
Sports (“athleticism”): if you use the product, you will more like your favorite professional athletes, or you feel it is safe for you to use the produce because a sports star does.
Masculinity/Femininity (“attractiveness”): if you use their product you will be more attractive and wanted by other people
Beauty (“glamour”): these products appear to be glamorous and will help you get to that stage too.�

Give students an opportunity to share if they’ve noticed any of these strategies in ads before.

* https://www.ncbi.nlm.nih.gov/books/NBK99238/#ch5.s7

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Instructor Notes:

Explain the two types of advertising: Direct and Indirect. Direct advertising is when a company or business is directly trying to impact consumers' or business customers' buying decisions and is often done through the mail, billboards and magazine ads.�

When you see direct advertising, you know someone is trying to sell you something.

Examples of direct advertising include billboards, TV commercials, internet banner ads, radio ads, magazine ads, and more.�

Click to show an example of direct advertising. Ask students to share how they know that it is direct. Students should be able to explain that it is clear the companies want you to buy their products.

Ask students what else they notice about the advertising. If they need help getting to the key point, ask them about where the e-cigarettes are located in the store or what they are next to.

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Indirect advertising hides that it’s an ad

Social Media: Companies pay people to post about vaping to make it look cool
Movies/Television: Companies pay actors to smoke their brands in movies and on TV

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Instructor Notes:

Ask students to reassemble into their groups. Distribute one E-cigarette Advertising Appeals student handout to each group. Remind students that companies use different tactics, or appeals, to convince you to buy their products. Explain that advertising appeals are strategies that companies use to grab your attention and persuade you to buy and use their product.�

Read the directions and make sure students understand what they are going to do.

Direct one student in each group to record their group’s reactions to each ad and responses to the questions listed on the slide. The recommended work time is 10-15 minutes. �

As students work, circulate around the room to provide help and push thinking where needed. If students are struggling, ask them questions like “Who do you think would be most persuaded by this ad?” “Why do you think the advertisers chose this color/graphic/background/etc.?”

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What appeal is being used?

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What appeal is being used?

Why do you think the advertisers chose this image?

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What appeal is being used?

Who do you think would be most persuaded by this ad?

Why do you think the advertisers chose this color/graphic/background/etc.?

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What appeal is being used?

Who do you think would be most persuaded by this ad?

Why do you think the advertisers chose this color/graphic/background/etc.?

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Instructor Notes:

Explain to students that they will be working with their groups to brainstorm a creative slogan and imaging for an e-cigarette warning label.�

Distribute one copy of the Warning Labels student handout and one piece of blank paper or poster board to each group. �

Explain that the Food and Drug Administration (FDA) requires that all e-cigarette products have a warning that says, “This product contains nicotine. Nicotine is an addictive chemical” in large black font in a white box. �

Challenge groups to create alternative warning labels that are eye-catching and inform people of the potential dangers to e-cigarettes. Each label must include a slogan and key information.�

The estimated work time for this session is 10 minutes which can be adjusted depending on class length.

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Why do tobacco/e-cigarette companies spend billions of dollars on ads targeting young people?

What information do vaping ads NOT include?

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Session 4

Your Life. Your Choice.

Agenda

Video Review (5 min)
Warning Labels (20 min)
Role Model Recap (5 min)
Your Life Your Choice (10 min)

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Instructor Notes:

Remind students that tobacco and vaping companies use marketing and advertising to convince them to experiment with their product and become addicted so they can make more money.

Remind students that this is the final session of CATCH My Breath. �

Provide students with time to complete their warning label projects.�

As you circulate, remind them of the appeals discussed in the last session and how they can use those to “sell” the behavior of NOT using e-cigarettes. Also, remind them that the warning label needs to include a slogan and information about the potential harm of e-cigarettes.

Have each group present their warning label. With each one, ask the class what appeals the group was using and what information they were able to incorporate into their poster. As you notice the students using information from the class, emphasize those points to reinforce them.

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How would you feel if your younger sibling, cousin or friend began vaping?

What’s one piece of information that you learned from this program that you would share with them?

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What is your choice regarding e-cigarettes?
What are your reasons for your choice?
Using the scenarios on the handout, plan out your responses so you can be prepared.

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Instructor Notes:

Remind students that they are in control of their own choices and goals. Reinforce that it is okay to be curious, but they should research and absorb all the information possible to make an “informed decision.” But they should remember, smoking tobacco and e-cigarettes can quickly lead to nicotine addiction- and will limit their choices. Now that they have gone through the CATCH My Breath program, they have more information and skills to make a healthy choice about e-cigarettes.

Distribute one copy of the Your Life. Your Choice. student handout to each student. Ask students to take the next few minutes to think critically and respond to the questions listed on their worksheet. It is okay if they need more time to finish the activity after class.

Ask for students to volunteer to share their choice. Be sure to reassure and support students who share out.

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I’m vape free because I want to stay fit for sports.

I’m focusing on my goals. Who’s got time to vape?

I’ve got way better things to spend my money on.

I don’t vape either. I want to be a good example to my little sister.

I tried it once but addiction is too scary. I stopped before it was too late.

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