While many Hawaii teens vape as a way to cope with stress, the impacts of nicotine can actually exacerbate mental health issues and negatively affect brain development.

That’s the message shared by the state Department of Health via its new campaign, “Nicotine Brain Explained,” in an effort to counter decades of deceptive marketing that has created the false impression that tobacco is a stress reliever.

The campaign, part of the “Escape the Vape Hawaii” series, was launched ahead of Thursday’s Great American Smokeout sponsored by the American Cancer Society.

“Studies show that nicotine use by adolescents negatively affects their brain development,” said Lola Irvin, administrator of DOH’s Chronic Disease Prevention and Health Promotion Division. “If teens are already experiencing depression or other mental health issues, vaping can worsen these conditions.”

During a survey evaluating youths and vaping in Hawaii, Irvin said only a third who had not started yet thought it was very harmful, while less than a quarter of those who had already tried it thought it was harmful.

Among the misconceptions is that vape products have little to no nicotine, when most sold in the U.S. do indeed contain nicotine, which is highly addictive.

Moreover, a report on e-cigarette products released in March by the Federal Trade Commission found a nearly 60% increase in the concentration of nicotine in disposable e-cigarettes between 2015 and 2018. In 2015, disposable products on average contained 25 milligrams of nicotine per milliliter of e-liquid, which increased to 39.5 in 2018, enhancing their addictiveness.

In cartridge-based e-cigarettes, which are popular among youths, there were even higher nicotine concentrations, at 50 and 60 milligrams per milliliter.

“We know that many Hawaii teens may not realize how much nicotine they may be vaping and how vaping harms their health and overall well-being,” said Irvin. “The use of vape products can complicate existing mental health issues, and a vicious cycle of nicotine withdrawal symptoms includes anxiety, depression, problems concentrating, and sleep and mood disorders.

“We hope to build on the success of our previous vaping prevention campaign while focusing on educating teens and their ohana on the serious mental health risks of vaping.”

Vaping can actually increase feelings of stress over time because nicotine triggers receptors in the brain that lead to the production of cortisol, which affect how a body responds to stress. This results in an addictive loop that requires more nicotine to cope with more stress.

Nicotine also throws off the natural balance of neurotransmitters such as dopamine and serotonin in the brain, leaving vapers unhappy. It can affect memory, making it harder to concentrate, and increase risk of long-term mood disorders.

“It will actually then become this snowball effect,” said Irvin. “It will actually rewire the brain for addiction, throw off their dopamine and serotonin balance, and can leave them feeling even more stressed and depressed.”

HAWAII HAS among the highest rates of youth vaping nationally, with nearly 1 in 3 high school students and about 1 in 5 middle school students reporting as current users of e-cigarettes.

Most said they started tobacco use with flavored products, including those with fruit, mint or candy flavors that appeal to youths, prompting Hawaii legislators to introduce bills prohibiting sales of flavored tobacco products.

The bills have been introduced for years, with no success at passage of a statewide ban.

The U.S. Centers for Disease Control and Prevention’s latest Youth Risk Behavior Survey in 2019 found the rate of daily vaping that year had more than doubled over two years. Survey results from 2021 are expected some time this year.

DOH said the latest campaign was developed with feedback from Hawaii teens to find out what would resonate with them the most. It aims to reach and educate middle and high school youths in particular, between the ages of 13 and 18.

Most youths start tobacco use in middle school by the time they are 14, according to Irvin.

The campaign will take a multichannel approach, with ads inspiring Hawaii youths to live vape-free featured on TikTok, YouTube and other social media channels that influence teens, to counter pro-vaping imagery.

The escapethevapehi.com website offers an interactive presentation of facts, such as what’s in vapes and how they harm human health. While many think vapes just contain water vapor, they contain dangerous chemicals such as formaldehyde and metal particles.

In addition to inflaming airways, vaping increases one’s risk for chronic lung diseases and lung infections from bacteria, such as pneumonia. A Stanford study has also linked vaping among young adults to a much higher risk of contracting COVID-19 than their peers who do not vape.

The industry, meanwhile, from 2015 to 2018, more than tripled spending on advertising and promotion of e-cigarettes, spending more than $640 million in 2018, according to the FTC’s e-cigarette report.

Companies spent millions on television advertising and gave discounts to retailers and wholesalers to reduce the price of e-cigarette products to consumers. They also hired celebrities, social media influencers and brand ambassadors to endorse their e-cigarette products.

Over those three years, e-cigarette sales increased more than sixfold to $2 billion, according to the FTC, and sales of flavored e-cigarette cartridges increased sevenfold.

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Want to quit smoking or vaping?

The Hawaii Tobacco Quitline continues to offer “My Life, My Quit,” a free program with trained coaches to help youths up to 17 years old quit smoking or vaping. Sign up by texting “Start My Quit” to 36072.

Visit MyLifeMyQuit.com for more information.