A recent statewide survey concluded that even though youth smoking has reached historically low levels, e-cigarettes use is much more common, but maybe not as common as some teens think.

One in five Minnesota high school students reported using e-cigarettes within a 30-day period, according to the 2020 Minnesota Youth Tobacco Survey results released by the Minnesota Department of Health.

On the local level, a Positive Community Norms Survey survey conducted in Alexandria found that about a third of the students at Alexandria Area High School had used e-cigarettes within a 30-day period. But it also showed that students tend to assume their peers are using substances more than they actually are.

In that 2019 survey, distributed to students in grades 6-12, 13% of high school students reported using e-cigarettes daily, while 61% of students thought that their peers were using them on a daily basis.

Discovery Middle School and Alexandria Area High School students complete the Positive Community Norms Survey every other year, so the February 2021 results will come back in April.

Katie Strickler of Horizon Public Health, coordinator of Healthy Voices Healthy Choices, said that this gap between student perception and reality is problematic.

“If students think that their peers are using at a higher rate, they are more likely to use themselves,” she said. “It is human nature to want to fit in with the crowd and do what you think everyone else is doing.”

Finding resources

Local students have access to several resources specifically geared toward youth, Strickler said.

The Healthy Voices Healthy Choices Coalition consists of community members who aim to prevent underage substance use in the Alexandria area. A student group called VIBE (Voice. Influence. Build. Educate) partners with the coalition to engage their peers in prevention efforts.

VIBE has a chapter at both Alexandria Area High School and Discovery Middle School. The group is open to any student who wants to organize activities that promote healthy behaviors and commit to making healthy choices themselves.

At a Wednesday morning meeting last week, current members of the high school chapter shared with Strickler that they joined the group to be around other students who support their decision to avoid substance use and contribute to something positive.

The state has developed its own program called My Life My Quit. On a national level, initiatives like Smoke Free Teen or This is Quitting offer free, confidential support through text, online chat or phone call.

Working toward state solutions

Minnesotans for a Smoke-Free Generation is a collection of more than 60 organizations that share common goals of reducing youth tobacco use and ending commercial tobacco’s harm. The organization supports Minnesota lawmakers’ proposed bills that would end the sale of all flavored tobacco products in Minnesota and invest in tobacco prevention and treatment.

The 2020 Minnesota Youth Tobacco Survey stated that 84% of Minnesota high school students who used tobacco in a 30-day period reported using a flavored product, so Strickler agrees that passing these bills would be steps in the right direction.

“Flavorings are a big hook for youth to start using in the first place, so if we can eliminate that, it would be one less thing to attract our youth,” Strickler said.

Pointing to the positive

Rather than focusing on the percentage of students who are using tobacco products, Strickler says that the coalition focuses on reframing these numbers.

Since the majority of local middle and high school students are choosing positive behaviors, the group emphasizes this larger statistic to support students and let them know that they aren’t alone in their decision to avoid using substances.

“Research tells us that scare tactics do not work,” Strickler said. “While there may be an immediate emotional reaction, those emotions do not translate to a long term behavior change.”

At their high school chapter meeting, VIBE members also explained that they’re more likely to think lots of students are using e-cigarettes or other substances because it’s viewed as the cool thing to do. If e-cigarette use happens within a certain friend group someone chooses to spend time in, the high school students said that peer pressure may lead someone to assume that everyone does.

The VIBE members also pointed to topics of conversation after returning to school on Mondays. They won’t hear about the group of students that got together to watch a movie, but word will spread quickly about one student who used substances and made poor choices. Strickler summarized their comments by saying that when one student’s negative story is highlighted, this adds to the misperceptions of how common substance use is.

To combat these misleading conclusions, Strickler said that the Healthy Voices Healthy Choices coalition leads the Positive Community Norms campaign and partners with the schools to acknowledge positive student behaviors by providing teachers a la carte food vouchers to distribute to students who exhibit positive behaviors.

To set more of a positive example outside the school environment, Strickler said the coalition is also encouraging all adults around the community to get involved and set an example for students.

“Everyone can play a role in positively impacting the health and wellbeing of youth in our community,” Strickler said.