A group of 10 sophomores, juniors and seniors spent the 2018-2019 school year learning about health and policy issues associated with the use of e-cigarettes and vaporizers as part of Blair’s first-ever research fellows program. In partnership with a renowned public health expert from Boston University School of Medicine (BUSM), the student researchers examined the influence and impact of such devices on the health and well-being of high school students and young adults. 

Over the course of the year, they worked to better understand the science behind vaping and the challenges and opportunities associated with addressing the problem, tackling a wide range of projects ranging from producing podcasts and reviewing scientific data to conducting individual research and sharing their findings with their peers and teachers.

“The Food and Drug Administration has made it clear that the use of such devices among adolescents has grown to epidemic proportions, and recent statistics showed an 80-percent rise in teenage vaporizer use, making it a public health problem that affects every high school in America,” said Head of School Chris Fortunato. “I am incredibly proud of this action-oriented group for bringing this complex issue further into the light and considering it from many different angles. In the process, they no doubt created something with a lasting legacy at Blair.”

With support and guidance from Mr. Fortunato, English teacher John Redos ’09 and Timken Library director Ann Williams—as well as video conferences and phone calls with Michael Siegel, MD, MPH, a professor in BUSM’s Department of Community Health Services—the group considered ways to change adolescent behavior and educate their peers about the dangers of vaporizer use and abuse. 

A Competitive & Influence-Oriented Program

Given the timeliness of the issue, it is not surprising that a large number of Blair students applied to be part of the pilot program when it was announced in spring 2018. Accepting only 10 students during the program’s inaugural year, Mr. Fortunato charged students with discovering compelling information on the topic and sharing it with the Blair community in a way that would have an impact. 

That was one of the major reasons Ryan Green ’19 wanted to become involved. “I enjoy helping to create positive change and thought this could be a way to make a big difference in our community,” explained Ryan, whose individual project work led him to present to the Six Mid-Atlantic Boarding Schools (SMABS) deans of students about school policies related to vaping and to continue this work during an internship at Department of Health and Human Services in Marin County, California, over the summer. “I learned how hard it is to actually write and enact formal policy and, despite working on this all year, feel like I have barely scratched the surface. The hardest part is the lack of physical research on what works because vaping has only become a major issue in the last couple of years.”

Enter Dr. Siegel, who worked with Blair’s coordinator of health education Erin Fortunato in Boston before she and her family came to Blair in 2013. Well regarded as one of the premier authorities on issues associated with tobacco, alcohol and firearms use, Dr. Siegel helped students understand the complex science and policy issues associated with this controversial public health topic. 

“I have been incredibly impressed by these amazing Blair students,” he said. “The level of their understanding is extremely high, and they have asked exactly the right questions to obtain the critical information needed to appropriately address the issues in an evidence-based way. The students were well-prepared for every phone call and video conference, and they have considered the issues with a high degree of sophistication. I hope they all run for public office because we could use policy makers like them.” 

Considering the Issue from Many Angles

The fact that Dr. Siegel is a vocal proponent of using e-cigarettes as a treatment for smoking cessation—while at the same time warning of dangers such as popcorn lung, cancers and nicotine overdose when used recreationally—illustrates the issue’s deep complexity. “Public health is a balancing act that requires weighing the benefits and costs of various approaches to dealing with a problem,” Dr. Siegel said. “We often have to make decisions in the absence of definitive scientific data, and how one uses the data that are available is critical.” 

Many of the research fellows hadn’t previously considered the complex science behind vaping, and found Dr. Siegel to be an excellent resource as they built a strong knowledge base at the outset of the program. He also offered valuable insights about the importance of motivation and persuasion in public-health campaigns. “Students were surprised to find that underscoring the health effects of such devices didn’t convince users to stop, but they were more responsive when made aware of e-cigarettes’ high nicotine levels and the idea that nicotine addiction takes away a degree of their freedom,” said Mr. Fortunato.

Not surprisingly, Dr. Siegel’s nuanced take on the issues deeply impacted students as they explored the emotional and mental components that drive teens’ decision to vape. 

“Hands down, my favorite part of this process has been my interactions with Dr. Siegel,” said Katherine Holding ’20, who spent the spring putting the finishing touches on a podcast she submitted to the National Public Radio podcast challenge that features Dr. Siegel and Mr. Fortunato discussing the benefits of vaping as a smoking cessation tool and its dangers when habitually used otherwise. “Interviewing him was one of the most interesting discussions of my life because we were able to transcend society’s normal black-and-white understanding of vaping’s place in society. Going into it, I had a demonized concept of Juul as a company and, while that’s still pretty much intact, Dr. Siegel exposed me to some of the more complicated considerations when it comes to regulation.” Project-wise, Katherine added, Dr. Siegel helped her to explore and develop ideas, while on a personal note, he validated and encouraged her curiosity, giving her the confidence to step outside her “intellectual niche.”

The fellows have enjoyed sharing their new perspectives and deepening understanding of the issues with their classmates at Blair and others at peer schools. At February’s TEDx conference at Gill St. Bernard’s School in Gladstone, New Jersey, for example, Tanner Humphrey ’19 touched on what he has learned as part of the research fellowship in “From Tragedy to Triumph,” a talk about his personal journey of coping with grief following his mother’s death from lung cancer. Abby Morris ’20 and Madina Shabazz ’20, on the other hand, teamed up to provide insight on the use of vaping products among teenagers in “Vaping: A Teen Epidemic,” a TEDx presentation that addressed health risks, government policies and product marketing strategies of vape companies.

Two months later, five students (Ryan, Abby, Tanner, Madina and Lucy Clayton ’21) spent a day teaching health-and-wellness classes at The Hun School of Princeton, where they led candid student-only discussions about vaping and Juuls. Preparing for that visit—which some fellows hope becomes an annual event that ultimately spreads to all Mid-Atlantic Prep League (MAPL) schools—required a great deal of research on health effects, marketing campaigns and school policies. While there, the research fellows also had the opportunity to gather their own data about students’ personal experiences with vaping, impressions of school policies and feedback about what could influence behavior change. “Hun students remarked that they felt comfortable participating in a conversation about vaping led by students their own age to whom they could relate,” Abby said. 

Coming away from those experiences with a new respect for how difficult public speaking and teaching can be, the students also got a firsthand look at effective communication techniques and classroom-management strategies. “The TEDx talks impressed me most,” said Mrs. Williams. At Hun, she added, the research fellows “hit on just the right tone” to engage their peers and share with them scientific information. 

“This fellowship has taught our students how to follow their own path of curiosity, find scientific truth to underpin personal beliefs and opinions, and engage with peers on difficult topics,” Mrs. Williams continued. “Blair students are hard-working and busy people who are learning to make choices about where they allocate their time and energy. It is heartwarming to see that they are inspired, passionate citizens of the world, even as they juggle their core responsibilities.” 

Individual Project Work

As the spring semester came to a close, students presented the findings and outcomes of their individual project work in various venues. 

The students who presented at Gill or taught at Hun summarized for their classmates what they took away from those experiences, while Chloe Park ’20 will present a poster on the biochemistry and cellular processes involved in nicotine use and addiction at the Blair Science Poster Expo at the end of the school year. Kathleen Devlin ’20 took a broader view of addiction in general in a short film she produced and will screen at Blair’s annual Student Film Festival in early May, whereas Clearly Waldo ’19 conducted general research to inform an op-ed she plans to submit to at least one local northwestern New Jersey newspaper, a piece she wrote with input from Cornell University Associate Professor of Communications Jeff Niederdeppe (a mentor at Mr. Redos’s alma mater with whom he connected her at the start of the spring semester).

As for potentially lasting impacts, the outcomes of the research fellows’ work could be far-reaching. Ryan and Tanner are advocating for the creation of an annual cross-MAPL peer health education program in which each school would send student-teachers to the others to educate peers about vaping and other public-health issues; SMABS deans of students are considering Ryan’s proposal that they create a uniform policy for discipline as it relates to vaping; and Liam Junkerman ’19 is advocating for schools to institute health-center-sponsored vaping paraphernalia “buy-back” programs. And, armed with information gleaned from a review of recent literature and a field interview, John Hadden ’21 is developing a website for adolescents looking for help in understanding and fighting addiction to nicotine products.

Educating the Community

As the school year ends, the group will get final lesson in how to present data and information in an engaging way when they report their findings to the entire Blair community. 

Abby, who has analyzed vaping advertisements and marketing strategies for months now, feels certain her peers will share her shock at how much corporations are jeopardizing the health of young people for monetary gain by intentionally marketing to adolescents. “I look forward to sharing this information with my peers because I believe it will surprise many students and generate interest in preventing teenage vaping,” she said, adding that it is critical to frame the issue to individual audiences to make a convincing case. “Some information appeals to teenagers more than adults, thus making it important to filter when making a podcast, giving a speech or participating in a discussion. I’ve found that sharing real-life stories and quotes from professionals allow for a more compelling delivery of data, rather than simply stating the facts.” 

Ryan is hopeful that illuminating the contrast between false perceptions of vaping’s popularity to the actual number of students who vape will decrease the number of kids who give it a try. “I was leading a discussion group at Hun and students thought that 80 to 90 percent of students had tried vaping, when the number was actually less than half that,” he said. “I think this will help lessen perceived pressure and discourage younger students from starting to vape.”

At the Frontier

Mr. Fortunato and his colleagues look forward to building the research fellows program over time, likely with a continued focus on public health and controversial issues affecting the Blair community and the world beyond. Key elements will continue to be collaborating with experts outside of Blair, learning to communicate ideas to different audiences in ways that get their attention, practicing curating information, mastering research techniques and considering different perspectives. And, of course, encouraging students to integrate these lessons into future learning.

“With vaping, we are at the forefront of research and scientific data and, in the next 10 years, we’ll know much more about its impacts and implications on health and school policy,” concluded Mr. Fortunato. “At that point, it will be interesting to reflect on the work we are doing today, especially as many of the same questions can be posed for other illicit substances, including marijuana and THC, which might be something future research fellows want to look into.”

As a group, research fellows took away from the year-long experience a deeper appreciation for the complexity of public health issues. “The idea that a product can be life-saving for one demographic and toxic to another breeds such an interesting dilemma of what to do with it,” Katherine concluded. “The first step to addressing the problem is to bring it out of the shadows, and that’s what I hope my podcast will help to do.”

Looking ahead, Mr. Redos is interested in exploring new topics and potentially tying the research fellowship to the curriculum of Blair’s health-and-wellness program, which is overseen by Mrs. Fortunato. “Our inaugural research fellows made a positive impact with the work they did, and I have no doubt that a few of their projects will be carried forward in the years to come,” he said. “Beyond that legacy, the most valuable part of this experience is developing an intrinsic motivation to learn. When students get to college, their professors are not necessarily going to be experts in the fields or areas in which they are interested. They need to know how to get answers, gather information themselves and connect with people in positions of authority. Our research fellows had the opportunity to practice this, with guidance from Blair faculty, and will therefore be much more prepared to navigate life as undergraduates more successfully.”