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E-cigarettes are the current drug of choice in St. Louis’ middle and high schools, students say. Locker rooms and bathrooms smell like fruit from the vapor. Principals have drawers full of confiscated vaping cartridges.

Schools have stepped up their anti-vaping efforts this year after a mysterious lung infection has caused at least 450 illnesses and six deaths nationwide. The U.S. Food and Drug Administration plans to ban most flavored vaping products, federal officials announced last week.

Two teenagers are currently hospitalized at St. Louis Children’s Hospital with suspected cases, officials said. There are nine confirmed or suspected cases of the lung illness across Missouri.

“(Vaping) is probably our biggest problem right now,” said Savannah Araya, 17, a senior at Parkway West High School and president of the school’s Teen Voice for Change leadership club.

Under a new policy, students at Parkway West caught with vaping products will have the device confiscated. On a second offense, the student must complete an anti-vaping class. The five-hour course includes videos and quizzes, which administrators hope will serve as a deterrent as well as educate students on the dangers of vaping.

“We’re trying to figure out how to help them instead of punish them,” said Julie Knost, youth programs coordinator for the Alliance for Healthy Communities, which works with the Parkway School District.

One in five St. Louis County students in grades six through 12 reported using e-cigarettes, more than alcohol or any other drug, in the 2018 Missouri Student Survey. But local students say the real numbers are much higher. A recent survey at Parkway West found more than 80% of students had tried vaping, and more than half vape regularly.

The lung illness linked to vaping products that typically contain nicotine can cause symptoms including cough, shortness of breath, weight loss and vomiting. Some patients require ventilators to breathe, said Dr. Thomas Ferkol, director of pediatric pulmonary medicine at Washington University.

Disease investigators are trying to figure out a common cause of the illnesses, such as a contaminant or bacteria. Ferkol suspects that vaping has caused illnesses prior to this summer’s outbreak, but the problem went unrecognized.

“We’re at a disadvantage because we really have no idea what they’re inhaling into their lungs,” he said. “My greatest concern is that we have no idea what impact this is going to have on the lungs of these young people 10, 20, 30 years from now.”

Tom Gilliam has owned the Blue Vapor shop in Ballwin for seven years and said a ban on flavored vaping products would destroy the business. He estimates the average age of his customer is 27, and says nearly all have taken up vaping to help them quit tobacco cigarettes.

“It has to be a tainted product (causing the illnesses),” Gilliam said. “Let’s not banish a whole industry.”

This year, the Hancock Place School District in south St. Louis County adopted the anti-smoking program Aspire, created by the MD Anderson Cancer Center at the University of Texas. The online, bilingual program includes videos and quizzes for middle and high school students to learn the dangers of smoking and vaping, along with help to quit if needed.

“We just need to help these leaders come up with nontraditional ways to address the issue because it is escalating as a health risk,” said Erin Kelley, executive director of StepUp, an anti-drug organization in South County that helped Hancock Place launch the program.

Kelley met Friday with student leaders and staff at Nerinx Hall High School in Webster Groves to brainstorm anti-vaping programs. The students decided that an amnesty week, where users could turn in their vaping products without consequence would be a good first step.

Vaping is popular in public, private, urban and suburban schools, students said.

“When it first came along it was cool, everyone was doing it, and a lot of people are now addicted,” said Meta Stephens, Nerinx’s senior class treasurer.

Parkway schools disciplined 70 students during the 2018-19 school year for possession or use of a vaping device in school, out of a total enrollment of 17,600, according to a district spokesman.

The leadership clubs at all four district high schools created maps to identify where vaping products were sold. Students sent out emails to the store owners and received some positive responses. The owners said they would review surveillance videos to make sure employees weren’t selling vaping equipment to minors.

Knost, the youth programs coordinator, and MJ Stricker, a 2019 Parkway West graduate, traveled to vape shops, gas stations and convenience stores along Manchester Road from Interstate 270 to Clarkson Road over the summer. They spoke to store managers and owners about the problem and handed out signage and guides for checking IDs.

The sale of vaping products to anyone younger than 21 is banned in St. Louis city and county. Several store owners told Knost they’ve had parents buy vaping products for their kids, she said.

“The conversation I’ve had with the kids is we’re still in an education phase,” Knost said. “It took us 20, 30 years to educate people about the dangers of cigarettes and tobacco. We’re still at that point where we need to get that information out to kids and to adults also.”