Lesson Plan: Health Risks of Vaping

Subjects:

• Math
  • This lesson uses the instructional routine Slow Reveal Graphs. A slow reveal graph begins with the image of a graph where all of the labels and quantitative information have been obscured so that students can focus on graphic features. As more of the graph is revealed, students refine their interpretation and construct meaning, often in surprising and insightful ways.
• Health
  • This lesson focuses on the health effects and psychology behind young people’s use of tobacco cigarettes and vaping products.
• Social Studies, particularly Civics/Government and Economics
  • For more on the connection between math and social studies, read “Why is the math teacher here for social studies?” by Jenna Laib
• Media Literacy
  • This lesson explores how marketing worked for cigarettes in the 20th century, and e-cigarette or vaping products in the 20th. Students can evaluate techniques used in the advertising campaign, and analyze how these strategies can be manipulative.

Lesson Duration:

Two class periods

Essential Questions:

• Is teenagers’ use of vaping products a problem? Why or why not?
• How should companies that make vaping devices market their products?
• What actions should governments, healthcare professionals and community stakeholders take to support the health of teenagers?

Lesson Objectives:

Students will:

• Apply mathematical understandings about slope, linear relationships, functions, and percentages to Interpret graphical and statistical information about teenage use of vaping products and marketing dollars spent.
• Examine the role of economics and marketing in public health decisions.
• Identify actions that different stakeholders (e.g. the federal government, healthcare professionals, parents and caregivers, etc.) could take to support the health of teenagers.

Materials:

• Slow Reveal Graph #1: Just Say No
  • Note: Links to the Slow Reveal Graphs are not included on the Student Activity handout so that slides can be revealed and analyzed one at a time.
• Student Activity handout (do not distribute until after Slow Reveal Graph #1)
• Retro Report video “Health Risks of Vaping: Lessons From the Battle With Big Tobacco” (Transcript)
• Slow Reveal Graph #2: Going Up in Smoke
  • Note: People with color blindness may have difficulty distinguishing between the colors red and green on Graph 2. The top dot is green, as are the bars. The bottom dot is red, as is the line.

Procedure:

Day 1:

1. Activating Prior Knowledge: Slow Reveal Graph #1
2. Show Slide 1. Ask:
   1. What do you notice?
   2. What do you wonder?
   3. When does the data for the orange line begin?
   4. What do you think this graph might be about?
3. Show Slide 2. Ask:
   1. What new information did we just learn? How does it change your thinking?
   2. What do you think the orange line represents?
4. Show Slide 3. Ask:
   1. What new information did we just learn?
   2. What do you think is being measured along the Y axis?
5. Show Slide 4. Ask:
   1. What new information did we just learn?
   2. What do you think the Y axis represents? What do you think the scale is?
   3. Potential misconception: Students may assume theY axis stretches from 0 to 100 percent. Prompt students to use the given values (e.g. 26.7 percent as the highest value on the orange line) to estimate the scale of the Y axis)
6. Show Slide 5. Ask:
   1. What new information did we just learn?
   2. This data doesn’t represent every single person in the world. Who do you think this data is about?
   3. What percentage of these people smoked cigarettes in 1997?
7. Show Slide 6. Ask:
   1. What new information did we just learn? What do you think the value is of the first point on the blue line? How did you estimate it?
   2. Potential misconception: students may not realize that they can use known benchmarks to estimate the value of a point. Ask them what values might make sense, and how specific (e.g. going into decimal places) they think the number should be.
8. Show Slide 7. Ask:
   1. What new information did we just learn? Does this surprise you? Why or why not?
   2. Data for years after 2018 is not available. What do you think it looked like in 2019? …2020? …this year?
   3. What might it look like in the future (e.g. 2035)?
   • Is teenagers’ vape use a problem? Why or why not?
9. Have students record their responses to the questions on the activity handout.
   1. Potential Misconception: Students might think that the rate of teenagers smoking tobacco cigarettes or using vaping products changes at a constant rate. It does not. Ask students to evaluate sample answers for reasonableness if they seem stuck.
10. Watch the Retro Report video “Health Risks of Vaping: Lessons From the Battle With Big Tobacco” and have students record their thinking on the handout.
    1. What strategies did tobacco cigarette companies like Camel and Phillip Morris use to try to persuade Americans that smoking was safe?
    2. What similarities are there between how tobacco cigarettes were marketed in the U.S. and how e-cigarettes are being marketed today?
    3. What current information do we have about the safety of vaping products?
    4. Note: Students may need a review of some terminology (e-cigarettes, vaping products, vaping devices) prior to or during viewing.

Day 2:

3. Activity: Slow Reveal Graph #2
4. Show Slide 1. Ask:
   1. What do you notice about this graph? What do you wonder?
   2. We know what the red line represents. What do you think the green bars might represent?
   3. What does the slope of the red line tell you about the percentage or percentage point change? When did e-cigarette use increase the most?
   4. Why do you think the label for the Y axis is on the right side of the graph? What might be on the left side?
   5. Potential misconception: Students may not have seen a Y-axis label on the right side of a graph. There will be a separate measurement along the left side of the Y axis. Make this explicit early on in the slow reveal graph.
5. Show Slide 2. Ask:
   1. What information did we just learn? How does it change how you think about the graph?
   2. Why are there two labels for the Y axis?
   3. What do you think the green bars represent now?
6. Show Slide 3. Ask:
   1. What information did we just learn? How does it change how you think about the graph?
   2. Write a headline that describes a trend you see in this data visualization.
7. Show Slide 4. Ask:
   1. Now that you’ve seen the full graph, what are you thinking about e-cigarette use and advertising?
   2. How does this compare with your thinking after watching the RetroReport documentary?
8. On the Activity handout, have students record their responses to:
   1. What headline did you write for the graph?
   2. Name three key takeaways after analyzing this graph.
9. Show Slide 5. Ask:
   1. What do you notice about this data visualization?
   2. How many middle school studies saw any e-cigarette advertisements? How many high school students?
   3. Why do you think the overall number is not an average of the percentage of middle school students and the percentage of high school students?
10. Have students complete the questions on the activity handout:
    1. What headline did you write for the graph?
    2. Name three key takeaways after analyzing this graph.
11. Activity: What can we do?
12. In groups of three or four, students brainstorm potential courses of action for different stakeholders. What can the following groups of people do to take action or educate teenagers about vaping? Students should choose from one of the following groups:
    1. The state or federal government
    2. Local government and communities
    3. Pediatricians, nurses and other healthcare providers
    4. Parents and caregivers
    5. Students
13. Given students time to work with their group. If they are satisfied with their potential actions for one stakeholder, they can brainstorm another.
    1. Some ideas include: educational outreach programs, passing laws, continuing to track and monitor usage, restricting sales, etc.
14. Share solutions with the class. Ask:
    1. What is similar between stakeholders? …different?
    2. Which of these potential actions seems most feasible? Which of these potential actions seems most cost effective? Are these the same actions? Why or why not?
    3. What actions would you prioritize? Why?

Extension Activity:

1. Research current data around teenagers’ use of e-cigarettes and vaping products. Is it what you anticipated after participating in the first slow reveal graph? Why or why not? Does this change how your predictions for 2035? What do you think accounts for this change?
2. Write a letter to a local or state government official. What actions would you like to see that person take to decrease teenage use of e-cigarettes and vaping devices?

Citations:

• Belluz, Julia. “Survey: the epidemic of teen vaping continues to surge, unabated.” Vox. November 8, 2019. Accessed September 22, 2023.
• Centers for Disease Control and Population (CDC), “E-cigarette Ads and Youth.” Vital Signs, 2017. Accessed September 22, 2023.
• Miech, R., Johnston, L., O’Malley, P. M., Bachman, J. G., & Patrick, M. E. (2019). Trends in Adolescent Vaping, 2017–2019. In New England Journal of Medicine (Vol. 381, Issue 15, pp. 1490–1491). Massachusetts Medical Society. https://doi.org/10.1056/nejmc1910739
• Roane, Kit R. “Health Risks of Vaping: Lessons From the Battle With Big Tobacco.” Retro Report, November 16, 2020.

About the Author:

Jenna Laib is a math specialist at the Driscoll K–8 School in Brookline, Mass. She blogs about her practice at jennalaib.wordpress.com, and is the site curator of slowrevealgraphs.com.

Standards

Common Core Math Standards

• 6.RP.3 Use ratio and rate reasoning to solve real-world and mathematical problems, e.g., by reasoning about tables of equivalent ratios, tape diagrams, double number line diagrams, or equations.
• 7.RP.3 Use proportional relationships to solve multistep ratio and percent problems. Examples: simple interest, tax, markups and markdowns, gratuities and commissions, fees, percent increase and decrease, percent error.
• HSS.ID.C.7 Interpret the slope (rate of change) and the intercept (constant term) of a linear model in the context of the data.
• HSS.ID.C.9 Distinguish between correlation and causation.

College, Career, and Civic Life (C3) Framework for Social Studies

• D2.Eco.1.6-8. Explain how economic decisions affect the well-being of individuals, businesses, and society.
• D2.Eco.1.9-12. Analyze how incentives influence choices that may result in policies with a range of costs and benefits for different groups. 
• D2.Civ.1.6-8. Distinguish the powers and responsibilities of citizens, political parties, interest groups, and the media in a variety of governmental and nongovernmental contexts.
• D2.Civ.1.9-12. Distinguish the powers and responsibilities of local, state, tribal, national, and international civic and political institutions.
• D2.Civ.7.6-8. Apply civic virtues and democratic principles in school and community settings.
• D2.Civ.7.9-12. Apply civic virtues and democratic principles when working with others.
• D4.3.6-8. Present adaptations of arguments and explanations on topics of interest to others to reach audiences and venues outside the classroom using print and oral technologies (e.g., posters, essays, letters, debates, speeches, reports, and maps) and digital technologies (e.g., Internet, social media, and digital documentary).
• D4.3.9-12. Present adaptations of arguments and explanations that feature evocative ideas and perspectives on issues and topics to reach a range of audiences and venues outside the classroom using print and oral technologies (e.g., posters, essays, letters, debates, speeches, reports, and maps) and digital technologies (e.g., Internet, social media, and digital documentary).
• D4.7.6-8. Assess their individual and collective capacities to take action to address local, regional, and global problems, taking into account a range of possible levers of power, strategies, and potential outcomes.
• D4.7.9-12. Assess options for individual and collective action to address local, regional, and global problems by engaging in self-reflection, strategy identification, and complex causal reasoning.

Common Core Literacy Standards

• CCSS.ELA-LITERACY.RH.6-8.2 Determine the central ideas or information of a primary or secondary source; provide an accurate summary of the source distinct from prior knowledge or opinions.
• CCSS.ELA-LITEARCY.RH.6-8.7 Integrate visual information (e.g., in charts, graphs, photographs, videos, or maps) with other information in print and digital texts.