Table 3.

Qualitative Themes from Interview with School Leaders (N = 20)

Theme	Description	Representative Quote
Challenges	School leaders described challenges of vaping in schools to include frustration from their teachers or school district to fix the problem and overwhelmed by the task. Many described students as one step ahead of them by concealing the devices and use. Many were overwhelmed or were hopeless in their attempt to address youth vaping in their schools.	I need parents involved. I need community members involved. I need especially those that know have seen the effects of those devices and so, I need more of those people involved. I really need a committee to stop it. They expect me to do it alone, and it’s such a daunting task with all the other things that we do in a day. #10 We have for the past few years had a major problem with kids vaping. That is definitely what we discipline the most is vaping. #13 My teachers are really frustrated. They want me to wave a magical wand and fix it, and I can’t. Some are not always so helpful in their criticism. They want me to literally strip search a kid, and I'm like, “Ain’t no way I'm looking in their bra, or their underwear, behind their belt buckle.” Their suggestion was to put myself in every bathroom between classes, and I'm like, “We literally have 15 bathrooms. That’s not even possible.” And then they're like, “Well, we'll take turns going in there.” I'm like, “You literally can’t go stand in a stall with a kid.” So, it’s just a frustration for everybody. #19
Reactive vs. Proactive Responses	Almost all participants explained that their current policies and procedures were reactive, including punitive measures when students were caught vaping, with few discussing proactive measures to prevent use or create healthy alternatives for students who wanted to quote.	Well, as far as the consequences the student gets a citation, especially if we find the vape. They also get disciplinary consequences in our school for 3 days and usually those are either out-of-school suspension or in-school suspension, depending on if it’s the first offense or second offense. #5 Right now it’s (school policies) all punitive. There's nothing there to deter them…. I just wish there was a way we could be more proactive instead of just, yeah, we catch you with it and slap you on the hand and send you on the way….we've got to find a way to be proactive whether that’s the first day of school, whether that’s once a month, where that’s getting more help from our parents…I mean it’s a good policy, but it’s not, it’s not deterring. #18
Education and Prevention	Many participants stated that they needed more education and prevention opportunities, but some were apathetic about the effectiveness of current strategies. Educational needs included those for students, parents, and teachers.	Students This year was one of the worst years that we've had. It was pretty bad. We're trying to do different things, different approaches, different consequences. Working more on, not just consequences, but also education, anything that we can do to prevent the use and start of it. A lot of the kids that I I had conversations with this year . . . [talk about] their struggles with being addicted and just how they had tried to quit so many times. . . It’s a major problem, and it’s not just here. #20 Parents We definitely need parents to be more involved. We've had incidents where kids are bringing their parents’ product. #2 Teachers I can’t think of any training that’s offered to them [teachers]. #2