As vaping and e-cigarettes become more popular with teens, some worry that they are being led down a dangerous path.

When electronic smoking devices were first introduced, they were marketed as a possible solution to help deter adults away from cigarettes and nicotine addiction. And while some folks did ditch tobacco to give them a try, so, too, did many of today’s youth. Now, some experts feel these teenagers are clouding their judgment by thinking what they are inhaling is inherently safe. What’s more is the fear that parents are even further in the dark—especially since there are also kids who have gravitated toward “vaping” highly concentrated THC oil to get high.

Vaporizers, e-cigarettes and vape pens are interchangeable terms among younger teens representing one object: an electronic device containing inhalable liquid. While cigarette use in the U.S. has had a huge decrease in middle school and high school students since 2011, electronic cigarette use has increased within the same time period.

As more research is done on vaping, the devices remain uncertified by the FDA as a quit-safe measure. And while some adults have turned to the devices in hopes to kick their pack-a-day habit, local authorities and physicians are concerned that they are having the opposite effect on teens, turning them onto smoking, and forging a new pathway to addiction.

The Florida Youth Substance Abuse Survey of the Orange County middle and high schools showed about 3 percent of middle school students and almost 9 percent of high school students smoked e-cigarettes in the past 30 days.

An increasingly popular electronic cigarette called Juul, which at first glance might look like a flash drive, has become a new phenomenon with teens. They are easily found in convenience stores, online and area vape shops, and they can be concealed in the palm of your hand, making them even more attractive to kids looking to sneak a puff in between classes, in the home or out in public.

The Attraction to Vaping
Imagine your favorite flavor of candy, a delicious snack or refreshing drink and it’s probably one of the thousands of flavored e-liquid options for vape pens. A leading reason vaping is becoming more prominent among teens is the appeal of varieties such as vanilla or bubble gum. The whimsical flavors almost mask the reality that some ingredients inside are harmful, even if there’s no nicotine in the mixture.

In May, the FDA sent out 13 letters to companies selling e-liquids that had packaging resembling other products, ultimately misleading buyers. These flavors included whipped cream cartridges bordering a mini Reddi-wip can, apple juice box packaging similar to kids’ juice boxes and packaging resembling a soda can.

“This is absolutely targeted for youth. They have something that looks like the Sour Patch Kids,” says Carol Burkett, director of the Orange County Drug Free Office. “And if you don’t look closely as a parent or an adult or caregiver, you won’t know.

“A statistic that was out nationally said that more than 85 percent of e-cigarette users age 12 to 17 use flavored e-cigarettes, and they said flavors are the leading reason for youth to use,” Burkett says. “I thought that was pretty alarming.”

A Risky Alternative to Cigarettes
For teens, the multitude of flavors might make vaping seem like a fun and harmless activity, but there are consequences that minors might not have the knowledge to show discretion.

No matter the age, the same amount of damage is being done to teens’ lungs. Dr. Akinyemi Ajayi, pediatric pulmonologist and medical director at The Children’s Lung, Asthma and Sleep Specialists, says while there are more harmful toxins in traditional cigarettes, ingredients in vape pens such as diacetyl, nickel and chromium severely damage the lungs.

“One of the problems with a vape pen is that some of them come with different high voltage, low voltage in terms of the rate at which they burn the vape liquid,” Ajayi says. “And the ones that are actually capable of burning faster and at a higher temperature actually create more dangerous chemicals that create more damage to the lungs.”

One health concern that has arisen with the usage of vape pens is the risk of developing oral cancer and lung cancer due to the carcinogens in the devices, whether the e-liquid contains nicotine or flavoring only.

A rare but more serious condition called bronchiolitis obliterans is in connection with the ingredient diacetyl, which is associated with causing significant scarring to the lungs’ small airways. The term is more commonly referred to as popcorn lung. The irreversible lung disease causes coughing, wheezing and shortness of breath, according to the American Lung Association.

Dr. Floyd Livingston, chief of pulmonary medicine at Nemours Children’s Hospital, says doctors are also seeing a lot of asthma in adolescents and teens who smoke vape pens.

“It’s a little different than regular tobacco smoking,” Livingston says. “There [are] just chemicals in vaping that kind of promote different inflammatory reactions in lungs that sometimes can make certain patients with asthma exacerbate a lot more or have more attacks.”

However, Ajayi mentions that the lack of data with vaping makes physicians question how the product will affect younger people in the long term. 

Face to Face with the Law
Another concern with vaping is the risk of minors becoming addicted at a much younger age. Being exposed as an adolescent increases the possibility teens will develop a habit that could lead to possibly wanting the higher nicotine intake found in traditional cigarettes.

“This came out of the surgeon general’s report that said that nicotine can prime the brain’s reward system, putting those people that vape at risk for addiction to other drugs like methamphetamine and cocaine,” Burkett says.

Not only do nicotine and toxins exist in e-liquid, but minors in other parts of the country are getting their hands on e-liquids laced with THC oils. The marijuana concentrate contains 40 to 80 percent higher amounts of THC than flower. The oils have no odor aside from the scents e-liquids give off making it impossible to tell between the two.

Counselor and addiction specialist John Cox, who works with House of Hope in Orlando, says marijuana potency has escalated and that kids aren’t intellectually developed enough to understand the drugs and will try anything without a second thought of what might be inside. Although everyone’s genetic makeup is different, Cox believes vaping can lead to a curiosity in other drugs, especially with the potency of THC oil.

“What’s sad right now is … it’s much easier to get fentanyl mixed into things because it’s not regulated with whatever they want to smoke,” Cox says. “It’s a suicide mission.”

The FDA regulates tobacco products that were on the market as of May 2016 but have yet to put regulations on the newer devices made after that point. Some e-liquids with just flavoring were tested and had small amounts of nicotine in them, according to Burkett.

While other states have more advanced policies and laws for minors smoking vape pens, Central Florida is learning and enacting policies before the trend becomes uncontrollable.

Orlando Family Magazine reached out to several area police departments and local schools, and both officers and school staff said they don’t have enough information on the trend but are keeping a close eye on things.

Florida is already ahead of the game by enforcing new laws. For those selling or giving electronic cigarettes to anyone underage, it’s considered a second degree misdemeanor and if there is another violation within a year of the first, it will be considered a first degree misdemeanor. A non-criminal violation is given to a minor who’s in possession of the electronic smoking device. A minor’s first violation receives 16 hours of community service or pays a $25 fine.

Ajayi and Burkett both agree that parents should keep an open conversation with their children about vaping and Ajayi says it’s never too early to start the conversation.

“I see seventh grade kids who actually know what vaping is,” Ajayi says. “Which I know it might sound like a funny thing, but that’s not really funny when a seventh grade kid can tell you, ‘Oh, yeah my classmates talk about vaping.’”

This article originally appeared in Orlando Family Magazine’s August 2018 issue.