Ask a teen about e-cigarettes and the chances are good they will describe them as a safe substitute for smoking. With a fruit flavored vapor smell and the appearance of a thumb drive, they are being used in school hallways, bathrooms and at home. Their use has become cool, according to Bob Collett, Director of the Cape Cod Regional Tobacco Control Program.

"Kids believe the false notion that an e-cigarette is just flavored water vapor. But the truth is that these devices contain nicotine, even when labeled 'no nicotine,'" he said.

This year the U.S. Surgeon General issued an advisory describing the use of e-cigarettes by youth as an epidemic, according to the Barnstable County Department of Health and Environment. The advisory notes that "one in five high school students, and one in 20 middle school students, currently use e-cigarettes."

In a youth risk survey conducted in 2016, 40 percent of high school students reported having tried the devices.

"That's just remarkable," Collett said, adding "everyday use is at 25 percent for the high school population and that's frightening."

"Vaping, as it is commonly called, is not an alternative to smoking," said Harwich Health Director Meggan Eldredge. "It's a different type of poison." Along with Chatham and other towns on Cape Cod, Harwich has worked closely with Collett and the county to get out the facts about e-cigarettes to students and families. In 2017 the board of health updated its smoking regulations to include e-cigarettes and raised the age for purchasing the devices to 21.

"Teens feel vaping is the healthier alternative," Eldredge said. "The perception that these devices are less harmful is just not true."
Judy Giorgio, Chatham's health agent, agrees.

"These are gateways to cigarettes and other nicotine products," she said. "It is an addictive product." Last year Chatham also updated its tobacco control regulations to include e-cigarettes and raised the age to purchase the devices to 21.

Prior to the introduction of e-cigarettes, cigarette use by teens had been declining, Collett said. "The introduction of e-cigarettes is a direct response by the tobacco industry to the efforts to reduce youth smoking."

In many cases, teachers, administrators and parents were caught off guard. "These devices look like flash drives, pens, even lipstick," Collett said. "They don't look like a nicotine delivery device. And when the user exhales, you may smell a faint fruity smell but you might never suspect it was an e-cigarette," he added.

Most parents aren't aware that the users "are not the usual suspects. These are members of the choir, key club, basketball teams," he added. "They think its harmless."

Collett stressed that vaping nicotine is not a harmless practice. "Nicotine exposure during adolescence can harm the developing brain – which continues to develop until about age 25 – and impact learning, memory and attention. The data show that youth who are using these products are likely to turn to combustible tobacco products after becoming addicted to e-cigarettes. Don't assume your kids aren't using it. This is an epidemic and even the top student leaders are attracted to the devices."

For more information, go to the Massachusetts Department of Public Health Website at www.makesmokinghistory.org or the Campaign for Tobacco Free Kids at www.tobaccofreekids.org.