Photo by Jenny Kirk Local Statewide Health Improvement Partnership (SHIP) coordinator Jennifer Nelson discusses the dangers of using electronic cigarettes to the Marshall ACTS (alcohol, chemicals, tobacco and substances) group recently at Marshall High School.

MARSHALL — Minnesota teen tobacco use is up for the first time in more than 15 years and experts believe that it’s because of the growing popularity of electronic cigarettes — a trend that is considered especially harmful to children, teens and young adults.

One in four middle school and high school students in Minnesota had tried E-cigarettes — which are battery-powered devices that heat an e-liquid sometimes called an e-juice — according to the Minnesota Department of Health’s 2017 Minnesota Youth Tobacco Survey.

The survey also found that nearly 20 percent of high schoolers used E-cigarettes, compared to more than 9 percent who use regular cigarettes.

“A lot of youth think (E-cigarettes) aren’t harmful, but they are,” Southwest Health and Human Services public health educator Jennifer Nelson said. “They have nicotine and lots of other chemicals in them. There is lead, nickel and other things in there that are very harmful to them. When youth are vaping, it affects their learning, their memory and their cognitive abilities because their adolescent brain continues to grow and change until their mid-20s.”

Also known as JUULs (pronounced “jewels”), e-cigs, vapes and hookah pens, E-cigarettes prime the adolescent brain for addiction by stimulating the pleasure centers of the brain.

“Kids do it for the nicotine buzz, and once you do it, that nicotine goes into your brain, which has a reward-type sensor in it,” Nelson said. “So once you get it, you like it. So the more you do it, the more you like it and the more you want it.”

Through a Statewide Health Improvement Partnership (SHIP) grant, Nelson educates small groups of people at schools, worksites and other places throughout communities in six different counties.

“Vaping is on the rise everywhere in Minnesota, so one of our strategies has to do with tobacco,” she said. “This is the highest tobacco use has been in 17 years, so we’re trying to get out there and educate the youth and parents on what E-cigarettes are and what vaping is. We do that so they’re aware and know there are health risks with it.”

On Wednesday, Nelson spoke to Marshall High School ACTS (alcohol, chemicals, tobacco and substances) members, who will be giving tobacco presentations to middle school students in the community this spring.

“The liquid is what contains the nicotine and other chemicals,” Nelson said. “(The E-cigarette) heats that liquid and then people inhale that. It goes into their lungs. Users think they’re not harmful because they don’t smell like tobacco and don’t look like regular tobacco and because they’re flavorful. They come in over 7,000 flavors now.”

Vape juice comes in fruit flavors, coffee flavors and candy flavors like Skittles, bubble gum and cotton candy. A simple Google search can also produce unique names such as: smurf cake, unicorn milk, hawk sauce, cowboy cooler and Hannibal Nectar.

“According to the 2017 survey, 26 percent of high school students reported using tobacco products in the past 30 days,” Nelson said. “And when they asked them why, 60 percent said because the flavors are appealing. So it goes back to the marketing by the tobacco companies.”

Nelson said large tobacco companies target youth because vaping often leads to smoking regular cigarettes and if individuals don’t start smoking by the age of 21, they’ll rarely become smokers later on — more than 80 percent of adult smokers had their first cigarette before they turned 18 and nearly 95 percent started smoking before age 21, according to the National Survey on Drug Use and Health.

“The big cigarette companies know that people usually start to smoke regular cigarettes when they’re under 21, so they market to the youth,” Nelson said. “The R.J. Reynolds Tobacco Company bought shares into JUUL, which is the most popular vape right now. They bought shares into that now because they know that’s the new and upcoming trend.”

While Big Tobacco seems to be obsessed with hooking teens — a market strategy that contributes to billions of dollars in profits a year — experts warn that E-cigarettes have not been proven as a safer alternative to regular cigarettes.

“There have been studies done on all E-cigarettes and some that say they have zero nicotine but still have nicotine in them,” Nelson said. “And the reason that can happen is because they’re not FDA (Food and Drug Administration) approved. So it’s very scary because you really have no idea what’s in them.”

Some flavoring have also been found to contain diacetyl and acetyl propionyl, which have been linked to lung disease. Nelson said vaping can also cause oral health concerns, such as gum recession, gum disease and burns within a user’s mouth.

“E-Cigarette aerosol can irritate the throat, nose and eyes as well,” she said. “It can cause sore throats and nosebleeds and (users) are also more likely to catch colds or the flu.”

There’s also unintended injuries to consider. In February, an exploding vaporizer pen resulted in the death of a 24-year-old man from Texas. In her PowerPoint, Nelson showed a photo of an individual with severe burns to his leg.

“The person, I believe, had an E-cigarette in his pocket and it blew up,” she said. “So they’re not always the safest.”

Nelson also shared that research also showed that emergency room visits in the United States had went up 1,400 percent in the last years due to E-cigarettes.

“It’s because toddlers and kids were getting into E-cigarette juices and because they’re not FDA regulated, they don’t have the safety caps on the bottles — and a teaspoon of that e-liquid is fatal to a toddler.”

People of all ages can also be affected by second- and third-hand smoke, but small children and toddlers are most at risk.

“When you vape, there is second-hand smoke is there’s that cloud of smoke that comes out just like regular cigarettes,” Nelson said. “And if I’m vaping in here and that aerosol lands on the table and someone comes up and is doing something on the table — they wipe their hand on it and then they’re wiping their face or eating — they’re going to get that third-hand smoke. They, in turn, are going to ingest those chemicals.”

While it’s not only unhealthy, it is illegal for anyone under 18 to purchase, possess or use an electronic delivery device.

“It’s the same as tobacco,” Nelson said. “You have to be 18 in Minnesota. The good news is that the state of Minnesota is trying to pass a Tobacco 21 Law right now and it’s in legislation. That would mean you have to be 21 to purchase tobacco, which would greatly reduce our vaping issue.”

For parents, teachers and others who interact with teens regularly, it can be difficult to identify suspected users and the many different devices they might utilize.

“It doesn’t always have a smoke cloud or a vape to it, so it’s easy to conceal,” Nelson said. “And a lot of different tobacco products can look like everyday products.”

Tobacco products are often designed to look like candy, such as gum, mints and fruit roll-ups, as well as school supplies, such as pens, highlighters and USB flash drives.

“They can be very easy to disguise,” Nelson said.

The 2017 survey also revealed that 57.4 percent of the high school students had seen ads for E-cigarettes on TV in the past 30 days. Nelson said the various social media sites would undoubtedly have similar advertisements.

“I think it’s good that we teach the younger kids all about vaping because it’s put in their face a lot with social media and everywhere,” MHS junior Hugo Cifuentes said. “It’s important to just let them know more about it — not show them really detailed stuff about it — but more like speaking about it and how they need to make good choices. Once they get to the high school, it’s just there, and that they don’t have to use chemicals to be accepted.”

To combat the over-abundance of negative marketing attention toward teens, MHS senior Ashley Arndorfer said she planned to create positive videos regarding dealing with the subject matter.

“I do a lot of videos, so I think that would be good,” Arndorfer said. “I’d correlate some of the stuff I learned and make it fun so kids will actually pay attention to the video. We’ll also present something to the seventh and eighth grade. We’ll definitely include all the information we learned today.”

Arndorfer said she was surprised to learn the truth about vaping.

“I never knew all this,” she said. “I always believed all my friends when they’re like, ‘Oh, there’s no nicotine in this, blah, blah, blah. But if it’s not FDA approved, I feel like we need to present this to the full high school, too, so they’re checking on it or not doing it in the first place. That would be even better.”