GPB's Ellen Eldridge reports on vaping associated risks to young people.

Despite raising the age to buy tobacco and e-cigarettes to 21, teenagers and even preteens are still at risk of exposure and addiction to vaping, pediatric pulmonologist Dr. Christy Sadreameli of Johns Hopkins says.

“(Vaping) is the most common way that young people are using tobacco products and getting hooked on nicotine, which can be a lifelong addiction,” she said.

Georgia’s high school vaping rate is 17%, according to 2019 data from the Centers for Disease Control and Prevention, which is lower than the national average of 27%. One in 10 middle school students nationwide currently use e-cigarettes.

In 2018, the state ranked 47th in the nation for funding programs to prevent children from using tobacco, according to a report that looked at what states did with money from the 1998 tobacco settlement. While lawmakers passed a tax on e-cigarette products this year, Georgia continues to have one of the nation’s lowest taxes on tobacco products at just 3 cents per cigarette pack, and that money isn't going toward prevention.

Georgia ranks 48th out of 50 for the lowest cigarette tax in the nation.

MORE: Study Says Georgia Ranks Near The Bottom For Teen Smoking Prevention

Another recent study, published in the Journal Preventative Medicine, links youth vaping to tobacco imagery on television.

The use of e-cigarettes by teens has seen an exponential increase of 135% over the last two years, equating to 2.4 million new teens using e-cigarettes.

Vape products make it easier for young smokers to hide what they are doing, Sadreameli said, because the devices can look like a USB or a charger and is easily passed between friends.

“They're easily disguised,” she said. “They don't emit a strong tobacco scent that parents and teachers would recognize.”

One of the risks of using e-cigarette products is a newly recognized disease called EVALI (e-cigarette, or vaping, product use associated lung injury). Last fall, the Georgia Department of Public Health identified 42 cases of EVALI and six Georgians died of the disease.

But officials banned “black market” products, some of which contained vitamin E acetate, Sadreameli said. In January, the U.S. Food and Drug Administration finalized its ban on unauthorized e-cigarette products, and cases of EVALI slowed.

Only one “probable” case of EVALI was identified in Georgia in March, DPH spokeswoman Nancy Nydam said in an email.

But Sadreameli, who is based at Johns Hopkins, said cases of EVALI still exist, though rarer.

“We do see kids presenting with asthma who never had it before and the only thing that changed was using e-cigarettes,” Sadreameli said. “And the long-term effects, we still don't know. So, while we're glad to see less of EVALI, it's not like we never see it anymore.”

The American Lung Association launched a “Get Your Head Out of the Cloud” youth vaping awareness campaign this week to educate people about the ongoing dangers of tobacco and raise awareness of the continuing problem of youth addiction.

“One of the reasons for this campaign is to let parents of 10 to 14 year olds know that this is a window of time where, potentially, the child has not even tried e-cigarettes yet, or maybe they've tried it, but they're not hooked yet,” Sadreameli said. “And it's really a good opportunity for parents to talk to their to their young people, their young teens and preteens about the damage and the effects of e-cigarettes.”

Youth who use e-cigarettes are four times more likely to try a cigarette and three times more likely to become frequent cigarette smokers, according to the ALA.

With stress being a key driver for kids to start vaping, and amidst a pandemic where those who smoke or vape are at a higher risk of more severe symptoms from COVID-19, now more than ever, it’s critically important to educate parents on how they can intervene and prevent their kids from vaping, the nonprofit said.

“This can affect their brain development, their cognitive development,” Sadreameli said. “It can lead to lifelong nicotine addiction.”

Many teenagers and even preteens also fail to realize the products that are so popular among youth contain very high levels of nicotine, she added.

Sadreameli said e-cigarettes and inhaled tobacco add to lung inflammation, which could exacerbate the effects of COVID-19.

“If possible, it's better to not take any chances with that,” she said.

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