“With e-cigarettes, we don’t really have an education campaign going on," Rich said. "No one is talking to kids about it, and we’ve got talk to kids about it.”
Young people who use e-cigarettes, but have not used traditional cigarettes, are significantly more likely to smoke cigarettes in the future, according to the Tobacco Prevention and Control Branch of the North Carolina Department of Health and Human Services.
Although traditional cigarette use has fallen in the past decade among young people in North Carolina, the rise in popularity of e-cigarettes has presented a new challenge for health officials.
E-cigarettes pose particular health risks to young adults because of the negative effects nicotine can have on a developing brain, said Sally Herndon, the head of the North Carolina Department of Health and Human Services Tobacco Prevention and Control Branch.
“Nicotine can cause learning problems, including memory and attention problems, behavioral problems and can increase the chance of future addiction," she said.
Since many e-cigarettes and vapes lack quality and manufacturing standards, the NC Prevention and Control Branch also noted it can be difficult for users to know how much nicotine they are consuming, which may increase their risk for toxic exposure and nicotine poisoning.
The Tobacco Prevention and Control Branch reported that between 2011 and 2015, e-cigarette use among high school students in North Carolina increased 888 percent. Electronic cigarette usage increased by 600 percent among NC middle school students during the same time period.
Health officials and students alike agree that advertisements that depict e-cigarettes as a sleek, healthy and tasty alternative to traditional tobacco products have contributed to their popularity and use among young people.
“I think a lot of the reason why vapes have gotten more popular in recent years is the social status that comes with it, and how the media portrays it,” first-year Tony Elsea said.
Herndon said the appeal of a new technological device, as well as celebrity endorsements of the vapes and e-cigarettes, are also contributing to their popularity.
“In some ways they’re taking things out of the old cigarette playbook, and re-inventing them for e-cigarette promotions,” Herndon said.
The North Carolina General Assembly has provided funding for an awareness campaign to educate young people in the state about the health effects of e-cigarettes as part of Vision 2020, a larger initiative to reduce the health and economic burdens of tobacco across North Carolina.
This year, the campaign will primarily focus on raising awareness about the health risks associated with e-cigarette use among the college-aged demographic, who are likely to influence younger children. Next year, however, Herndon said that emerging research from UNC’s Gillings School of Global Public Health will help inform health officials about the best ways to message the health risks of e-cigarettes to younger populations.
In an emerging effort to address e-cigarette use in schools across North Carolina, the Department of Public Instruction is working closely with the Tobacco Prevention and Control Branch to update and modernize the tobacco-free signage in schools to include e-cigarette and vapes.
April Richard, Tobacco Prevention and Control program coordinator for the Orange County Health Department, stressed the importance of these new signs and said the county is currently ordering new signage for its schools.
“It is vastly important that our youth are not seeing tobacco products being used in an environment in which they spend half of their day — school," Richard said.