SALT LAKE CITY — If you're a kid these days, cigarettes have never been more unpopular.
"You can pretty much ask any teenager: It is very, very uncool," said Davis High School senior Carson Robb, who called the idea of ashtrays and the smell of cigarette smoke "disgusting."
But when it comes to e-cigarettes — battery-powered devices that deliver nicotine and flavoring through clouds of water vapor and have to be charged "just like iPhones" — they have never seemed more appealing, said Robb, who is creating a club called SAEV, or Students Against Electronic Vaping.
New data from the Utah Department of Health and Utah Department of Human Services are adding to public health officials' fears that youths are increasingly turning to e-cigarettes.
Results from the state's biennial Student Health and Risk Prevention survey shows that 56 percent of Utah youths who reported recently drinking alcohol also reported using e-cigarettes or vape products.
Just 26 percent of those same students reported using traditional cigarettes.
"It's a big number," said Brittany Karzen, a spokeswoman with the health department's tobacco prevention and control program.
Karzen said health officials believe the allure of e-cigarettes is reaching beyond those kids who are at high risk and into teens lower on the spectrum.
"Because these products have been talked about and looked at as a safe alternative, or safer, these kids might be thinking, 'Hey, it's not that bad. My friend has it. I'm going to try it too,'" Karzen said.
E-cigarette use among adults is hotly debated in medical circles. In the U.K., a prestigious medical panel released a report encouraging their use as a healthier alternative to traditional cigarettes.
Many doctors in the U.S., however, remain wary of the potential to normalize smoking to children.
"In terms of our adult population, if somebody has gone from smoking cigarettes to smoking an e-cigarette, that's probably a good thing," said University of Utah Health Care cardiologist John Ryan.
Ryan's concern, he said, is the appeal that the devices pose to youths.
"How will that translate into an older population? Are we creating another generation of people who are going to become dependent and addicted to nicotine?" he said.
In contrast with traditional cigarettes, e-cigarettes are not a tobacco product.
Instead, the devices deliver nicotine through water vapor by heating up cartridges of "e-juice," which is why the U.K.'s Royal College of Physicians recommended it as a smoking cessation tool.
Supporters of the e-cigarettes have long said they do not support selling to kids. In Utah, it is illegal to sell e-cigarettes to anyone under 19.
"We're concerned anytime anybody underage and anybody who's a never-user picks one up," said Aaron Frazier, executive director of the Utah Smoke-Free Association. "That should never happen."
Frazier said Utah is doing more to prevent youths from accessing e-cigarettes than other states, including banning online sales of vaping-related products.
He said the Utah Smoke-Free Association, which represents about half of the e-cigarette retailers across the state, has also pushed for retailers to employ ID scanners at the point of sale.
Frazier expressed skepticism about fears that teens who use e-cigarettes will graduate to traditional cigarettes.
He noted that researchers who looked at the nationwide survey data last year found that three-fourths of high school seniors who reported using e-cigarettes had previously smoked traditional cigarettes. The researchers noted that nonsmoking high school students are "highly unlikely to use e-cigarettes."
"It shows this whole gateway theory is false," Frazier said. "It doesn't exist."
According to the health department, Utah students also reported similar levels of alcohol and e-cigarette experimentation (23 percent) and comparatively low levels of traditional cigarette experimentation (13 percent), according to the Utah Department of Health.
Just 3 percent of Utah students reported current cigarette use, 9 percent reported current alcohol use, and 11 percent reported current e-cigarette use.
Karzen said e-cigarettes pose a challenge to public health officials who oversaw a historic decline in traditional cigarette use and now have a "different animal" to tackle.
"Our youth tobacco rate is 3.4 percent, so obviously the way we've talked about that has worked," she said. "Now the question is: Can we talk about e-cigarettes in the same way or do we need to find different ways to approach the problem?'"
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