Tantalus resident Isaiah Higuchi started vaping after high school while he was still in his teens.

The 21-year-old began using electronic devices when his mom wanted him to stop smoking cigarettes, a habit he started at around 14, he said.

“My mom didn’t like it. She’s like, ‘Why don’t you just vape.’ I got to listen to my mom. She’s like, ‘It’d be a little bit safer,’” Higuchi said. “At the time that was like the new way of smoking. It’s less harmful to your body than a cigarette in a way, ‘cause the cigarette has like thousands of toxins and poison.”

Higuchi is among a growing number of local youths and young adults turning to vaping, which has been linked to 805 cases of severe lung injuries in one U.S. territory and 46 states, including Hawaii.

State health officials confirmed last week Hawaii’s first case of severe respiratory illness related to e-cigarettes in a Hawaii island youth who was hospitalized. More than a dozen deaths associated with vaping — double the number than just two weeks ago — now have been confirmed in 10 states, according to the U.S. Centers for Disease Control and Prevention.

“People are getting just after-market things … so that’s why I feel like these kids are dying. They’re buying illegal products,” Higuchi said. “They don’t know what they’re smoking.”

Hawaii ranks second in the nation for e-cigarette use among high school students, with an estimated 25.5% currently vaping, twice the national average, according to Health Department statistics. E-cigarettes are even more prevalent on the neighbor islands, with as many as 34% of high school students using the devices.

State health officials expect to see a spike from the past two years in the number of youths who vape.

Lola Irvin, Department of Health administrator of the Chronic Disease Prevention and Health Promotion Division, said the alarming trend is expected to worsen as e-cigarette devices become more sophisticated and gain popularity among children across the state. The electronic devices, which have yet to be approved by the U.S. Food and Drug Administration, heat liquids that could contain nicotine, marijuana, flavored chemicals and possible toxins that turn into a vapor that is inhaled.

“We suspect that it’s increasing because of the response we’re getting from teachers and students and the concerns being raised. Most recently we’ve heard of second and thirdgraders using e-cigs in the classroom,” she said. “The concern is that kids do not realize these are dangerous. They come in fun flavors and … they’re addictive.”

What’s more, health officials say, the devices are easily available from friends at school or online and are easy to hide. The most popular devices known as pods — cartridges that contain flavored nicotine or oils that contain cannabinoids (CBD) or tetrahydrocanna­binol (THC), the psychoactive component of marijuana — look like pens or flash drives that plug into computers when charging. The cartridges, which have enough nicotine to equal 20 cigarettes, are being promoted on social media and at events called “pod parties” that attract young kids, Irvin said.

“That’s a lot of nicotine and the brain is developing until age 25. Nicotine is highly addictive and also primes the brain for more addiction,” she said. “We don’t know what long-term health consequences these young people will face.”

Vape shops

About 660 electronic vaping retailers have registered in Hawaii over the past year, according to the state Department of the Attorney General. State law prohibits those younger than 21 from purchasing vape products.

“It’s the parents or friends who are 21 or over who are purchasing these vape products for the kids and then giving it to them. Most vape shops here, they’re on the up and up. There’s always one or two rogue shops and it just gives everybody else a bad name,” said Tina Yamaki, president of Retail Merchants of Hawaii, which has 200 retail members. “If parents come in and buy something and walk out of the store, we don’t know what they do with the merchandise afterward. Once we sell the vaping device, we don’t know what people put in it either.”

Kevin Ramirez, coordinator of the Hawaii Public Health Institute’s 808 No Vape campaign, which began in 2017, said elementary school teachers and principals are “busting kids as young as the third grade for vaping in school.”

“Kids as young as fifth grade are dealing vape supplies in their schools and also being able to purchase in their communities,” he said. “We need adults to be fully aware of the risks and dangers of these products. Their attitude is my kid could be doing worse drugs or could be smoking cigarettes so I‘d rather them vape.”

Toxic chemicals

The chemicals used by “vape juice” companies have been approved for human consumption by the FDA, however, they’re not safe to use as inhalants, and “that’s the big loophole,” Ramirez said.

“Some of these chemicals are really toxic. People are ending up having lung injuries, collapsed lungs and pulmonary issues with all these mysterious chemicals,” he said. “We have a crisis here with young people vaping and getting sick. We are up against a billion- dollar industry. The tobacco industry, we know that they have enough money to spend a million dollars an hour on marketing. The 808 No Vape campaign had half a million dollars to spend in two years. You can just imagine the David-and-Goliath type of scenario we’re in.”

Kahala resident Russell Chinaka, 27, who began vaping about five years ago after cigarettes caused her respiratory problems, said he stays away from cheap black market products and illegal juices.

“I try to only vape the good stuff like from America. The cheaper juices have the dangerous stuff in it so I try to stay away from that,” he said. “I have a bunch of friends that vape the regulated devices … and they’re fine but there’s other people that try to find the cheapest way to get that high. I think that’s where it gets really bad. I think it is a better alternative if you do it the right way.”

Nationally, the popularity of vaping among teenagers continues to soar, more than doubling in the eighth, 10th and 12th grades this year from 2017, according to federal health officials. A recent survey showed that 1 in 4 high school seniors use e-cigarettes, as do 1 in 5 10th graders and 1 in 11 eighth graders.

The National Tobacco Youth Survey said e-cigarette use rose to 27.5% from 20% last year among teenagers who answered questions about the habit in the last 30 days.

“We all could die from it. It’s still fairly new. It might be killing us, we don’t know,” Higuchi said. “It’s life. What’s life without risks?”