State health officials and a community organization are alerting the public to an alarming increase in the use of electronic cigarettes among Hawaii’s youth.

Findings in a 2013 Hawaii Youth Tobacco Survey revealed that although smoking of traditional cigarettes has declined, the use of e-cigarettes tripled among public high school students and quadrupled for middle-school students from 2011 to 2013.

"Just in a short two-year period, it has gone up dramatically," said Tonya Lowery St. John, epidemiologist with the Department of Health’s Chronic Disease Prevention and Health Promotion Division, at a news conference Wednesday.

The youth tobacco survey is conducted every two years among public school students in grades six-12 by the state Health and Education departments in collaboration with the U.S. Centers for Disease Control and Prevention.

Survey results showed high school students who have tried e-cigarettes jumped to 17.6 percent in 2013 from 5.1 percent in 2011. For middle-school students, those who say they tried e-cigarettes surged to 7.9 percent from 1.8 percent during the same period.

Experimentation and use of other nontraditional tobacco products such as tobacco in water pipes or hookahs and roll-your-own cigarettes are increasing among youth as well.

The study also revealed Hawaii’s youth are using e-cigarettes more than their peers on the mainland.

During the news conference, St. John said Hawaii’s enforcement on prohibiting the sale of cigarettes to youth and high taxes on cigarettes are going to make e-cigarettes a much more attractive option to them.

Officials are working to dispel the notion that electronic smoking devices are safe.

"When we go out and talk to kids about e-cigarettes, 9 out of 10 have no idea that it’s bad for them," St. John said.

Lola Irvin, manager of the Chronic Disease Prevention and Health Promotion Division, said, "You can be sure that these are not safe products. They have nicotine, which is highly addictive, which can be passed through your skin and it can result in nausea, dizziness, and for young children, especially, poisoning."

More than 7,000 different flavors of e-juices — liquid nicotine in the e-cigarette cartridge — are marketed by the tobacco industry to attract youth. Flavors include bubble gum, chocolate cake and cotton candy.

The industry is inundating youth with advertisements via email, social media or text messages, offering coupons for products.

In a recent study, researchers said the billowy substance emitted from the e-cigarette should not be referred to as vapor.

"This is not water-based in terms of what you see," Irvin said. "When you see that puff, those are chemical microscopic particulates, and so some researchers have gone as far as to refer to them as air pollutants. Others referred to them as aerosolizing."

To follow the study’s recommendations, Irvin said the Health Department will refer to them as aerosols.

Experts say the particulate concentration in electronic smoking devices is higher than in conventional cigarette smoke.

Over the past month, the Coalition for a Tobacco-Free Hawaii said, there has been a dramatic increase in calls from teachers and administrators requesting that the organization visit their schools to educate students about the dangers of e-cigarettes. Executive Director Jessica Yamauchi said schools are realizing that there’s a problem.

Last year, the Department of Education passed a policy that makes e-cigarettes contraband. A student can face disciplinary action if he or she brings the product on campus.

To address the problem, the coalition plans to propose legislation requiring vendors, retailers and distributors to obtain a license to sell tobacco.

"That would help us track who is selling them," said Yamauchi.

They are also looking into proposing warning labels on e-cigarettes and child-proof type packaging for the e-juices.

Last summer, Hawaii County became the fourth municipality in the country to raise the legal age to purchase tobacco products to 21. The new law includes banning anyone under 21 from buying e-cigarettes.

Yamauchi emphasized that parents need to talk to their children about the dangers of e-cigarettes and also educate themselves about the various types of electronic smoking devices out there. During the news conference, Yamauchi held up an e-cigarette that was the size and shape of a pen.

"Kids can sneak these in the classroom easily without anybody realizing it. If this fell out of your kid’s backpack, would you know what it is?"

They are not harmless devices, she said.

For more information on the 2013 Hawaii Youth Tobacco Survey, go to the Hawai’i Health Data Warehouse website at www.hhdw.org.