Attention parents: That USB drive for back-to-school might be an e-cigarette

Double-check that "USB drive" in your teenager's back-to-school supplies - it might be an e-cigarette. That's the message the New York State Smokers' Quitline wants to send parents of teenagers as another school year begins across the state.

Electronic nicotine delivery systems (ENDS) are intended to be an alternative to combustible cigarettes for adults and even serve as a device to help traditional smokers transition to a tobacco-free lifestyle. ENDS such as e-cigarettes are increasing in popularity among teenagers in New York. In addition, many devices resemble USB drives, making it difficult for parents to detect on first glance. According to the New York State Department of Health, the number of statewide high school students using ENDS doubled in two years, with an increase from 10.5 percent in 2014 to 20.6 percent in 2016.

The New York State Smokers' Quitline would like to educate parents of teenagers about the following ENDS facts as school starts again:

•ENDS are easy to use and easy to hide. One of the most popular ENDS, called JUUL, looks like a USB drive and even charges in a USB port. These devices are easy to quickly puff during school and easy to hide in clothing and backpacks. Countless social media videos promote "JUULing" accessories and tricks.

•Thousands of flavors entice teens to ENDS. A major reason for the increase in popularity of ENDS among teenagers is the variety of flavors available. While product-makers contend that flavors entice adults to give up traditional cigarettes, many flavors appeal to youth and are sold in packaging that resembles candy. Just some of the thousands of flavors available include banana split, bubble gum, cotton candy, gummy bears, and whipped cream.

•ENDS are not healthy, nor do they simply contain "water vapor." Some teenagers have a misconception that vaping involves nothing more than water vapor. While most ENDS do not have as many cancer-causing toxins as traditional cigarettes, one JUUL cartridge contains as much nicotine as a pack of cigarettes. Nicotine stunts brain development, which continues to about age 25. ENDS also can contain dangerous chemical and toxic heavy metals.

"The danger of ENDS is that the devices may create a whole new generation of nicotine addicts," said Maciej Goniewicz, Ph.D., PharmD, associate professor of oncology at Roswell Park Comprehensive Cancer Center in Buffalo, and expert resource for the New York State Smokers' Quitline. "Ongoing research in the field shows that, while ENDS may be 'safer' than traditional cigarettes, they carry an assortment of dangerous health risks."

One of the latest ENDS research surveys of nearly 70,000 Americans found daily use of an e-cigarette doubles the odds of a heart attack. Many teenagers, however, do not believe the use of ENDS poses health risks. According to the 2016 National Youth Tobacco Survey, nearly 75 percent of teenage e-cigarette users thought their product was "not harmful." The Truth Initiative also published a study in April showing 63 percent of JUUL users aged 15 to 24 did not know the product always contains nicotine.

•Teenagers are becoming addicted to ENDS, but support to quit is available. Plenty of resources are available to help parents talk with their teenagers about the dangers of using ENDS. A website through the National Institutes of Health, https://teen.smokefree.gov, provides an app and text messaging to help teenagers quit. The Centers for Disease Control and Prevention provides a colorful, four-page brochure with infographics to help parents, educators and health care providers explain ENDS facts to teenagers. And finally, while the New York State Smokers' Quitline focuses primarily on helping adults quit traditional combustible cigarettes, anyone addicted to nicotine may call 1-866-NY-QUITS (1-866-697-8487) seven days a week to speak with a "Quit Coach" about developing a quit-plan and overcoming triggers and relapses. Most adult callers to the Quitline will qualify for a free starter kit of nicotine replacement therapy.

"Tobacco use and nicotine in any form is unsafe," Goniewicz said. "By educating parents of teenagers about the dangers of using ENDS, we can save countless lives and promote healthier lifestyles."

The New York State Smokers' Quitline is a service of the New York State Department of Health and based at Roswell Park Comprehensive Cancer Center. It is one of the first and busiest state quitlines in the nation, and has responded to more than 2.5 million calls since its inception in 1999. The Quitline encourages tobacco users to talk with their health care providers and access available Medicaid or health insurance benefits for stop-smoking medications. All New York state residents can call 1-866-NY-QUITS (1-866-697-8487) for coaching and resources, free of charge, seven days a week beginning at 9 a.m. Visit www.nysmokefree.com for more information.