According to 2018 data, nearly 2.4 million middle and high school teens say they have used a flavored e-cigarette at least once over the past 30 days.
Among teens, "e-cigarettes were the most commonly used flavored tobacco product in 2018; flavored e-cigarette use has increased in recent years," according to researchers led by Karen Cullen. She's from the Center for Tobacco Products at the U.S. Food and Drug Administration.
In fact, almost two-thirds (about 65%) of the nearly 5 million teenagers who used some form of tobacco product in 2018 said they had used a flavored e-cigarette over the past month. The figures come from annual National Youth Tobacco Surveys.
Experts in lung health said the numbers are troubling, because any nicotine-containing product that comes in fruit, candy or other flavors can be a gateway to lifelong addiction.
"In order to make vaping more enticing, flavors have been introduced into the manufacturing of both commercial brands and black market products," said Dr. Len Horovitz, a pulmonary specialist at Lenox Hill Hospital in New York City.
"Young people are attracted to the flavorings, but as they get older, they add other substances like nicotine and THC," he added. THC is the chemical in marijuana that provides a high.
And there's an even more frightening issue emerging - cases of serious lung injury linked to vaping. According to the latest figures, more than 800 such cases have occurred this year across the United States, including up to 17 deaths.
The exact cause of the illness is unclear, but diacetyl, often used in flavored vapes, has been "implicated now in the pulmonary syndromes," Horovitz noted.
Responding to the epidemic of youth vaping and the recent spate of vaping-linked lung injury, federal and state governments are moving to ban flavored e-cigarettes.
On the national level, the situation has spurred the Trump administration to call for a ban on flavored e-cigarettes.
And on Tuesday, Los Angeles County banned flavored forms of e-cigarettes - echoing a move made recently by Michigan and the state of New York. Ohio Gov. Mike DeWine called for similar legislation in his state on Tuesday, and last week retail giant Walmart announced that it would pull all e-cigarette products from its shelves.
Cullen and her colleagues believe such efforts can help. They point out that after New York City initiated an almost total ban on the sale of many flavored cigars and "chew" products in 2009, cigar sales dropped by 12%, even as sales rose elsewhere in the nation.
Another lung health specialist agreed that something must be done to spare kids a lifetime of addiction to nicotine.
"Many youth admit that flavored e-cigarettes are the major reason they started vaping," said Dr. Mina Makaryus, a pulmonary specialist at Northwell Health in New Hyde Park, N.Y.
"Given the addictive nature of nicotine, these youth are now addicted to nicotine at a very young age, and they are more likely to continue using e-cigarettes and even start smoking regular combustion cigarettes in the future," he said.
Makaryus hopes that "more states will start to ban flavored e-cigarettes. There also needs to be increased FDA regulation of e-cigarettes, including their marketing and targeting of underage youth."
The new study is published in the Oct. 4 issue of Morbidity & Mortality Weekly Report, a journal of the U.S. Centers for Disease Control and Prevention.