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Smoking rates have stopped falling among U.S. kids, and health officials believe youth vaping is responsible. For decades, the percentage of high school and middle school students who smoked cigarettes had been declining fairly steadily.

Alcohol use and binge drinking may be down among Iowa teens, but they've found a new vice in e-cigarettes and vaping.

The 2018 Iowa Department of Public Health's Youth Survey, which questions sixth-, eighth- and 11th-grade students, showed alcohol and tobacco use decreasing while e-cigarette use and suicide risk increased.

In particular, 23 percent of 11th-grade students who responded reported using e-cigarettes (including vape-pens, JUUL and hookah-pens, among others) one day or more. Eight percent of eighth-graders reported using e-cigarettes at least one day or more, and 2 percent of sixth-graders reported it. Overall, vaping is up 78 percent.

Cigarette use among students who smoked in the past 30 days has decreased by 57.1 percent since 2012, according to the survey. Binge drinking has also decreased by 36.3 percent since 2012, though it has remained relatively stable since 2014. There was, however, a reported decrease of 16.7 percent among 11th-graders in 2018.

"That is trending upward. It's a relatively new product that's out there. We've probably had alcohol-related questions since before the survey began, at least since 1999," Youth Survey coordinator Pat McGovern said about e-cigarettes. "Whereas questions about e-cigarettes, we added some in 2014, added some more in 2016 and 2018 to try and get a better handle on that and ask kids in terms they understand and use."

That increase in e-cigarette use aligns with what's seen in national reports and surveys as well, McGovern said. "I don't think this is kind of a false positive, and I know that our tobacco division here at IDPH is aware of this and certainly looking at what they can do to support schools, communities, families, to help kids who may be at risk or starting to use e-cigarettes."

Mental health and suicide risks have also increased, McGovern said. From 2012-2018, there's been an increase in all three grades of 53 percent regarding students having a plan. One in 10 reported having a plan, while one in 20 reported an actual attempt.

"So if you have a class of 30 students, on average there are three kids who went so far in their thinking that they started a plan of how they would kill themselves," he said. "So that's certainly a number that is concerning because oftentimes that plan comes before an attempt."

The next question, McGovern said, is what we can do about it.

"The biggest thing is be open to others, and feel free to ask," he said, saying it's OK to ask someone and check in on them. "If we can get to the point where we can openly ask and talk about mental health just like we do physical health, I think that'll go a long way."  

In schools, resource officers can play a role in helping out.

"Generally, when situations involve students we try to let the school handle it until it's to the point where it becomes more than they can handle, and then we step in," Davenport Police Sgt. Andy Neyrinck said. 

With vaping, Sgt. Neyrinck said, it's like getting pulled over for speeding with a fine in excess of $150.

"We don't write a ton of those, but we do write some of them. We'll leave it to the discretion of the school," he said, though he noted controlled substances are obviously different. 

In an interview Tuesday, Campaign for Tobacco Free Kids director of state communications John Schachter touted the "tremendous" progress made on reducing smoking, especially among kids. "Smoking rates are at record lows, 14 percent for adults, about 7.5 percent for high school students," he said, a nearly three-quarter reduction in the rate of high school smoking since 2000. However, tobacco use is still the leading cause of death in the United States and costs over $170 billion in health care expenses.

In Iowa, the high school smoking rate is at 9.9 percent, higher than the national average, Schachter said. That translates to over 17,000 students who smoke in the state, and the e-cigarette rate is similar. 

The Campaign for Tobacco Free Kids has asked both the federal government and state governments to do more to address e-cigarettes, including the banning of flavors of e-cigarettes and menthol cigarettes, raising the tobacco age to 21 and raising the tobacco tax.

"There's a lot of things that can be done," Schachter said, "and unfortunately we're not seeing enough of them being done in Iowa as well as other states."

It's important, Schachter said, for parents and students to get the facts themselves about e-cigarettes, including the fact that a JUUL pod contains about 5 percent nicotine, the same as a pack of cigarettes, according to the company.

There will be county level data as well from the survey, which is expected to be available later this year.

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