A growing number of teens are starting to use devices that are similar to e-cigarettes, with names such as "hookah pens," "e-hookahs" or "vape pens."
The devices are being marketed to avoid the stigma associated with smoking any kind of cigarette, The New York Times reports.
The new devices are colorful and come in candy flavors, but are otherwise almost identical to e-cigarettes, according to the article.
Like e-cigarettes, they have nicotine and other chemicals, which are unregulated.
Health officials say surveys about e-cigarette use generally don't ask about these other products, so they may be greatly underestimating how many people are using e-cigarettes and similar devices. They say teens appear to view e-cigarettes and e-hookahs as being different products, even though they are basically the same.
Many young people say they are not interested in using e-cigarettes, but have tried hookah pens, vape pens or e-hookahs.
Emily Anne McDonald of the University of California, San Francisco, who is studying e-cigarette use among young people, told the newspaper that the lack of information about nicotine-vapor products was creating a vacuum "so that young adults are getting information from marketing and from each other. We need to understand what people are calling these before we send out large surveys," she said. Otherwise the responses are not accurate, "and then you're back to the beginning."
Critics of e-cigarettes say secondhand vapor is a pollutant, and e-cigarettes can get more people addicted to nicotine.
The Food and Drug Administration (FDA) will soon propose rules on regulating e-cigarettes.
The FDA is expected to consider e-cigarettes as tobacco products, which will allow the agency to provide the same federal oversight that applies to cigarettes, chewing tobacco, cigarette tobacco, and roll-your-own tobacco. E-cigarettes could be subjected to the same requirements for disclosure of ingredients, manufacturing quality and restrictions on sales to minors that apply to regular cigarettes.