For the first time in 17 years, tobacco use among teenagers is on the rise in Minnesota.
And the reason for that, according to the Minnesota Youth Tobacco Survey, is the proliferation of electronic cigarettes and other vaping devices.
Their rise in popularity is such that 1 in 5 high school students admit to using e-cigarettes – a 50 percent increase since data was last collected in 2014.
Tobacco use amongst Minnesota high school students was at 26.4 percent, up from 24.6 percent in 2014.
This is the first time since 2000 that tobacco use has risen among Minnesota youth, with vaping quickly replacing cigarettes as the go-to form of tobacco.
Less than 10 percent of high schoolers smoke cigarettes, with smoker numbers falling 70 percent since the turn of the century.
Health official blames tobacco industry
But the rise of e-cigs is causing Minnesota Health Commissioner Jan Malcolm to fear it will reverse the success the state's had in cutting down teen smoking.
"Just as we successfully reduced cigarette use to under 10 percent of high school students, giving us the hope that a smoke-free generation was within reach, the industry responded with new products designed to get youth addicted to nicotine," she said.
Of the students who responded to the survey, 88 percent said they'd seen ads promoting e-cigarettes.
Molly Moilanen, of ClearWay Minnesota, described the report as highlighting a "frightening trend," and she too blamed the "Big Tobacco" for "easy access, prolific advertising and kid-friendly flavors" of e-cigs.
The state's Department of Health found that teenagers who use e-cigs are twice as likely to take up smoking cigarettes as those who don't try them.
It also notes that many are using vaping devices to experiment with recreational marijuana and "other illicit substances," potentially providing a gateway to more dangerous drugs in the future.
It quotes Dr. Peter Dehnel, medical director with the Twin Cities Medical Society, as saying: "It provides a platform for illicit drugs and for nicotine, which we know is highly addictive and can harm brain development as teens grow, impairing learning, memory and attention."
The National Institute of Drug Abuse has found that boys are twice as likely to start smoking e-cigs than girls, though only 66 percent of all teenage e-cig users are only vaping flavoring.
Around 13 percent say they use it to vape nicotine products, while 5.8 percent use it for marijuana.