The Irish Times has published a lengthy report on e-cigarette use among teenagers in the country, saying e-cigarettes have become a teenage obsession, with teen use rising for the first time in decades.

Christina's first exposure to e-cigarettes was when she was in fifth grade, in an empty classroom next to her engineering class on Friday morning.

"I coughed. I was too scared to get caught."

By her sixth grade, brightly colored single-use e-cigarettes hit the market. "That's when the trend exploded," sweeping her Donegal school with the same frenzy as the Loom Band stage 10 years ago.

The most popular brands of disposable e-cigarettes in her circle of friends currently sell for about 7 euros each, with one offering 500-600 puffs. They come in flavors like Watermelon Ice and Raspberry Orange Blossom.

"They're like the happy ranchers of e-cigarettes," Christina said, referring to a popular sweet treat -- except that most contain 20 milligrams, or 2 percent, of nicotine. This is equivalent to the amount of nicotine a smoker would get from 20 cigarettes, although traditional smokers are of course exposed to additional harmful chemicals. Christina's friends often meet once a day. After a night out, "it feels horrible in your chest -- like someone sprayed strawberry air freshener in your mouth."

Almost overnight, or as it seemed, vaping became ubiquitous. TikTok influencers are doing just that. In school, "everyone is using them. People are vaping left and right and in the middle, they leave the classroom to vape, they vape in the toilet during recess."

The 19-year-old prefers to smoke cigarettes while out at night, and e-cigarettes can last for two weeks. But at the chip shop where she works, “every 10 or 15 minutes, someone asks me if I can go out and vape. Everyone is doing it because everyone else is doing it.”

Christina's observations were echoed by Alison, a teacher at a school in south Dublin. Her school has started monitoring toilet breaks to curb vaping. Students write in their homework journals when they leave and when they return.

"I hate having to question and time students when they go to the toilet. I know it sucks. But it's for their health and safety. Parents won't be impressed if they find out their kids are vaping regularly during school hours impression."

A teacher for nearly 25 years, she seems baffled by finding herself re-monitoring young people's nicotine use. "Actually, for a long time, smoking wasn't a problem at all. The kids didn't seem to smoke."

"Childhood smoking rates have been falling for 20 years. From 1995 to 2015, every time we measured it, it fell." Founder of the Irish Tobacco Free Institute and one of the authors of the European Schools Project on Alcohol and Other Drugs (ESPAD) 1 Professor Luke Clancy said. Then, apparently out of nowhere, "it went up in 2019."

Professor Luke Clancy, founder of the Irish Tobacco Free Institute, said youth smoking rates had fallen every year since 1995, before suddenly rising again in 2019.

The survey found an increase in the number of 15- to 17-year-olds who smoked - from 13% in 2015 to 14.4% in 2019. At the same time, e-cigarette use among young people is on the rise.

The ESPAD survey found that between 2015 and 2019, the use of e-cigarettes among children aged 15 to 17 in Ireland increased from 10% to 18%. The State of Tobacco Control report released earlier this year said e-cigarette use among 15-year-olds increased from 1% to 24% from 2015 to 2021.

Dr Paul Kavanagh, Public Health Medical Consultant at HSE's Tobacco Free Ireland programme, said: "I think we have reason to expect this trend to continue to rise.

Chris Macey, director of advocacy at the Irish Heart Foundation, put it more bluntly. He believes that the introduction of beautifully packaged single-use e-cigarettes into the market has led to an explosion in their use.

"They're cheaper and easier because they don't need a charger. According to the World Health Organization, there are 16,000 different flavors. There's bubble gum, chocolate chip cookies, gummy bears. How would you need the gummy bear flavor to make You quit smoking?"

He worries about stealth marketing of e-cigarettes through social media, using hashtags linked to external parties at GAA events and concerts, or through influencer promotion.

We have seen an increase in both teenage smoking and vaping. The question that has not been satisfactorily answered is which comes first. A 2020 review of evidence commissioned by the Health Research Council found that "children who use e-cigarettes are three to five times more likely to continue smoking and start smoking than children who have never vaped. I I don't think we need to wait until we have beyond a reasonable doubt that there is a relationship between vaping and smoking to intervene," Dr Kavanagh said.

"Nicotine is one of the most addictive substances known to man. So you only have a certain amount of time before the horse runs."

Macey believes that we should be absolutely shocked that all the hard-earned gains of the previous generation of tobacco control will now be lost, and they will be lost through complacency. Nicotine is one of the most addictive substances known to man. Therefore, you only have a certain amount of time to deal with this before the horse runs away.

Non-combustible tobacco equipment should not be the gateway to smoking, if it turns out to be the case. The first products were patented in the United States in the 1960s as an alternative to cigarettes, but were never commercialized. Chinese pharmacist Han Li revived the idea in 2003 after his father died of lung cancer.

Big Tobacco initially viewed e-cigarettes as a one-hit wonder, but began making a big push in 2012, acquiring smaller e-cigarette companies and introducing sophisticated marketing and lobbying tactics to the nascent industry.

All the big four - Philip Morris, British American Tobacco, Imperial Brands and Altria - have since started vaping under their own brands. Altria is known to have acquired a 35% stake in Juul in 2018 for $12.8 billion. They use the language of no smoking, next-generation products and a non-combustible future.

One of the strategies of some pro-vaping groups is to obfuscate what vaping actually does by marketing it both as a smoking cessation device and as a cool new consumer product. Tobacco Strategies at the University of Bath said part of the confusion was to delay regulation. It seems to be working.

In the UK, Public Health England is far more relaxed about vaping than most EU countries, New Zealand and the US. Ireland doesn't seem entirely sure which approach to follow.

The report of the Joint Commission on Health, Tobacco and Nicotine Inhalation Products, released last July, made 10 recommendations, including a ban on the sale of e-cigarettes to those under 18.

Several experts argue that it goes further, adding flavor bans and restrictions on packaging. Since then, the Public Health (Tobacco and Nicotine Inhalation Products) Act 2019, which would impose a ban on sales to children under 18, has not been enacted. This means that 10 years after the idea of the legislation was first proposed, Ireland remains one of the only countries in the EU where children can legally buy vaping devices.

"The reality is that today's kids can walk into a Bray, Mullingar or West Cork vaping store and sell the product. There's no law against that," Dr Kavanagh said.

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