Recent reports of illness and deaths associated with the use of e-cigarettes or vaping has drawn an inappropriate amount of attention to the industry, according to Cordell Hoff, owner of The Vapor Shoppe in Jamestown.

"It is not the nicotine products," he said. "It is the black market marijuana cartridges that cause the problem."

Testimony by the Centers for Disease Control and Prevention before congress Sept. 26 said there had been 805 cases of lung disease and 12 deaths in 10 states associated with vaping across the country reported at that time. At least one of the illnesses was reported in North Dakota.

"Most patients have reported a history of using e-cigarette products containing THC (marijuana)," said the report. "Many patients have reported using THC and nicotine. Some have reported the use of e-cigarette products containing only nicotine."

The CDC report said its early investigation did not find a common "product, substance, or additive" in the cases.

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The lack of research and studies about vaping is a concern to Neil Charvat, director of tobacco prevention and control for the North Dakota Department of Health.

"Vaping products are not proven safe by anyone," he said. "We don't advise anyone using them."

Charvat said vaping is not limited to youth but is a "population epidemic" although keeping the products out of the hands of youth is a particular concern.

Nancy Neary, tobacco prevention coordinator at Central Valley Health District, said a 2017 study reported more than 20% of North Dakota high school students used vaping products. This compared to 12.6% who used cigarettes.

Neary considers the use of vaping products at Jamestown High School so prevalent, she is in the planning stages for a cessation class at the high school for students sometime this school year.

"We did a survey last spring of ninth graders," she said. "A lot showed an interest in quitting."

How the students are getting the vaping products varies.

"We hear of both local sources and through the internet," Neary said.

A Jamestown city ordinance prohibits sales of tobacco products to anyone under the age of 18. That law has been interpreted to include e-cigarettes although compliance checks by police officers are rare due to staff shortages at the Police Department, Neary said.

Hoff said his store has a strict policy that all customers, no matter how old they appear, must provide identification to make a purchase although he said he could not control what happens after the product leaves his store. He also said there are other retailers in Jamestown offering similar products.

Hoff said he would support an increase in the minimum age to purchase vaping products to 21.

Neary said raising the minimum age to purchase tobacco products to 21 would reduce the "social sources" some young people use to acquire tobacco products. The theory is that a 16-year-old, for example, might have friends that are 18, but doesn't likely have friends that are 21.

Banning flavored vaping products is another possible way to discourage youth use, Neary said. She advocated banning all flavors including menthol which numbs the throat making tobacco of any form more tolerable to young users.

Hoff said a flavor ban would create another black market of unregulated products and make it more difficult for adults who want to use e-cigarettes to quit smoking.

"Adults looking to quit smoking often look for something that doesn't taste like tobacco," he said.

While Charvat said regulatory oversight of the vaping industry is lacking, Hoff said he considered the industry "over regulated."

"We need to change the argument from 'there is no proof these aren't safe,'" Charvat said, "to 'these are making people sick.'"

Hoff sees further regulation or bans as counter productive.

"It's scary," he said. "Because if there is a ban of any of these products it makes the black market industry stronger."