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Dr. Jennifer Vines, deputy health officer of Multnomah County, warns the Board of Commissioners on Thursday about electronic cigarettes and use among young people.

(Multnomah County Health Department)

The number of young people in Oregon turning to electronic cigarettes -- infused with flavorings like Irish cream, blackberry cobbler and watermelon -- is on the rise.

With that increase, comes a public health threat, Dr. Jennifer Vines, deputy health officer for Multnomah County, told the Board of Commissioners at Thursday's meeting.

To make her point, she displayed a graph comparing cigarette and e-cigarette use among 11th graders in Oregon between 2011 to 2013. Regular smoking dropped from 11.5 percent to 9.4 percent but e-cigarette use almost tripled in the same period, from 1.8 percent to 5.2 percent.

"On the tobacco front, we have some work to do," Vines told The Oregonian after the meeting. "On the electronic cigarette front, it's the Wild West."

The e-cigarette industry, which is relatively new, is not regulated by the Food and Drug Administration, which has yet to make a ruling. It's also not restricted by the state of Oregon.

The industry claims e-cigarettes produce a harmless water vapor that does not pollute the air. But no one really knows what the long-term health impacts might be. They can deliver a powerful punch, holding as much nicotine in one device as a pack of cigarettes.

E. cigarette flavorings are sold in little bottles with candy names.

Basically, they are a nicotine delivery device. They have a battery, an atomizer with a heating element and reservoir that holds the nicotine, flavorings and other compounds, which can include carcinogenic substances. The aerosol or vapor does have lower levels of harmful ingredients than conventional cigarettes but just about all of them contain nicotine.

That's what worries Multnomah County health officials.

"Nicotine is a hazardous substance, it is a very seductive drug," Vines said. "It also has adverse health consequences."

Nicotine can affect movement, breathing, heart rate, learning and memory while stimulating the pleasure center of the brain. Some studies suggest it can cause long-term structural change. Others indicate it can lead to depression and anxiety later in life. But one thing is well known: Nicotine is highly addictive, with most smokers starting as minors.

"Their brains are more susceptible to the addictive quality of nicotine, and they can easily get their hands on nicotine products," Vines said.

Multnomah County has one of the highest rates of illegal tobacco sales to minors in the country, with 27 percent of young people saying in a 2012 survey they had smoked at least once. That's higher than the national average, according to a study published Thursday by the Centers for Disease Control and Prevention. It said 23 percent of high schoolers nationwide use a tobacco product.

But in Oregon only a fraction smoke all the time -- 7 percent -- and about 4 percent use e-cigarettes.

Some counties statewide limit sales of e-cigarettes to minors, but there are no restrictions in Multnomah County, either on sales or marketing. Often sold near candy in jam-packed convenience stories, e-cigarettes and nicotine-laced flavorings have led to a rise in calls to poison centers, both nationwide and in Oregon.

From January through July this year, 54 people called the Oregon Poison Center at Oregon Health & Science University about overexposure to an e-cigarette product. That compares with fewer than 40 for the prior three years combined. And more than one-third of those calls were about a child under 5 years old being exposed to the nicotine.

The flavorings, sold in little bottles and labeled Bubble Gum, Snicker Doodle, Gummi Bear and Skittles, are a youth magnet, Vines said.

"Little kids can get their hands on them and drink them," Vines said.

The flavorings even have similar chemical compounds as candy, according to a study by James Pankow, a Portland State University chemistry and civil and environmental engineering professor.

The market for these products is exploding, with more than 460 brands and nearly 7,800 flavors as of early this year.

"We now have a sense of urgency that we can't wait for others to act," Vines said.

Some cities around Oregon have banned the sale of e-cigarettes to minors, including Corvallis, Hillsboro, Banks and North Plains. They also not permitted on tobacco-free campuses around the state, including in Multnomah County.

Several of the commissioners expressed concern after the presentation.

"This is really disturbing information," said Deborah Kafoury, county chair. She didn't realize that a child could go into any convenience store and buy an e-cigarette, which can look like lip gloss.

She asked health officials to come back Nov. 25 with recommendations.

-- Lynne Terry