In this Wednesday, April 11, 2018 photo, an unidentified 15-year-old high school student uses a vaping device near the school's campus in Cambridge, Mass. Health and education officials across the country are raising alarms over wide underage use of e-cigarettes and other vaping products.

Steven Senne/AP Photo

We’ve already learned that Colorado teens lead the nation in vaping and a statewide survey may show one reason why. Of the kids they asked, just half think vaping is risky. Conversely, 87 percent see conventional tobacco smoking as risky.

It’s that disconnect that has state health officials worried.

"A lot of these products are represented in a way to make them seem less risky," said Dr. Larry Wolk, the state’s chief medical officer. "Cotton candy, banana split, gummy bears. I mean, how can that be harmful?"

The 2017 Healthy Kids Colorado Survey shows 58 percent of kids say it’s easy to get e-cigarettes. And more than a quarter, 27 percent, of minors now use e-cigarettes — far more than conventional cigarettes at a singular 7 percent.

One other thing: e-cigarette use nearly doubles over the course of high school. Jumping from 18 percent during the freshman year to 34 percent in the senior year.

About 56,000 students from nearly 200 middle and high schools across the state were sampled. A third of teens said they are using nicotine, which includes conventional cigarettes and e-cigarettes, chew, hookah and cigars.

E-cigarettes are the second most tried substance, notably ahead of marijuana (which is only legal in Colorado for users over 21). Nearly 60 percent of young people say they’ve tried alcohol at least once. Forty-four percent have tried e-cigarettes, that’s ahead of 35 percent who’ve tried marijuana and 16 percent for cigarettes.

"Why Colorado? What is it about this state or maybe the regulatory environment, or us culturally relative to other states, that would earn us this dubious distinction?" Wolk said.

In response to the larger trend, Colorado is starting to see the passage of Tobacco 21 laws to raise the age to purchase from 18 to 21. The mountain towns of Aspen, Basalt and most recently, Carbondale, have passed such rules. Carbondale Mayor Dan Richardson said retailers have already told the town "Hey, we’re getting the message."

The non-partisan Colorado Health Institute looked at e-cigarette use and state and national policy efforts in a report entitled Vapor Trail. Research analyst Jayln Ingalls said Colorado is behind other states that have e-cigarette taxes and retail licenses — moves retailers and manufacturers generally oppose as burdensome.

"Some have put on specific taxes for their e-cigarettes, others just tax them similar to cigarettes, they essentially just apply the same tax structure," Ingalls said. "I think what’s hard with e-cigarettes is you can buy them online so easily."

The National Academy of Sciences, Engineering and Medicine reviewed e-cigarette research and found "among youth — who use e-cigarettes at higher rates than adults do — there is substantial evidence that e-cigarette use increases the risk of transitioning to smoking conventional cigarettes." It also reported vaping exposes users to high levels of nicotine and result in symptoms of dependence.

Citing the Center for Disease Control, CHI’s report notes e-cigarettes have some benefit for users who substitute them for traditional cigarettes, because they produce fewer harmful chemicals, but more research is needed to see how effective they are to help users quit smoking.

Even with these regulatory approaches, parents aren’t off the hook when it comes to teen vaping.

The 2017 Healthy Kids Colorado Survey provides insights into how parents can play a role. Teens whose parents know where they are and who they are with are nearly 50 percent less likely to vape. Minors who have clear family rules are 39 percent less likely to vape. Those who can ask a parent for help are 31 percent less likely to vape.