By Donald Bucklin

About a year ago, I was surprised to find out from my daughter that Hookah Pens were all the rage among the high school crowd.

If you are, like I was, among the uninitiated, this is a device of roughly cigarette proportions that contains a battery, a tiny vaporizer, something to vaporize and a button to make it go.

Most commonly that “something” is propylene glycol and nicotine. Press a button and you can inhale a smoke-like vapor that contains nicotine or a few other drugs for the more adventuresome.

Since nothing is burning, you are not technically smoking, and the smoke-free laws are therefore neatly sidestepped. Yet all the while people are getting a very smoking-like experience. Clever little device, huh?

E-cigarettes/Hookah Pens are kind of a half-full/half-empty sort of thing. The industry likes to take the high road. They want you to believe that if you are a two- or three-pack-a-day smoker, and you switch to e-cigarettes as a substitution, you are better off.

And why wouldn’t you be? There’s no tar, no carbon monoxide and no 400-plus chemicals released from burning tobacco. You won’t burn the house down, and there is only one thing to worry about — nicotine! That’s a pretty impressive list of positives.

The e-cigarette competes for these presumably soon-to-be ex-smokers with nicotine gum, patches, Chantix, antidepressants, hypnotism, willpower and tracheostomy.

There is no great evidence that these devices are an effective way to quit. But they might be. This doesn’t seem like a growing customer base on which to start an industry, since fewer and fewer people are smoking.

To figure out what the e-cigarette industry is actually betting on, we need look no further than the Centers for Disease Control’s 2012 National Youth Tobacco Survey. A few of our tax dollars keep track of smoking rates in young people. That seems prudent, given the negative health consequences of smoking.

Overall, looking at students in grades 6-12, e-cigarette use more than doubled between 2011 and 2012, going from 3.3 percent who tried it to 6.8 percent. Of the 2.1 percent who were currently e-cigarette users, 75 percent also smoked non e-cigarettes — aka “regular” cigarettes with their 400-plus chemicals that require a match.

Small percentages doubling in a year’s time doesn’t sound like much, but there are a lot of kids in school — about 15 million in high school alone. A little math works out to more than 1 million high school students who are or have become e-cigarette customers, most of whom also smoke regular cigarettes.

If the trend continues with Hookah Pens, next year there will be 2 million, and before long, a new generation of smokers. Does the expression “gateway drug” come to mind?

Are Hookah Pens the latest version of Joe Camel? Are they wrapped in purple paper and sold at “head shops” to attract adult smokers or teens?

Interestingly, when one of the largest university systems in the world — the University of California — decided to ban smoking on all its campuses effective Jan. 1, it included e-cigarettes in the ban. The California State University system is considering a similar ban.

We have made great progress in the past two decades to reduce smoking. In many areas, smoking is so rare that it’s actually startling to see someone lighting one up.

Let’s not fool ourselves that these cute “personal vaporizers” are out there to get 60-year-old smokers to quit. The real purpose is getting 16-year-olds to start.

— Donald Bucklin, M.D., is a regional medical director for U.S. HealthWorks and has been practicing clinical occupational medicine for more than 25 years.

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