FRESNO, Calif. (KFSN) -- It's a multi-billion dollar industry that's marketed as a "smoking alternative."
A new study suggests that e-cigarette ads double the likelihood of teen vaping. The study, published in the September 2019 issue of Pediatrics, says the growing popularity is unregulated marketing, like in retail stores.
Researchers found that kids (ages 12-17) who report remembering store-based e-cigarette ads were twice as likely to start vaping within two and a half years.
"We are seeing a high rise in vaping or the use of e-cigarettes in Fresno County alone," said Fresno County Department of Public Health Education specialist, Monique Peralta.
A separate survey conducted by the Public Health Department shows traditional use of cigarettes may have gone down but 8.9 percent of 10th, 11th and 12th graders, in Fresno County, are vaping.
Peralta adds, "there is a lot of misinformation and children are thinking they are smoking something like water or water vapor."
Tower Smoke Manager Dillon Root says they're taught to I.D. everyone upon entry.
"That's our line of defense first and last, (identifying) at the door basically stops it right in their tracks. If they're not 21, I just ask them to leave," Root said.
He says e-cigarette products are their most popular, but they've gone through changes, including how they're packaged and labeled.
Many labels include larger nicotine warnings that are now the prominent feature on the packaging.
"It is illegal for kids to vape, but it is an alternative for people that are trying to get off cigarettes," Root added.
A Fresno man's lawsuit against Juul, calls the company "a wolf-in-sheep's-clothing, delivering as much or more nicotine and harmful chemicals as bigger, more conspicuous e-cigarettes. What has been marketed and sold as a fun, harmless, and trendy pastime is anything but that."
Fresno Unified is starting programs aimed at early intervention. Director of Health of Services, Jane Banks, said with young adults, vaping causes a high risk of anxiety, depression, and it opens the door to using other drugs.
If you want to talk to your kids about vaping visit teen.smokefree.gov/.
If you have or know a teen that may be struggling with addiction, you can reach the smoke-free teen organization by texting the word QUIT to 87848.
There is also a free smartphone app, called QuitSTART, that helps you quit smoking with tailored tips, inspiration and challenges.
New study says in-store e-cigarette ads double likelihood of teen vaping