RIVER FALLS — Nate Murphy knows vaping isn’t healthy.

“Inhaling anything other than oxygen” carries risks, the River Falls man said.

But Murphy, a clerk at Big Top Vape in River Falls, said he’s also not alarmed by recent hospitalizations in Wisconsin and Minnesota by other young people who have vaped and developed lung disease.

READ MORE: Inquiring Reporter: What is your take on vaping?

In Wisconsin, 34 cases have been confirmed, with 12 probable cases needing further investigation. In Minnesota, 17 cases have been confirmed, including one death, with another 15 under investigation.

Murphy, 23, said he suspects other factors may be at play, such as pre-existing lung conditions or unreported use of other substances in vaping devices. He said he has two friends who have been hospitalized after inhaling from “fake THC” cartridges they’d bought online that they used in their vaping devices.

Investigations by the Wisconsin Department of Health show that THC may have a connection. Of the 27 cases interviewed so far, 89% reported using vaping devices to inhale THC products, according to an Aug. 29 news release.

As to Youtube videos of young people immersed in thick clouds of vapor, Murphy and others at Big Top Vape said those images aren’t anything unusual. Murphy said he’s been part of “vape comps,” or competitions to see who can blow the biggest cloud, that didn’t lead to hospitalizations.

“In some ways, it is the safer alternative to smoking,” he said.

Untold consequences

But health officials cautioned against adopting that mindset.

Dr. Thomas Kottke, a senior clinical investigator and medical director for well-being at HealthPartners, warned of untold consequences from vaping. He fears it will lead to a condition called bronchiolitis obliterans

“I think we are seeing the leading edge of an epidemic of irreversible severe lung disease in young people,” he said, describing how lung transplants would be the only treatment.

Kottke said he thinks such an epidemic will continue until vaping is banned.

While e-cigarettes may be less harmful than regular cigarettes, that doesn’t mean they are safe, according to the Centers for Disease Control. The aerosol from the devices can contain harmful substances, such as heavy metals, volatile organic compounds, nicotine and more. Scientists are still learning about the long-term health effects.

On Monday, the Food and Drug Administration issued warning to Juul, which is estimated to have three-quarters of the vaping market, for making false claims that vaping is "much safer than cigarettes." The FDA said that amounts to illegal marketing.

The FDA has not approved e-cigarettes as a quit smoking aid, but information from the CDC says they may help adult smokers if they are used as a substitute to tobacco.

That does nothing to solve the problem of addiction, said Peter VanDusartz, director of HealthPartners St. Croix Valley Behavioral Health.

“Our team sees this as an extension and worsening of addiction problems, and sometimes as a way to justify and minimize, to self and others, the severity of their substance abuse,” he said.

Meanwhile, a CDC study showed many adults use e-cigarettes alongside regular cigarettes.

River Falls resident Jordan Averson admitted some vape users hold misconceptions that it’s harmless.

“There are dangers,” Averson, 19, said.

Murphy agreed, saying vape-juice manufacturers “should be more up front” about the chemicals in their products.

Most vaping substances or juices are marketed as having options for a variety of flavors. One vape juice distributor, Vape Wild, offers more than 150 flavors including everything from breakfast food and fruit flavors to traditional menthol and tobacco, all of which are labeled as containing nicotine.

Still, Murphy said features in vaping devices allow former cigarette smokers like himself to transition into a different experience. He said vape-juice options allow users to adjust the nicotine levels they ingest. Some devices have a “mod” feature that limits the number of vape hits a user can take each day, he said.

Sharp hike in nicotine use

Local municipalities and schools have concerns about the growing popularity of vaping, particularly for minors.

The use of e-cigarettes by high school students increased by 78% last year, according to the National Youth Tobacco Survey from the CDC. In 2018, 1 in 5 high school students, more than 3 million total, used e-cigarettes. At the middle school level, that statistic was 1 in 20, about 570,000 students.

According to the Wisconsin health department, e-cig popularity greatly outpaces cigarettes among teens in the state. A 2018 youth tobacco survey showed 20% of Wisconsin teens tried vaping — a 154% increase in use since 2014 — while 4.7 reported smoking cigarettes.

Among admitted Wisconsin teens, 89% reported they would not use unflavored tobacco products.

Bans in place: Hudson, New Richmond

Students’ safety was the main reason behind the Hudson School District’s efforts to pass an ordinance ban in the city. The city did so last year, banning any vape delivery system or product, nicotine or otherwise, for those under 18. The village of North Hudson followed suit this year.

Hudson High School Dean of Students Andrew Bauschelt said in a March 2018 interview that the city ordinance has more teeth than do school bans.

Since it passed in March 2018, the Hudson Police Department has issued 58 citations for possession by a minor. Police Chief Geoff Willems said the ordinance has had a positive impact, but the devices are still being used widely by both middle and high school students.

New Richmond’s vaping ordinance was also passed last year. In addition to banning any person under the age of 18 from purchasing or possessing a vaping device product, it aso bans vaping devices on school property, regardless of age.

New Richmond Police Chief Craig Yehlik said the ordinance has helped curb vaping in and around the schools.

“I think that has been effective as one of the major issues with vaping devices is that it is very difficult to tell what material is being ‘vaped.’ It may be a nicotine based product, but it could be a multitude of other products, legal or otherwise,” Yehlik said.

Yehlik said the city and the school district are concerned about the health and safety of its students.

“I think the big question for everyone is, ‘What are the long-term effects of vaping?” he said.

New Richmond District Administrator Patrick Olson said the district continues to provide education and resources to students and parents.

In development: River Falls, Ellsworth

River Falls is considering an ordinance of its own, but with the older age requirement of 21.

The River Falls School District is seeking the 21 age limit within city limits to restrict access to the products. The current age limit there is 18.

District officials urged City Council to review this proposal at a joint meeting in August.

“The School Board understands that raising the vaping age to 21 will not completely solve the problem, but we do hope it could be one component of a solution to the vaping epidemic in our high school,” School Board President Stacy Johnson Myers said in an email.

Superintendent Jamie Benson said he wants the city at least to know the school stands against what he called an “epidemic.”

The district’s biggest concerns are for students’ developmental health and the time it takes administrators to discipline students who violate the school’s current substance use policy, according to Myers.

Myers added she believes a conversation between city council and school resource officers would be helpful. The board hears from the officers about behavior leading to expulsion, which “too many times” includes vaping with THC substances.

Taking a cue from the surrounding areas, Ellsworth officials have considered proposing a similar vaping ordinance.

Gerald DeWolfe, Ellsworth Village Board president, supports the push to up the age required to purchase vaping products to 21 and hopes to eventually develop an ordinance.

“Right now we are working with our village attorney’s office in getting something in black and white,” DeWolfe said.

Ellsworth is only in the beginning stages of combating the issue. DeWolfe says they still need to get it drafted, reviewed and have a discussion with the school board. He predicts it will come up in the next couple of months.

“It’s a work in progress at this point,” DeWolfe said.

Bans have received statewide attention as well. On Aug. 29, Wisconsin State Sen. Patty Schachtner tweeted that she would be co-sponsoring legislation that would require people to be at least 21 to purchase vaping products.

Vaping on campus

University of Wisconsin-River Falls (UWRF) also stands against smoking in campus policies along with 2,375 other American universities, according to American Nonsmokers’ Rights Foundation.

Nearly 2,000 of those universities, along with UWRF, also prohibit e-cigarette use campus-wide.

“We just educate them and ask for compliance (to not vape) because it is a campus policy,” UWRF Campus Police Chief Karl Fleury said. “If they’re using the vaping pen to smoke marijuana, we charge them with possession of drug paraphernalia and possession of marijuana, so, yes, we do take enforcement action.”

Keven Syverson, Assistant Director of Health Promotion at UWRF, said the campus has seen cigarette use (students who smoked at least once in the last 30 days from taking the survey) drop from 24% to 6.8% in the last 18 years.

A spring 2018 study revealed 10% of students had used an e-cigarette at least once in the last 30 days, according to Syverson.

As of Sept. 3, there has been no conversation between the school district or city council and the university about the proposed citywide age limit.

Syverson said historically, it is best practice to raise the age limit and product prices to positively contribute to lower use.

Chippewa Valley Technical College River Falls campus and Wisconsin Indianhead Technical College New Richmond campus also prohibit all smoking, including vaping, on campus.

Tom Lindfors, Jordan Willi and Ashley Rezachek contributed to this report.