A disturbing public health trend has been reported in recent months: 26 percent of Colorado’s high school students have used e-cigarettes in the last 30 days, which is double the national average. In fact, out of 38 states surveyed, Colorado had the highest e-cigarette use among high school students. In the Tri-County Health Department’s three counties — Adams, Arapahoe and Douglas — the number of students who have ever used an electronic vape product increased more than 200 percent since 2013!

The epidemic has grown so much that Gov. John Hickenlooper declared November “Vape-Free” to increase awareness among Colorado’s youth of the damaging, long-term physical and mental effects that e-cigarettes have on developing brains.

Nicotine addiction from e-cigarettes can lead to cigarette smoking, creating the potential for long-term consequences such as cancer and heart and lung disease.

Colorado isn’t the only state facing this skyrocketing threat. Recently, the commissioner of the U.S. Food and Drug Administration declared youth use of e-cigarettes across the country an “epidemic” and a dangerous and intolerable trend.

Now is the time to add e-cigarettes to the list of restricted substances indoors as part of the Colorado Clean Indoor Air Act. Not only would this improve air quality for everyone, but it would also help increase awareness of vaping’s harmful effects.

E-cigarettes are battery-operated devices that people use to inhale (vape) an aerosol, which typically contain nicotine or other substances such as marijuana, flavorings and harmful chemicals. Extensive research has shown the negative effects of nicotine on developing young brains, such as the impairment of cognitive function and development. When teens become addicted to nicotine, it is more likely they may be addicted for life.

It’s no surprise that new e-cigarette products have recently saturated the market and increasingly, they are being heavily advertised and used in public places by people of all ages. Secondhand smoke from these products continues to threaten community health, while also contributing to the $1.9 billion in health-care costs associated with smoking each year in Colorado.

The only way to fully eliminate exposure to secondhand smoke is to prohibit cigarette tobacco, marijuana smoking, hookah and e-cigarette aerosolizing in all public places and workplaces, including restaurants, bars and casinos, making them 100 percent smoke-free. This also limits youth vulnerability to secondhand smoke and the normalization that comes from exposure to these products.

More than 10 years ago, Colorado lawmakers passed a statewide smoke-free policy, the Colorado Clean Indoor Air Act, prohibiting indoor smoking in public places. Five years ago, legislators added marijuana as a restricted substance indoors. Now in 2018, with the challenges that Colorado faces from growing use of e-cigarettes, it is critical for the legislature to modernize the Clean Indoor Air Act by following the lead of more than 29 Colorado municipalities and 13 states across the country that have already implemented policies to address e-cigarette use in public places.

Lawmakers have an important opportunity to modernize our state policy by eliminating all forms of secondhand exposure to nicotine, marijuana and other harmful chemicals in public places. We urge them to move quickly to show leadership regarding this concerning public health threat.

John M. Douglas Jr., M.D., is the executive director of the Tri-County Health Department, serving Douglas, Arapahoe and Adams counties.