Advocates are reaching out to the FDA in an effort to pressure them to take action against e-cigarettes.
Six national organizations wrote a letter to the agency, taking particular issue with Juul, an e-cigarette popular among teens. The organizations are the American Academy of Pediatrics, American Lung Association, Truth Initiative, American Heart Association, Cancer Action Network (American Cancer Society), and Campaign for Tobacco-Free Kids.
The Centers for Disease Control and Prevention reports 2 million teens are using e-cigarettes nationwide.
"It doesn't start in middle school, unfortunately. Unfortunately, we see young people using Juul's later when they're in elementary school," said Dr. Wanda Boone, who works with Together for Resilient Youth, a Durham-based advocacy group.
She's been outspoken about the growing use of e-cigarettes, working with school resource officers and community members to issue warnings.
"They're packed to be cool looking. The nicotine flavor is not there. And it's something that can be easily hidden or carried," Boone said when asked about what makes e-cigarettes particularly appealing.
As to that last point, a Juul can be confused for a computer cartridge or thumbdrive, making it easy to hide from unsuspecting adults.
"We know that kids and teens who use these products are more likely to use tobacco products in the future," said Dr. Edith Bracho-Sanchez, a pediatrician.
The FDA is considering regulations to enact by 2022, which could include banning flavored e-cigarette liquids that are favored by teens.
"We know that more and more products are hitting the market that are targeting teens and kids," Bracho-Sanchez said, and she added that the FDA reviews all available evidence.
Next month, it will launch a nationwide vaping prevention campaign.
Last August, Juul raised the minimum purchase age from 18 to 21 on its website and added that it works with an independent age-verification company to ensure products aren't shipped to minors.