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    Mayo Clinic Minute: Rise in teen tobacco use linked to vaping

The use of tobacco products among American youth is on the rise, reversing a national trend over the past decade. And health officials say it is a direct result of a rapid increase in the use of e-cigarettes, also known as vaping. In 2018, more than 1 in 4 high school students and 1 in 14 middle school students said they had used a tobacco product in the past 30 days, according to the Centers for Disease Control and Prevention.

Most e-cigarettes contain nicotine, the highly addictive substance also found in cigarettes, which is just one of the reasons why health officials are concerned about the increase in teen vaping.

Watch: The Mayo Clinic Minute

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The use of e-cigarettes, or vaping, by teens is rapidly on the rise ─ nearly a 50 percent increase in just four years. And health officials believe it's creating more tobacco smokers.

"I think the data is pretty clear so far, in the limited studies we have, that it looks like it is a gateway for youth smoking," says Dr. Taylor Hays, director of the Mayo Clinic Nicotine Dependence Center.

Dr. Hays says teens who have never smoked a cigarette are three to four times more likely to start smoking in the future if they use e-cigarettes.

"We know that kids who start vaping using e-cigarettes are more likely to use combustible tobacco cigarettes later," he says.

Dr. Hays says he's concerned that vaping appears to be reversing a long-term trend of declining teen tobacco use. He says 6–7 million people from around the world die every year from smoking.

"If the current trends of smoking prevalence continue across the world, we’ll reach 1 billion smoking-related deaths in this century."