Olivia Zacks, 17, recently took a drag of peach-flavored vapor from a device that most people would call an e-cigarette.
But Ms. Zacks, a high school senior, does not call it that. In fact, she insists she has never even tried an e-cigarette. Like many teenagers, Ms. Zacks calls such products "hookah pens" or "e-hookahs" or "vape pipes."
These devices are part of a subgenre of the fast-growing e-cigarette market and are being shrewdly marketed to avoid the stigma associated with cigarettes of any kind. The products, which are exploding in popularity, come in a rainbow of colors and candy-sweet flavors but, beneath the surface, they are often virtually identical to e-cigarettes, right down to their addictive nicotine and unregulated swirl of other chemicals.
The emergence of e-hookahs and their ilk is frustrating public health officials who are already struggling to measure the spread of e-cigarettes, particularly among young people. The new products and new names have health authorities wondering if they are significantly underestimating use because they are asking the wrong questions when they survey people about e-cigarettes.
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