DULUTH – Hardly a day ever passes here at East High School without Principal Danette Seboe confiscating another vape pen or e-cigarette.

A sickly sweet scent fills her office when she opens the bin next to her desk, unleashing the peculiar fragrance of too many fruity flavors mixed together. Seboe dons gloves to pull out the dozens of devices she has taken away from students, a colorful array of battery-operated gadgets that look like pens or toys or flash drives.

"There's nothing to call it but an epidemic," Seboe said. "It hit so fast and so hard."

The number of students vaping in Minnesota high schools is soaring. A new survey of students by the state's Health Department shows that more than a quarter of Minnesota 11th-graders reported vaping at least once in the last month — a 54% increase from 2016, when the survey was last administered.

Usage rates in the Northland region are even higher, with nearly one in three students reporting vaping recently, the highest percentage of any region in the state. In several northeastern Minnesota districts, more than half of 11th-grade students reported vaping at least once in the last month.

Early nicotine addiction

In recent months, following the outbreak of a lung illness that has caused deaths and serious injuries, including one death in Duluth of a patient over 50 years old, anti-vaping campaigns have multiplied. In communities across the country, coalitions of politicians, academics, physicians, educators and parents have banded together in search of a way to stop the habit from growing even more popular among teens.

But despite the increasingly dire warnings they're issuing, these groups are scrambling to catch up with an industry that Seboe said has fostered addictions among her students, forcing high schools to confront problems that they haven't experienced for years.

"There's not really a treatment protocol for nicotine addiction in 14-year-olds," Seboe said.

Regional officials and administrators don't know why students in the area are vaping more; school-district level survey results were released fairly recently.

And the northeast is not alone. From St. Louis County to Blue Earth County, high schools — particularly those in rural areas — have seen vaping rates shoot up.

Tobacco usage rates have historically been higher in northeastern Minnesota, said Essentia Health's tobacco treatment program manager, Jill Doberstein, who suggested that students could be mimicking the smoking habits of adults in their communities.

"Is it greater access?" said Louise Anderson, director of the Carlton-Cook-Lake-St. Louis Community Health Board. "If what we're seeing is true, we'll really have to look deeper."

'There's no fear of it'

In the Twin Ports area, the trend exploded in fall 2018. Jaylynn Glaus, then a senior at Superior High School, said more and more students would find excuses to leave class to vape in bathrooms, stairwells and parking lots.

At Chisholm High School, nearly two-thirds of juniors reported having vaped at least once in the last 30 days — the highest rate in the state among the 81% of districts that took the survey, though Chisholm's result was based on a small sample size with only 37 juniors completing it.

"It's still a scary number," said Principal Mark Morrison. "The scary part is with these kids, there's no fear of it."

Morrison said the behavior really grew popular at the beginning of the current school year.

Teens have gotten better at concealing their wispy vape clouds by exhaling down their shirts or into their sleeves. Some have mastered the ability to take a hit in the few seconds that a teacher's back is turned.

"It's not like a cigarette, where anyone within 1,000 feet smells it," Morrison said.

One of the major points of concern for school officials is how prolific vaping is. The behavior transcends the social strata of high schools.

"You could pretty much pigeonhole a kid that used to be a smoker, for the most part," said Tom Tusken, assistant principal of Denfeld High School. "You cannot pigeonhole this at all."

The other fear is that vaping has created a new generation addicted to nicotine, Seboe said. In Duluth Public Schools, 13% of juniors surveyed reported vaping every day in the last month.

And as the juniors keep up with new vaping fads, like the sleek Suorin devices that have been trendy this school year, they're selling their old Juuls — the first e-cigarette brand to make it big — to freshmen and middle schoolers, potentially nurturing nicotine dependencies among even younger students.

There are signs and symptoms of addictions — anxiety, irritability, weight loss, shortness of breath. Glaus was part of a marketing group that designed the "Don't Blow It" campaign to educate students in the region about the dangers of vaping. Her team partnered with Essentia to make a video showing local students talking about their vaping addictions, which they said caused them to experience mood changes and made it hard to exercise.

"There are people who needed that nicotine just to be able to sit through class," Glaus said.

The punishment for getting caught vaping on school grounds varies. At Chisholm, students are suspended, while at Denfeld they receive a tobacco class ticket from the school's resource officer. Tusken said that hasn't stopped the behavior.

"They're willing to take more risks to get what they need," he said, "because they can't make it through the day without it."

The war on vaping

Those working to lower vaping rates are raising awareness. They're hosting information sessions to train parents and teachers what to look for and explain the potential effects of using e-cigarettes, which are filled with liquid that usually contains nicotine and a variety of other chemicals.

Duluth's high schools are also working with Essentia to bring a chemical dependency specialist to their campuses for a chunk of time each week, as some schools in the metro area have done.

But with usage rates on the rise, anti-vaping advocates are seeking a more lasting solution through legislation. Many liken their approach to the long-fought campaign against combustible tobacco products, such as cigarettes.

"Combustibles aren't cool anymore to young people," said Pat McKone, director of health promotion and policy at the American Lung Association of the Upper Midwest. "I'm hoping we're turning that corner, slowly, with these new devices."

Their efforts could pick up more traction as research catches up to the wildfire-like spread of usage, Doberstein added.

"Look at how long it took us to know that cigarettes were not fake or healthy," she said.

Growing pressure has prompted local, state and federal elected officials to weigh in on vaping. Gov. Tim Walz this month directed his staff to look into policy proposals ahead of the upcoming legislative session.

Many city and county governments have already taken action by banning nicotine products with flavors — which they say are marketed toward children — or requiring nicotine buyers to be 21. In northeastern Minnesota, however, only Duluth and Hermantown have passed such ordinances, though other communities are debating whether to implement similar laws.

Resistance has come from manufacturers of the devices who deny targeting children, as well as retailers and activists who say vaping helps people quit smoking.

"If that were the only public health consequence, discussions could be different," McKone said. "But it isn't. And what's happened with our young people, it's just not a trade-off."