After the 12th vaping death in the US, a Hawaii doctor is on the lookout for young vapers. Hawaii vaping rates are up to the second in the nation at 26%, reports the Center for Disease Prevention and Control.

“The CDC and the Department of Health are asking Hawaii doctors to inquire with their patients about their vaping history” said Doctor Brian Mih. This epidemic is relatively recent in Hawaii, with the first confirmed case reported on September 10th according to the DOH.

“What probably was the issue [with identification of the disease] is that it initially looked like pneumonia” said Mih. Patients would have a hard time breathing and chest pain, as well as abnormal CT scan result.

The Hawai’i DOH said that there are over 450 potential cases across the nation with that number recently being raised to 800.

“At the time, whoever saw them probably did not connect that to vaping, or they just did not report that they vaped” Mih said.

Doctors believe that this epidemic in Hawai’i can be attributed to at least 3 factors, the aggressive marketing campaign by e-cig companies, peer pressure in schools, and the stricter tobacco laws here.

“You know, the first and second generation devices, where you get the big plumes, were actually very strongly marketed to teens here first.” said Mih.

According to Doctor Mih, there are many misconceptions about vaping.

“We did a survey and found that over 60% of students start using e-cigarettes and don’t realize that there is nicotine in there.”