WASHINGTON -- When a teacher noticed what looked like smoke rising in her Eastern Middle School classroom one day this fall, she quickly investigated, finding an eighth-grade boy holding an e-cigarette.
The "smoke" was vapor, but for Casey Crouse, principal at the Silver Spring, Md. school, the episode was the first signal of what she would learn is a troubling teen trend nationally: an increasing number of students using electronic devices that simulate tobacco smoking.
E-cigarettes are beginning to show up in the hallways of the nation's middle schools and high schools. Just as health officials have begun to debate their potential dangers and school districts have started to pay attention to them, educators are grappling with how to deal with students who are found puffing on e-cigarettes while at school.
A report from the federal Centers for Disease Control and Prevention released Thursday underscored the popularity of products such as e-cigarettes, cigars and hookahs among the nation's youth. In just one year, from 2011 to 2012, e-cigarette use among middle and high school students nearly doubled, a fact that troubles researchers who worry that e-cigarettes could lead to nicotine addiction or be a gateway to tobacco products; about 90 percent of smokers pick up the habit as teenagers.
Like combustible traditional cigarettes, electronic cigarettes typically contain nicotine, which has been shown to interfere with adolescent brain development, according to the CDC. The devices are widely seen as an option that is less harmful than conventional smoking, and one that doesn't have the same odor. The Food and Drug Administration, which is seeking to regulate the devices, says further research is needed to assess potential health benefits and risks.
Christine DiFonzo, 17, an editor-in-chief of the Rockville Rampage, the student newspaper at Rockville High School in Montgomery County, Md., wrote an article about e-cigarettes that suggested some students use them instead of regular cigarettes, alcohol or drugs. The story quoted a student who uses e-cigarettes socially but chooses a nicotine-free variety.
Such social use among teens appears to be on the rise: The CDC released figures in September showing that in 2012, an estimated 1.78 million students in middle and high school had tried e-cigarettes.
Among high school students, 10 percent reported having used them at least once as of last year, compared with less than 5 percent the previous year. Nearly 3 percent said they had used e-cigarettes in the past 30 days, up from 1.5 percent in 2011. By comparison, 14 percent of high school students reported in 2012 that they had recently smoked cigarettes.
Tim McAfee, director of the CDC's Office on Smoking and Health, said in an interview that CDC officials were so disturbed by the numbers, they published the results on the fastest possible timetable.
"I think it is very important for parents, for teachers and for policymakers to be aware of the fact that our children are experimenting with these products," said McAfee, who described their popularity as "a dangerous situation."
Many experts worry that e-cigarettes are alluring to children and threaten longtime efforts to discourage teen smoking.
"It introduces young people to smoking and nicotine in a way that nothing has in decades," said Matthew Myers, president of the Washington-based Campaign for Tobacco-Free Kids, who said he urges school districts to treat e-cigarettes as they would treat other forms of smoking: Ban them.
The tobacco products that e-cigarettes aim to mimic are banned from nearly all U.S. public schools, and it is illegal to sell conventional cigarettes to minors. But it is less clear what the rules are for the electronic devices, which some adult smokers use as a tool to quit. Maryland bans the sale of e-cigarettes to minors. District of Columbia officials are considering a broad e-cigarette bill that includes banning sales to minors, with a council hearing planned for next week. Officials in the Virginia Attorney General's Office said they could find no state law that regulates the sale of e-cigarettes.
In school systems across the Washington region, educators report scattered sightings of the battery-powered devices, which can turn a liquid form of nicotine into an inhalable vapor. Many of the liquids are flavored -- vanilla, cherry, gummy bear -- which can make them more appealing to young people.
"It's really new, and it's popping up, and I think it bears some looking at in terms of offering resources for prevention and particularly for intervention," said Richard Moody, supervisor for student affairs/Safe and Drug-Free Schools In Prince George's County, Md. Moody said two cases have come to his attention, both involving middle school boys. "I think students are just a little naive, and they think it's harmless when it really isn't."
In Fairfax County, Va., administrators have encountered students with e-cigarettes since spring, though they say the problem is not widespread.
Mary Ann Panarelli, director of intervention and prevention services, said her office takes the occasional call from administrators asking: Should I handle it like tobacco?
The county's answer is yes.
"I think everyone across the country is increasing their awareness about this," Panarelli said.
For violations at the high school level, students typically are sent to a one-day tobacco seminar that includes a discussion about e-cigarettes, she said. Younger students receive one-on-one intervention.
Panarelli said she expects e-cigarettes will soon be addressed through prevention efforts, both as a topic in Fairfax's health curriculum and in a newsletter to schools. She said students might not understand the potential dangers. "The kids, when they first hear about it, think, 'Oh, this must be safer somehow because it's only an imitation,' " she said.
In Prince George's, a student handbook distributed in September says that having or using e-cigarettes on school property is a "tobacco violation" akin to having a conventional cigarette. A first offense would result in a call to parents and a tobacco education program; additional offenses can result in suspensions.
In Prince William County, spokesman Phil Kavits said e-cigarettes would probably be treated like the more typical variety. "Smoking is not permitted," Kavits said.
Yvette Alexander, a D.C. Council member and chairwoman of its Health Committee, has urged in proposed legislation that e-cigarettes be treated like tobacco products and that sales to those younger than 18 be prohibited.
"What I'm so concerned about is that kids who don't smoke cigarettes might turn to [e-cigarettes] as a trendy, cool thing to do," Alexander said.
Kip Schwartz, whose Washington law firm represents a number of manufacturers and distributors, said a growing segment of the e-cigarette industry does not support marketing to minors.
Montgomery officials said they are not aware of cases other than the one at Eastern Middle, but they said such issues are often handled at the school level. Students who take e-cigarettes to school would be violating state and local policies about smoke-free environments, but principals decide on the consequences, spokesman Dana Tofig said.
At Eastern Middle, Crouse, the principal, said the eighth-grader who had the e-cigarette told school leaders he hadn't thought it was a problem because the item was electronic. He said he was just "playing around with it," she said.
The item was confiscated, Crouse said, and the boy's parents were contacted.
As Crouse and her staff looked into the issue, she decided to send a message to school families in late October, warning them about e-cigarettes and other devices.
"We urge you to discuss these products with your children and to discourage them from using these items," she wrote.
Crouse also wanted families to know how Eastern views devices that simulate smoking: They're like the real thing.
"I hope that our kids are smart enough to make good decisions, but peer pressure is tough," Crouse said.