The statistics are concerning. It's an important message for parents now that alarming data out of the 2021 update to the Guam State Epidemiological Report is made public.

In 2019, a staggering 68.9% of high school students and 49% of middle school students have tried vaping.

One in three of Guam’s youth are currently vaping.

A primary author of the report, Dr. Annette David said Guam’s youth have the highest rate of e-cigarette use globally.

"When you look at the data and compare them to the rest of the nation and the rest of the western Pacific region, our youth have some of the highest rates, not just in the U.S. but in the region and in fact globally," she said. "It’s very very worrisome."

But what’s not stated in the report, is that even as young as elementary school children are also vaping.

"From the reports that the teachers and students are telling us, electronic cigarette U.S. is also happening on elementary schools too," David said. "In fact, some of the elementary schools have reached out to us because they had to confiscate the electronic cigarettes from their students. And we’re talking about very young students here."

She says it's a serious concern as vaping is a gateway that leads them down a path to nicotine addiction and a grim future for their health.

Back in February, parents at Untalan Middle School were on edge after hearing reports of students suddenly falling ill.

The Guam Department of Education later confirmed two middle schoolers got sick after they apparently inhaled cannabis-infused vapes.

American Medical Center family physician Dr. Hoa Nguyen outlines some of the health risks.

"It's a big problem for us. It’s addictive just like cigarette smoking," he said. "When you start at such a young age, and you have much more children that are vaping than smoking in the past, smoking is a lot like vaping at this point. You’re going to have increased risks of palpitations, lung diseases and heart diseases."

It's dangerous in a number of ways from pulmonary, cardiovascular, and potential carcinogenic effects.

And aside from the physiological effects, there are also risks of physical injury, David said.

"Risks such as explosion and fire, we’ve had those happen here in Guam where the devices have exploded," she said. "In fact there was one case that was reported by one of our surgeons where the patient was vaping and the device exploded while he was smoking and he needed to have facial reconstruction. And of course, the fire that comes when these devices explode."

The report states there were at least two known cases of vapes exploding at GDOE schools which led the Guam Police Department to step in.

Guam law prohibits the sale, distribution, purchase and use of vapes to anyone under the age of 21 but it's not stopping the youth.

Nguyen said there needs to be more education on the risks of vaping.

"This is where the education part needs to be much more out there," he said. "Also it starts with the family. The parents really need to pay attention to their children and make sure the children do not vape. It’s a lot of pressure in school."

Meanwhile, David is hoping for more regulation.

"For instance, there are so many flavors that are out there," she said. "So really regulating those flavors and perhaps even banning them altogether will be a way to protect the youth."