Youth tobacco use in Minnesota had in past few years “gone down,” said Lisa Kocer, director of Mower County Health and Human Services on Tuesday. “But now, it is starting to go up again.” She said officials said e-cigarettes were the cause.

Kocer was providing the county commissioners a report on tobacco use in the county during the regular meeting of the commissioners.

As a result, she said, more communities are considering ways to prevent smoking among teens, from raising the purchase age to 21 years, to increasing the price of tobacco, among other efforts.

“We have done a lot of good things” in the state, she said, “but we still have work to do.”

E-cigarettes have been touted as having less harmful effects than nicotine cigarettes, but the Surgeon General in 2016 said the e-cigarette aerosol is not safe. Kocer said the major increase in use of e-cigarettes has been seen among middle-school students.

Her report said regular tobacco is being used as well, noting that 13.6 percent of ninth graders use tobacco, e-cigarettes or smokeless tobacco. According to the report, 10.4 percent of the students use e-cigarettes.

Among juniors, 15.7 percent of 11th graders use some type of tobacco, and 12.2 percent use e-cigarettes.

Still, Mower County compares well with the state of Minnesota, where 21.8 percent of juniors use tobacco.

Perhaps just as troubling was a statistic that showed 17.6 percent of pregnant women in Mower County were smoking during their pregnancies, compared to 10.2 percent statewide. Nationally, that number is 8.3 percent.

The report noted that 3,200 Mower County adults – almost 10 percent — smoke cigarettes, and one in seven deaths are tobacco-related. Almost $28 million was spent in medical costs by Minnesotans that amounted to a $753-per family tax burden.