AUSTIN (Nexstar) — Latest numbers from the Texas Department of State Health Services show an increase in cases of severe lung disease in people who report vaping before developing symptoms.

There are now 210 cases across the state. 

The increase in cases comes as lawmakers from the Texas Senate Health and Human Services Committee work to identify the main challenges in preventing youth vaping. 

This year, Gov. Greg Abbott signed into law Senate Bill 21, which stops the sale of cigarettes, e-cigarettes and other tobacco products to Texans younger than 21. Texas became the 16th state in the U.S. to raise the minimum legal tobacco age to 21 as part of an effort to crack down on youth tobacco and e-cigarette use.

However, testimony legislators heard during Tuesday’s committee meeting highlighted how Texas youth are getting around rules.

“With the vaping, a kid can actually just kind of go to the side, take a puff and he and she can be very creative in how they blow it out,” said Eric Mullens, principal at Hempstead High School. “Sometimes they can yawn or cover it with their clothing, so it’s very easy to hide.” 

Mullens said his school immediately got outreach materials to students and families once they identified cases on their campus. But some other hurdles remain. 

“No one seems to know what the ingredients are,” he said. “It’s like giving a kid a smoothie and saying, ‘Drink this, you don’t know what’s in it.’” 

Kellen Kruk, a sophomore at Texas State University, works with the group Say What! Texas and says the vaping trend he saw in high school is something he still sees in college. 

“College students today don’t tend to really listen to e-cigarette facts because they’ve heard it all before,” he said. “They’re more focused on getting their degree than what’s going to save them in the long run, so they’re not really paying attention to all the facts and statistics. I try to get to them and they’re just not receptive to it.” 

But what legislators learned during the committee meeting is how there’s a difference in the permitting requirements for vape retailers. 

“Taxpayers who sell e-cigarettes do not have any permitting requirements other than a sales tax permit,” said Joshua Thigpen from the Texas Comptroller of Public Accounts. “Because of this, we are unable to identify retailers who only sell e-cigarette products to conduct our compliance inspections.” 

Vape shop owners worry the bad actors who illegally sell to minors will create more problems for the rest of the industry.

Justin Gibson, owner of Vintage Vapor in Central Texas, says employees at his shop don’t allow minors to step foot inside the store. 

“We do everything we can to keep children out of our stores, much less market to them,” he said. “We barely market at all.” 

“There is a way for us to co-exist with the rest of the market, but there’s also the saying where a bad apple can spoil the bunch and that’s what we’re seeing here,” he added. 

House Bill 3218, filed during the 86th Legislature, would have required manufacturers, distributors and retailers of e-cigarettes to be permitted by the Health and Human Services Commission. HHSC would have been in charge of setting up permit fees and imposing administrative penalties against permit holders for violations.

Funds from permitting and penalties would have been deposited into a Dedicated Tobacco and E-Cigarette Education and Enforcement Fund, according to the fiscal note attached to the bill. However, the bill was left pending in committee.